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 the One-day Blended Learning ALSO Training

Questions for ALSO Course Attendees

Questions for Nurses and Nurse Midwives

Questions for Course Sponsors and Directors

Questions for ALSO-Approved 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 the One-day Blended Learning ALSO Training

What are the differences between the original Advanced Life Support in Obstetrics (ALSO) Provider Course and the one-day blended learning version?

The blended learning classroom format allows the live portion of the ALSO Provider Course to be held in one day instead of two without reducing the covered materials by introducing an online portion. In recognition of the importance of interprofessional education, the megacode delivery has been eliminated and replaced with new team-based simulated learning opportunities through group-testing scenarios. Additionally, other key safety components related to the interaction of the maternity care team during an obstetrical emergency are emphasized in the updated course.

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 required online course elements at their own learning pace prior to the live course.

What are the advantages of the one-day blended learning format?

The one-day blended learning format reduces the time learners and faculty spend away from patient care. The approach also allows content to be absorbed at the learner’s chosen pace and lends itself to increased retention of the materials. ALSO created the blended learning format in response to course evaluations and feedback repeatedly requesting a course that allows more flexibility.

How can comprehensive ALSO content be taught in just one day?

It is not. Prior to the one-day live course, learners must complete all required online elements at their own pace, pass the online examination, and provide their Online Letter of Participation to the course sponsor as proof they prepared. The live portion primarily assesses learners’ skills during workstation check-offs and group testing scenarios, as the ALSO content is taught online.

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

Learners are required to watch recorded lectures with slide presentation on the following topics: 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: 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, “Safety in Maternity Care,” is taught at the very beginning of the live course. All other required sessions have video recorded lectures that the learner will watch online.

The learner’s application of knowledge is 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 are held on the topics of eclampsia, labor dystocia, and intrapartum fetal surveillance. The live portion of the course concludes with group testing on seven different obstetrical emergency scenarios.

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

Learners are encouraged to review chapter content available in the ALSO Provider Manual, watch 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.

Can I still hold a course in the two-day format?

Course sponsors have the option to hold an ALSO Provider Course using the traditional two-day format for a transition period of one year. After June 1, 2018, the ALSO Provider Course will fully transition to the blended learning format.

What is the cost for the one-day blended learning course?

The one-day blended learning option is $35 less per learner than the two-day live option. Other cost savings include one less day of honorarium for faculty, potentially reduced travel costs for instructors and advisory faculty, lowered food expenses, and less time required to reserve rooms in which to hold the course.

Won’t learners be unprepared to demonstrate their knowledge of ALSO content if there are no lectures?

No. In fact, our blended classroom pilots 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 than learners in the traditional provider course format.

Questions for ALSO for Course Attendees

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, the course will be listed on our course schedule[GET LINK]. If a course is not open for registration, it will not be listed. If you find a specific course location you would like to attend, please contact the course sponsor directly for pricing and registration.

Why does the course offer group testing instead of individual testing?

Adult learning principles prove that adults learn more effectively when working together to problem solve. ALSO incorporates an interprofessional education approach so all healthcare team members learn the same standardized approach to apply during obstetrical emergencies. Group testing recreates scenarios that maternity care providers encounter during real-life patient care situations. Learners apply their knowledge of ALSO content while communicating effectively as a team as well as demonstrate adequate debriefing after the event.

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. The ALSO Provider Course is an effective means of ensuring all residents can demonstrate emergency obstetrical techniques and team safety behaviors.

I'm an OBGYN, why should I take training by family physicians, and how do I know it is evidenced-based?

Although the ALSO program is owned and operated by the AAFP, its content is developed by a multispecialty and interprofessional team of medical editors, authors, and peer reviewers. This expert editorial team is comprised of perinatologists, obstetricians, midwives, nurses, as well as family physicians to encourage a comprehensive, yet standardized approach to obstetrical emergency training. Review a sampling of research related to ALSO in the literature.

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 the two-year expiration date listed on the wallet card. If you become an instructor, you do not need to recertify. Instead, you must just teach three courses in a five-year period to maintain your ALSO Approved Instructor certification status with the program.

Is ALSO approved to offer continuing nursing education (CNE) or continuing education units (CEU)?

Yes, the AAFP is approved as a provider of continuing nursing education (CNE) by the Kansas State Board of Nursing. This course offering is approved for 10.80 nursing contact hours applicable for APRN, RN, LPN, or LMHT relicensure. This is an advanced level course and may not be suitable for all general continuing nursing education.

Does ALSO currently qualify for any MOC Part IV activities?

Yes. ALSO courses meet conditions for MOC Part IV for Obstetricians through the American Board of Obstetrics and Gynecology (ABOG). However, due to different requirements through the American Board of Family Medicine (ABFM), the course is not currently available for the ABFM's Family Medicine Certification requirements.

What can I expect from the ALSO Staff?

ALSO staff is available to assist you with course preparation, identifying advisory faculty and approved instructors, approving the course, closing out the course with receipt of all required paperwork and fees, and distributing certificates with wallet cards. We can also work with you to resolve unexpected issues with the course. Please give us a call or send us an email: We are happy to assist you!

What exactly are the laminated mnemonic reference cards?

These individualized laminated cards allow learners to mix and match what obstetrical emergency mnemonics they would like to hang on their badge as a quick reference during an obstetrical emergency. The content is the same as our older accordion-style reference cards with modifications that reflect our new interprofessional approach.

Questions for Nurses and Nurse Midwives

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.

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 that team-based learning, where every member of the team understands what other care providers are doing during an obstetric emergency, is critical. Nurses should be familiar with certain maneuvers and techniques so that they can respond appropriately to physician orders, as well as effectively document what techniques are being performed in the medical record.

What must be submitted for nurses to be awarded continuing nursing education (CNE) credits or continuing education units (CEU)?

The AAFP is approved as a provider of continuing nursing education (CNE) by the Kansas State Board of Nursing. To report nursing contact hours, course sponsors must ensure that the nurse roster is complete; each nurse must sign the roster each day they are present in the course. Sponsors should scan and email the document to the ALSO staff within one week of the course.

Is ALSO approved to offer continuing nursing education (CNE) or continuing education units (CEU)?

Yes, the AAFP is approved as a provider of continuing nursing education (CNE) by the Kansas State Board of Nursing. This course offering is approved for 10.80 nursing contact hours applicable for APRN, RN, LPN, or LMHT relicensure. This is an advanced level course and may not be suitable for all general continuing nursing education.

Questions for Course Sponsors and Directors

How many CME credits should I request for the provider course when completing the CME application?

You should estimate and request credits only 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 required online course elements.

What is the ALSO provider certification period for the course?

Those who took the course prior to June 1, 2017, will be grandfathered in with their five-year ALSO certification period. Starting June 1, 2017, the course recertification period be a period of two years.

Our leadership believes a two-year recertification cycle provides the most benefit to the largest range of maternity care providers. Not only does this change align ALSO with all other advanced life support course certification periods, but education research also suggests this cycle best supports learner retention of the educational content. Practice recommendations change rapidly in the healthcare field, and a more frequent recertification cycle ensures our learners are prepared to manage obstetrical emergencies in the safest way possible.

If our residency program typically teaches ALSO to first-year family medicine residents, does this mean all residents must take the course again during their third year?

There is no mandate for residents to recertify in ALSO if their certification expires. Some programs choose to teach the ALSO content primarily to their second-year residents. However, residents—particularly those family medicine residents who plan to pursue any form of maternity care practice after residency—should consider carefully the benefits of recertification in the third year and how recertification in the most up-to-date, evidenced-based methodologies will better prepare them for the private practice environment.

What costs are involved in a one-day ALSO Provider Course utilizing the blended classroom format?

Program costs for the one-day course follow an “access fee per learner” model. When you assign your students the blended classroom format you will be given a unique course code that you may then distribute to each of your learners. Attendees must then log in to (or create) their AAFP account and enter the unique code for your course. Once entered, they will have instant access to their online pre-work and can begin the course. The system tracks how many people access the online content utilizing your unique course code; after the course is complete, you will receive an invoice itemizing all learners who enrolled with your unique code.

Will I have to purchase additional products in addition to the learner fee for each course format?

There are no additional products for the one-day blended classroom format. Access to an electronic version of the slides and a full provider manual are included in the price of your learner fee for the blended classroom. Attendees may download and/or print these products.

The traditional two-day course format requires a learner fee, and you will need to purchase 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
  • 1 instructor for every 5-6 learners
  • 1 manikin for every 5-6 learners set. ALSO offers a manikin rental program; a form will be emailed following course approval. If you have immediate questions, please contact the Member Resource Center.
  • 1 room to fit 6-8 people with table, chairs, A/V equipment, and workstation materials
  • Course materials such as CD-ROM or flash drive, current provider manual for learners and instructors, current instructor manual for course staff

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

One pelvic manikin is required for every skills workstation. The number of required workstations is dependent on how many learners attend your course. We recommend five learners to one pelvic manikin at each workstation. Consult the ALSO Instructor Manual for more guidance on course logistics.

Manikins are available for rent from the AAFP upon request on a first come, first serve basis. A form will be emailed following course approval. If you have immediate questions, please contact the Member Resource Center.

What must be submitted for nurses to be awarded CNE?

The Kansas State Board of Nursing has approved the provider course for CNE. To report ALSO for CNE, course sponsors must ensure that the nurse roster is signed each day the nurse is present at the course. A separate nursing evaluation must also be completed by each nurse as required by KSBN. Sponsors are then responsible for keeping these documents on file for two years. There is no longer any need to return these documents to the AAFP.

Has the way the learners sign up for the course changed?

Yes. It now includes several fewer steps. You may sign up to hold a course by first reading our Provider Course guidelines(6 page PDF).

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

First, determine the number of learners your facility can hold. Then plan for at least one instructor for every five to six learners. ALSO staff can provide a list of ALSO Approved Instructors in your area, if you need assistance in finding qualified individuals to teach for you.

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

No. Payment is not required, but it is recommended. The 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, compensation can be negotiated on a case-by-case basis. When there are multiple courses in the same area, some course sponsors have formed an ALSO instructor consortium of 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 Course. 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 instructors, space, and equipment. Oftentimes, the availability of qualified instructors is the limiting factor. Because most courses taught are in association with residency programs or hospitals, looking for others in your area who already teach ALSO can be helpful. A skilled administrative point person to serve as the course coordinator is important to accomplishing an excellent course. 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, the course sponsor is responsible for clearly communicating the deadline by which all online pre-course work should be completed. 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.

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

No. It is now up to the individual courses to decide whether they provide their own instructor evaluation sheets to learners and aggregate their own instructor data.

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

Within one week, sponsors will receive an email from ALSO staff to inform them their application has been received and is under review.

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. However, we do encourage all efforts to hold multidisciplinary team-based learning. Inviting a variety of disciplines and professions (i.e., private family medicine and OB/GYN physicians, midwives, maternity care nurses) to your course is an excellent way to build relationships and to incorporate ALSO firmly into your culture. Additionally, practicing physicians, midwives, and nurses often bring their own rich history and experiences to the course that makes the learning environment more robust and creates a more realistic team experience. Many course directors have reported by opening course registration to the public, they have supplemented their educational budgets by bringing in additional income from outside learners.

How do I recruit ALSO Approved Instructors?

The ALSO staff can provide you a listing of approved instructors in your area. If you do not have enough instructors in your area, consider sending local obstetric practitioners to an instructor course to become approved instructors for your course.

Questions for ALSO Approved Instructors

If instructors no longer lecture in the blended classroom format, won’t I need to spend more time teaching and demonstrating skills in the individual workstations?

No. We recognize that this is a huge shift for ALSO Approved Instructors, who must keep in mind that the learner has already spent hours preparing for this course. Additionally, instructors must adhere strictly to the time allotted for their skills workstation to keep the course schedule on track.

Is purchasing the new instructor manual necessary?

The ALSO Provider Course is evolving so rapidly that we highly encourage you obtain the most up-to-date version of the instructor manual. Not only will the new manual allow you to anticipate impacts on the way you teach the course, but it also includes all the group testing scenarios that you need to read before guiding learners through the activities.

When is the ALSO content best taught?

The ALSO Provider Course is an excellent educational tool at any stage of maternity care training. Many hospitals utilize it as a standardized evidence-based method to orient new staff in addressing obstetric emergencies. Residency programs 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, allowing residents to learn the basics of childbirth before focusing on urgencies and emergencies.

How can I become an ALSO Approved Instructor?

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 Approved Instructor?

Not just yet. To become an ALSO Approved Instructor, you must teach in a provider course within one 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, followed by a letter and wallet card notifying you of your status change.

How do I find courses that I can teach?

If you need assistance in finding a course to teach, please find our provider course schedule or 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, we recommend individuals serve in only 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?

ALSO instructors are not required to recertify at this time; ALSO Approved Instructor status is maintained by teaching three provider courses in five years. However, we strongly recommend that instructors purchase and review the new ALSO Instructor Manual versions as they are released. At minimum, instructors should review the current version prior to teaching a course. We also encourage instructors to retake the online portion of the ALSO course every two years to remain up-to-date on the content. To assist you in this, we will notify ALSO Approved Instructors when updated chapters or new course materials are available.