Training in Ultrasound to Determine Gestational Age (TUDA): Evaluation of a Novel Education Package to Teach Ultrasound-Naive Midwives Basic Obstetric Ultrasound in Malawi.
Training in Ultrasound to Determine Gestational Age (TUDA): Evaluation of a Novel Education Package to Teach Ultrasound-Naive Midwives Basic Obstetric Ultrasound in Malawi.
复制标题
DOI：
10.3389/fgwh.2022.880615
复制
发表时间：
2022
影响因子：
--
通讯作者：
Gadama, Luis
中科院分区：
文献类型：
--
作者：
Viner, Alexandra C. C.;Membe-Gadama, Gladys;Whyte, Sonia;Kayambo, Doris;Masamba, Martha;Makwakwa, Enita;Lissauer, David;Stock, Sarah J.;Norman, Jane E. E.;Reynolds, Rebecca M. M.;Magowan, Brian;Freyne, Bridget;Gadama, Luis
虽然超声波检查以确定胎龄是最佳妊娠管理的基础，并且世界卫生组织建议所有妇女使用，但在低收入国家，受过培训的从业人员稀缺，许多妇女仍然无法使用。本研究的目的是评估一种新颖的，特定于上下文的教育包，教导助产士基本产科超声，包括通过测量胎儿股骨长度来确定胎龄。该研究于2021年1月在马拉维的六个地点进行。在虚拟“培训员培训”之后，当地小组提供了一个为期10天的方案，包括教学和“动手”两部分。匹配的课程前和课程后测试评估参与者的关键概念的知识，与客观结构化临床考试用于评估实践技能。为了获得通过，要求受训者将胎龄确定为有经验的从业者的±7天内，并连续五次获得>65%的总分。一个匹配的课程前后调查探讨了参与者的态度和信心进行超声检查。在参加培训的29名助产士中，有28名完成了培训并达到了规定的及格标准。22名助产士完成了知识匹配测试，平均分（SD）由培训前的10.2分（3.3分）提高到培训后的18分（2.5分）（P <0.0001）。平均差异7.9，95% CI 6.5-9.2。助产士通过了87%的观察结构化临床检查，在89%的评估中，将胎龄确定为有经验的从业者±7天内。关于产前超声检查重要性的信念在课程结束后增加（p = 0.02），进行超声检查的信心也增加（p <0.0001）。这项研究表明，不仅可以教超声天真的从业者进行基本的产科超声约会扫描，自信和胜任，经过10天的培训，但也可以定位当地团队，以成功地提供虚拟程序。以前的超声波培训计划，虽然往往在他们的教学大纲更全面，已经相当长的时间，这可能是一个障碍，升级的机会。我们建议，这种有重点的培训可以增加可持续和可持续执行的潜力。
Although ultrasound to determine gestational age is fundamental to the optimum management of pregnancy and is recommended for all women by the World Health Organisation, it remains unavailable to many women in low-income countries where trained practitioners are scarce. This study aimed to evaluate a novel, context-specific education package to teach midwives basic obstetric ultrasound, including the determination of gestational age by measurement of fetal femur length. The study was conducted across six sites in Malawi in January 2021. Following a virtual “training of the trainers”, local teams delivered a 10-day programme encompassing both didactic and “hands on” components. Matched pre and post course tests assessed participants' knowledge of key concepts, with Objective Structured Clinical Examinations used to evaluate practical skills. To achieve a pass, trainees were required to establish the gestational age to within ±7 days of an experienced practitioner and achieve an overall score of >65% on five consecutive occasions. A matched pre and post course survey explored participants' attitudes and confidence in performing ultrasound examinations. Of the 29 midwives who participated, 28 finished the programme and met the criteria specified to pass. 22 midwives completed the matched knowledge tests, with the mean (SD) score increasing from 10.2 (3.3) to 18 (2.5) after training (P <0.0001). Mean difference 7.9, 95% CI 6.5–9.2. Midwives passed 87% of the Observed Structured Clinical Examinations, establishing the gestational age to within ±7 days of an experienced practitioner in 89% of assessments. Beliefs regarding the importance of antenatal ultrasound increased post course (p = 0.02), as did confidence in performing ultrasound examinations (p <0.0001). This study demonstrates not only that ultrasound-naive practitioners can be taught to perform basic obstetric ultrasound dating scans, confidently and competently, after 10 days of training, but also that local teams can be orientated to successfully deliver the programme virtually. Previous ultrasound training initiatives, while often more comprehensive in their syllabus, have been of considerably longer duration and this is likely to be a barrier to upscaling opportunities. We propose that this focused training increases the potential for widescale and sustainable implementation.
登录
查看更多内容
影响因子：
1.3
作者：
Nathan R;Swanson JO;Marks W;Goldsmith N;Vance C;Sserwanga NB;Swanson D;McClure EM;Franklin H;Mirza W;Mwenechanya M;Muyodi D;Figuero L;Bolamba VL;Goldenberg RL;Pineda IS
通讯作者：
Pineda IS
影响因子：
7.1
作者：
Neufeld, L. M.;Wagatsuma, Y.;Frongillo, E. A.
通讯作者：
Frongillo, E. A.
影响因子：
7.1
作者：
Rijken, M. J.;Lee, S. J.;Boel, M. E.;Papageorghiou, A. T.;Visser, G. H. A.;Dwell, S. L. M.;Kennedy, S. H.;Singhasivanon, P.;White, N. J.;Nosten, F.;McGready, R.
通讯作者：
McGready, R.
影响因子：
7.2
作者：
Ritchie, Lisa M. Puchalski;Khan, Sobia;Straus, Sharon E.
通讯作者：
Straus, Sharon E.
影响因子：
3.6
作者：
Kim J;Shakya PR;Choi S;Park JS;Tamrakar SR;Heo J;Kim WH
通讯作者：
Kim WH