Fetal Monitoring - e-Learning for Healthcare
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This programme is in partnership with...
  • Royal College of Obstetricians & Gynaecoloists
  • The Royal College of Midwives

About the Fetal Monitoring programme

eFM is a comprehensive web-based resource developed by the Royal College of Obstetricians and Gynaecologists and the Royal College of Midwives in partnership with Health Education England e-Learning for Healthcare.

eFM will teach and assess learners in all aspects of intrapartum fetal monitoring and is directed at both obstetricians and midwives in training as well as those who have completed their training. eFM is split into three sections:

  • A knowledge-based, interactive tutorial section.
  • An assessment section which formally tests what knowledge the learner has acquired from the knowledge-based sessions. Note: Each case study has an intrinsic assessment of the learner’s skill at CTG interpretation and subsequent management.
  • A case study section which allows the learner to practise their skills at interpretation of an actual fetal heart rate recording, and the subsequent management in a virtual labour ward setting. The challenging nature of the content, including the interpretation of cardiotocographs and subsequent appropriate management, will provide learners with valuable knowledge that does not currently exist in other resources. This section is separated into ‘Test’ and ‘Learning’ case studies. Test case studies are to be worked through 1 trace hour at a time and will carry CPD points and certification. ‘Learning’ case studies have been designed with a ‘freedom of movement’ throughout the case study, enabling users to discuss and debate any point or trace hour, at any time. They will be designed to ignite discussion and will be a great addition to the classroom/lecture theatre as well as study groups. Learning case studies will not benefit from CPD points as there will be no scoring attached to these.

About the case studies

eFM currently has 24 case studies (2011 and 2013) for reference purposes only now. We also have 10 case studies, released for 2015, and a further 6 case studies, released for 2016, both sets have been developed in accordance with the 2017 updated NICE guidelines. Three or more expert opinions have populated the clinical cases with their answers. Answers can now be collated and scored to give a final % score, to allow for CPD points (‘Test’ case studies only). Users are allowed as many attempts as they like to improve their score. ‘Learning’ case studies have also been created to provide a foundation for debate and classroom discussion. These will not carry CPD points.

More information

Obstetricians and midwives, both those training and those who have completed their training are required to independently interpret cardiotocographs (CTGs) in the crucial lead up to birth.

eFM educates learners using assessment-driven, case-based learning. Interactive learning sessions will test knowledge of CTG interpretation and clinical management, and will provide feedback to the learner regarding their performance. This feedback is based on the collective responses of three experts.

eFM teaches and assesses by mirroring real-life cases and situations. Learners will evaluate, interpret and reflect on a variety of situations presented, with the aim of minimising errors in the labour ward. Learners will be able to see the results of their actions including any life threatening harm to a baby and the subsequent litigation consequences for the doctor or midwife.

Midwives and obstetricians, both those in training and those who have completed their training, will be able to assess themselves regularly and apply their knowledge in the same way they do in real-life situations. The Royal College of Obstetricians and Gynaecologists (RCOG) will add 60 cases every five years in order to reflect the continuing professional development cycle. Evidence of achievement can be used for recertification of healthcare professionals by the RCOG, the RCM and the Nursing and Midwifery Council (NMC).

Course information

  • Course 1

    Background and Practical Issues
  • Course 2

    Care in Normal Labour
  • Course 3

    Normal and Non-normal CTGs
  • Course 4

    Management Issues
  • Course 5

    Education and Governance
  • Assessments

  • Case Studies

CPD points

The Continuing Professional Development (CPD) Programme of the Royal College of Obstetricians and Gynaecologists (RCOG) has agreed that CPD credits can be earned for the online materials in the eFM programme.

A maximum of 25 RCOG CPD credits in the Knowledge-Based Assessment category (KBA) may be claimed each 5-year cycle for eFM activities. The following credits are available:

  • Each assessment where you achieve the pass mark of 70% will get 2 CPD credits
  • Each case study published from 2013 where you achieve a pass mark of 70% will provide 2 credits in the Knowledge Based Assessment category. Case studies published prior to 2013 will earn no CPD credits

A certificate of completion which details your learning history is available in pdf format for you to download or print out.

Sample sessions

eFM offers 21 knowledge based sessions featuring graphics, animations, video and interactive questions. There are also 5 assessments (one for each module), and a series of case studies, which allow the learner to practise their skills at interpretation of an actual fetal heart rate recording, and the subsequent management in a virtual labour ward setting.

An example of a knowledge based session can be found below. To work your way through this, simply click on the ‘Next’ button on the top right hand corner of each page and follow the instructions on screen.

  • The History of and Rationale for Electronic Fetal Monitoring

    This session describes the history of and rationale for fetal heart rate monitoring.

Project team

  • Anita Hedditch

    Anita Hedditch

    Clinical Project Lead
  • Scott Mountifield

    Project Manager, HEE e-Learning for Healthcare
  • Phil Kington

    Implementation Manager, HEE e-Learning for Healthcare
  • Jo Davies

    Joint Head of Education Resources, RCOG (On maternity leave)
  • Sabrina Sostero

    Sabrina Sostero

    Head of Education Resources, RCOG (Maternity cover)

Executive group

  • Profile picture of programme director Martin Sinclair

    Martin Sinclair

    Programme Lead, HEE e-Learning for Healthcare
  • Gail Johnson

    Gail Johnson

    Professional Advisor, Education, RCM
  • Amanda Hutcherson

    Amanda Hutcherson

    Lecturer in Midwifery, City University London
  • Profile picture of article author Alex Drinkall

    Alex Drinkall

    Stakeholder Manager, HEE e-Learning for Healthcare
  • Kristina Vard

    Kristina Vard

    Campaigns and Digital Marketing Executive, RCOG

Editorial team

  • Debbie Johnson

    Debbie Johnson

    Senior Lecturer in Midwifery, University of Greenwich
  • Bode Williams

    Bode Williams

    Consultant Obstetrician, Liverpool Women’s NHS Foundation Trust
  • Rowena Pykett

    Rowena Pykett

    ST5 in Obstetrics & Gynaecology, East Midlands North Deanery
  • Bronwen Grigg

    Bronwen Grigg

    Midwife, St George's Hospital, Tooting, London
  • Anita Hedditch

    Anita Hedditch

    Senior Midwife, Oxford University Hospital NHS Trust
  • Venkat Raman

    Venkat Raman

    Consultant Obstetrician and Gynaecologist, Southend University Hospitals NHS Foundation Trust


We would also like to kindly acknowledge Prof Chris Redman and Mary Moulden from John Radcliffe Hospital, Oxford for their invaluable assistance in providing CTG cases for the eFM project.

How to access

In order to access any e-LfH programme, you will need an e-LfH account. If you do not have one, then you can register by selecting the Register button below.

Register >

If you already have an account with e-LfH, then you can enrol on to the Fetal Monitoring programme by logging in to the e-LfH Hub, selecting My Account > Enrolment and selecting the programme. You can then access the programme immediately in the My e-Learning section.

How to license

In the event that you do not qualify for free access to the Fetal Monitoring programme, you are able to license access through eIntegrity, a community-interest company established for this purpose.

For more information on the licensing options available for the Fetal Monitoring programme, please visit the eIntegrity website.

NHS healthcare staff in England

The Fetal Monitoring programme is also available to NHS healthcare staff via the Electronic Staff Record (ESR). Accessing this e-Learning via ESR means that your completions will transfer with you throughout your NHS career.

Further details are available here.


Many thanks


eFM would like to acknowledge and thank Huntleigh for their ongoing support with this project.

e-LfH is a Health Education England Programme in partnership with the NHS and Professional Bodies