Sharon Kibwana1, Rachel Haws2, Adrienne Kols3, Firew Ayalew4, Young-Mi Kim5, Jos van Roosmalen6, Jelle Stekelenburg7. 1. Jhpiego/Ethiopia, an affiliate of Johns Hopkins University, Kirkos Subcity, Kebele 02/03, House 693, Wollo Sefer, Addis Ababa, Ethiopia. Electronic address: Sharon.Kibwana@jhpiego.org. 2. Jhpiego, an affiliate of Johns Hopkins University, Baltimore, USA. Electronic address: rachel.haws@gmail.com. 3. Jhpiego, an affiliate of Johns Hopkins University, Baltimore, USA. Electronic address: Adrienne.Kols@jhpiego.org. 4. Jhpiego/Ethiopia, an affiliate of Johns Hopkins University, Addis Ababa, Ethiopia. Electronic address: Firew.Ayalew@jhpiego.org. 5. Jhpiego, an affiliate of Johns Hopkins University, Baltimore, USA. Electronic address: Young-Mi.Kim@jhpiego.org. 6. Athena Institute, Vrije Universiteit, Amsterdam, The Netherlands. Electronic address: J.J.M.van_Roosmalen@lumc.nl. 7. Department of Obstetrics & Gynecology, Leeuwarden Medical Centre, Leeuwarden, The Netherlands; Department of Health Sciences, Global Health, University Medical Centre Groningen/University of Groningen, Groningen, The Netherlands. Electronic address: jelle.stekelenburg@online.nl.
Abstract
BACKGROUND: Ethiopia has successfully expanded training for midwives and anesthetists in public institutions. This study explored the perceptions of trainers (instructors, clinical lab assistants and preceptors) towards the adequacy of students' learning experience and implications for achieving mastery of core competencies. METHODS: In-depth interviews with 96 trainers at 9 public universities and 17 regional health science colleges across Ethiopia were conducted to elicit their opinions about available resources, program curriculum suitability, and competence of graduating students. Using Dedoose, data were thematically analyzed using grounded theory. RESULTS: Perceptions of anesthesia and midwifery programs were similar. Common challenges included unpreparedness and poor motivation of students, shortages of skills lab space and equipment, difficulties ensuring students' exposure to sufficient and varied enough cases to develop competence, and lack of coordination between academic training institutions and clinical attachment sites. Additional logistical barriers included lack of student transport to clinical sites. Informants recommended improved recruitment strategies, curriculum adjustments, increased time in skills labs, and better communication across academic and clinical sites. CONCLUSIONS: An adequate learning environment ensures that graduating midwives and anesthetists are competent to provide quality services. Minimizing the human resource, infrastructural and logistical gaps identified in this study requires continued, targeted investment in health systems strengthening.
BACKGROUND: Ethiopia has successfully expanded training for midwives and anesthetists in public institutions. This study explored the perceptions of trainers (instructors, clinical lab assistants and preceptors) towards the adequacy of students' learning experience and implications for achieving mastery of core competencies. METHODS: In-depth interviews with 96 trainers at 9 public universities and 17 regional health science colleges across Ethiopia were conducted to elicit their opinions about available resources, program curriculum suitability, and competence of graduating students. Using Dedoose, data were thematically analyzed using grounded theory. RESULTS: Perceptions of anesthesia and midwifery programs were similar. Common challenges included unpreparedness and poor motivation of students, shortages of skills lab space and equipment, difficulties ensuring students' exposure to sufficient and varied enough cases to develop competence, and lack of coordination between academic training institutions and clinical attachment sites. Additional logistical barriers included lack of student transport to clinical sites. Informants recommended improved recruitment strategies, curriculum adjustments, increased time in skills labs, and better communication across academic and clinical sites. CONCLUSIONS: An adequate learning environment ensures that graduating midwives and anesthetists are competent to provide quality services. Minimizing the human resource, infrastructural and logistical gaps identified in this study requires continued, targeted investment in health systems strengthening.
Authors: Hilary Edgcombe; Linden S Baxter; Soren Kudsk-Iversen; Victoria Thwaites; Fred Bulamba Journal: BMJ Open Date: 2019-03-07 Impact factor: 2.692