Needs Assessment for Simulation Training for Prehospital Providers in Botswana

Glomb, Nicolaus W; Kosoko, Adeola; Doughty, Cara; Rus, Marideth; Shah, Manish I.; Cox, Megan; Galapi, Cafen; Parkes, Presley; Kumar, Sandeep; Laba, Bushe

doi:10.1017/s1049023x18001024

Cited by 13 publications

(11 citation statements)

References 6 publications

(10 reference statements)

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“…A critical step toward advancing prehospital care training in Botswana was to identify, establish, and promote sustainable instruments that were specifically suited to serve the local emergency medical conditions 3. Hence, we used the results of a formal needs assessment4 to better tailor an educational initiative.…”

Section: Introductionmentioning

confidence: 99%

Evaluating a Novel Simulation Course for Prehospital Provider Resuscitation Training in Botswana

Kosoko

Glomb

Laba

et al. 2019

WestJEM

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IntroductionIn 2012, Botswana embarked on an organized public approach to prehospital medicine. One goal of the Ministry of Health (MOH) was to improve provider education regarding patient stabilization and resuscitation. Simulation-based instruction is an effective educational strategy particularly for high-risk, low-frequency events. In collaboration with partners in the United States, the team created a short, simulation-based course to teach and update prehospital providers on common field responses in this resource-limited setting. The objective of this study was to evaluate an educational program for Botswanan prehospital providers via written and simulation-based examinations.MethodsWe developed a two-day course based on a formal needs assessment and MOH leadership input. The subject matter of the simulation scenarios represented common calls to the prehospital system in Botswana. Didactic lectures and facilitated skills training were conducted by U.S. practitioners who also served as instructors for a rapid-cycle, deliberate practice simulation education model and simulation-based testing scenarios. Three courses, held in three cities in Botswana, were offered to off-duty MOH prehospital providers, and the participants were evaluated using written multiple-choice tests, videotaped traditional simulation scenarios, and self-efficacy surveys.ResultsCollectively, 31 prehospital providers participated in the three courses. The mean scores on the written pretest were 67% (standard deviation [SD], 10) and 85% (SD, 7) on the post-test (p < 0.001). The mean scores for the simulation were 42% (SD, 14.2) on the pretest and 75% (SD, 11.3) on the post-test (p < 0.001). Moreover, the intraclass correlation coefficient scores between reviewers were highly correlated at 0.64 for single measures and 0.78 for average measures (p < 0.001 for both). Twenty-one participants (68%) considered the course “extremely useful.”ConclusionBotswanan prehospital providers who participated in this course significantly improved in both written and simulation-based performance testing. General feedback from the participants indicated that the simulation scenarios were the most useful and enjoyable aspects of the course. These results suggest that this curriculum can be a useful educational tool for teaching and reinforcing prehospital care concepts in Botswana and may be adapted for use in other resource-limited settings.

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Section: Introductionmentioning

confidence: 99%

Evaluating a Novel Simulation Course for Prehospital Provider Resuscitation Training in Botswana

Kosoko

Glomb

Laba

et al. 2019

WestJEM

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“…While trauma courses including simulation components have been found to improve assessment scores [ 10 ] in LMICs, there is little data regarding the effects of trauma simulations on clinical outcomes. However, in a needs assessment for prehospital care in Botswana 85% of prehospital personnel rated training for penetrating trauma high priority or essential and 18% of EMS calls involved traumatic injuries [ 11 ]. Thus, given the prevalence and severity of motor vehicle collisions in Ghana [ 12 ], there is a similar need for high-quality prehospital trauma care.…”

Section: Discussionmentioning

confidence: 99%

The state of emergency medical technician education in Ghana

Flaherty

Zakariah

Vescio

et al. 2020

African Journal of Emergency Medicine

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Objective The National Ambulance Service (NAS) provides emergency medical services throughout Ghana and trains emergency medical technicians (EMTs) at the NAS Prehospital Emergency Care Training School (PECTS). Currently the majority of EMT training occurs primarily in a traditional didactic format. Students and faculty were interviewed to better understand their views of the current curriculum. Additionally, any barriers to integration of simulation-based learning were assessed. Following the interviews, the faculty was trained to conduct obstetric and neonatal simulations. The faculty was then observed introducing the simulations to the EMT students. Methods A standardized list of questions developed in consultation with an education expert was used to elicit student and faculty expression of opinion. Interviews were conducted in-person in small group settings. Training sessions were conducted in-person in large group settings. Results Students and faculty alike expressed pride in their work and 14/25 groups felt that teaching efforts were high. However, students verbalized concern involving their lack of rest (12/18) and the high volume of lectures per day (11/18). Both students and faculty felt limited by the lack of simulation tools (17/25), library resources (14/25), internet access (17/25), and infrastructure (20/25). All groups felt favorably towards the integration of simulation-based learning (25/25). Conclusion The faculty and students of PECTS support the transition from a curriculum based on traditional didactic learning to one based on simulation learning.

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“…For feasibility reasons, we chose to provide the same education to all participants. While the curriculum was designed based on the educational needs that were previously assessed in the capital city, 14 it is possible that the educational programme might not entirely fulfil the needs of the learners in different cities in Botswana. Although we observed an improvement in both the written and simulation test scores, this study did not evaluate level 4 of Kirkpatrick’s model in determining whether real-world outcomes in patients improved after the training.…”

Section: Discussionmentioning

confidence: 99%

“…In response to the need for training, we previously developed a curriculum based on a prior needs assessment, 14 as well as communication with the Botswana EMS coordinator. The curriculum focused on the most common and high-risk prehospital scenarios and procedures for both adults and children.…”

Section: Introductionmentioning

confidence: 99%

Educational impact of a pilot paediatric simulation-based training course in Botswana

et al. 2019

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BackgroundAs emergency medical services (EMS) systems develop globally in resource-limited settings, equipping providers with paediatric training is essential. Low-fidelity simulation-based training is an effective modality for training healthcare workers, though limited data exist on the impact of such training programmes. The objective of this study was to evaluate the paediatric portion of a simulation-based curriculum for prehospital providers in Botswana.MethodsThis was a prospective cohort study of EMS providers from more populated regions of Botswana, who attended a 2-day training that included didactic lectures, hands-on skills stations and low-fidelity simulation training. We collected data on participant self-efficacy with paediatric knowledge and skills and performance on both written and simulation-based tests. Self-efficacy and test data were analysed, and qualitative course feedback was summarised.ResultsThirty-one EMS providers participated in the training. Median self-efficacy levels increased for 13/15 (87%) variables queried. The most notable improvements were observed in airway management, newborn resuscitation and weight estimation. Mean written test scores increased by 10.6%, while mean simulation test scores increased by 21.5% (p<0.0001). One hundred per cent of the participants rated the course as extremely useful or very useful.Discussion/ConclusionWe have demonstrated that a low-fidelity simulation-based training course based on a rigorous needs assessment may enhance short-term paediatric knowledge and skills for providers in a developing EMS system in a limited-resource setting. Future studies should focus on studying larger groups of learners in similar settings, especially with respect to the impact of educational programmes like these on real-world patient outcomes.

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Needs Assessment for Simulation Training for Prehospital Providers in Botswana

Cited by 13 publications

References 6 publications

Evaluating a Novel Simulation Course for Prehospital Provider Resuscitation Training in Botswana

Evaluating a Novel Simulation Course for Prehospital Provider Resuscitation Training in Botswana

The state of emergency medical technician education in Ghana

Educational impact of a pilot paediatric simulation-based training course in Botswana

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