Daniel Engelman1, Emmy Okello2, Andrea Beaton3, Gary Selnow4, Bo Remenyi5, Caroline Watson6, Chris T Longenecker7, Craig Sable3, Andrew C Steer8. 1. Department of Paediatrics, Centre for International Child Health, University of Melbourne, Melbourne, Australia; Group A Streptococcal Research, Murdoch Childrens Research Institute, Melbourne, Australia. Electronic address: Daniel.Engelman@rch.org.au. 2. Uganda Heart Institute, Mulago National Referral Hospital, Makerere University, Kampala, Uganda. 3. Department of Cardiology, Children's National Health System, Washington, DC, USA. 4. Marian Wright Edelman Institute, San Francisco State University, San Francisco, CA, USA; WiRED International, San Francisco, CA, USA. 5. Global and Tropical Health, Menzies School of Health Research, Darwin, Australia. 6. Department of Haematology, Oxford University Hospitals NHS Trust, Oxford, United Kingdom. 7. Case Western Reserve University School of Medicine, Cleveland, OH, USA; University Hospitals Harrington Heart and Vascular Institute, Cleveland, OH, USA. 8. Group A Streptococcal Research, Murdoch Childrens Research Institute, Melbourne, Australia.
Abstract
BACKGROUND: The implementation of screening for rheumatic heart disease at a population-scale would require a considerable increase in human resources. Training nonexpert staff in echocardiography requires appropriate methods and materials. OBJECTIVES: This pre/post study aims to measure the change in the knowledge and confidence of a group of health workers after a computer-assisted training intervention in basic echocardiography for rheumatic heart disease. METHODS: A syllabus of self-guided, computer-based modules to train nonexpert health workers in basic echocardiography for rheumatic heart disease was developed. Thirty-eight health workers from Uganda participated in the training. Using a pre/post design, identical test instruments were administered before and after the training intervention, assessing the knowledge (using multiple-choice questions) and confidence (using Likert scale questions) in clinical science and echocardiography. RESULTS: The mean total score on knowledge tests rose from 44.8% to 85.4% (mean difference: 40.6%, 95% confidence interval [CI]: 35.4% to 45.8%), with strong evidence for an increase in scores across all knowledge theme areas (p < 0.001). Increased confidence with each key aspect was reported, and there was strong evidence for an increase in the mean score for confidence scales in clinical science (difference: 7.1, 95% CI: 6.2 to 8.0; p < 0.001) and echocardiography (difference: 18.3, 95% CI: 16.6 to 20.0; p < 0.001). CONCLUSIONS: The training program was effective at increasing knowledge and confidence for basic echocardiography in nonexpert health workers. Use of computer-assisted learning may reduce the human resource requirements for training staff in echocardiography.
BACKGROUND: The implementation of screening for rheumatic heart disease at a population-scale would require a considerable increase in human resources. Training nonexpert staff in echocardiography requires appropriate methods and materials. OBJECTIVES: This pre/post study aims to measure the change in the knowledge and confidence of a group of health workers after a computer-assisted training intervention in basic echocardiography for rheumatic heart disease. METHODS: A syllabus of self-guided, computer-based modules to train nonexpert health workers in basic echocardiography for rheumatic heart disease was developed. Thirty-eight health workers from Uganda participated in the training. Using a pre/post design, identical test instruments were administered before and after the training intervention, assessing the knowledge (using multiple-choice questions) and confidence (using Likert scale questions) in clinical science and echocardiography. RESULTS: The mean total score on knowledge tests rose from 44.8% to 85.4% (mean difference: 40.6%, 95% confidence interval [CI]: 35.4% to 45.8%), with strong evidence for an increase in scores across all knowledge theme areas (p < 0.001). Increased confidence with each key aspect was reported, and there was strong evidence for an increase in the mean score for confidence scales in clinical science (difference: 7.1, 95% CI: 6.2 to 8.0; p < 0.001) and echocardiography (difference: 18.3, 95% CI: 16.6 to 20.0; p < 0.001). CONCLUSIONS: The training program was effective at increasing knowledge and confidence for basic echocardiography in nonexpert health workers. Use of computer-assisted learning may reduce the human resource requirements for training staff in echocardiography.
Authors: Bo Remenyi; Jonathan Carapetis; John W Stirling; Beatrice Ferreira; Krishnan Kumar; John Lawrenson; Eloi Marijon; Mariana Mirabel; A O Mocumbi; Cleonice Mota; John Paar; Anita Saxena; Janet Scheel; Satu Viali; I B Vijayalakshmi; Gavin R Wheaton; Liesl Zuhlke; Karishma Sidhu; Eliazar Dimalapang; Thomas L Gentles; Nigel J Wilson Journal: Heart Asia Date: 2019-06-24