Table 1 Content of the improving perinatal mortality review and outcomes via education (IMPROVE) programme

Introduction

To provide an overview of: perinatal mortality in Australia with a focus on stillbirth in the international context; the Perinatal Society of Australia and New Zealand (PSANZ) Clinical Practice Guideline for Perinatal Mortality; and, the IMPROVE programme

1. Understand the basic epidemiology of perinatal mortality and stillbirth

2. Understand the scope and purpose of the PSANZ Guidelines

3. Know the definitions of perinatal mortality applied in the appropriate jurisdiction

4. Understand the rationale for the IMPROVE Programme

1. Communicating with parents about perinatal autopsy

To provide information to assist clinicians to help parents to make an informed choice about perinatal autopsy

1. Understand the principles of compassionate communication around parental consent for autopsy

2. Know the relevant information to provide to parents to enable informed choice about perinatal autopsy including the value of autopsy

3. Understand the common barriers to obtaining consent for autopsy and be able to discuss possible solutions

2. Autopsy and placental examination

To describe the perinatal autopsy procedure and demonstrate the process of placental examination

1. Understand the procedure of perinatal autopsy and the appearance of a baby after an autopsy examination

2. Be able to perform clinical examination of the placenta and cord

3. Understand the clinical information required by the pathologist to undertake a high quality autopsy examination

3. Investigation of perinatal deaths

To demonstrate the approach to investigation of stillbirths according to the PSANZ Guidelines

1. Understand the timing, type and the reasons for the core investigations for stillbirths

2. Understand extra targeted investigations for stillbirths

3. Understand the role of alternative non-invasive investigations where permission for autopsy is not obtained

4. Examination of babies who die in the perinatal period

To demonstrate how to undertake a detailed clinical examination of stillbirths and neonatal deaths including measurements and clinical photographs

1. Use the recommended checklist to examine a baby following perinatal death

2. Measure a baby and plot these measurements on centile charts

3. Perform recommended standardised clinical photographs

5. Audit and classification of perinatal deaths

To provide an understanding of the process of perinatal mortality audit and the importance of documentation and classification as to causes and contributing factors for stillbirths and neonatal deaths

1. Know the process for high quality perinatal mortality audit

2. Understand the purpose and benefits of classifications using the PSANZ perinatal mortality classifications for stillbirths and neonatal deaths.

3. Understand how to apply the classification system

6. Psychological and social aspects of perinatal bereavement

To provide an understanding of how to provide appropriate psychological and social support for families after a stillbirth and neonatal death

1. Understand parental responses after experiencing perinatal death

2. Know the factors considered to be important for bereaved parents which will influence their experience and outcome

3. Be able to provide appropriate information to parents concerning birth options, special circumstances, creating memories, hospital stay, funeral arrangements and aftercare

Formative assessment

To consolidate key learning objectives for each of the IMPROVE stations

1. Have increased confidence in applying the principles learned to real life clinical scenarios around stillbirths and neonatal deaths

2. Identify areas for additional learning

3. Understand where to find help to address additional learning requirements