Salehi Roxana, Asamoah Augustine, de Young Stephanie, Acquah Hannah, Agarwal Nikhil, Aryee Sawdah Esaka, Stevens Bonnie, Zlotkin Stanley
Centre for Global Child Health, Hospital for Sick Children, Toronto, Canada.
Ghana College of Nurses and Midwives, Accra, Ghana.
BMC Nurs. 2021 Feb 16;20(1):32. doi: 10.1186/s12912-021-00550-1.
Inadequate health human resources is a key challenge to advancing child survival in Ghana. Nurses are an essential human resource to target because they represent the largest portion of the health workforce. Building on lessons learned from our pilot pediatric nurse training project and World Health Organization guidelines for transforming and scaling up health professional education, this project aimed to; train 500 pediatric nurse specialists through a one-year training program; develop and integrate a critical mass of pediatric nursing faculty and establish a national standardized pediatric nursing curriculum. This study aimed to evaluate the effectiveness of a national pediatric nurse training program in Ghana at the end of 4 years, including eight cohorts with 330 graduates.
This was a mixed-method evaluation with surveys, focus groups and a pre-test/post-test design. Before and after surveys were used to measure knowledge and confidence at baseline and graduation. Objective Structured Clinical Examinations (OSCE) were used to measure clinical skills at baseline, graduation, and 14 months follow-up. At the end of every module, surveys were used to measure students' satisfaction. Focus groups at graduation qualitatively measured program outcomes. Repeat focus groups and surveys at 14 months after graduation captured the graduates' career progress, experiences reintegrating into the health system and long-term program outcomes.
Overall, the graduates completed the program with significantly increased knowledge, confidence, and clinical skills. They also had increased job satisfaction and were able to apply what they learned to their jobs, including leadership skills and gender-sensitive care. Data from 14-month follow-up OSCEs showed that all graduates remained competent in communication, physical assessment, and emergency care, although some obtained a lower mark compared to their performance at graduation. This finding is linked with the observation that the amount of mentorship, support from leadership and equipment that the graduates accessed from their respective facilities varied.
Mixed-methods evaluations demonstrated significant increases in knowledge confidence and skills by completing the program and maintenance of skills more than 1 year after graduation. Findings have implications for those working on the design, implementation, and evaluation of nursing education interventions in low- and middle-income countries.
卫生人力资源不足是加纳提高儿童存活率面临的一项关键挑战。护士是需要关注的重要人力资源，因为他们在卫生工作队伍中占比最大。基于我们的儿科护士培训试点项目所吸取的经验教训以及世界卫生组织关于转变和扩大卫生专业教育的指导方针，本项目旨在：通过一项为期一年的培训计划培训500名儿科护士专家；培养并整合相当数量的儿科护理师资，并建立全国标准化的儿科护理课程。本研究旨在评估加纳一项全国儿科护士培训计划在4年末的效果，该计划包括八个队列，共有330名毕业生。
这是一项采用调查、焦点小组和前测/后测设计的混合方法评估。前后调查用于衡量基线和毕业时的知识水平和信心。客观结构化临床考试（OSCE）用于衡量基线、毕业时和随访14个月时的临床技能。在每个模块结束时，通过调查来衡量学生的满意度。毕业时的焦点小组对项目成果进行定性评估。毕业14个月后的重复焦点小组和调查了解了毕业生的职业进展、重新融入卫生系统的经历以及长期项目成果。
总体而言，毕业生完成该项目后，知识、信心和临床技能显著提高。他们的工作满意度也有所提高，并且能够将所学知识应用到工作中，包括领导技能和对性别敏感的护理。14个月随访OSCE的数据显示，所有毕业生在沟通、体格检查和急救方面仍保持胜任能力，尽管有些人的成绩与毕业时相比有所下降。这一发现与以下观察结果相关：毕业生从各自机构获得的指导、领导支持和设备数量各不相同。
混合方法评估表明，完成该项目后，知识、信心和技能显著提高，并且毕业一年多后技能仍得以保持。研究结果对中低收入国家护理教育干预措施的设计、实施和评估工作具有启示意义。
