Learnings from FetaLink Implementation at Imperial College Healthcare NHS Trust



Training was planned in the working and steering groups, and classroom training was opted for over bedside training. Types of training included the ‘Train the Trainer’ programme provided by Cerner for those involved in training clinical staff, classroom training and eLearning.

‘Train the trainer’ programme

This was a 2-day session led by Cerner to give trainers a thorough understanding of the software, equipment connectivity and troubleshooting. Among those who received this training were senior clinical and IT staff, the training lead, managers and some key members from the steering group.

‘We had two days training to completely cover every single aspect of troubleshooting.’
– Lead Trainer for Maternity

Classroom training

The classroom training script was developed by those who attended the ‘train the trainer’ session and delivered by the Clinical Systems Training Team. For most clinical staff this was a 4-hour session consisting of a click-through demonstration of FetaLink and exercises to complete. The click-through training included simulation cases, which helped staff understand what the system looked like and made the learning experience more realistic. Unfortunately, this classroom domain is no longer available for trust staff.

‘The Lead Clinician raised all the training points. […] We took all these training points and integrated them into our classroom training script.’
– Lead Trainer for Maternity

Clinical champions

Clinical champions had one full day of classroom-based training and were given information about hardware issues and troubleshooting by the ICT Project Manager. These champions tended to be band 7 midwives.


An eLearning package was developed based on the classroom training script. Staff were encouraged to complete this in the run-up to go-live, and this is still available for training new staff or as a refresher.

Other resources

As well as the training, there were also user guides available, and quick reference guides attached to each computer.


Clinical staff attended the classroom training during their non-clinical shift, in order to ensure there were still adequate staff on the ward.

‘If anyone doesn’t feel confident to use the system, they can always book another training [session] and come and get trained again. If some of the midwives don’t feel confident in the classroom due to their IT skill level, we can arrange one-to-one training for them and give them slower paced training to give them the confidence to use the system.’
– Lead Trainer for Maternity

Key lessons

  • Schedule clinical staff for training: You must ensure that the costs of taking clinical staff out of their area can be covered, i.e. for bank staff to fill in, or schedule training during the non-clinical shift.
  • Teach troubleshooting: Whilst the midwives were trained to troubleshoot to a certain level, it may have been useful to include more troubleshooting information in the training so that users had the confidence to deal with even more issues themselves.

Supporting evidence

The importance of training in ensuring the successful implementation of innovations within the NHS is well-known. A systematic review of NHS innovation efforts by the King’s Fund (Collins, 2018) identified a lack of training and appropriate skills among staff as one of the main barriers to innovation spread, with research by the Health Foundation (2015) reaching similar conclusions.

At ICHT, it is likely that the involvement of clinicians in the development of the training guide and the identification of clinical champion users contributed to the smooth implementation of FetaLink, as clinician-to-clinician lesson sharing benefits from the use of existing networks, overcoming communication barriers and favouring more efficient learning (the Health Foundation, 2015).

Finally, although the lack of troubleshooting training did not result in any major issues, possibly because of the support provided at and beyond deployment, its importance should not be underestimated. The high-pressure environment in which foetal monitoring documentation takes place (during labour or other obstetric procedures) makes quick problem solving essential to ensure that clinical teams do not get distracted and can focus on ensuring patient safety and delivering the best possible care (Cypher, 2018).


Collins, B. (2018). Adoption and spread of innovation in the NHS. The King’s Fund, London. Available here.  (accessed 19/02/19)

Cypher, R.L., 2018. Electronic Fetal Monitoring Documentation. The Journal of perinatal & neonatal nursing, 32(1), pp.24-33.

The Health Foundation (2015). What’s getting in the way? barriers to improvement in the NHS. The Health Foundation: London. Available here. (accessed 19/02/19)

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