提高肯尼亚大学助产教育者教授急症产科和新生儿护理的能力：一项前后测研究。
Improving midwifery educators' capacity to teach emergency obstetrics and newborn care in Kenya universities: a pre-post study.
机构信息
Liverpool School of Tropical Medicine (Kenya), P.O. Box 24672-00100, Nairobi, Kenya.
Liverpool School of Tropical Medicine (UK), L3 5QA, Liverpool, UK.
出版信息
BMC Med Educ. 2022 Oct 31;22(1):749. doi: 10.1186/s12909-022-03827-4.
BACKGROUND
International Confederation of Midwives and World Health Organization recommend core competencies for midwifery educators for effective theory and practical teaching and practice. Deficient curricula and lack of skilled midwifery educators are important factors affecting the quality of graduates from midwifery programmes. The objective of the study was to assess the capacity of university midwifery educators to deliver the updated competency-based curriculum after the capacity strengthening workshop in Kenya.
METHODS
The study used a quasi-experimental (pre-post) design. A four-day training to strengthen the capacity of educators to deliver emergency obstetrics and newborn care (EmONC) within the updated curriculum was conducted for 30 midwifery educators from 27 universities in Kenya. Before-after training assessments in knowledge, two EmONC skills and self-perceived confidence in using different teaching methodologies to deliver the competency-based curricula were conducted. Wilcoxon signed-rank test was used to compare the before-after knowledge and skills mean scores. McNemar test was used to compare differences in the proportion of educators' self-reported confidence in applying the different teaching pedagogies. P-values < 0.05 were considered statistically significant.
FINDINGS
Thirty educators (7 males and 23 females) participated, of whom only 11 (37%) had participated in a previous hands-on basic EmONC training - with 10 (91%) having had the training over two years beforehand. Performance mean scores increased significantly for knowledge (60.3% - 88. %), shoulder dystocia management (51.4 - 88.3%), newborn resuscitation (37.9 - 89.1%), and overall skill score (44.7 - 88.7%), p < 0.0001. The proportion of educators with confidence in using different stimulatory participatory teaching methods increased significantly for simulation (36.7 - 70%, p = 0.006), scenarios (53.3 - 80%, p = 0.039) and peer teaching and support (33.3 - 63.3%, p = 0.022). There was improvement in use of lecture method (80 - 90%, p = 0.289), small group discussions (73.3 - 86.7%, p = 0.344) and giving effective feedback (60 - 80%, p = 0.146), although this was not statistically significant.
CONCLUSION
Training improved midwifery educators' knowledge, skills and confidence to deliver the updated EmONC-enhanced curriculum. To ensure that midwifery educators maintain their competence, there is need for structured regular mentoring and continuous professional development. Besides, there is need to cascade the capacity strengthening to reach more midwifery educators for a competent midwifery workforce.
背景
国际助产士联合会和世界卫生组织建议助产士教育者具备核心能力，以进行有效的理论和实践教学。课程不足和缺乏熟练的助产士教育者是影响助产士课程毕业生质量的重要因素。本研究的目的是评估肯尼亚能力强化研讨会后，大学助产士教育者实施更新的基于能力的课程的能力。
方法
本研究采用准实验（前后）设计。为来自肯尼亚 27 所大学的 30 名助产士教育者举办了为期四天的培训，以加强他们在更新的课程中提供紧急产科和新生儿护理（EmONC）的能力。在培训前后进行知识、两项 EmONC 技能以及自我评估在使用不同教学方法实施基于能力的课程方面的信心的评估。使用 Wilcoxon 符号秩检验比较知识和技能平均分的前后差异。使用 McNemar 检验比较教育者自我报告应用不同教学方法的信心的比例差异。P 值<0.05 被认为具有统计学意义。
结果
共有 30 名教育者（7 名男性和 23 名女性）参加了培训，其中只有 11 名（37%）参加过之前的基础 EmONC 实践培训-其中 10 名（91%）是在两年前参加的。知识（60.3%-88. ）、肩难产管理（51.4%-88.3%）、新生儿复苏（37.9%-89.1%）和整体技能评分（44.7%-88.7%）的表现平均分显著提高，p<0.0001。教育者对使用不同的刺激性参与式教学方法的信心比例显著增加，包括模拟（36.7%-70%，p=0.006）、情景（53.3%-80%，p=0.039）和同伴教学和支持（33.3%-63.3%，p=0.022）。使用讲座方法（80%-90%，p=0.289）、小组讨论（73.3%-86.7%，p=0.344）和提供有效反馈（60%-80%，p=0.146）的比例也有所提高，但这并不具有统计学意义。
结论
培训提高了助产士教育者实施更新的 EmONC 强化课程的知识、技能和信心。为确保助产士教育者保持其能力，需要进行结构化的定期指导和持续的专业发展。此外，需要将能力强化扩展到更多的助产士教育者，以培养有能力的助产士队伍。
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