WHO Collaborating Center for Maternal and Child Health, Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy.
Epidemiologist, Trieste, Italy.
Int Breastfeed J. 2021 Nov 27;16(1):89. doi: 10.1186/s13006-021-00439-4.
Problem-Based Learning (PBL) is extensively used in pre- and post-graduate teaching programmes. However, it has been seldom used for in-service training and continuing medical education. We aimed to develop a PBL curriculum for a short in-service training on breastfeeding for maternal and child health professionals, and to assess the effect of these courses on their knowledge and skills. Also, the project aimed at increasing exclusive breastfeeding rates and duration in an Italian region.
After initial training on PBL and an assessment of the learning needs of about 400 health professionals, a small working group developed learning objectives, designed a curriculum, produced manuals, and shaped assessment tools for a new PBL course on breastfeeding. The field test of the new course allowed selection of the tutors for the scaling up of the training to the whole region. During this extension phase, participants were asked to complete an evaluation questionnaire. In addition, the health professionals who attended the PBL courses in 2019 were asked to complete an online survey to assess knowledge, attitudes and practices (KAP) just before, soon after the course, and 4-6 months later.
The new 29 - hour PBL course, to be delivered in four days over four consecutive weeks, gives priority to tutorial groups and practical activities (71% of the total time). Supervised clinical practices absorb 16% of time. Ethics, communication and woman-centred clinical management content run throughout the four days and all activities. The three manuals, for tutors, participants and practical activities, facilitate the tasks and performance of tutors and participants. After the field test, 32 regional tutors ran courses for 562 health professionals. The analysis of the evaluation showed a high level of satisfaction for perceived effectiveness, relevance to practice, and educational quality. The KAP questionnaires indicated a general improvement after the course and retention after 4-6 months.
Despite some predictable shortcomings, this new PBL approach for short in-service training courses on breastfeeding showed encouraging results as far as participants' satisfaction and KAP are concerned. The possible effects on rates and duration of exclusive breastfeeding need further research.
基于问题的学习（Problem-Based Learning，PBL）广泛应用于研究生前和研究生教学计划中。然而，它很少用于在职培训和继续医学教育。我们旨在为母婴保健专业人员的母乳喂养短期在职培训制定 PBL 课程，并评估这些课程对他们知识和技能的影响。此外，该项目旨在提高意大利一个地区的纯母乳喂养率和持续时间。
在对大约 400 名卫生专业人员进行 PBL 初步培训并评估其学习需求后，一个小型工作组制定了学习目标、课程设计、教材编写和评估工具，用于母乳喂养的新 PBL 课程。新课程的现场测试为培训扩展到整个地区选择了导师。在扩展阶段，参与者被要求完成评估问卷。此外，还要求参加 2019 年 PBL 课程的卫生专业人员在课程前、课程后不久以及 4-6 个月后完成在线调查，以评估知识、态度和实践（KAP）。
新的 29 小时 PBL 课程，分四周四个连续星期完成，优先考虑辅导小组和实践活动（总时间的 71%）。监督临床实践占用 16%的时间。伦理、沟通和以妇女为中心的临床管理内容贯穿四天和所有活动。三本手册，分别为导师、参与者和实践活动手册，方便了导师和参与者的任务和表现。经过现场测试后，32 名区域导师为 562 名卫生专业人员开设了课程。评估分析显示，对有效性、与实践的相关性和教育质量的满意度很高。KAP 问卷表明，课程结束后和 4-6 个月后普遍有所改善。
尽管存在一些可预见的缺点，但这种新的母乳喂养短期在职培训 PBL 方法在参与者的满意度和 KAP 方面显示出了令人鼓舞的结果。对纯母乳喂养率和持续时间的可能影响需要进一步研究。
