A tool to improve competence in the management of emergency patients by rural clinic health workers: a pilot assessment on the Thai-Myanmar border.
BACKGROUND: Shoklo Malaria Research Unit has been providing health care in remote clinics on the Thai-Myanmar border to refugee and migrant populations since 1986 and 1995, respectively. Clinics are staffed by local health workers with a variety of training and experience. The need for a tool to...
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th-mahidol.8082023-03-30T17:05:55Z A tool to improve competence in the management of emergency patients by rural clinic health workers: a pilot assessment on the Thai-Myanmar border. Stanley, Lilian Min, Thaw Htwe Than, Hla Hla Stolbrink, Marie McGregor, Kathryn Chu, Cindy Nosten, François H McGready, Rose Stanley, Lilian Mahidol University. Faculty of Tropical Medicine. Shoklo Malaria Research Unit (SMRU), Mahidol-Oxford Tropical Medicine Research Unit Mahidol University. Faculty of Tropical Medicine. Mahidol-Oxford Tropical Medicine Research Unit (MORU) Confidence Knowledge Low resource setting Medical emergencies Paramedical staff Training Open Access article BACKGROUND: Shoklo Malaria Research Unit has been providing health care in remote clinics on the Thai-Myanmar border to refugee and migrant populations since 1986 and 1995, respectively. Clinics are staffed by local health workers with a variety of training and experience. The need for a tool to improve the competence of local health workers in basic emergency assessment and management was recognised by medical faculty after observing the case mix seen at the clinic and reviewing the teaching programme that had been delivered in the past year (Jan-13 to March-14). AIMS: To pilot the development and evaluation of a simple teaching tool to improve competence in the assessment and management of acutely unwell patients by local health workers that can be delivered onsite with minimal resources. METHODS: A structured approach to common emergencies presenting to rural clinics and utilizing equipment available in the clinics was developed. A prospective repeated-measures observed structured clinical examination (OSCE) assessment design was used to score participants in their competence to assess and manage a scenario based 'emergency patient' at baseline, immediately post-course, and 8 weeks after the delivery of the teaching course. The assessment was conducted at 3 clinic sites and staff participation was voluntary. Participants filled out questionnaires on their confidence with different scenario based emergency patients. RESULTS: All staff who underwent the baseline assessment failed to carry out the essential steps in initial emergency assessment and management of an unconscious patient scenario. Following delivery of the teaching session, all groups showed improved competence in both objective assessment and subjective confidence levels. CONCLUSIONS: Structured and practical teaching and learning with minimal theory in this resource limited setting had a positive short-term effect on the competence of individual staff to carry out an initial assessment and manage an acutely unwell patient. Health-worker confidence likewise improved. Workplace assessments are needed to determine if this type of skills training impacts upon mortality or near miss mortality patients at the clinic. 2015-05-27T04:25:42Z 2016-10-10T09:06:41Z 2015-05-27T04:25:42Z 2016-10-10T09:06:41Z 2015 2015-05-19 2015-04-13 Article Stanley L, Min TH, Than HH, Stolbrink M, McGregor K, Chu C, et al. A tool to improve competence in the management of emergency patients by rural clinic health workers: a pilot assessment on the Thai-Myanmar border. Confl Health. 2015 Apr 13;9:11. 10.1186/s13031-015-0041-x 1752-1505 (electronic) https://repository.li.mahidol.ac.th/handle/123456789/808 eng Mahidol University BioMed Central application/pdf |
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Confidence Knowledge Low resource setting Medical emergencies Paramedical staff Training Open Access article Stanley, Lilian Min, Thaw Htwe Than, Hla Hla Stolbrink, Marie McGregor, Kathryn Chu, Cindy Nosten, François H McGready, Rose A tool to improve competence in the management of emergency patients by rural clinic health workers: a pilot assessment on the Thai-Myanmar border. |
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BACKGROUND: Shoklo Malaria Research Unit has been providing health care in remote
clinics on the Thai-Myanmar border to refugee and migrant populations since 1986
and 1995, respectively. Clinics are staffed by local health workers with a
variety of training and experience. The need for a tool to improve the competence
of local health workers in basic emergency assessment and management was
recognised by medical faculty after observing the case mix seen at the clinic and
reviewing the teaching programme that had been delivered in the past year (Jan-13
to March-14).
AIMS: To pilot the development and evaluation of a simple teaching tool to
improve competence in the assessment and management of acutely unwell patients by
local health workers that can be delivered onsite with minimal resources.
METHODS: A structured approach to common emergencies presenting to rural clinics
and utilizing equipment available in the clinics was developed. A prospective
repeated-measures observed structured clinical examination (OSCE) assessment
design was used to score participants in their competence to assess and manage a
scenario based 'emergency patient' at baseline, immediately post-course, and
8 weeks after the delivery of the teaching course. The assessment was conducted
at 3 clinic sites and staff participation was voluntary. Participants filled out
questionnaires on their confidence with different scenario based emergency
patients.
RESULTS: All staff who underwent the baseline assessment failed to carry out the
essential steps in initial emergency assessment and management of an unconscious
patient scenario. Following delivery of the teaching session, all groups showed
improved competence in both objective assessment and subjective confidence
levels.
CONCLUSIONS: Structured and practical teaching and learning with minimal theory
in this resource limited setting had a positive short-term effect on the
competence of individual staff to carry out an initial assessment and manage an
acutely unwell patient. Health-worker confidence likewise improved. Workplace
assessments are needed to determine if this type of skills training impacts upon
mortality or near miss mortality patients at the clinic. |
author2 |
Stanley, Lilian |
author_facet |
Stanley, Lilian Stanley, Lilian Min, Thaw Htwe Than, Hla Hla Stolbrink, Marie McGregor, Kathryn Chu, Cindy Nosten, François H McGready, Rose |
format |
Article |
author |
Stanley, Lilian Min, Thaw Htwe Than, Hla Hla Stolbrink, Marie McGregor, Kathryn Chu, Cindy Nosten, François H McGready, Rose |
author_sort |
Stanley, Lilian |
title |
A tool to improve competence in the management of emergency patients by rural clinic health workers: a pilot assessment on the Thai-Myanmar border. |
title_short |
A tool to improve competence in the management of emergency patients by rural clinic health workers: a pilot assessment on the Thai-Myanmar border. |
title_full |
A tool to improve competence in the management of emergency patients by rural clinic health workers: a pilot assessment on the Thai-Myanmar border. |
title_fullStr |
A tool to improve competence in the management of emergency patients by rural clinic health workers: a pilot assessment on the Thai-Myanmar border. |
title_full_unstemmed |
A tool to improve competence in the management of emergency patients by rural clinic health workers: a pilot assessment on the Thai-Myanmar border. |
title_sort |
tool to improve competence in the management of emergency patients by rural clinic health workers: a pilot assessment on the thai-myanmar border. |
publishDate |
2015 |
url |
https://repository.li.mahidol.ac.th/handle/123456789/808 |
_version_ |
1763491590551109632 |