Lisa M Nathan1, Desire Patauli2, Damien Nsabimana2, Peter S Bernstein3, Stephen Rulisa4, Dena Goffman3. 1. Department of Obstetrics and Gynecology and Women's Health, Division of Maternal Fetal Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, USA. Electronic address: lnathan@montefiore.org. 2. Kibogora District Hospital, Kibogora, Rwanda. 3. Department of Obstetrics and Gynecology and Women's Health, Division of Maternal Fetal Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, USA. 4. Department of Obstetrics and Gynecology, College of Medicine and Health Sciences, University of Rwanda; Department of Clinical Research, University Teaching Hospital of Kigali, Kigali, Rwanda.
Abstract
OBJECTIVE: To evaluate the long-term retention of skills gained by rural physicians who completed a postpartum hemorrhage simulation-training program. METHODS: A quasi-experimental pre-post intervention study enrolled a convenience sample of generalist physicians in rural Rwanda. Participants underwent initial simulation training including pre- and post-training testing in February 2012. Simulation drills to assess skill retention were conducted in March 2014. Participants were scored based on their communication, evaluation, and management skills. Median scores and inter-quartile ranges were calculated and the Wilcoxon signed-rank sum test was used to compare the pre-training, post-training, and retention scores. Physician confidence was assessed using a survey. RESULTS: In total, 11 physicians were enrolled; eight were available for the 2-year skill-retention evaluation. Significant improvements were observed when comparing participants' pre-training and post-training communication (P=0.03), evaluation (P=0.05), and management (P=0.02) scores, and there were no changes between participants' post-training and 2-year communication (P>0.99), evaluation (P=0.16), and management (P=0.46) scores. There were no differences in the self-reported confidence measures across the duration of the study. CONCLUSION: Simulation training is an effective method for teaching postpartum hemorrhage-management skills to generalist physicians in rural areas and skills are retained for at least 2 years. Further studies could determine the optimal time intervals for refresher training.
OBJECTIVE: To evaluate the long-term retention of skills gained by rural physicians who completed a postpartum hemorrhage simulation-training program. METHODS: A quasi-experimental pre-post intervention study enrolled a convenience sample of generalist physicians in rural Rwanda. Participants underwent initial simulation training including pre- and post-training testing in February 2012. Simulation drills to assess skill retention were conducted in March 2014. Participants were scored based on their communication, evaluation, and management skills. Median scores and inter-quartile ranges were calculated and the Wilcoxon signed-rank sum test was used to compare the pre-training, post-training, and retention scores. Physician confidence was assessed using a survey. RESULTS: In total, 11 physicians were enrolled; eight were available for the 2-year skill-retention evaluation. Significant improvements were observed when comparing participants' pre-training and post-training communication (P=0.03), evaluation (P=0.05), and management (P=0.02) scores, and there were no changes between participants' post-training and 2-year communication (P>0.99), evaluation (P=0.16), and management (P=0.46) scores. There were no differences in the self-reported confidence measures across the duration of the study. CONCLUSION: Simulation training is an effective method for teaching postpartum hemorrhage-management skills to generalist physicians in rural areas and skills are retained for at least 2 years. Further studies could determine the optimal time intervals for refresher training.
Authors: Cherrie Lynn Evans; Eva Bazant; Innocent Atukunda; Emma Williams; Susan Niermeyer; Cyndi Hiner; Ryan Zahn; Rose Namugerwa; Anthony Mbonye; Diwakar Mohan Journal: PLoS One Date: 2018-12-17 Impact factor: 3.240
Authors: Corrado Cancedda; Phil Cotton; Joseph Shema; Stephen Rulisa; Robert Riviello; Lisa V Adams; Paul E Farmer; Jeanne N Kagwiza; Patrick Kyamanywa; Donatilla Mukamana; Chrispinus Mumena; David K Tumusiime; Lydie Mukashyaka; Esperance Ndenga; Theogene Twagirumugabe; Kaitesi B Mukara; Vincent Dusabejambo; Timothy D Walker; Emmy Nkusi; Lisa Bazzett-Matabele; Alex Butera; Belson Rugwizangoga; Jean Claude Kabayiza; Simon Kanyandekwe; Louise Kalisa; Faustin Ntirenganya; Jeffrey Dixson; Tanya Rogo; Natalie McCall; Mark Corden; Rex Wong; Madeleine Mukeshimana; Agnes Gatarayiha; Egide Kayonga Ntagungira; Attila Yaman; Juliet Musabeyezu; Anne Sliney; Tej Nuthulaganti; Meredith Kernan; Peter Okwi; Joseph Rhatigan; Jane Barrow; Kim Wilson; Adam C Levine; Rebecca Reece; Michael Koster; Rachel T Moresky; Jennifer E O'Flaherty; Paul E Palumbo; Rashna Ginwalla; Cynthia A Binanay; Nathan Thielman; Michael Relf; Rodney Wright; Mary Hill; Deborah Chyun; Robin T Klar; Linda L McCreary; Tonda L Hughes; Marik Moen; Valli Meeks; Beth Barrows; Marcel E Durieux; Craig D McClain; Amy Bunts; Forrest J Calland; Bethany Hedt-Gauthier; Danny Milner; Giuseppe Raviola; Stacy E Smith; Meenu Tuteja; Urania Magriples; Asghar Rastegar; Linda Arnold; Ira Magaziner; Agnes Binagwaho Journal: Int J Health Policy Manag Date: 2018-11-01