AimTo determine whether, after the Emergency Triage, Assessment and Treatment plus Admission (ETAT+) course, a comprehensive paediatric life support course, final year medical undergraduates in Rwanda would achieve a high level of knowledge and practical skills and if these were retained. To guide further course development, student feedback was obtained.MethodsLongitudinal cohort study of knowledge and skills of all final year medical undergraduates at the University of Rwanda in academic year 2011–2012 who attended a 5-day ETAT+ course. Students completed a precourse knowledge test. Knowledge and clinical skills assessments, using standardised marking, were performed immediately postcourse and 3–9 months later. Feedback was obtained using printed questionnaires.Results84 students attended the course and re-evaluation. Knowledge test showed a significant improvement, from median 47% to 71% correct answers (p<0.001). For two clinical skills scenarios, 98% passed both scenarios, 37% after a retake, 2% failed both scenarios. Three to nine months later, students were re-evaluated, median score for knowledge test 67%, not significantly different from postcourse (p>0.1). For clinical skills, 74% passed, with 32% requiring a retake, 8% failed after retake, 18% failed both scenarios, a significant deterioration (p<0.0001).ConclusionsStudents performed well on knowledge and skills immediately after a comprehensive ETAT+ course. Knowledge was maintained 3–9 months later. Clinical skills, which require detailed sequential steps, declined, but most were able to perform them satisfactorily after feedback. The course was highly valued, but several short courses and more practical teaching were advocated.
Background: Networks have become a widely-used approach to address the complexity of issues around international health and health equity, and many types of networks have been described. The added value of networking is not straightforward and it should be documented. BeCause Health (BCH) is a unique, multistakeholder network linking the Belgian actors of the health and development sector, creating a partnership to support their commitment to equitable health. Consequently, BCH has very broad objectives with creative and dynamic outcomes. The aim of this study was to explore if the structure and process of the BCH network could be adapted to improve its effectiveness. Methods: The overall framework of the project included a narrative literature review combined with qualitative semi-structured interviews. The literature review looked at the structure and process of networks and the means of evaluating network effectiveness. The results of this review were used to inform the interviews of key BeCause Health members. Results: The reviewed articles illustrate the diversity of networking activities and the complexity of their evaluation, suggesting the use of participative evaluation methods to capture the intangible outcomes as experienced by the members themselves. The interviewees reported that the major benefits of their BCH membership were information sharing and connecting with peers. They felt the growth of the BCH network was mostly related to its culture of trust among members, to the inspiring leadership, to the concrete activities it could organise, to its flexible structure tailored to their needs,and to the support of the secretariat and to the embeddedness of the network in a wider institution with secured public funding. They identified a need for improved internal and external communication and for more concrete objectives of the working groups. Conclusion: The BCH network is a unique response to the complex challenges of health equity and development. The outcomes of such complex networks cannot be measured with a simple quantitative method, and require participative methods of evaluation. There is no formula to predict the change of effectiveness that would result from a change of structure.
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