MM-TI
Miscarriage Management
Training Initiative
Training Outline:
Opinion Exercise
This exercise is designed to facilitate a discussion on various aspects of miscarriage management. Our
experience has taught us that staff are sometimes resistant to a Values Clarification exercise and thus we
created a more generic Opinions Exercise. Your introduction should include a statement to participants that
affirms their personal and professional experiences, opinions and feelings around miscarriage. This exercise
provides the opportunity to reflect on one’s opinions and to hear their colleagues’ thoughts, feelings and
opinions.
Goal
Increase staff’s awareness of how their personal and professional experiences, opinions and
feelings may influence how miscarriage management services are integrated into their clinic.
Objectives
At the end of the training, participants will be able to:
 Identify personal and professional opinions and feelings related to early pregnancy
loss
 Identify personal and professional opinions and feelings related to outpatient
miscarriage management services

The amount of time this exercise takes may be managed by how many items on the handout
are chosen to discuss.
Time: 20 – 30 minutes
Materials
 Handout: Opinions about Miscarriage Management Services (2 examples included)
 AGREE and DISAGREE signs (written on 8.5 x 11 paper to designate sides of the room)
Trainer Tip
1) It is helpful to have a co-facilitator. The second person can participate in the
discussion by either supporting the side of the room with the fewest participants or
by giving voice to the minority point of view.
2) Invite one or two people from each side (agree or disagree) to share their opinions for
each statement. Encourage discussion.
3) Affirm everyone’s willingness to share their thoughts, feelings and opinions
throughout the exercise.
Prep
Review the handout, Opinions about Miscarriage Management Services. You may
want to edit the statements to make them applicable to your setting. Example: The
question; Many health care professionals perceive miscarriage management as
outside of the scope of clinicians was added at a training for Certified Nurse Midwives.
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Miscarriage Management-Training Initiative
Johnson-May, VanDerhei, Wallace
Time & Task
5 minutes
Complete written
opinion survey
Trainer Notes
Handout exercise
Sample introduction:
It is important to provide staff with the opportunity to review their personal and
professional opinions and feelings about a new service. This exercise is designed to help
you think about the various aspects of miscarriage management and should be
completed quickly. Please circle the answer that best describes your level of agreement
with the following statements. Remember, there is no right answer – it is your opinion
that counts.
15 minutes
Discussion
Instructions
When you observe that most participants have completed the exercise invite everyone to share
their opinions by standing on the side of the room that coincides with their response to the
statement. Sample script:
We will start the discussion by choosing a few statements that we feel are important, and then we’ll
ask you to pick one or two to discuss. I’ve posted Agree/Disagree signs on the wall and will ask you
to move to the side of the room based on your response to the statement. If you are undecided,
please stand in the middle. I will ask several of you to share your thoughts on this statement.
Because time is limited, we won’t be able to discuss all of the statements. I encourage you to
continue the conversations with your team as time allows.
Note: As a facilitator, you may want to choose three statements that you think are important to
discuss and then invite participants to choose a statement. The three statements that are often
chosen include:
1. It is better for women to have general anesthesia when undergoing uterine aspiration for
management of miscarriage.
6. Miscarriage management can be perceived by some as training to provide abortions.
7. A first trimester miscarriage is emotionally easier for women than a later one.
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Miscarriage Management-Training Initiative
Johnson-May, VanDerhei, Wallace
Debrief
5 minutes
Tips for debriefing exercise:
1. Thank the staff for participating
2. Reflect on what was observed or what people said
3. Encourage ongoing conversation
4. Note any ‘aha’ moments that occurred during the discussions.
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Miscarriage Management-Training Initiative
Johnson-May, VanDerhei, Wallace