The impact of the Fundamental Critical Course on knowledge acquisition in Rwanda

Abstract

Background. Emerging critical care systems have gained little attention in low- and middle-income countries. In sub-Saharan Africa, only 4% of the healthcare workforce is trained in critical care, and mortality rates are unacceptably high in this patient population. Aim. We sought to retrospectively describe the knowledge acquisition and confidence improvement of practitioners who attend the Fundamental Critical Care Support (FCCS) course in Rwanda. Methods. We conducted a retrospective study in which we assessed survey data and multiple-choice question data that were collected before and after course delivery. The purpose of these assessments at the time of delivery was to evaluate participants’ perception and acquisition of critical care knowledge. Results. Thirty-six interprofessional clinicians completed the training. Performance on the multiple-choice questions improved overall after the course (mean score pre-course of 56.5% to mean score post-course of 65.8%,p-value <0.001) and improved in all content areas with the exception of diagnosis and management of acute coronary syndrome and acute respiratory failure/mechanical ventilation. Both physicians and nurses improved their scores significantly (68.9% to 75.6%,p-value = 0.031 and 52.0% to 63.5%,p-value <0.001, respectively). Self-reported confidence in level of knowledge also increased in all areas. Survey respondents indicated on open-answer questions that they would like the course offerings at least annually, and that further dissemination of the course in Rwanda was warranted. Conclusion. Deploying the established FCCS course improved Rwandan healthcare provider knowledge and confidence across most critical care content areas. Therefore, this course represents a good first step in bridging the gaps noted in emerging critical care systems.

Impact of Standardized Multidisciplinary Critical Care Training on Confidence with Critical Illness and Attitudes Towards Interprofessional Education and Multidisciplinary Care

“…10 However, even as this course has grown significantly over almost a quarter of a century, very little analysis of the effectiveness of the course content has been completed. Other than small studies in international settings, [11][12][13][14] little work has addressed formal validation of the course or its content. Despite this, some have recommended the course be adopted universally in a variety of settings including undergraduate medical education 15,16 and nursing staff training.…”

Core competencies in critical care for general medical practitioners in South Africa: A Delphi study

“…[9] Exposure and training in critical care can, however, increase the knowledge, skills and confidence of doctors. [10] An additional benefit is reported by Haniffa et al, [11] who found that, if doctors and nurses working in resource-limited settings received dedicated training, ICU mortality rates declined from 41% to 18%. Training of primary care physicians will have an impact on the burden and outcomes of patients who are admitted to ICUs in SA.…”