University of Washington School of Medicine, Seattle, USA.
Int J Gynaecol Obstet. 2012 Jun;117(3):243-7. doi: 10.1016/j.ijgo.2012.01.013. Epub 2012 Mar 24.
To explore the feasibility of competency-based training of Zambian nurse-midwives in postplacental and postpartum intrauterine device (PPIUD) insertion and to estimate learning curves for this procedure.
A pilot service-delivery project was conducted, involving 9 nurse-midwives who participated in a 10-day PPIUD insertion training course at the University Teaching Hospital, Lusaka, Zambia. US and Zambian clinicians taught the didactic and practical curriculum. Checklists were used for standardization and a pelvic model was developed to achieve PPIUD insertion competency in the classroom before moving to clinical practice. Patients were recruited during prenatal visits, in early labor, and postpartum. Informed, voluntary consent was obtained. All clinical PPIUD insertions were supervised or performed by experienced trainers.
All 9 nurse-midwives achieved competency on the pelvic model after 3 attempts. During the training period, 38 PPIUDs were inserted in postpartum women; no complications occurred. By the end of training, 4 of the nurse-midwives were deemed competent to independently insert PPIUDs. On average, 4 PPIUD insertions were needed to achieve clinical competency.
Concentrated, competency-based training in PPIUD insertion is feasible in an African setting. Replication of such training could increase the popularity and prevalence of PPIUD use among African women.
探索在赞比亚对助产士进行基于能力的产后和产后宫内节育器（PPIUD）放置培训的可行性，并估计该程序的学习曲线。
开展了一项试点服务提供项目，涉及 9 名助产士，他们在赞比亚卢萨卡大学教学医院参加了为期 10 天的 PPIUD 插入培训课程。美国和赞比亚的临床医生教授了理论和实践课程。使用清单进行标准化，并开发了骨盆模型，以便在进入临床实践之前在课堂上实现 PPIUD 插入能力。在产前检查、早期分娩和产后期间招募患者。获得知情、自愿同意。所有临床 PPIUD 插入均由经验丰富的培训师进行监督或执行。
所有 9 名助产士在尝试 3 次后均在骨盆模型上达到能力。在培训期间，在产后妇女中插入了 38 个 PPIUD；没有发生并发症。培训结束时，有 4 名助产士被认为有能力独立插入 PPIUD。平均需要 4 次 PPIUD 插入才能达到临床能力。
在非洲环境中，集中、基于能力的 PPIUD 插入培训是可行的。这种培训的复制可以增加非洲妇女对 PPIUD 使用的普及和流行。
