Questions About ALSO?

Review the following responses to Frequently Asked Questions regarding the AAFP's Advanced Life Support in Obstetrics (ALSO®):

Questions About ALSO for Military Maternity Care Training

Questions About What's New in 2017

General ALSO Questions

Questions for Course Sponsors & Directors

Questions for ALSO Instructors

Questions About ALSO for Military Maternity Care Training

Is ALSO an approved option for required obstetrical emergency simulation training?

ALSO is an approved option for Department of Defense (DoD) required training for obstetrics interval training requirements for staff involved in the provision of military maternity care. The ALSO training program meets all requirements of the program.

Does ALSO have experience in training military personnel?

Yes. ALSO has been providing maternity care training to Air Force, Army, and Navy personnel and supporting military hospitals since 2009.

Which military hospitals have used the ALSO program?

  • 96th Medical Group
  • Mike O'Callaghan Federal Medical Center
  • Madigan Army Medical Center
  • Tripler Army Medical Center
  • Womack Army Medical Center
  • Walter Reed National Military Medical Center
  • Fort Belvoir Community Hospital
  • Naval Medical Centers in Portsmouth, VA, and San Diego, CA
  • Naval Hospitals in the United States, Guam, Japan, and Spain

Why should I choose ALSO for this mandated training?

ALSO offers a turnkey solution for your maternity care training. With more than 25 years’ experience in training care providers around the world, we are a proven program and have direct experience supporting military hospitals; more than 160,000 individuals have completed ALSO training. ALSO uses a standardized, evidence-based, interprofessional training program to prepare maternity care providers to better manage obstetrical emergencies. It can boost learners’ skill sets through hands-on training, team-based activities, in situ simulation drills, and the use of mnemonics.  The interprofessional nature of the training provides the care team with a common understanding of terms, medications, and correct execution of procedures; it is a critical piece of the training program to improve patient outcomes.  

ALSO has a dedicated military program specialist who understands the unique needs of the military and will provide support for course coordinators to aid them in planning an efficient and effective training experience.

Does ALSO include obstetrical emergency simulation training?

Through a combination of online education and a live workshop with multiple simulation stations, ALSO provides simulated training and group testing scenarios on such topics as amniotic fluid embolism, maternal resuscitation, placental abruption, eclampsia, and more.

How comprehensive is the ALSO program?

ALSO offers a robust training program with twenty curriculum topics, including:

  • Birth Crisis
  • Cesarean Delivery
  • Cord Prolapse
  • Diagnostic Ultrasound
  • Emergency Breech Delivery
  • First-Trimester Pregnancy Complications
  • Intrapartum Fetal Surveillance
  • Labor Dystocia
  • Malpresentations
  • Malpositions and Multiple Gestation
  • Maternal Resuscitation and Trauma
  • Medical Complications of Pregnancy
  • Neonatal Resuscitation
  • Perineal Laceration Repair
  • Postpartum Hemorrhage
  • Preterm Labor and Premature Rupture of Membranes
  • Safety in Maternity Care
  • Shoulder Dystocia
  • Simulated Group Testing Scenarios
  • Vaginal Bleeding in Late Pregnancy

Can ALSO help me implement maternity training at my military hospital and treatment center?

ALSO has dedicated staff available to support program implementation. The program provides planning tools including a budget template, project management worksheet, scheduling worksheet, evaluation forms, letters of participations, wallet cards, and more.

Can ALSO track course completion?

ALSO will provide letters of participation with wallet cards and reports to help administrators track completion within a military institution.

Does ALSO have dedicated staff to administer ALSO Armed Forces?

Yes, we have a dedicated team available to assist you in launching and administering the program.

Questions About What's New in 2017

What is changing about the ALSO course content in June 2017?

The ALSO course is evolving to a blended learning classroom format which will allow the live portion of the course to be held in One-Day format instead of two. In recognizing the importance of interprofessional education, the megacode delivery has been eliminated, but has been replaced with new team based simulated learning opportunities through group testing scenarios in addition to emphasizing other key safety components related to the interaction of the maternity care team during an obstetrical emergency.

What is Blended Learning?

Blended learning is an educational format that combines online digital media with traditional classroom methods. The Learner will be asked to complete online required course elements prior to the live course at their own learning pace.

Why is the course evolving to a blended learning format?

In response to ALSO Course evaluations and feedback repeatedly requesting a course that allows the Learners and faculty to spend less time away from patient care, a one day course has been developed. This allows content to be absorbed at the Learner’s chosen pace, and lends itself to increased retention of the materials.

How will all of the comprehensive ALSO content be taught in just one day?

It is not. Prior to the one-day course, Learners must complete all required online elements, pass the online examination, and provide their Online Letter of Participation to the Course Sponsor as proof they are coming prepared for the live hands-on portion of the course. The one-day live portion of the course is primarily spent assessing the Learners application of the ALSO content through assessment of skills at workstation check-offs and group testing scenarios, versus time spent during the course teaching the actual ALSO content.

What type of learning format is utilized in the online pre-course elements?

Learners are encouraged to review chapter content available in the ALSO manual, view video recorded lectures, view video recorded workstation demonstrations, complete online case studies, and utilize interactive gaming technology to reinforce memorization of ALSO mnemonics taught throughout the course.

What ALSO content is covered in the online portion of the course?

Video recorded lectures with slide presentation is presented on First-Trimester Pregnancy Complications, Medical Complications of Pregnancy, Vaginal Bleeding in Late Pregnancy, Preterm Labor and premature Rupture of Membranes, Intrapartum Fetal Surveillance, Labor Dystocia; Malpresentations, Malposition, and Multiple Gestation; Assisted Vaginal Delivery; Shoulder Dystocia; Maternal Resuscitation and Trauma, and Postpartum Hemorrhage. Two online case studies are included on Cord Prolapse, and Late Trimester Bleeding. Video recorded workstation demonstrations by ALSO Course Faculty are presented on Maternal Resuscitation, Postpartum Hemorrhage, Malpresentations, Shoulder Dystocia, and Assisted Vaginal Delivery.

What ALSO content is covered in the live portion of the course

One lecture on “Safety in Maternity Care” is to be taught at the very beginning of the live course. All other required sessions have video recorded lectures which are to be watched by the Learner online.

The Learner’s application of knowledge will be assessed at various Skills Workstations throughout the day. These workstations include; Shoulder Dystocia; Malpositions (OP management); Emergency Breech Delivery; Assisted Vaginal Delivery; Maternal Resuscitation; and Postpartum Hemorrhage. Interactive Group Case Study Discussions held on the topic of Eclampsia; Labor Dystocia; and Intrapartum Fetal Surveillance. The live portion of the course concludes with Group Testing on seven different obstetrical emergency scenarios (also referred to as In-Situ Drills).

Is the ALSO Provider certification period for the course still 5 years?

Those who have taken the course prior to June 1, 2017 will all be grandfathered in to their five year ALSO certification period. However, starting on June 1, 2017 the course re-certification period will transition to being a period of two years. There are benefits as well as challenges with moving to a two year cycle. But weighing the pros and cons, our leadership believes evolving to a two year cycle will provide the most benefit to the largest range of maternity care providers and is evidence based to best support retention of the educational content. This decision was made in an effort to align with all other advanced life support course certification periods. Practice recommendations change rapidly in the healthcare field, and having a more frequent re-certification cycle helps ensure our Learners are more adequately prepared to manage obstetrical emergencies in the safest way possible.

If our residency program typically teaches ALSO to first year family medicine residents, won’t this lessened re-certification period force all third year residents to take the course again during their third year?

At this time there is no mandated requirement stating that residents are required to recertify in ALSO if their certification expires. Some programs choose to teach the ALSO content primarily to their second year residents. However, particularly for those family medicine residents who are planning on pursuing any form of maternity care practice after residency, careful consideration should be given to the benefits of recertification as a third year resident. And how recertifying in the most up-to-date evidenced based methodologies will only renew and reinforce their knowledge, ultimately better preparing them for the private practice environment.

Is this change going to cause the ALSO course to be more expensive?

The cost of the course has actually decreased by $35 per Learner. Holding the new One-day course will result in one less day of honorarium being paid to faculty, potentially less travel costs for Instructors and Advisory Faculty, less food expenses, and less time required to reserve rooms in which to hold the course.

Why has the course changed from individual testing to group testing?

The ALSO program has realized the importance of interprofessional education where all members of the healthcare team learn the same standardized approach to apply during obstetrical emergencies. Adult learning principles prove that adults learn more effectively when working together to problem solve. Group testing aims to recreate scenarios that maternity care providers encounter during real life patient care situations. Learners are required Learners to apply their knowledge of ALSO content while communicating effectively as a team, as well as demonstrate adequate debriefing after the event.

Can I still hold a course the way I always have in the Traditional Two Day Format?

Course Sponsors are being given the option to still hold an ALSO Provider Course using the Traditional Two Day Format for a transition period of one year starting June 1st, 2017. After that one year transition period is complete on June 1st, 2018, the ALSO Provider Course will fully transition to being available only in the blended learning format.

If Instructors no longer lecture, won’t the Learners be unprepared to demonstrate their knowledge of ALSO content?

No. In fact, our piloting of the blended classroom format reflected just the opposite. Instructors reported that Learners who had successfully completed the online pre-work came to the course better prepared and more confident of their skills in comparison to the Traditional ALSO Provider course format.

General Questions

Are there different testing requirements for physicians, nurses, midwives, or physician assistants?

No. The ALSO course is designed to be applicable to all professions, and testing is based upon knowledge and application of the standardized ALSO content. Therefore, testing elements are applicable to all.

Is ALSO training commonly part of Family Medicine Residency training programs? Is it required?

Yes. In a survey* conducted by the ALSO Advisory Board in January 2007, more than 80% of all Family Medicine residency training programs reported that ALSO Provider training was a required element in their program. New Accreditation Council on Graduate Medical Education (ACGME) requirements have emphasized the use of simulated team training to demonstrate competency in approaching emergency responses, and ALSO Provider Course training is an effective means of ensuring all residents can demonstrate emergency obstetrical techniques and team safety behaviors.

I’m a nurse, so why should I understand about things such as how to deliver a breech presentation or assisted vaginal delivery techniques?

The ALSO Program believes in team based learning, where every member of the team has an understanding of what other care providers are doing during an obstetric emergency. Nurses should be familiar with certain maneuvers or techniques so that they can both be responding appropriately to physician orders, as well as be able to effectively document what techniques are being performed in the medical record.

How can I find a course to attend on my own?

If a course sponsor has available openings in the live portion of their course, and is accepting registrations from individuals outside of their organization, that particular course will be listed on our COURSE SCHEDULE. If a course is not open for registration, it will not be listed on our website. If you find a specific course location you would like to attend, please contact the course sponsor directly for pricing and other specific information on how to get registered for their course.

How often will I need to take the ALSO Provider course to remain certified?

After successfully completing an ALSO Provider Course, an active ALSO Provider status can be maintained by attending another Provider Course, or by taking the ALSO Instructor Course prior to their 2 year expiration date listed on the wallet card. If you become an ALSO Instructor, you do not need to recertify at this time. Instead, you must just teach three courses in a five year period of time to maintain your Approved Instructor certification status with the program.

Is the ALSO Course approved to offer Continuing Nursing Education credits?

Yes, the ALSO Provider Course is approved to offer CNE through the Kansas State Board of Nursing.

Does the ALSO Course currently qualify for any MOC Part IV activities?

Yes. The ALSO Provider and Instructor Courses are approved courses that qualify to meet conditions for MOC Part IV for Obstetricians through the American Board of Obstetrics and Gynecology (ABOG) at this time. However, due to different requirements through the American Board of Family Medicine (ABFM) at this time, the course is not currently available for the ABFM's Family Medicine Certification requirements.

What can I expect from the ALSO Staff?

Assistance with course preparation, help in identifying Advisory Faculty and Approved Instructors, approval of the course, closing out the course with receipt of all required paperwork and fees, and distribution of certificates and wallet cards. ALSO Staff can help to problem-solve unexpected issues with the course. Please give us a call or send us an email. We are happy to assist you.

Questions for Course Sponsors & Directors

How many CME credits should I request for the Provider Course when completing the CME application? 

You should only estimate and request credits for the Live Portion of your course (one credit = one hour of learning). The Online Portion of the ALSO course has already been approved for a set number of credits separately by the AAFP. The approved credit amount will be indicated on the letter of participation that learners receive after completing all of the required online course elements.

Is the cost of the course increasing?

The cost of the course is ultimately up to the Course Sponsor to decide upon based on their unique resources. AAFP materials required to be purchased for the blended course are overall remaining the same, and in some instances have decreased. No. In fact, many elements of the course will result in a cost savings, when compared to the Traditional two-day format offered in the past. Due to the content being covered in one day, facility/room costs will decrease, faculty travel expenses will decrease, and honorarium will only need to be paid for one day.

What costs are involved in a One-Day ALSO Provider Course utilizing the Blended Classroom format?

The program costs are now divided up on a “access fee per-Learner” model. You will be given the option to assign your students the blended classroom format. When you do this, you will be assigned a unique course code which you may then distribute to each of your Learners you want to sign up for your course. The Learners must then log into (or create) their AAFP account, and enter the unique code to your course. They will then have access and can instantly begin their online pre-work. The system will then track how many people have accessed the online content utilizing your unique course code. After the course is complete, you will receive an invoice with the names of all Learners who took the course utilizing your unique course code that you shared.

Will I have to purchase additional products in addition to the “Learner Fee” for each course format?

No, it is not required. In fact, included in the price of your Learner fee for the Blended Classroom, each Learner gains access to an electronic version of their slides and a full Provider Manual, which they can either download and/or print. It is not required to purchase an additional ALSO Provider Manual. The Traditional Course format will require a Learner fee, but in addition will require a purchase of the ALSO Provider Manual in your choice of media format.

What are the minimum requirements necessary for holding an ALSO Provider Course?

  • 1 Course Director
  • 1 Advisory Faculty
  • 5 Learners
  • 1 mannequin set
  • 1 room to fit 6-8 people with table, chairs and A/V, and workstation materials
  • 1 Course Materials CD-ROM or Flash drive, current Provider Manual for Learners and Instructors, current Instructor Manual for course staff.

What exactly are the new laminated mnemonic reference cards?

They consist of the same exact material of the accordion style reference cards. However, since mnemonics keep getting added, and the ALSO course is evolving towards an interprofessional approach, these individualized laminated cards allow the Learner to mix and match what obstetrical emergency mnemonics they would like to hang on their badge as a quick reference during an obstetrical emergency.

What must be submitted for nurses to be awarded CNE?

The Provider Course has been approved for CNE by the Kansas State Board of Nursing. Course Sponsors must ensure that the Nurse Roster is complete, ensuring each nurse is signing the roster each day they are present in the course. Then scan and email the document to the ALSO Staff within one week of the course.

Has the way the Learners sign up for the course changed at all?

Yes. It now includes several less steps. You may sign up to hold a course by first reading our COURSE GUIDELINES.

How many ALSO instructors do I need to find to conduct a course?

First, determine the amount of Learners you can allow your facility to hold. Then plan for at least one Instructor for every five Learners. ALSO staff can provide a list of ALSO Approved Instructors in your area if you need assistance in finding qualified Instructors to teach for you.

Educational funding is limited in our institution. Do I absolutely have to pay for ALSO Instructors?

The financial budget and arrangements for any course are up to the individual Course Director. If you will be using instructors from outside of your institution, appropriate compensation for time and travel is common, however can be negotiated on a case by case basis. Where there are multiple courses in the same area, some course sponsors have formed an ALSO Instructor consortia amongst local instructors who donate their time, and trade off teaching at one another’s courses. Another consideration is to increase the number of available Instructors in your own organization is by sending individuals from your own organization through the ALSO Instructor Courses. If there is a shortage of ALSO Instructors in your area, you may also consider holding a local ALSO Instructor Course to increase your local pool of ALSO Approved Instructors.

What is the best way to get an ALSO Provider Course started?

An ALSO Provider Course requires the availability of instructors, space, and equipment. Oftentimes, the availability of qualified instructors is the limiting factor. Because the majority of courses taught are in association with residency programs or hospitals, looking for others in your area that already teach ALSO can be helpful. A skilled administrative point person to serve as the Course Coordinator is important to accomplishing an excellent course. The ALSO Staff can provide a listing of Advisory Faculty and Approved Instructors in surrounding areas upon request.

How can I ensure Learners do their part online of the Blended Classroom?

As with any other professional online course, it is the responsibility of the course sponsor to clearly communicate the expectation that all online pre-course work is completed and the deadline by which that work should be accomplished. If Learners do not successfully complete the required online elements prior to the start of the course, they will not be admitted into the live portion of the course.

Will course sponsors still have access to their individual course and instructor evaluation data?


How long does it take to hear about my course request?

Within 2 business days, sponsors will receive an email from ALSO Staff to inform them their application has been received and is being reviewed.

If I sponsor a course, do I have to invite the public to participate?

No, you do not. Course Sponsors are not required to advertise their courses to the public, but we do encourage all efforts to hold multidisciplinary team-based learning. Inviting a variety of disciplines and professions (ie, private Family Medicine and OB/GYN physicians, midwives, maternity care nurses) to your course is an excellent way to build collaborative relationships and to incorporate ALSO firmly into the culture of your environment. Additionally, practicing physicians, midwives, and nurses often bring a rich history of their own experiences to the course that makes the learning environment more robust, and creates a more realistic team approach to learning.

How do I recruit Approved Instructors?

The ALSO Staff can provide you a listing of Approved Instructors in your surrounding area. If you do not have enough Instructors in your area, consider sending locally practicing and willing obstetric practitioners to an Instructor Course to become Approved Instructors for your course.

I only have one mannequin. Can I still sponsor a course?

Mannequins are available for rent from the AAFP upon request on a first come, first serve basis. One pelvic mannequin is required for every skills workstation. The number of workstations required will be dependent upon the number of Learners in your course. We recommend five Learners to one pelvic mannequin at each workstation. Please review the options for equipment purchase on the ALSO website or by consulting the ALSO Instructor Manual for logistical course guidance.

Questions for Course Instructors

If Instructors no longer lecture in the Blended Classroom format, won’t I need to spend more time actually teaching and demonstrating skills in the individual workstations?

No. This is a huge shift in thinking for our instructors who must keep in mind that the Learner has already spent hours preparing for this course. In addition, Instructors must strictly adhere to the amount of time allotted for their particular skills workstation to keep the course schedule on track.

Is purchasing the new Instructor Manual really necessary?

The ALSO Provider Course is evolving so rapidly, we highly encourage you obtain the most up to date version of the Instructor Manual to learn about how the upcoming changes will impact the way you teach the course. It also includes all of the Group Testing Scenarios to give you an idea of how you should read them before your course in order to familiarize yourself with how you should guide the Learners through the scenarios.

When is the ALSO content best taught?

The ALSO Provider Course could be an excellent educational tool at any stage of maternity care training. Many hospitals utilize the ALSO Course as a standardized evidence-based method to orient new staff in addressing obstetric emergencies. Residency programs may use the ALSO Course to prepare their residents at the beginning of their first year to help prepare new residents to care for their first maternity care patients. Other residency programs teach the course after the first year so that first-year residents can learn the basics of childbirth before focusing on urgencies and emergencies taught in the ALSO Course content.

Can anyone become an ALSO Approved Instructor?

Yes, anyone providing obstetrical care can become an Approved Instructor including residents, nurses, midwives, nurse practitioners, paramedics, physician assistants, and physicians. You must first become an ALSO Provider and then follow the required steps in the ALSO life cycle to become an ALSO Approved Instructor.

Now that I have completed the ALSO Instructor Course, am I an official ALSO instructor?

No. For you to become an Approved Instructor, you must teach in an ALSO Provider Course within 1 year of your Instructor Course date, and have the Advisory Faculty for that course evaluate your teaching. The evaluation will then be submitted to the ALSO Staff for final processing.

How do I find courses that I can teach in?

If you need assistance in finding a course to teach, please find our COURSE SCHEDULEor contact the ALSO Staff directly for assistance.

I am a current Advisory Faculty. May I also serve as Course Director in the same course?

No. Because of the importance of both roles, it is now required that individuals only serve in one role at a time during the same course.

As an ALSO Approved Instructor, how can I keep up to date on the latest updates and new information in the course?

At this time, ALSO Instructors are not required to recertify. Instructor status is maintained by teaching three provider courses in five years. However, it is strongly recommended that Instructors stay up to date on the most current course format by purchasing and reviewing the most current version of the ALSO Instructor Manual as they are newly released. Instructors should minimally be reviewing the most current version of the Instructor Manual prior to teaching a course. Instructors are also encouraged to retake the online portion of the new Blended Classroom format every two years in order to remain up to date on the most current content that is being taught to your students. ALSO Approved Instructors will be notified via email when chapters are updated or new Course Materials are available.