Analysis of an obstetrics point-of-care ultrasound training program for healthcare practitioners in Zanzibar, Tanzania.

Autor: Hall EA; Department of Emergency Medicine, Providence St. John's Health Center, 2121 Santa Monica Blvd, Santa Monica, CA, 90404, USA. Elizabeth.Hall1@gmail.com.; Point-of-Care Ultrasound in Resource-Limited Environments (PURE), Malvern, PA, USA. Elizabeth.Hall1@gmail.com., Matilsky D; Point-of-Care Ultrasound in Resource-Limited Environments (PURE), Malvern, PA, USA.; Department of Emergency Medicine, Howard County General Hospital, John Hopkins University, Baltimore, MD, USA., Zang R; Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA, USA., Hase N; Obstetrics & Gynecology, Wayne State University, Detroit, MI, USA., Habibu Ali A; Chake Chake Hospital, Pemba, Zanzibar, Tanzania., Henwood PC; Point-of-Care Ultrasound in Resource-Limited Environments (PURE), Malvern, PA, USA.; Department of Emergency Medicine, Thomas Jefferson University Hospital, Philadelphia, PA, USA., Dean AJ; Point-of-Care Ultrasound in Resource-Limited Environments (PURE), Malvern, PA, USA.; Emergency Medicine and Emergency Medicine in Radiology, University of Pennsylvania, Philadelphia, PA, USA.; World Interactive Network for Focused Ultrasound (WINFOCUS), Philadelphia, PA, USA.
Jazyk: angličtina
Zdroj: The ultrasound journal [Ultrasound J] 2021 Apr 08; Vol. 13 (1), pp. 18. Date of Electronic Publication: 2021 Apr 08.
DOI: 10.1186/s13089-021-00220-y
Abstrakt: Background: A point-of-care ultrasound education program in obstetrics was developed to train antenatal healthcare practitioners in rural Zanzibar. The study group consisted of 13 practitioners with different training backgrounds: physicians, clinical officers, and nurse/midwives. Trainees received an intensive 2-week antenatal ultrasound course consisting of lectures and hands-on practice followed by 6 months of direct supervision of hands-on scanning and bedside education in their clinical practice environments. Trainees were given a pre-course written exam, a final exam at course completion, and practical exams at 19 and 27 weeks. Trainees were expected to complete written documentation and record ultrasound images of at least 75 proctored ultrasounds. The objective of this study was prospectively to analyze the success of a longitudinal point-of-care ultrasound training program for antepartum obstetrical care providers in Zanzibar.
Results: During the 6-month course, trainees completed 1338 ultrasound exams (average 99 exams per trainee with a range of 42-128 and median of 109). Written exam scores improved from a mean of 33.7% (95% CI 28.6-38.8%) at pre-course assessment to 77.5% (95% CI 71-84%) at course completion (P < 0.0001). Practical exam mean scores improved from 71.2% at course midpoint (95% CI 62.3-80.1%) to 84.7% at course completion (95% Cl 78.5-90.8%) (P < 0.0005). Eight of the 13 trainees completed all training requirements including 75 proctored ultrasound exams.
Conclusion: Trainees improved significantly on all measures after the training program. 62% of the participants completed all requirements. This relatively low completion rate reflects the challenges of establishing ultrasound capacity in this type of setting. Further study is needed to determine trainees' long-term retention of ultrasound skills and the impact of the program on clinical practice and health outcomes.
Databáze: MEDLINE
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