Training nurse simulation educators at scale to improve maternal and newborn health: a case study from Bihar, India.

Global Health Health Education Low-resource setting Maternal and Newborn Health Simulation Simulation Educator

Journal

BMC medical education
ISSN: 1472-6920
Titre abrégé: BMC Med Educ
Pays: England
ID NLM: 101088679

Informations de publication

Date de publication:
15 Dec 2022
Historique:
received: 04 03 2022
accepted: 21 11 2022
entrez: 15 12 2022
pubmed: 16 12 2022
medline: 20 12 2022
Statut: epublish

Résumé

Simulation has been shown to improve clinical and behavioral skills of birth attendants in low-resource settings at a low scale. Populous, low-resource settings such as Bihar, India, require large cadres of simulation educators to improve maternal and newborn health. It's unknown if simulation facilitation skills can be adopted through a train of trainers' cascade. To fill this gap, we designed a study to evaluate the simulation and debrief knowledge, attitudes and skills of a third generation of 701 simulation educators in Bihar, India. In addition, we assessed the physical infrastructure where simulation takes place in 40 primary healthcare facilities in Bihar, India. We performed a 1 year before-after intervention study to assess the simulation facilitation strengths and weaknesses of a cadre of 701 nurses in Bihar, India. The data included 701 pre-post knowledge and attitudes self-assessments; videos of simulations and associated debriefs conducted by 701 providers at 40 primary healthcare centers. We observed a statistically significant difference in knowledge and attitude scores before and after the 4-day PRONTO simulation educator training. The average number of participants in a simulation video was 5 participants (range 3-8). The average length of simulation videos was 10:21 minutes. The simulation educators under study, covered behavioral in 90% of debriefs and cognitive objectives were discussed in all debriefs. This is the first study assessing the simulation and debrief facilitation knowledge and skills of a cadre of 701 nurses in a low-resource setting. Simulation was implemented by local nurses at 353 primary healthcare centers in Bihar, India. Primary healthcare centers have the physical infrastructure to conduct simulation training. Some simulation skills such as communication via whiteboard were widely adopted. Advanced skills such as eliciting constructive feedback without judgment require practice.

Sections du résumé

BACKGROUND BACKGROUND
Simulation has been shown to improve clinical and behavioral skills of birth attendants in low-resource settings at a low scale. Populous, low-resource settings such as Bihar, India, require large cadres of simulation educators to improve maternal and newborn health. It's unknown if simulation facilitation skills can be adopted through a train of trainers' cascade. To fill this gap, we designed a study to evaluate the simulation and debrief knowledge, attitudes and skills of a third generation of 701 simulation educators in Bihar, India. In addition, we assessed the physical infrastructure where simulation takes place in 40 primary healthcare facilities in Bihar, India.
METHODS METHODS
We performed a 1 year before-after intervention study to assess the simulation facilitation strengths and weaknesses of a cadre of 701 nurses in Bihar, India. The data included 701 pre-post knowledge and attitudes self-assessments; videos of simulations and associated debriefs conducted by 701 providers at 40 primary healthcare centers.
RESULTS RESULTS
We observed a statistically significant difference in knowledge and attitude scores before and after the 4-day PRONTO simulation educator training. The average number of participants in a simulation video was 5 participants (range 3-8). The average length of simulation videos was 10:21 minutes. The simulation educators under study, covered behavioral in 90% of debriefs and cognitive objectives were discussed in all debriefs.
CONCLUSION CONCLUSIONS
This is the first study assessing the simulation and debrief facilitation knowledge and skills of a cadre of 701 nurses in a low-resource setting. Simulation was implemented by local nurses at 353 primary healthcare centers in Bihar, India. Primary healthcare centers have the physical infrastructure to conduct simulation training. Some simulation skills such as communication via whiteboard were widely adopted. Advanced skills such as eliciting constructive feedback without judgment require practice.

Identifiants

pubmed: 36522624
doi: 10.1186/s12909-022-03911-9
pii: 10.1186/s12909-022-03911-9
pmc: PMC9753256
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

869

Informations de copyright

© 2022. The Author(s).

Références

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Auteurs

Solange Madriz (S)

Institute for Global Health Sciences, University of California, San Francisco, San Francisco, California, USA. solange.madriz@ucsf.edu.

Patience Afulani (P)

Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA.

Hilary Spindler (H)

Institute for Global Health Sciences, University of California, San Francisco, San Francisco, California, USA.

Rakesh Ghosh (R)

Institute for Global Health Sciences, University of California, San Francisco, San Francisco, California, USA.

Nidhi Subramaniam (N)

PRONTO International, Patna, Bihar, India.

Tanmay Mahapatra (T)

CARE India, Patna, Bihar, India.

Aritra Das (A)

CARE India, Patna, Bihar, India.

Sunil Sonthalia (S)

CARE India, Patna, Bihar, India.

Aboli Gore (A)

CARE India, Patna, Bihar, India.

Susanna R Cohen (SR)

Department of Obstetrics and Gynecology University of Utah, Salt Lake City, UT, USA.

Seema Handu (S)

PRONTO International, Patna, Bihar, India.

Dilys Walker (D)

Institute for Global Health Sciences, University of California, San Francisco, San Francisco, California, USA.

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Classifications MeSH