Preparing the healthcare workforce in South Africa for short-course rifampicin-resistant TB treatment: Inter-professional training and task-sharing considerations

Abstract Background: Treatment for rifampicin-resistant Mycobacterium tuberculosis (RR-TB) is complex, however, shorter treatment, with newer antimicrobials are improving treatment outcomes. The South African National Department of Health (NDoH) recently accelerated the rollout of 9-month, all oral, RR-TB short-course regimens. We sought to evaluate an inter-professional training program using pre-test and post-test performance of Professional Nurses (PNs), Advanced Practice Professional Nurses (APPNs) and Medical Officers (MOs) to inform: a) training needs across cadres; b) knowledge performance, by cadres; and c) training differences in knowledge by nurse type. Methods: A 4-day didactic and case-based clinical decision support course for RR-TB regimens in South Africa (SA) was developed, reviewed and nationally accredited. Between February 2017 and July 2018, 12 training events were held. Clinicians who may initiate RR-TB treatment, specifically MOs and PN/APPNs with matched pre-post tests and demographic surveys were analyzed. Descriptive statistics are provided. Pre-post test evaluations included 25 evidence-based clinically related questions about RR-TB diagnosis, treatment, and care. Results: Participants (N=842) participated in testing, and matched evaluations were received for 800 (95.0%) training participants. Demographic data was available for 793 (99.13%) participants, of whom 762 (96.1%) were MOs, or nurses, either PN or APPNs. Average correct response pre-test and post-test scores were 61.7% (range 7-24 correct responses) and 85.9% (range 12-25), respectively. Overall, 95.8% (730/762) of participants demonstrated improved knowledge. PNs improved on average 25% (6.22 points) whereas MOs improved 10% (2.89 points) with better mean test scores on both pre- and post-test (p<0.000). APPNs performed the same as the MOs on post-test scores (p=NS). Conclusions: The inter-professional training program in short-course RR-TB treatment improved knowledge for participants. MOs had significantly greater pre-test scores. Of the nurses, APPNs outperformed other PNs, and performed equally to MOs on post-test scores, suggesting this advanced cadre of nurses might be the most appropriate to initiate and monitor treatment in close collaboration with MOs. All cadres of nurse reported the need for additional clinical training and mentoring prior to managing such patients.

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Preparing the healthcare workforce in South Africa for short-course rifampicin-resistant TB treatment: Inter-professional training and task-sharing considerations

10.21203/rs.3.rs-36480/v1 ◽

2020 ◽

Author(s):

Paul D Stamper ◽

Khaya Mlandu ◽

Kelly Lowensen ◽

Keri Geiger ◽

Yen Nguyen ◽

...

Keyword(s):

South Africa ◽

Training Program ◽

Test Scores ◽

Clinical Training ◽

Professional Training ◽

Demographic Data ◽

Tb Treatment ◽

Short Course ◽

Post Test ◽

Professional Nurses

Abstract Background Treatment for rifampicin-resistant Mycobacterium tuberculosis (RR-TB) is complex, however, shorter treatment, with newer antimicrobials are improving treatment outcomes. The South African National Department of Health (NDoH) recently accelerated the rollout of 9-month, all oral, RR-TB short-course regimens. We sought to evaluate an inter-professional training program using pre-test and post-test performance of Professional Nurses (PNs), Advanced Practice Professional Nurses (APPNs) and Medical Officers (MOs) to inform: a) training needs across cadres; b) knowledge performance, by cadres; and c) training differences in knowledge by nurse type. Methods A 4-day didactic and case-based clinical decision support course for RR-TB regimens in South Africa (SA) was developed, reviewed and nationally accredited. Between February 2017 and July 2018, 12 training events were held. Clinicians who may initiate RR-TB treatment, specifically MOs and PN/APPNs with matched pre-post tests and demographic surveys were analyzed. Descriptive statistics are provided. Pre-post test evaluations included 25 evidence-based clinically related questions about RR-TB diagnosis, treatment, and care. Results Participants (N = 842) participated in testing, and matched evaluations were received for 800 (95.0%) training participants. Demographic data was available for 793 (99.13%) participants, of whom 762 (96.1%) were MOs, or nurses, either PN or APPNs. Average correct response pre-test and post-test scores were 61.7% (range 7–24 correct responses) and 85.9% (range 12–25), respectively. Overall, 95.8% (730/762) of participants demonstrated improved knowledge. PNs improved on average 25% (6.22 points) whereas MOs improved 10% (2.89 points) with better mean test scores on both pre- and post-test (p < 0.000). APPNs performed the same as the MOs on post-test scores (p = NS). Conclusions The inter-professional training program in short-course RR-TB treatment improved knowledge for participants. MOs had significantly greater pre-test scores. Of the nurses, APPNs outperformed other PNs, and performed equally to MOs on post-test scores, suggesting this advanced cadre of nurses might be the most appropriate to initiate and monitor treatment in close collaboration with MOs. All cadres of nurse reported the need for additional clinical training and mentoring prior to managing such patients.

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Preparing the healthcare workforce in South Africa for short-course rifampicin-resistant TB treatment: inter-professional training and task-sharing considerations

Human Resources for Health ◽

10.1186/s12960-020-00552-1 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Jason E. Farley ◽

Norbert Ndjeka ◽

Khaya Mlandu ◽

Kelly Lowensen ◽

Keri Geiger ◽

...

Keyword(s):

South Africa ◽

Training Program ◽

Test Scores ◽

Clinical Training ◽

Professional Training ◽

Demographic Data ◽

Tb Treatment ◽

Short Course ◽

Post Test ◽

Professional Nurses

Abstract Background Treatment for rifampicin-resistant Mycobacterium tuberculosis (RR-TB) is complex, however, shorter treatment, with newer antimicrobials are improving treatment outcomes. The South African National Department of Health (NDoH) recently accelerated the rollout of 9-month, all-oral, RR-TB short-course regimens. We sought to evaluate an inter-professional training program using pre-test and post-test performance of Professional Nurses (PNs), Advanced Practice Professional Nurses (APPNs) and Medical Officers (MOs) to inform: (a) training needs across cadres; (b) knowledge performance, by cadres; and (c) training differences in knowledge by nurse type. Methods A 4-day didactic and case-based clinical decision support course for RR-TB regimens in South Africa (SA) was developed, reviewed and nationally accredited. Between February 2017 and July 2018, 12 training events were held. Clinicians who may initiate RR-TB treatment, specifically MOs and PN/APPNs with matched pre–post tests and demographic surveys were analyzed. Descriptive statistics are provided. Pre–post test evaluations included 25 evidence-based clinically related questions about RR-TB diagnosis, treatment, and care. Results Participants (N = 842) participated in testing, and matched evaluations were received for 800 (95.0%) training participants. Demographic data were available for 793 (99.13%) participants, of whom 762 (96.1%) were MOs, or nurses, either PN or APPNs. Average correct response pre-test and post-test scores were 61.7% (range 7–24 correct responses) and 85.9% (range 12–25), respectively. Overall, 95.8% (730/762) of participants demonstrated improved knowledge. PNs improved on average 25% (6.22 points), whereas MOs improved 10% (2.89 points) with better mean test scores on both pre- and post-test (p < 0.000). APPNs performed the same as the MOs on post-test scores (p = NS). Conclusions The inter-professional training program in short-course RR-TB treatment improved knowledge for participants. MOs had significantly greater pre-test scores. Of the nurses, APPNs outperformed other PNs, and performed equally to MOs on post-test scores, suggesting this advanced cadre of nurses might be the most appropriate to initiate and monitor treatment in close collaboration with MOs. All cadres of nurse reported the need for additional clinical training and mentoring prior to managing such patients.

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Preparing the healthcare workforce in South Africa for short-course rifampicin-resistant TB treatment: Inter-professional training and task-sharing considerations

10.21203/rs.3.rs-36480/v2 ◽

2020 ◽

Author(s):

Jason E. Farley ◽

Norbert Ndjeka ◽

Khaya Mlandu ◽

Kelly Lowensen ◽

Keri Geiger ◽

...

Keyword(s):

South Africa ◽

Training Program ◽

Test Scores ◽

Clinical Training ◽

Professional Training ◽

Demographic Data ◽

Tb Treatment ◽

Short Course ◽

Post Test ◽

Professional Nurses

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The Impacts of a Face-to-Face Training in Combination with LINE Application and Professional Learning Communities on English Teacher Development

English Language Teaching ◽

10.5539/elt.v14n4p25 ◽

2021 ◽

Vol 14 (4) ◽

pp. 25

Author(s):

Areerug Mejang ◽

Wannaprapha Suksawas

Keyword(s):

Professional Learning Communities ◽

Learning Communities ◽

Training Program ◽

Professional Learning ◽

Test Scores ◽

Reading Skills ◽

English Teachers ◽

Teaching English ◽

English Reading ◽

Post Test

This study examines the impact of a teacher-training program on the development of teachers’ knowledge, skills, and attitudes towards English reading teaching. The training program was implemented in combination with the use of LINE (a message application) and the teachers’ participation in school-based professional learning communities. The framework supports the training of English teachers to teach students in accordance with the national core curriculum and its emphasis on reading skills. The participants of this study were 50 English teachers working in the central part of Thailand. Four research instruments were used to collect data: a 12-item pre-test and post-test on teaching English reading skills covering the content of the training, an open-ended form for recording emerging points from the implementation of the lesson plan and preparation of the video clip, a survey including 5-point Likert-scale options and an open-ended response field to assess teachers’ satisfaction with the training program, and an observation form of the teachers’ level of participation in the training program. The findings of this study revealed that participants had developed in three major areas: knowledge, skills, and attitude, and they indicated satisfaction with the training program in all areas. The participants’ post test scores was higher than the pre-test scores. With a statistical significance improvement (p=0.05). Participants demonstrated their skills in designing more creative lesson plans with suitable educational objectives. Finally, the participants reflected a positive attitude towards their participation in the PLC. The significance of this study is related to the theoretical and pedagogical implications of the knowledge, skills, and attitudes of teachers teaching English reading skills in an EFL context.

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Evaluation of Training Course on “Integrated Management of Neonatal & Childhood Illness” (IMNCI) Using Kirkpatrick Model at Level-2

Health Professions Educator Journal ◽

10.53708/hpej.v4i1.100 ◽

2021 ◽

Vol 4 (1) ◽

pp. 18-22

Author(s):

Muhammad Haroon Hamid ◽

Muhammad Faheem Afzal ◽

Saira Khan

Keyword(s):

Training Program ◽

Test Scores ◽

Integrated Management ◽

Pairwise Comparison ◽

Childhood Illness ◽

Childhood Mortality ◽

Median Score ◽

Post Test ◽

Kirkpatrick Model ◽

Level 2

Introduction: Integrated Management of Childhood Illness (IMNCI), taught by a 6-day training course, is an important initiative to decrease childhood mortality. Level 2 of the Kirkpatrick model entails the assessment of the learning achieved by training activity.Objective: To assess improvement in the knowledge of IMNCI content among the participants of the 6-day IMNCI training program.Methods: After taking approval from IRB, this one-group pre-test-post-test study was carried out in the Paediatrics Medicine Department, King Edward Medical University / Mayo Hospital Lahore over 3 months. By non-probability consecutive sampling, all 77 participants of three 6-day courses (with no previous formal training of IMNCI) were included in the study. To assess any improvement in the knowledge (Kirkpatrick Model Level 2), each participant filled a pre-test and a similar post-test after the training.Data was analyzed by SPSS software. As the data was not normally distributed, the Wilcoxon test was applied to compare the overall median scores of pre-test and post-test. Kruskal-Wallis Test was applied for the comparison of the median scores of pre-test and post-test scores of each professional group. While Mann-Whitney U-test was applied for pairwise comparison of the pre-test and post-test scores between different pairs of professional groups.Results: Of the 77 participants, there were 35 doctors, 20 nurses, 20 Lady Health Visitors, and 2 midwives. The overall median score was 3 (IQR 3) of the pre-test and 8 (IQR 2) for the post-test (p-value < 0.001). Except for the midwives, there was a statistically significant improvement in the median score of each group. Item-analysis of the questions showed that compared to the pre-test, the proportion of correct answers in the post-test showed statistically significant improvement for all the 10 questions. Pairwise comparison of the median pre-test and post-test scores between different professional groups did not show statistical significance except for the doctor-nurse pair.Conclusion: IMNCI training program significantly increased the knowledge of health care providers with no statistical difference between the post-test scores of doctors, LHVs, and midwives. KEYWORDS: IMNCI, Training program, Kirkpatrick Model, Childhood mortality, Knowledge evaluation

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Preventing Suicide and Depression: A Training Program for Long-Term Care Staff

OMEGA - Journal of Death and Dying ◽

10.2190/73tm-4x4w-rg2p-yhew ◽

2001 ◽

Vol 42 (1) ◽

pp. 55-69 ◽

Cited By ~ 12

Author(s):

Bonnie L. Walker ◽

Nancy J. Osgood

Keyword(s):

Training Program ◽

Test Scores ◽

Long Term Care ◽

The Elderly ◽

Care Staff ◽

Term Care ◽

Attitudes And Practices ◽

Care Facilities ◽

Post Test

Approximately 5 percent of those sixty-five and older live in long-term care facilities (1.5 million). Neither suicide and depression among the elderly who reside in long-term care facilities nor prevention techniques are well-understood by staff. This article discusses the development of a curriculum designed to train long-term care staff in preventing suicide among the elderly and the results of a pilot test of a training program based on that curriculum. The participants ( N=43) significantly improved their scores from pre- to post-test on the knowledge, attitudes, and practices subtests. The knowledge areas in which staff performed the most poorly at pre-test were related to identifying appropriate primary and secondary interventions, the relationship between dementia and suicide, methods of self-destruction used by the elderly, and understanding of depression in the elderly. There was a significant relationship between pre-test and post-test scores on all subtests. Staff with higher levels of education had significantly higher pre- and post-test scores on the knowledge and attitudes subtests. More experienced staff had significantly higher post-test scores on the practices subtest. A large majority of the participants had highly positive attitudes toward the program and thought the program had been very useful or useful to them as caregivers. The study demonstrated the need for staff training related to suicide prevention in long-term care as well as the usefulness of even a brief training.

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Improving the pipeline for pathologists in Botswana

American Journal of Clinical Pathology ◽

10.1093/ajcp/aqab191.249 ◽

2021 ◽

Vol 156 (Supplement_1) ◽

pp. S116-S117

Author(s):

L Kyokunda ◽

S Souda ◽

R Obeng

Keyword(s):

South Africa ◽

Training Program ◽

Clinical Training ◽

Core Competencies ◽

The United States ◽

Fellowship Training ◽

Substantial Improvement ◽

Clinical Diagnostics ◽

Sub Saharan Africa ◽

Effect Change

Abstract Introduction/Objective In the United States, there are approximately 39 pathologists per one million people. In contrast, there is only one pathologist per one million people in sub-Saharan Africa. This shortage of the pathologist workforce significantly impacts the quality of pathology and laboratory services that can be provided in Botswana. Methods/Case Report Root cause and SWOT analyses consisting of the major stakeholders including government officials and key leadership figures from the training university and national referral laboratories were conducted to identify areas within the training pipeline that can be improved. The educational structure, core competencies, clinical exposure and hands-on training, as well as retention and additional faculty were some of the areas in the pipeline identified for improvement. Results (if a Case Study enter NA) NA Conclusion The collaborative training program between Botswana and South Africa were strengthened and additional clinical training sites were incorporated into the training program. The core competencies required of residents were reviewed and additional resources were provided to current residents. The collaboration between Botswana and South Africa for residency and fellowship training was strengthened to include active participation of the head of Pathology at the University of Botswana on the educational curriculum committee. These implemented changes led to the successful advancement of four anatomic pathology residents from the didactic phase to the practical phase of their training. Furthermore, two pathologists were hired to support clinical diagnostics and the education of the pathology residents. In conclusion, a structured review of the educational pipeline and resources that included stakeholders that could effect change led to substantial improvement in the training program and workforce of pathologists in Botswana.

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Impact of training program regarding first aid knowledge and practices among preparatory schools' teachers at Assiut City

Journal of Nursing Education and Practice ◽

10.5430/jnep.v7n12p89 ◽

2017 ◽

Vol 7 (12) ◽

pp. 89 ◽

Cited By ~ 4

Author(s):

Neama Mohamed El magrabi ◽

Shimaa ElwardanyAly ◽

Shaimaa Abdel-Rahim Khalaf Khalaf

Keyword(s):

Training Program ◽

School Environment ◽

Demographic Data ◽

First Aid ◽

P Value ◽

Traumatic Injuries ◽

Preparatory Schools ◽

Post Test ◽

Quasi Experimental ◽

The Impact

Teachers and children spend considerable time together within the school environment. Schools are places where one can find a noticeable risk of traumatic injuries. The study aimed to evaluate the impact of training program regarding first aid knowledge and practices among preparatory schools' teachers. Subjects and methods: Quasi-experimental study with one group pre/post test research design was used. Multistage random sample used to select the five preparatory schools and the participated teachers which included 150 teachers. A structured self-administered questionnaire included two tools: Tool I: Part I: Demographic data. Part II: Assessment of knowledge about first aid and Tool II included observational checklist about first aid. The findings of the study revealed that Mean ± SD of teachers' age were 38.78 ± 8.83, 26.7% of the teacher attended training program about first aid, there was statistical significant differences between total score of teachers' knowledge (p-value = .000) in pre and immediate post-test. There was statistical significant differences between the performance level of preparatory schools teachers (p-value = .000*). The study concluded that: there was improvement of teachers’ knowledge and practices regarding first aid after implementation of the training program. The study recommended that: Continuous educational and training programs for teachers and public as a whole about first aid.

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Program Pelatihan Motivasi Usaha, Sumber Modal Usaha dan Penyusunan Laporan Keuangan bagi Penyandang Disabilitas di Wilayah Kecamatan Sukajadi Kota Bandung

Indonesian Journal for Social Responsibility ◽

10.36782/ijsr.v3i1.83 ◽

2021 ◽

Vol 3 (1) ◽

pp. 47-64

Author(s):

Dudi Rudianto ◽

◽

Monica Weni Pratiwi ◽

Siti Zubaidah Chaidir ◽

Nurusyifa Nurusyifa

Keyword(s):

Training Program ◽

Test Scores ◽

People With Disabilities ◽

Financial Statement ◽

Financial Reports ◽

Persons With Disabilities ◽

Business Plans ◽

Training Materials ◽

Post Test ◽

People With Physical Disabilities

Handling for persons with disabilities requires assistance and broad community participation so that they can live independently and feel “normal” among other members of the community. These efforts are carried out through business motivation training programs, business plans, sources of business capital and preparation of financial reports facilitated by the Bakrie University Community Service Institute (LPkM) for people with disabilities in the Sukajadi District, Bandung City. The training program was carried out offline for 2 days from 15-16 March 2021 at the Sukajadi District Hall, Bandung City. The participants who attended the training were 18 people with disabilities, consisting of 9 people with physical disabilities, 7 people who were blind and 2 people who were deaf. The training materials consist of business motivation, business plans, sources of venture capital and the preparation of simple financial reports. After participating in this training program, all participants feel the benefits obtained, this result is shown by the post-test scores which are higher than the pre-test scores for all training materials, each increasing 40% for business motivation materials, 30% for planning materials business, 60% for business capital sources and 40% for financial statement preparation materials. Likewise, the participants' increased desire to receive follow-up from the training program in the form of mentoring to become real entrepreneurs. This desire is shown by video testimonials from participant representatives and the active participation of participants in the WhatsApp Group whose members are fellow trainees and all resource persons, as a means of discussion and information. One of the results of the implementation of this training activity, one of the training participants joined the MSME convection business to take part in the exhibition held at the Bandung Trade Mall.

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Utility of a Brief Self-Efficacy Scale in Clinical Training Program Evaluation

Evaluation & the Health Professions ◽

10.1177/016327870002300204 ◽

2000 ◽

Vol 23 (2) ◽

pp. 182-193 ◽

Cited By ~ 18

Author(s):

Rodney Lorenz ◽

Rebecca P. Gregory ◽

Dianne L. Davis

Keyword(s):

Program Evaluation ◽

Training Program ◽

Self Efficacy ◽

Clinical Training ◽

Practice Change ◽

Training Program Evaluation ◽

Post Test ◽

Training Post ◽

Skill Mastery ◽

Clinical Training Program

Self-efficacy is often studied as a predictor of professional practice behaviors or as an outcome of clinical training, using brief scales with little validation. This study examines the utility of a brief self-efficacy scale in the evaluation of a clinical training program. Subjects were 119 registered dietitians who participated in diabetes training. Hypothesized relationships between self-efficacy ratings and indices of skill mastery, participation in training, and subsequent practice change were examined. Self-efficacy ratings after training correlated significantly with relevant prior experience (r = .4 and .29, p < .01) but not total experience and with knowledge post-test score (r = .21, p < .02). Self-efficacy for all 12 program objectives increased significantly after training. Post-training self-efficacy for two program objectives correlated significantly with self-reported successful practice changes related to those objectives (r = .4, p < .04 and r = .51, p < .01). The data suggest that brief self-efficacy assessments can contribute meaningfully to clinical training program evaluation.

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