Kpangaala-Flomo Cecelia C, Tiah Mary W, Zeantoe G Clinton, Loweal Humphrey Gibbs, Matte Rita Florence, Lake Sodey C, Altman Susan D, Mendoza Maria, Tringali Tanya, Stalonas Kerry, Goldsamt Lloyd, Kurz Renata, Zogbaum Lily, Klar Robin Toft
Liberian Board for Nursing and Midwifery, LR.
United Methodist University, LR.
Ann Glob Health. 2021 Oct 8;87(1):97. doi: 10.5334/aogh.3248. eCollection 2021.
The Republic of Liberia has had major disruptions to the education of its health care cadres. Post Ebola, the Resilient and Responsive Health Systems (RRHS) initiative began a new era of capacity building with the support of PEPFAR and HRSA. Nursing and Midwifery serve as the largest healthcare cadres in Liberia. The national nursing and midwifery curricula were overdue for the regulated review and revisions.
The Science of Improvement was used as the framework to accomplish this multilateral activity. The Institute for Healthcare Improvement's (IHI) stages of improvement included: 1) Forming the team, 2) Setting the aims, 3) Establishing measures, 4) Selecting measures, 5) Testing changes, 6) Implementing changes, and 7) Spreading changes. These stages served as the blueprint for the structures and processes put into place to accomplish this national activity.
The RN, Bridging, and BScM curricula all had redundant content that did not reflect teaching pedagogy and health priorities in Liberia. Courses were eliminated or reconfigured and new courses were created. Development of Nursing and Midwifery Curricular Taskforces were not as successful as was hoped. Two large stakeholder meetings ensured that this was the curricula of the Liberian faculty, deans and directors, and clinical partners. Monitoring and evaluation tools have been adopted by the Liberian Board for Nursing and Midwifery to serve as another improvement to check that the new curricula are being implemented and to identify gaps that may require future cycles of change for continued quality and improvement.
Developing trust among the multilateral partners was critical to the success of this activity. Networks have been expanded, and a proposed pilot with the Ghana Board of Nursing and Midwifery and the US academic partner will examine the feasibility of implementing electronic licensing examinations for nurses and midwives.
利比里亚共和国的医疗保健干部教育受到重大干扰。埃博拉疫情过后，有韧性和应变能力的卫生系统（RRHS）倡议在总统紧急艾滋病救援计划（PEPFAR）和美国卫生资源与服务管理局（HRSA）的支持下开启了能力建设的新时代。护理和助产是利比里亚最大的医疗保健干部群体。国家护理和助产课程早就该进行规范审查和修订了。
改进科学被用作完成这项多边活动的框架。医疗保健改进研究所（IHI）的改进阶段包括：1）组建团队，2）设定目标，3）确定衡量标准，4）选择衡量标准，5）测试变革，6）实施变革，以及7）推广变革。这些阶段为实现这项国家活动所建立的结构和流程提供了蓝图。
注册护士、衔接课程和护理学学士课程都有冗余内容，未能反映利比里亚的教学方法和卫生重点。一些课程被取消或重新配置，同时开设了新课程。护理和助产课程特别工作组的发展并不像预期的那样成功。两次大型利益相关者会议确保了这是利比里亚教员、院长和主任以及临床合作伙伴的课程。利比里亚护理和助产委员会采用了监测和评估工具，作为另一项改进措施，以检查新课程的实施情况，并找出可能需要未来几轮变革以持续保证质量和改进的差距。
多边伙伴之间建立信任对这项活动的成功至关重要。网络已经扩大，一项与加纳护理和助产委员会以及美国学术伙伴的拟议试点将研究实施护士和助产士电子执照考试的可行性。
