O&G Cases · Intrapartum care — fetal surveillance
Changing the monitoring plan — communication and decision-making station
Communication and shared decision-making station: renegotiating the fetal monitoring plan with a woman whose birth preferences are being changed by a clinical development. Tests honest presentation of the evidence in both directions, respect for autonomy, offering telemetry rather than a bed, handling an angry support person, and documenting a declined recommendation safely. Includes assessor timeline, marking domains, assessor key and fail criteria.
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Target exams
Station brief
Format. Communication and shared decision-making station, approximately 12 minutes, with a simulated woman and a simulated partner. There is no procedure to perform. You are being assessed on whether you can give an honest, numerate explanation, respect a decision you disagree with, and still keep the labour safe. [2][1]
Candidate instruction. Explain why continuous monitoring is being recommended now, answer her question about refusing it, respond to her partner, and agree a plan. [2][3]
References7ShowHide
- [1]Alfirevic Z, Devane D, Gyte GM, et al. Continuous cardiotocography (CTG) as a form of electronic fetal monitoring (EFM) for fetal assessment during labour Cochrane Database Syst Rev, 2017.PMID 28157275
- [2]Yeoh M, Ameratunga D, Lee J, et al. Simplifying the language of fetal monitoring Aust N Z J Obstet Gynaecol, 2019.PMID 30460717
- [3]Fox D, Maude R, Coddington R, et al. The use of continuous foetal monitoring technologies that enable mobility in labour for women with complex pregnancies: A survey of Australian and New Zealand hospitals Midwifery, 2021.PMID 33260005
- [4]Watson K, Mills TA, Lavender T Experiences and outcomes on the use of telemetry to monitor the fetal heart during labour: findings from a mixed methods study Women Birth, 2022.PMID 34219033
- [5]Lewis D, Downe S FIGO consensus guidelines on intrapartum fetal monitoring: Intermittent auscultation Int J Gynaecol Obstet, 2015.PMID 26433400
- [6]Tome M, Lovers AAK, Impey L, et al. Revisiting the Value of Admission Cardiotocography in Term Pregnancies: An Updated Systematic Review and Meta-Analysis BJOG, 2026.PMID 41074594
- [7]Simpson KR Avoiding confusion of maternal heart rate with fetal heart rate during labor MCN Am J Matern Child Nurs, 2011.PMID 21709529