Measuring the Impact of onsite mentorship on midlevel practitioners HIV and TB Ca

摘要 需要解决有效的培训解决方案，以确保高能力的卫生保健工作者 在将任务转移到非医生从业者的背景下对能力建设的巨大需求 (MLP)艾滋病毒和相关机会性感染的管理。这件事中的合作伙伴 拟议的研究之前实施了现场干预的大规模评估 支持部分包括为期9个月的每月1-2小时的个人临床指导。 这种方法似乎没有对个人能力产生预期的影响，但它是 假设临床指导剂量可能不够。这项研究将建立 根据之前的工作，确定延长现场临床使用时间的有效性 导师制以提高临床医生和护理人员在预防方面的临床能力； 在乌干达的八个以农村为基础的四级保健设施中护理和治疗艾滋病毒/艾滋病和结核病。 四个干预点将与四个控制点相匹配。每个干预点都将收到 一个由一名临床医生组成的指导团队每六周访问一次，为期九个月 一名警官、一名实验室专家和一名区卫生护士。导师们将提供8小时的 在访问期间，重点对每个站点的MLP进行一对一的指导，教授 MLP认为乌干达的结核病和艾滋病毒/艾滋病指南和护理和指导标准 病人。研究的主要结果，将使用书面案例方案和 观察干预开始、干预结束和6个月后的临床技能评估 干预。与预期的艾滋病毒、结核病和结核病护理标准相比，业绩/做法有所改善 在整个项目实施过程中，将持续监控其他相关的OIS 期间采用改进型和计算机化的卫生部管理信息数据采集 工具。这项研究的结果将指导临床剂量水平的决策 需要指导才能对中层提供者的能力产生重大影响。

Abstract Effective training solutions for ensuring highly competent health care workers are needed to address the vast need for capacity building in the context of task shifting to non physician practitioners (MLPs) of the management of HIV and related opportunistic infections. The partners in this proposed study previously implemented a large scale evaluation of an intervention with an on site support component including 1-2 hours of individual clinical mentorship monthly for nine months. That approach did not appear to achieve the expected impact on individual competencies and it is hypothesized that the clinical mentorship dosage may have been inadequate. This study will build upon the previous work to determine the effectiveness of using prolonged hours of on-site clinical mentorship to improve clinical competencies of clinical officers and nursing officers in prevention, care and treatment of HIV/AIDS and TB at eight rural based level IV health facilities in Uganda. Four intervention sites will be matched with four control sites. Each intervention site will receive week long visits every six weeks for nine months from a mentorship team composed of one clinical officer, a laboratory specialist and a district health nurse. The mentors will provide 8-hours of focused one to one mentorship to each of the sites' MLP during the visit, teaching core principles of Uganda's TB and HIV/AIDS guidelines and standards of care and coaching as the MLP sees patients. Key outcomes of the study which will be measured using written case scenarios and observed clinical skills assessments at the start, end of intervention, and six months post intervention. Improved performance/practice against expected standards of care for HIV, TB and other related OIs will be monitored on continuous basis throughout the project implementation period using modified and computerized Ministry of Health management information data collection tools. The results from the study will guide decision making about the dosage levels of clinical mentorship required to make a significant impact on midlevel provider's competencies.