Department of Medical Laboratory Sciences and Pathology, Jimma University, Jimma, Ethiopia.
BMC Health Serv Res. 2013 Oct 7;13:392. doi: 10.1186/1472-6963-13-392.
Tuberculosis (TB) remains major cause of morbidity and mortality due to any one of infectious agent worldwide. In low income countries, Ziehl-Neelsen sputum smear microscopy is the only cost-effective tool for diagnosis and monitoring of patients on treatment. In order to have efficient AFB microscopy centers, it is imperative to have continuous refresher training for laboratory professionals and strong External Quality Assessment (EQA) system). However, very little data exists as to the effect of in-service training on performance of laboratory personnel in Ethiopia.The objective of this study was to investigate the role of AFB microscopy refresher training on the performance of laboratory professionals.
A cross-sectional retrospective study was conducted to appraise theoretical and practical performance of laboratory professionals before and after AFB microscopy training. Theoretical assessment was based on standard questions while practical assessment was based on smear reading of 10 standard slides. Data on eight rounds of a five days training at Adama regional laboratory on AFB microscopy in 2009 was obtained and analyzed using SPSS 16.0 statistical software.
The pre-training mean score of the theoretical knowledge and practical skills were 61.8% and 75.7%, respectively. The post training mean scores were 84.2% and 89.2% for theoretical knowledge and practical skills, respectively. The increase in mean score of both theoretical and practical assessment was statistically significant (p < 0.0001). Post training mean score of theoretical knowledge was higher among diploma holders trainees than the BSc degree counter parts (p = 0.001). The mean scores on practice before and after training was dependent on participation in previous AFB microscopy trainings (p < 0.0001). Proportions of trainees with both major and minor errors were found to decrease after they were trained. Trainees who have had previous training were found to commit less errors than those who were not participated in previous training (p < 0.0001).
Training has improved theoretical and practical performance of laboratory professionals. Pre-placement and continuous training irrespective of lab professionals qualification and service year and sustainable EQA are highly recommended to ensure quality of AFB microscopy service.
结核病（TB）仍然是全球范围内因任何一种感染因子导致发病率和死亡率的主要原因。在低收入国家，齐-尼氏痰涂片显微镜检查是诊断和监测治疗中患者的唯一具有成本效益的工具。为了建立高效的抗酸杆菌显微镜检查中心，实验室专业人员必须持续接受进修培训，并建立强大的外部质量评估（EQA）体系。然而，在埃塞俄比亚，关于在职培训对实验室人员工作表现影响的数据非常有限。本研究的目的是调查抗酸杆菌显微镜检查进修培训对实验室专业人员工作表现的作用。
采用横断面回顾性研究，评估实验室专业人员在接受抗酸杆菌显微镜检查培训前后的理论和实际操作表现。理论评估基于标准问题，而实际评估则基于对 10 张标准载玻片的涂片阅读。获取并分析了 2009 年在阿达玛地区实验室进行的为期五天的五次抗酸杆菌显微镜检查培训的八轮数据，使用 SPSS 16.0 统计软件进行分析。
培训前理论知识和实际技能的平均得分分别为 61.8%和 75.7%。培训后，理论知识和实际技能的平均得分分别为 84.2%和 89.2%。理论和实际评估的平均得分增加均具有统计学意义（p<0.0001）。在理论知识方面，文凭持有者的培训生得分高于理学学士学位的培训生（p=0.001）。培训前后实践得分的均值取决于他们之前是否参加过抗酸杆菌显微镜检查培训（p<0.0001）。培训后，主要和次要错误的比例均有所下降。与未参加过之前培训的培训生相比，有过培训经历的培训生犯的错误更少（p<0.0001）。
培训提高了实验室专业人员的理论和实际操作能力。建议无论实验室专业人员的资格和服务年限如何，都应进行入职前和持续培训，并建立可持续的外部质量评估体系，以确保抗酸杆菌显微镜检查服务的质量。
