Abstract
BackgroundVideo-based feedback has been shown to aid knowledge retention, skills learning and improve team functionality. We explored the use of video-based feedback and low fidelity simulation for training rural healthcare workers along the Thailand-Myanmar border and Papua New Guinea (PNG) to manage medical emergencies effectively.MethodsTwenty-four study participants were recruited from three Shoklo Malaria Research Unit clinics along the Thailand-Myanmar border and eight participants from Kudjip Nazarene Hospital, PNG. The teams were recorded on video managing a simulated medical emergency scenario and the video was used to aid feedback and assess performance using Observed Structured Clinical Examination (OSCE) scoring and Team Emergency Assessment Measure (TEAM) questionnaire. The process was repeated post-feedback at both sites and at 6 weeks at the Thailand-Myanmar border site. Thailand-Myanmar border participants’ individual confidence levels and baseline knowledge (using OSCE scoring) were assessed before team assessment and feedback at week 1 and repeated post-feedback and at 6 weeks. Focus group discussions (FGD) were held at each Thailand-Myanmar border clinic at week 1 (8 participants at each clinic).ResultsIndividual paired tests of OSCE scores showed significant improvement post-feedback at week 1 (p < 0.001) and week 6 (p < 0.001) compared to baseline OSCE scores. There was a trend for increased team OSCE scores compared to baseline at week 1 (p = 0.068) and week 6 (p = 0.109) although not significant. Thailand-Myanmar border TEAM scores demonstrated improvement post-feedback mainly in leadership, teamwork and task management which was sustained up to week 6. PNG showed an improvement mainly in teamwork and task management. The global rating of the teams’ non-technical performance at both sites improved post feedback and at week 6 on the Thailand-Myanmar border site. Self-rated confidence scores by Thailand-Myanmar border participants increased significantly from baseline following training at week 1 (p = 0.020), and while higher at 6 weeks follow up than at baseline, this was not significant (p = 0.471). The FGD revealed majority of participants felt that watching the video recording of their performance and the video-based feedback contributed most to their learning.ConclusionVideo-assisted feedback resulted in an improvement in clinical knowledge, confidence and quality of teamwork for managing medical emergencies in two low resource medical facilities in South East Asia and the South Pacific.
Highlights
Video-based feedback has been shown to aid knowledge retention, skills learning and improve team functionality
Whilst the previous study relied on didactic teaching and the Observed Structured Clinical Examination (OSCE) method of assessment with verbal feedback, we explore the use of video-assisted feedback and low fidelity simulation as a means of training rural healthcare workers in Thailand and Papua New Guinea (PNG) to manage medical emergencies effectively
The aim of the current study is to determine if the use of video-assisted feedback is an effective means of training rural healthcare workers in Thailand and Papua New Guinea (PNG) to manage medical emergencies effectively
Summary
Video-based feedback has been shown to aid knowledge retention, skills learning and improve team functionality. We explored the use of video-based feedback and low fidelity simulation for training rural healthcare workers along the Thailand-Myanmar border and Papua New Guinea (PNG) to manage medical emergencies effectively. Various studies have identified lack of training as a reason for poor emergency medical care provision in low resource settings [5,6,7], there is a dearth of literature about methods of training rural healthcare workers to be competent in dealing with emergency medical illnesses. As non-communicable diseases become more prominent in low to middle income countries, acute illnesses such as heart failure, diabetic and hypertensive emergencies will become increasingly common [8] It is, essential to provide effective training for rural healthcare workers in low resource settings to enable them to manage acute illnesses appropriately
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