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A process evaluation of PRONTO simulation training for obstetric and neonatal emergency response teams in Guatemala
BACKGROUND: Despite expanding access to institutional birth in Guatemala, maternal mortality remains largely unchanged over the last ten years. Enhancing the quality of emergency obstetric and neonatal care is one important strategy to decrease mortality. An innovative, low-tech, simulation-based te...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4513701/ https://www.ncbi.nlm.nih.gov/pubmed/26206373 http://dx.doi.org/10.1186/s12909-015-0401-7 |
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author | Walker, Dilys M. Holme, Francesca Zelek, Sarah T. Olvera-García, Marisela Montoya-Rodríguez, Airaín Fritz, Jimena Fahey, Jenifer Lamadrid-Figueroa, Héctor Cohen, Susanna Kestler, Edgar |
author_facet | Walker, Dilys M. Holme, Francesca Zelek, Sarah T. Olvera-García, Marisela Montoya-Rodríguez, Airaín Fritz, Jimena Fahey, Jenifer Lamadrid-Figueroa, Héctor Cohen, Susanna Kestler, Edgar |
author_sort | Walker, Dilys M. |
collection | PubMed |
description | BACKGROUND: Despite expanding access to institutional birth in Guatemala, maternal mortality remains largely unchanged over the last ten years. Enhancing the quality of emergency obstetric and neonatal care is one important strategy to decrease mortality. An innovative, low-tech, simulation-based team training program (PRONTO) aims to optimize care provided during obstetric and neonatal emergencies in low-resource settings. METHODS: We conducted PRONTO simulation training between July 2012 and December 2012 in 15 clinics in Alta Verapaz, Huehuetenango, San Marcos, and Quiche, Guatemala. These clinics received PRONTO as part of a larger pair-matched cluster randomized trial of a comprehensive intervention package. Training participants were obstetric and neonatal care providers that completed pre- and post- training assessments for the two PRONTO training modules, which evaluated knowledge of evidence-based practice and self-efficacy in obstetric and neonatal topics. Part of the training included a session for trained teams to establish strategic goals to improve clinical practice. We utilized a pre/post-test design to evaluate the impact of the course on both knowledge and self-efficacy with longitudinal fixed effects linear regression with robust standard errors. Pearson correlation coefficients were used to assess the correlation between knowledge and self-efficacy. Poisson regression was used to assess the association between the number of goals achieved and knowledge, self-efficacy, and identified facility-level factors. RESULTS: Knowledge and self-efficacy scores improved significantly in all areas of teaching. Scores were correlated for all topics overall at training completion. More than 60 % of goals set to improve clinic functioning and emergency care were achieved. No predictors of goal achievement were identified. CONCLUSIONS: PRONTO training is effective at improving provider knowledge and self-efficacy in training areas. Further research is needed to evaluate the impact of the training on provider use of evidence-based practices and on maternal and neonatal health outcomes. TRIAL REGISTRATION: NCT01653626 |
format | Online Article Text |
id | pubmed-4513701 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-45137012015-07-25 A process evaluation of PRONTO simulation training for obstetric and neonatal emergency response teams in Guatemala Walker, Dilys M. Holme, Francesca Zelek, Sarah T. Olvera-García, Marisela Montoya-Rodríguez, Airaín Fritz, Jimena Fahey, Jenifer Lamadrid-Figueroa, Héctor Cohen, Susanna Kestler, Edgar BMC Med Educ Research Article BACKGROUND: Despite expanding access to institutional birth in Guatemala, maternal mortality remains largely unchanged over the last ten years. Enhancing the quality of emergency obstetric and neonatal care is one important strategy to decrease mortality. An innovative, low-tech, simulation-based team training program (PRONTO) aims to optimize care provided during obstetric and neonatal emergencies in low-resource settings. METHODS: We conducted PRONTO simulation training between July 2012 and December 2012 in 15 clinics in Alta Verapaz, Huehuetenango, San Marcos, and Quiche, Guatemala. These clinics received PRONTO as part of a larger pair-matched cluster randomized trial of a comprehensive intervention package. Training participants were obstetric and neonatal care providers that completed pre- and post- training assessments for the two PRONTO training modules, which evaluated knowledge of evidence-based practice and self-efficacy in obstetric and neonatal topics. Part of the training included a session for trained teams to establish strategic goals to improve clinical practice. We utilized a pre/post-test design to evaluate the impact of the course on both knowledge and self-efficacy with longitudinal fixed effects linear regression with robust standard errors. Pearson correlation coefficients were used to assess the correlation between knowledge and self-efficacy. Poisson regression was used to assess the association between the number of goals achieved and knowledge, self-efficacy, and identified facility-level factors. RESULTS: Knowledge and self-efficacy scores improved significantly in all areas of teaching. Scores were correlated for all topics overall at training completion. More than 60 % of goals set to improve clinic functioning and emergency care were achieved. No predictors of goal achievement were identified. CONCLUSIONS: PRONTO training is effective at improving provider knowledge and self-efficacy in training areas. Further research is needed to evaluate the impact of the training on provider use of evidence-based practices and on maternal and neonatal health outcomes. TRIAL REGISTRATION: NCT01653626 BioMed Central 2015-07-24 /pmc/articles/PMC4513701/ /pubmed/26206373 http://dx.doi.org/10.1186/s12909-015-0401-7 Text en © Walker et al. 2015 This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Walker, Dilys M. Holme, Francesca Zelek, Sarah T. Olvera-García, Marisela Montoya-Rodríguez, Airaín Fritz, Jimena Fahey, Jenifer Lamadrid-Figueroa, Héctor Cohen, Susanna Kestler, Edgar A process evaluation of PRONTO simulation training for obstetric and neonatal emergency response teams in Guatemala |
title | A process evaluation of PRONTO simulation training for obstetric and neonatal emergency response teams in Guatemala |
title_full | A process evaluation of PRONTO simulation training for obstetric and neonatal emergency response teams in Guatemala |
title_fullStr | A process evaluation of PRONTO simulation training for obstetric and neonatal emergency response teams in Guatemala |
title_full_unstemmed | A process evaluation of PRONTO simulation training for obstetric and neonatal emergency response teams in Guatemala |
title_short | A process evaluation of PRONTO simulation training for obstetric and neonatal emergency response teams in Guatemala |
title_sort | process evaluation of pronto simulation training for obstetric and neonatal emergency response teams in guatemala |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4513701/ https://www.ncbi.nlm.nih.gov/pubmed/26206373 http://dx.doi.org/10.1186/s12909-015-0401-7 |
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