An online learning programme improves traumatic brain injury guideline adherence in a South African Helicopter Emergency Medical Service

Stassen, Willem; Wylie, Craig; Holgate, Robyn

doi:10.1016/j.afjem.2015.05.001

Cited by 6 publications

(4 citation statements)

References 5 publications

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“…Face-to-face training regarding study procedures can be replaced by an online training module instead. Such an approach has been used previously within the setting to improve traumatic brain injury guideline adherence [30]. This allows for self-paced learning that can span across shift work and geographic dispersion and is dynamic enough to allow for training of new staff during organisational orientation.…”

Section: Discussionmentioning

confidence: 99%

A prehospital randomised controlled trial in South Africa: Challenges and lessons learnt

Stassen

Wallis

Castrèn

et al. 2019

African Journal of Emergency Medicine

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The incidence of cardiovascular disease and STEMI is on the rise in sub-Saharan Africa. Timely treatment is essential to reduce mortality. Internationally, prehospital 12 lead ECG telemetry has been proposed to reduce time to reperfusion. Its value in South Africa has not been established. The aim of this study was to determine the effect of prehospital 12 lead ECG telemetry on the PCI-times of STEMI patients in South Africa. A multicentre randomised controlled trial was attempted among adult patients with prehospital 12 lead ECG evidence of STEMI. Due to poor enrolment and small sample sizes, meaningful analyses could not be made. The challenges and lessons learnt from this attempt at Africa's first prehospital RCT are discussed. Challenges associated with conducting this RCT related to the healthcare landscape, resources, training of paramedics, rollout and randomisation, technology, consent and research culture. High quality evidence to guide prehospital emergency care practice is lacking both in Africa and the rest of the world. This is likely due to the difficulties with performing prehospital clinical trials. Every trial will be unique to the test intervention and setting of each study, but by considering some of the challenges and lessons learnt in the attempt at this trial, future studies might experience less difficulty. This may lead to a stronger evidence-base for prehospital emergency care.

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Section: Discussionmentioning

confidence: 99%

A prehospital randomised controlled trial in South Africa: Challenges and lessons learnt

Stassen

Wallis

Castrèn

et al. 2019

African Journal of Emergency Medicine

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“…The practical component suggested by participants is in line with the theory of situated learning where students will learn within their community of practice. The benefit of an online component was also demonstrated by Stassen et al [ 39 ] where the implementation of an online course in managing traumatic brain injury (TBI) patients improved the care provided by Helicopter Emergency Medical Services (HEMS) personnel. The COVID-19 pandemic accelerated the use of online learning as a teaching medium, which is controversial in an LMIC setting with a digital divide due to an unequal society.…”

Section: Discussionmentioning

confidence: 92%

Developing a South African curriculum for education in neonatal critical care retrieval: An initial exploration

Williams,

Theron,

Khan

et al. 2023

PLoS ONE

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Background Owing to limited or centralised neonatal critical care resources, the interfacility transfer of neonates is inevitable. In many high-income settings, dedicated Critical Care Retrieval Services (CCRS) with additional education and training undertake neonatal critical care retrieval (CCR). In South Africa, however, these transfers are mostly conducted by advanced paramedics with limited education in neonatal care, and this may lead to high adverse event rates. In SA, a shortage of skilled neonatal interfacility transport services has been identified as one of the top ten avoidable causes of under-5 mortality. In order to address this gap in neonatal transfer education for paramedics in South Africa, the aim of this study is to develop a curriculum for neonatal critical care retrieval in South Africa. Methods Using Kern’s approach to curriculum development, a general and targeted needs assessment was conducted through semi-structured interviews with experts in the field and a focus group discussion with a prospective student group. Interviews were preceded and informed by a literature review and retrospective chart review of neonates who underwent CCR in SA over a one-year period. Audio recordings of interviews were transcribed verbatim and subjected to inductive-dominant content analysis. Finally, qualitative codes were expanded into course outcome and a curriculum map was developed. Results Six experts in neonatal critical care and retrieval participated in semi-structured interviews with a mean duration of 59 minutes. Following transcription and analysis, 372 codes were developed. Seven prehospital providers (prospective students) who are involved in neonatal transfers in South Africa participated in a focus group discussion with a duration of 91 minutes. The audio recording was transcribed and analysed with 97 codes extracted. The main categories were: Current status of neonatal CCR in South Africa; learning and education in neonatal CCR; and proposed curriculum structure. The proposed curriculum structure described 13 broad course outcomes to be delivered as a blended postgraduate programme. Participants noted that funding, employer buy-in and internet resources would be required. The targeted prospective student group should be all Advanced Life Support (ALS) providers with a change in their scope of practice on completion. Conclusion This study described the need for additional education in neonatal critical care retrieval due to the limitations in the current and past education systems. This study provides a curriculum structure with course outcomes that can be used as a basis for the development of a complete curriculum for education in neonatal CCR, with the potential to greatly reduce adverse event rates.

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“…Upskilling pre-hospital providers, even through online learning modules, has been shown to improve treatment guideline adherence in the South African setting. 35…”

Section: Discussionmentioning

confidence: 99%

The accuracy of Bloemfontein-based Emergency Medical Services providers in recognising sepsis

Lewis

Jooste

Campbell

et al. 2021

SAJPEC

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Background: Sepsis is considered a severe life-threatening medical emergency and globally carries a high mortality. Research suggests early recognition of sepsis can lead to early initiation of treatment and effective communication of this condition to the receiving facility by pre-hospital emergency care (PEC) providers. Depending on system operations, this has been shown to improve patient outcomes. However, sepsis often presents non-specifically, and in the absence of validated pre-hospital sepsis screening tools, less than half of sepsis patients seen by PEC providers are recognised. This study aimed to determine the accuracy with which Bloemfontein-based PEC providers recognise sepsis in a series of patient vignettes. Methods: A series of seven case vignettes were presented to a convenient sample of advanced life support (ALS) and intermediate life support (ILS) PEC providers. The PEC providers were asked to review each vignette and indicate whether the patient described had sepsis or not. The vignettes consisted of a clinical case description with signs and symptoms of patients presenting with or without sepsis, and images were shown where relevant. Elements of the Robson Prehospital Severe Sepsis Screening (RPSS) tool were used to populate the sepsis vignettes. Results: A total of 27 ILS and ALS PEC providers in the Bloemfontein area partook in the research study. Thus, a total of 189 vignettes were evaluated for sepsis. PEC providers, both ILS and ALS, recognised sepsis with a sensitivity of 69.63% and a specificity of 37.04% (PPV 73.44%, NPV 32.79%), indicating an accuracy of 60.32%. Although all participants mentioned some motivations for their answers, none of the participants gave specific cut-off value ranges at which point they would suspect sepsis. Conclusion: This vignette-based study found that PEC providers can recognise sepsis with modest accuracy, echoing previous work on this topic. In addition, the study provides a platform for similar studies, which, in turn, could aid in the development of a validated, pre-hospital sepsis screening tool.

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An online learning programme improves traumatic brain injury guideline adherence in a South African Helicopter Emergency Medical Service

Cited by 6 publications

References 5 publications

A prehospital randomised controlled trial in South Africa: Challenges and lessons learnt

A prehospital randomised controlled trial in South Africa: Challenges and lessons learnt

Developing a South African curriculum for education in neonatal critical care retrieval: An initial exploration

The accuracy of Bloemfontein-based Emergency Medical Services providers in recognising sepsis

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