PDF(Pubmed)
Abstract：
BACKGROUND: The rates of maternal and neonatal deaths in Madagascar are among the highest in the world. In response to a request for additional training from obstetrical care providers at the Ambanja district hospital in north-eastern Madagascar, a partnership of institutions in Switzerland and Madagascar conducted innovative training on respectful emergency obstetric and newborn care using e-learning and simulation methodologies. The training focused on six topics: pre-eclampsia, physiological childbirth, obstetric maneuvers, postpartum hemorrhage, maternal sepsis, and newborn resuscitation. Cross-cutting themes were interprofessional communication and respectful patient care. Ten experienced trainers participated in an e-training-of-trainers course conducted by the Swiss partners. The newly-trained trainers and Swiss partners then jointly conducted the hybrid remote/in-person training for 11 obstetrical care providers in Ambanja.
METHODS: A mixed methods evaluation was conducted of the impact of the training on participants\' knowledge and practices. Trainees\' knowledge was tested before, immediately after, and 6 months after the training. Focus group discussions were conducted to elicit participants\' opinions about the training, including the content and pedagogical methods.
RESULTS: Trainees\' knowledge of the six topics was higher at 6 months (with an average of 71% correct answers) compared to before the training (62%), although it was even higher (83%) immediately after the training. During the focus group discussions, participants highlighted their positive impressions of the training, including its impact on their sense of professional effectiveness. They reported that their interprofessional relationships and focus on respectful care had improved. Simulation, which was a new methodology for the participants native to Madagascar, was appreciated for its engaging and active format, and they enjoyed the hybrid delivery of the training. Participants (including the trainers) expressed a desire for follow-up engagement, including additional training, and improved access to more equipment.
CONCLUSIONS: The evaluation showed improvements in trainees\' knowledge and capacity to provide respectful emergency care to pregnant women and newborns across all training topics. The hybrid simulation-based training method elicited strong enthusiasm. Significant opportunity exists to expand the use of hybrid onsite/remote simulation-based training to improve obstetrical care and health outcomes for women and newborns in Madagascar and elsewhere.
METHODS: A mixed methods evaluation was conducted of the impact of the training on participants\' knowledge and practices. Trainees\' knowledge was tested before, immediately after, and 6 months after the training. Focus group discussions were conducted to elicit participants\' opinions about the training, including the content and pedagogical methods.
RESULTS: Trainees\' knowledge of the six topics was higher at 6 months (with an average of 71% correct answers) compared to before the training (62%), although it was even higher (83%) immediately after the training. During the focus group discussions, participants highlighted their positive impressions of the training, including its impact on their sense of professional effectiveness. They reported that their interprofessional relationships and focus on respectful care had improved. Simulation, which was a new methodology for the participants native to Madagascar, was appreciated for its engaging and active format, and they enjoyed the hybrid delivery of the training. Participants (including the trainers) expressed a desire for follow-up engagement, including additional training, and improved access to more equipment.
CONCLUSIONS: The evaluation showed improvements in trainees\' knowledge and capacity to provide respectful emergency care to pregnant women and newborns across all training topics. The hybrid simulation-based training method elicited strong enthusiasm. Significant opportunity exists to expand the use of hybrid onsite/remote simulation-based training to improve obstetrical care and health outcomes for women and newborns in Madagascar and elsewhere.
摘要：
背景：马达加斯加的孕产妇和新生儿死亡率是世界上最高的。应马达加斯加东北部Ambanja区医院产科护理提供者的额外培训要求，瑞士和马达加斯加机构的伙伴关系利用电子学习和模拟方法，开展了关于尊重产科和新生儿急诊护理的创新培训。培训集中在六个主题：先兆子痫，生理分娩，产科演习，产后出血,母体败血症,和新生儿复苏。交叉主题是跨专业交流和尊重患者护理。10名经验丰富的培训员参加了瑞士合作伙伴举办的培训员电子培训课程。然后，新培训的培训师和瑞士合作伙伴共同为Ambanja的11名产科护理提供者进行了混合远程/面对面培训。
方法：对培训对参与者的知识和实践的影响进行了混合方法评估。受训人员的知识之前经过测试，紧接着,培训后6个月。进行了焦点小组讨论，以征求参与者对培训的意见，包括内容和教学方法。
结果：与培训前（62％）相比，学员对六个主题的知识在6个月时更高（平均正确答案为71％），尽管在训练后立即更高（83％）。在焦点小组讨论中,参与者强调了他们对培训的积极印象，包括它对他们专业效能感的影响。他们报告说，他们的专业关系和对尊重照顾的关注有所改善。模拟,这是马达加斯加本土参与者的一种新方法，因其引人入胜和活跃的格式而受到赞赏，他们喜欢混合提供的培训。参与者(包括培训人员)表示希望进行后续参与，包括额外的培训，并改善获得更多设备的机会。
结论：评估显示，在所有培训主题中，学员在为孕妇和新生儿提供尊重的紧急护理方面的知识和能力都有所提高。基于混合仿真的培训方法引起了强烈的热情。在马达加斯加和其他地方，存在扩大使用混合现场/远程模拟培训的重要机会，以改善妇女和新生儿的产科护理和健康结果。
方法：对培训对参与者的知识和实践的影响进行了混合方法评估。受训人员的知识之前经过测试，紧接着,培训后6个月。进行了焦点小组讨论，以征求参与者对培训的意见，包括内容和教学方法。
结果：与培训前（62％）相比，学员对六个主题的知识在6个月时更高（平均正确答案为71％），尽管在训练后立即更高（83％）。在焦点小组讨论中,参与者强调了他们对培训的积极印象，包括它对他们专业效能感的影响。他们报告说，他们的专业关系和对尊重照顾的关注有所改善。模拟,这是马达加斯加本土参与者的一种新方法，因其引人入胜和活跃的格式而受到赞赏，他们喜欢混合提供的培训。参与者(包括培训人员)表示希望进行后续参与，包括额外的培训，并改善获得更多设备的机会。
结论：评估显示，在所有培训主题中，学员在为孕妇和新生儿提供尊重的紧急护理方面的知识和能力都有所提高。基于混合仿真的培训方法引起了强烈的热情。在马达加斯加和其他地方，存在扩大使用混合现场/远程模拟培训的重要机会，以改善妇女和新生儿的产科护理和健康结果。
