Trial reportSimulation in healthcare : journal of the Society for Simulation in Healthcare2016
Impact Evaluation of PRONTO Mexico: A Simulation-Based Program in Obstetric and Neonatal Emergencies and Team Training.
Trial report in Simulation in healthcare : journal of the Society for Simulation in Healthcare, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT06509113 (Reducing Stigmatizing Attitudes and Behaviors of Nursing Students in Simulated Clinical Visits of Patients Living With HIV in Iran), which is not on this map. Cited by 45 papers, 6 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Reducing Stigmatizing Attitudes and Behaviors of Nursing Students in Simulated Clinical Visits of Patients Living With HIV in Iran
Who cites it
45 citing papers in PubMed, 6 syntheses or guidelines pooled it, 83 citations in OpenAlex.
- Evaluating the impact of simulation on patient outcomes in pediatric and neonatal critical care: a systematic review and critical appraisal of the evidence.European journal of pediatrics · 2026Pooled it
- Simulation-Based Education of Health Workers in Low- and Middle-Income Countries: A Systematic Review.Global health, science and practice · 2024Pooled it
- Multi-professional simulation-based team training in obstetric emergencies for improving patient outcomes and trainees' performance.The Cochrane database of systematic reviews · 2020Pooled it
- The effects of interactive training of healthcare providers on the management of life-threatening emergencies in hospital.The Cochrane database of systematic reviews · 2019Pooled it
- The effectiveness of training in emergency obstetric care: a systematic literature review.Health policy and planning · 2019Pooled it
- Non-clinical interventions for reducing unnecessary caesarean section.The Cochrane database of systematic reviews · 2018Pooled it
- Effect of a quality improvement intervention for management of preterm births on outcomes of all births in Kenya and Uganda: A secondary analysis from a facility-based cluster randomized trial.Journal of global health · 2022Trial
- Effect of a quality improvement package for intrapartum and immediate newborn care on fresh stillbirth and neonatal mortality among preterm and low-birthweight babies in Kenya and Uganda: a cluster-randomised facility-based trial.The Lancet. Global health · 2020Trial
- Trial
- Benefits of neonatal resuscitation training in high- and low-resource settings.Seminars in fetal & neonatal medicine · 2026Review
- Clinical Simulation in Maternal Code: Healthcare Personnel Satisfaction and Participant Characteristics.Cureus · 2026Article
- Protocol for the INSPIRE Study: A Training Package for the Intrapartum Team to Promote Respectful and Non-stigmatizing Care for Patients with Substance Use Disorder.Substance use & addiction journal · 2026Article
- A multi-perspective qualitative study on robotic-assisted surgery training demand.Scientific reports · 2025Article
- Article
- Participatory simulation training design: The MAMA interprofessional team-training program for obstetric care of pregnant individuals living with HIV in Tanzania.Evaluation and program planning · 2025Article
- Potential benefits and challenges of simulation-based neonatal resuscitation competition: A survey analysis of provincial competition in China.Resuscitation plus · 2025Article
- Examining the Impact of Integrated Obstetric Simulation Training on the Quality of Antenatal Care in Northern Ghana.Maternal and child health journal · 2025Article
- Virtual simulation training for postpartum hemorrhage in low-to-moderate-volume hospitals in the US.AJOG global reports · 2024Article
- Outcomes of the MAMA Training: A Simulation and Experiential Learning Intervention for Labor and Delivery Providers to Improve Respectful Maternity Care for Women Living with HIV in Tanzania.AIDS and behavior · 2024Article
- Defining and estimating effects in cluster randomized trials: A methods comparison.Statistics in medicine · 2023Review
Corrections and comments
- Erratum issued
Authors and funding
9 authors at 1 institution in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionMost maternal deaths in Mexico occur within health facilities, often attributable to suboptimal care and lack of access to emergency services. Improving obstetric and neonatal emergency care can improve health outcomes. We evaluated the impact of PRONTO, a simulation-based low-cost obstetric and neonatal emergency and team training program on patient outcomes.
methodsWe conducted a pair-matched hospital-based trial in Mexico from 2010 to 2013 with 24 public hospitals. Obstetric and neonatal care providers participated in PRONTO trainings at intervention hospitals. Control hospitals received no intervention. Outcome measures included hospital-based neonatal mortality, maternal complications, and cesarean delivery. We fitted mixed-effects negative binomial regression models to estimate incidence rate ratios and 95% confidence intervals using a difference-in-differences approach, cumulatively, and at follow-up intervals measured at 4, 8, and 12 months.
resultsThere was a significant estimated impact of PRONTO on the incidence of cesarean sections in intervention hospitals relative to controls adjusting for baseline differences during all 12 months cumulative of follow-up (21% decrease, P = 0.005) and in intervals measured at 4 (16% decrease, P = 0.02), 8 (20% decrease, P = 0.004), and 12 months' (20% decrease, P = 0.003) follow-up. We found no statistically significant impact of the intervention on the incidence of maternal complications. A significant impact of a 40% reduction in neonatal mortality adjusting for baseline differences was apparent at 8 months postintervention but not at 4 or 12 months.
conclusionsPRONTO reduced the incidence of cesarean delivery and may improve neonatal mortality, although the effect on the latter might not be sustainable. Further study is warranted to confirm whether obstetric and neonatal emergency simulation and team training can have lasting results on patient outcomes.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.