|Carol C. Chen, MD, MPH|
|Alexander L. Werne, MD|
|Katharine A. Osborn, MD|
|Holly Vo, MD, MPH, MSc|
|Upendo George, MD|
|Hendry Sawe, MD|
|Andrea G. Tenner, MD, MPH|
West J Emerg Med. 2020 January;21(1):130–140.
Effectiveness of a Pediatric Emergency Medicine Curriculum in a Public Tanzanian Referral Hospital
Chen CC, Werne AL, Osborn KA, Vo H, George U, Sawe H, Addo N, Tenner A
West J Emerg Med. 2020 March;21(2):469. Author name misspellled. The last author, originally published as Andrea T. Cruz, is revised to Andrea G. Tenner, MD, MPH.
Introduction: The World Health Organization recently recognized the importance of emergency and trauma care in reducing morbidity and mortality. Training programs are essential to improving emergency care in low-resource settings; however, a paucity of comprehensive curricula focusing specifically on pediatric emergency medicine (PEM) currently exists. The African Federation for Emergency Medicine (AFEM) developed a PEM curriculum that was pilot-tested in a non-randomized, controlled study to evaluate its effectiveness in nurses working in a public Tanzanian referral hospital.
Methods: Fifteen nurses were recruited to participate in a two-and-a-half-day curriculum of lectures, skill sessions, and simulation scenarios covering nine topics; they were matched with controls. Both groups completed pre- and post-training assessments of their knowledge (multiple-choice test), self-efficacy (Likert surveys), and behavior. Changes in behavior were assessed using a binary checklist of critical actions during observations of live pediatric resuscitations.
Results: Participant-rated pre-training self-efficacy and knowledge test scores were similar in both control and intervention groups. However, post-training, self-efficacy ratings in the intervention group increased by a median of 11.5 points (interquartile range [IQR]: 6–16) while unchanged in the control group. Knowledge test scores also increased by a median of three points (IQR: 0–4) in the nurses who received the training while the control group’s results did not differ in the two periods. A total of 1192 pediatric resuscitation cases were observed post-training, with the intervention group demonstrating higher rates of performance of three of 27 critical actions.
Conclusion: This pilot study of the AFEM PEM curriculum for nurses has shown it to be an effective tool in knowledge acquisition and improved self-efficacy of pediatric emergencies. Further evaluation will be needed to assess whether it is currently effective in changing nurse behavior and patient outcomes or whether curricular modifications are needed.
PMCID: PMC6948709 [PubMed – indexed for MEDLINE]
Full text available through open access at http://escholarship.org/uc/uciem_westjem