Impact of short basic emergency medicine training in introducing emergency medicine as a specialty in Sub-Saharan Africa: experience from Tanzania

Peter S Mabula,Victor Mwafongo,Brittany L Murray,Michael S Runyon,Juma A Mfinanga,Hendry R Sawe

doi:10.1186/s12245-018-0218-3

Peter S Mabula, Victor Mwafongo + Show 4 more

Open Access

https://doi.org/10.1186/s12245-018-0218-3

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Abstract

BackgroundEmergency medicine (EM) is a new specialty in Tanzania. Little is known about how to introduce EM to health care providers (HCPs) in hospitals without EM. We determined the impact of a 2-day EM training program on the understanding, perception, and choice of EM as a career amongst HCPs at hospitals in Tanzania without EM.MethodsThis was a pre- and post-training interventional study including randomly selected HCPs from four tertiary hospitals in Tanzania without EM. Understanding, perception, and desirability of EM as a career were assessed before and after a 2-day university-accredited basic EM short-course training given by EM physicians. A paper-based Likert scale (out of 5) questionnaire was used, which were analyzed by T tests, Mann-Whitney, and Kruskal-Wallis tests.ResultsDuring the study period, 96 health care providers (100% capture) in the four tertiary hospitals participated in the study. The median age of participants was 34 years (IQR 28–43); 35 (36.0%) were males. Sixty (63%) were nurses, 26 (27%) doctors, and 3 (3%) were administrators. The four hospitals were equally represented. Median pre-training scores for all Likert questions were 3.49 (IQR 3.3–3.9); understanding 3.3 (IQR 3.0–3.7), perception 3.40 (IQR 3.1–3.7), and career decision-making 3.7 (IQR 3.3–4.0). Post-training scores improved with median scores of 4.6 (IQR 4.5–4.7) overall, 4.7 (IQR 4.0–4.7) for understanding, 4.6 (IQR 4.5–4.9) for perception, and 4.7 (IQR 4.3–4.8) for career decision-making (all p < 0.01).ConclusionA 2-day training in basic EM care had a positive impact on understanding, perception, and career decisions regarding EM amongst Tanzania HCPs that work in hospitals without EM. Follow-up to assess long-term impact, and expansion of this program, is recommended to foster EM in countries where this is a new specialty.

Highlights

In Tanzania, Emergency medicine (EM) is a very new specialty [1]
Forty-five percent had worked as health care providers for 5 years or less
Health care providers (HCP) working in casualty, ICU, and administration, those most likely to be involved in setting up EM in the hospitals, constituted 23% of the sample

Summary

Introduction

In Tanzania, EM is a very new specialty [1]. In 2010, Tanzania established the first EM training program on the African continent outside of South Africa, at Muhimbili University of Health and Allied Sciences (MUHAS) in Dar es Salaam [1]. Until the inception of emergency medicine, hospitals in Tanzania, like many low- and middle-income countries (LMICs) have handled emergencies through designated acute areas (commonly referred as casualty). These are outpatient departments (OPDs), usually minimally equipped and staffed with HCPs with no or little emergency care training. EM graduates from Muhimbili practicing outside of MNH have encountered many challenges in their new working places. Graduates reported that their fellow HCPs had a poor perception of EM as a specialty and a poor understanding of what EM is and what it does. We determined the impact of a 2-day EM training program on the understanding, perception, and choice of EM as a career amongst HCPs at hospitals in Tanzania without EM

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Results

Conclusion