Development and initiation of a preceptor program to improve midwifery and nursing clinical education in sub-saharan Africa: protocol for a mixed methods study.
Capacity building
Clinical learning environment
Implementation science
Low-dose high-frequency training
Maternal and child health
Mentorship
Program development
Training of trainers
Journal
BMC nursing
ISSN: 1472-6955
Titre abrégé: BMC Nurs
Pays: England
ID NLM: 101088683
Informations de publication
Date de publication:
31 May 2024
31 May 2024
Historique:
received:
11
10
2023
accepted:
22
05
2024
medline:
1
6
2024
pubmed:
1
6
2024
entrez:
31
5
2024
Statut:
epublish
Résumé
Expanding the quality and quantity of midwifery and nursing clinical preceptors is a critical need in many sub-Saharan educational settings to strengthen students' clinical learning outcomes, and ultimately to improve maternal and child mortality. Therefore, this study protocol was developed to establish a year-long, four step, precepting program to (1) improve partnership building and program development (2) provide an evidence-based course to expand competency and confidence in precepting students (3) select preceptors to become train the trainers and (4) secure accreditation for the program, ultimately to engage and support cohorts of preceptors and continue to monitor and evaluate the effectiveness of the program over five years. Qualitative and quantitative approaches will be used including evaluation of preceptors, faculty and leadership involved with the program, as well as students taught by preceptors. Data will include validated self-assessment scales, objective structured clinical examinations (OSCEs), satisfaction surveys, and direct clinical observation, in-depth interviews and/or focus group discussions (preceptors); feedback forms (students); process mapping and organizational readiness for implementing change surveys (faculty and leadership). Median change in scores will be the primary outcome for quantitative data. Content analysis within a deductive framework to identify key implementation and adoption themes will be used for qualitative data analysis. This study aims to assess the readiness and early effectiveness for implementing a preceptor program for midwifery and nursing in Sierra Leone and Malawi. Determining the effectiveness of this program will guide future adaptations in order to strengthen the program for sustainability and potential scale-up.
Sections du résumé
BACKGROUND
BACKGROUND
Expanding the quality and quantity of midwifery and nursing clinical preceptors is a critical need in many sub-Saharan educational settings to strengthen students' clinical learning outcomes, and ultimately to improve maternal and child mortality. Therefore, this study protocol was developed to establish a year-long, four step, precepting program to (1) improve partnership building and program development (2) provide an evidence-based course to expand competency and confidence in precepting students (3) select preceptors to become train the trainers and (4) secure accreditation for the program, ultimately to engage and support cohorts of preceptors and continue to monitor and evaluate the effectiveness of the program over five years.
METHODS
METHODS
Qualitative and quantitative approaches will be used including evaluation of preceptors, faculty and leadership involved with the program, as well as students taught by preceptors. Data will include validated self-assessment scales, objective structured clinical examinations (OSCEs), satisfaction surveys, and direct clinical observation, in-depth interviews and/or focus group discussions (preceptors); feedback forms (students); process mapping and organizational readiness for implementing change surveys (faculty and leadership). Median change in scores will be the primary outcome for quantitative data. Content analysis within a deductive framework to identify key implementation and adoption themes will be used for qualitative data analysis.
DISCUSSION
CONCLUSIONS
This study aims to assess the readiness and early effectiveness for implementing a preceptor program for midwifery and nursing in Sierra Leone and Malawi. Determining the effectiveness of this program will guide future adaptations in order to strengthen the program for sustainability and potential scale-up.
Identifiants
pubmed: 38822288
doi: 10.1186/s12912-024-02036-2
pii: 10.1186/s12912-024-02036-2
doi:
Types de publication
Journal Article
Langues
eng
Pagination
365Informations de copyright
© 2024. The Author(s).
Références
World Health Organization. Maternal Mortality Key facts. Published online 2023. https://www.who.int/news-room/fact-sheets/detail/maternal-mortality#:~:text=Sub%2DSaharan%20Africa%20and%20Southern,16%25%20(47%20000) .
World Health Organization. Child mortality (under 5 years). Published online. January 2022. https://www.who.int/news-room/fact-sheets/detail/levels-and-trends-in-child-under-5-mortality-in-2020 .
World Health Organization. Newborn mortality. Published online. January 2022. https://www.who.int/news-room/fact-sheets/detail/levels-and-trends-in-child-mortality-report-2021#:~:text=Sub%2DSaharan%20Africa%20has%20the,36%25%20of%20global%20newborn%20deaths .
World Health Organization. Trends in Maternal Mortality 2000 to 2020: estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division., Published online 2023. https://www.who.int/publications/i/item/9789240068759 .
Statistics Sierra Leone. Sierra Leone Demographic and Health Survey 2019.; 2020.
UNICEF. Malawi (MWI) - demographics, health and infant mortality. Published Online May 2023. https://data.unicef.org/country/mwi/ .
Seed Global Health. Seed Global Health. Seed Global Health. Published 2022. https://seedglobalhealth.org/ .
United Nations Population Fund. State of the World’s Midwifery. 2021. Published online 2021. https://www.google.com/url?q=https://www.unfpa.org/sites/default/files/pub-pdf/21-038-UNFPA-SoWMy2021-Report-ENv4302_0.pdf&sa=D&source=docs&ust=1665761552296131&usg=AOvVaw2R7s35sON-kr4FpFsRszcO
UNFPA, WHO, ICM. The State of the World’s Midwifery 2021. State of the World’s Midwifery 2021. Accessed October 15. 2022. https://www.unfpa.org/publications/sowmy-2021 .
International Council of Nurses. The return on investment in nursing for global health is priceless – ICN calls for nurse-led models of care. ICN - International Council of Nurses. Accessed August 24, 2023. https://www.icn.ch/news/return-investment-nursing-global-health-priceless-icn-calls-nurse-led-models-care .
Sonnie M, Kella F, Stern A, et al. A Sierra Leone 2021 Midwifery Clinical Training needs Assessment: a call to action to Augment Clinical Precepting. Ann Glob Health. 2023;89(1):10. https://doi.org/10.5334/aogh.3970 .
doi: 10.5334/aogh.3970
pubmed: 36819968
pmcid: 9936905
Renning K, van de Water B, Brandstetter S, et al. Training needs assessment for practicing pediatric critical care nurses in Malawi to inform the development of a specialized master’s education pathway: a cohort study. BMC Nurs. 2022;21(1):6. https://doi.org/10.1186/s12912-021-00772-3 .
doi: 10.1186/s12912-021-00772-3
pubmed: 34983499
pmcid: 8724585
Mann J, Brooks MB, Kella F, Euller L, Adelman S, Sonnie M, van de Water B. The impact of clinical placement site, community clinic versus tertiary hospital, on midwifery students’ clinical learning experience in Sierra Leone: a cohort study. BMC Med Educ. 2023;23(1):416. https://doi.org/10.1186/s12909-023-04413-y . PMID: 37287016; PMCID: PMC10245409.
doi: 10.1186/s12909-023-04413-y
pubmed: 37287016
pmcid: 10245409
Dias JM, Lalwani E, Khowaja AA, Mithani YM. Emerging role of clinical preceptors (CPs) at a Private University, Karachi, Pakistan. J Educ Train Stud. 2017;5(8):46–50. https://doi.org/10.11114/jets.v5i8.2529 .
doi: 10.11114/jets.v5i8.2529
Ebu Enyan NI, Boso CM, Amoo SA. Preceptorship of Student nurses in Ghana: a descriptive phenomenology study. Nurs Res Pract. 2021;2021:e8844431. https://doi.org/10.1155/2021/8844431 .
doi: 10.1155/2021/8844431
Cotter E, Dienemann J. Professional Development of Preceptors improves nurse outcomes. J Nurses Prof Dev. 2016;32(4):192. https://doi.org/10.1097/NND.0000000000000266 .
doi: 10.1097/NND.0000000000000266
pubmed: 27434318
Gomez PP, Nelson AR, Asiedu A, et al. Accelerating newborn survival in Ghana through a low-dose, high-frequency health worker training approach: a cluster randomized trial. BMC Pregnancy Childbirth. 2018;18(1):72. https://doi.org/10.1186/s12884-018-1705-5 .
doi: 10.1186/s12884-018-1705-5
pubmed: 29566659
pmcid: 5863807
ICAP. The Pepfar Nursing Education Partnership Initiative (NEPI) 2012–2016: Transforming Nursing and Midwifery Education in sub-Saharan Africa. Published 2019. Accessed August 25. 2023. https://icap.columbia.edu/tools_resources/nepi-resources/ .
International Confederation of Midwives. ICM Global Standards for Midwifery Education. (Revised 2021). Published online 2021. https://www.internationalmidwives.org/assets/files/education-files/2021/10/global-standards-for-midwifery-education_2021_en-1.pdf .
International Confederation of Midwives. Guidance for Meeting the ICM Global Standards for Midwifery Education (2021): Practical/Clinical Experience. 2022. https://www.internationalmidwives.org/assets/files/education-files/2022/12/en_guidance-re-clinical-experience-education-standards-final-version_mar-18-2022-copyright_2021version.pdf .
Glasgow RE, Harden SM, Gaglio B, et al. RE-AIM planning and evaluation Framework: adapting to New Science and Practice with a 20-Year review. Front Public Health. 2019;7:64. https://doi.org/10.3389/fpubh.2019.00064 .
doi: 10.3389/fpubh.2019.00064
pubmed: 30984733
pmcid: 6450067
Weiner BJ. A theory of organizational readiness for change. Implement Sci IS. 2009;4:67. https://doi.org/10.1186/1748-5908-4-67 .
doi: 10.1186/1748-5908-4-67
pubmed: 19840381
Bluestone J, Johnson P, Fullerton J, Carr C, Alderman J, BonTempo J. Effective in-service training design and delivery: evidence from an integrative literature review. Hum Resour Health. 2013;11:51. https://doi.org/10.1186/1478-4491-11-51 .
doi: 10.1186/1478-4491-11-51
pubmed: 24083659
pmcid: 3850724
Bauer MS, Damschroder L, Hagedorn H, Smith J, Kilbourne AM. An introduction to implementation science for the non-specialist. BMC Psychol. 2015;3(1):32. https://doi.org/10.1186/s40359-015-0089-9 .
doi: 10.1186/s40359-015-0089-9
pubmed: 26376626
pmcid: 4573926
World Health Organization. Midwifery educator core competencies: building capacities of midwifery educators. Published online 2014.
Ministry of Health Malawi. Ministry of Health Republic of Malawi.
Shea CM, Jacobs SR, Esserman DA, Bruce K, Weiner BJ. Organizational readiness for implementing change: a psychometric assessment of a new measure. Implement Sci IS. 2014;9:7. https://doi.org/10.1186/1748-5908-9-7 .
doi: 10.1186/1748-5908-9-7
pubmed: 24410955
CFIR. The Consolidated Framework for Implementation Research (CFIR). CFIR. Published 2022. Accessed January 24. 2022. https://cfirguide.org/constructs/ .
van de Water BJ, Wilson M, le Roux K, et al. Healthcare worker perceived barriers and facilitators to implementing a tuberculosis preventive therapy program in rural South Africa: a content analysis using the consolidated framework for implementation research. Implement Sci Commun. 2023;4:107. https://doi.org/10.1186/s43058-023-00490-8 .
doi: 10.1186/s43058-023-00490-8
pubmed: 37649057
pmcid: 10468851
van de Water BJ, Brooks MB, Matji R, Ncanywa B, Dikgale F, Abuelezam NN, Mzileni B, Nokwe M, Moko S, Mvusi L, Loveday M, Gimbel S. Systems analysis and improvement approach to optimize tuberculosis (SAIA-TB) screening, treatment, and prevention in South Africa: a stepped-wedge cluster randomized trial. Implement Sci Commun. 2024;5(1):40. https://doi.org/10.1186/s43058-024-00582-z . PMID: 38627799; PMCID: PMC11021007.
doi: 10.1186/s43058-024-00582-z
pubmed: 38627799
pmcid: 11021007
Shorten A, Smith J. Mixed methods research: expanding the evidence base. Evidence-Based. Nursing. 2017;20:74–5.