Health worker competence

卫生工作者能力
  • 文章类型: Journal Article
    减少常见精神障碍的全球负担的努力集中在扩大非专业提供者的循证培训计划,以提供简短的心理干预。要评估这些提供者培训计划,需要与他们一起开发适当和可扩展的能力评估。我们遵循了一种系统的方法来进行文化适应,并将其翻译成有效的印地语,英语,多项选择应用知识测量来评估非专业人士对印度农村抑郁症进行简短心理干预的能力。然后,我们探索了30个非专业提供商在相同书面度量上的绩效与由两个角色扮演组成的基于绩效的结构化度量之间的关系。多项选择评估的结果的总体平均得分为37.40(SD=11.31),而角色扮演A(更容易的角色扮演)的平均得分为43.25(SD=14.50)和角色扮演B(更困难的角色扮演)的平均得分为43.25(SD=13.00)。角色扮演基于绩效的度量和书面应用知识度量代表了不同的方法,具有独特的优势和挑战来衡量能力。扩大培训计划需要开发可扩展的能力评估方法。探索这两种措施之间的关系,我们的团队发现两种评估模式之间没有明显差异.需要对这些方法进行持续比较,以确定两种格式的结果一致性,并将这些措施的得分与护理质量和患者结果所反映的临床表现联系起来。试用注册:ClinicalTrials.gov标识符:NCT04157816;2019年11月8日。
    Efforts to reduce the global burden of common mental disorders have focused on scaling up evidence-based training programs for non-specialist providers to deliver brief psychological interventions. To evaluate these provider training programs, appropriate and scalable assessments of competency need to be developed alongside them. We followed a systematic approach for the cultural adaptation and translation into Hindi of a valid, English, multiple-choice applied knowledge measure to assess non-specialists\' competence to deliver a brief psychological intervention for depression in rural India. We then explored the relationship between the performance of 30 non-specialist providers on the same written measure compared with a structured performance-based measure consisting of two role-plays. The results of the multiple-choice assessment had an overall mean score of 37.40 (SD = 11.31) compared to the mean scores of role-play A (the easier role-play) of 43.25 (SD = 14.50) and role-play B (the more difficult role-play) of 43.25 (SD = 13.00). Role-play performance-based measures and written applied knowledge measures represent different approaches with unique strengths and challenges to measuring competence. Scaling up training programs requires the development of scalable methods for competency assessment. Exploring the relationship between these two measures, our team found no apparent differences between the two modes of assessment. Continued comparison of these approaches is needed to determine the consistency of outcomes across the two formats and to link the scores on these measures with clinical performance as reflected by the quality of care and patient outcomes.Trial Registration: ClinicalTrials.gov Identifier: NCT04157816; 8th November 2019.
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  • 文章类型: Journal Article
    指导计划经常被推荐为创新和低成本的解决方案,这些措施已在许多医疗机构中实施,以应对多种与人力资源相关的挑战。这篇评论试图找到,评估和描述有关旨在提高非洲医护人员能力和机构绩效的导师计划的文献报告。
    这篇综述搜索并综合了评估非洲医护人员导师计划有效性的研究报告。我们在EMBASE中搜索了以英语报道的研究,CINAHL,COCHRANE和MEDLINE.在GoogleScholar中进行了其他搜索。
    我们纳入了30篇报告24项研究的论文。报告了多种指导方法:a)在医疗机构中放置导师一段时间(嵌入式导师),b)流动导师的访问,C)涉及移动多学科导师团队的指导方法,d)设施孪生,ande)within-facilitymentorshipbyafocuspersonoramanager.
    指导干预措施有效地改善了传染病的临床管理,母性,新生儿和儿童疾病。还发现指导干预措施可以提高管理绩效(会计,人力资源,监测和评估,和运输管理)卫生机构。此外,指导提高了实验室认可分数.指导干预措施可用于提高卫生专业人员对指南的依从性,标准,和协议。虽然不同类型的干预措施(嵌入式指导,移动导师的访问,设施结对和由协调人进行的设施内指导)被报告为有效的,没有证据表明推荐一种模式的指导而不是其他类型的指导。
    需要进一步的研究-测量不同指导格式的影响的实验方法和建立其长期有效性的纵向研究-来比较不同指导模型的有效性和成本效益。需要进一步的研究来探索不同的指导计划为什么以及如何成功,以及指导计划对不同利益相关者的意义也是必需的。
    UNASSIGNED: Mentoring programs are frequently recommended as innovative and low-cost solutions, and these have been implemented in many healthcare institutions to tackle multiple human resource-related challenges. This review sought to locate, appraise and describe the literature reporting on mentorship programs that were designed to improve healthcare worker competence and institutional performance in Africa.
    UNASSIGNED: This review searched and synthesized reports from studies that assessed the effectiveness of mentorship programs among healthcare workers in Africa. We searched for studies reported in the English language in EMBASE, CINAHL, COCHRANE and MEDLINE. Additional search was conducted in Google Scholar.
    UNASSIGNED: We included 30 papers reporting on 24 studies. Diverse approaches of mentorship were reported: a) placing a mentor in health facility for a period of time (embedded mentor), b) visits by a mobile mentor, c) a mentoring approach involving a team of mobile multidisciplinary mentors, d) facility twinning, and e) within-facility mentorship by a focal person or a manager.
    UNASSIGNED: Mentoring interventions were effective in improving the clinical management of infectious diseases, maternal, neonatal and childhood illnesses. Mentoring interventions were also found to improve managerial performance (accounting, human resources, monitoring and evaluation, and transportation management) of health institutions. Additionally, mentoring had improved laboratory accreditation scores. Mentoring interventions may be used to increase adherence of health professionals to guidelines, standards, and protocols. While different types of interventions (embedded mentoring, visits by mobile mentors, facility twinning and within-facility mentorship by a focal person) were reported to be effective, there is no evidence to recommend one model of mentoring over other types of mentoring.
    UNASSIGNED: Further research-experimental methods measuring the impact of different mentoring formats and longitudinal studies establishing their long-term effectiveness-is required to compare the effectiveness and cost-effectiveness of different models of mentoring. Further studies are needed to explore why and how different mentoring programs succeed and the meaningfulness of mentoring programs for the different stakeholders are also required.
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