Pre-training Scores Research Articles

Evaluation of a Breast Cancer Early Detection Curriculum Among Nurses Working in 5 Antiretroviral Clinics in Eswatini

PURPOSE Breast cancer (BC) incidence is rising in sub-Saharan Africa, and approximately 75% of cases are diagnosed at stages III and IV. Women living with HIV, who are surviving longer with antiretroviral use, are also increasingly affected. Survey data suggest that primary care providers often fail to recognize early-stage BC. We trained nurses from 5 antiretroviral clinics in Eswatini to assess breast abnormalities and evaluated our curriculum’s effectiveness in improving BC knowledge and skills. METHODS The 2-day curriculum covered breast physiology, benign pathology, and BC. Clinical breast exam and management were taught using mannequins and standardized patient scenarios, with emphasis on prompt referral for biopsy. After training, mentoring was provided every 2 to 4 weeks at each study clinic. A written examination of BC knowledge (maximum score, 23 points) and an observed examination of practical clinical skills (maximum score, 28 points) were administered before training, immediately after training, and 90 days after training. Pre- and post-training scores were compared using Wilcoxon signed-rank tests. RESULTS Forty-four nurses, with a median of 10 years of experience, underwent training; only 5 nurses (11%) reported prior BC education. All nurses completed the pre- and immediate post-training exams, and 38 completed the 90-day post-training exams. Median scores on pre-, immediate post-, and 90-day post-training knowledge exams were 17.5 (interquartile range [IQR], 16-19), 20 (IQR, 19-21), and 20 (IQR, 19-21), respectively. Median scores on pre-, immediate post-, and 90-day post-training practical exams were 10 (IQR, 7-11), 23 (IQR, 21.5-25), and 23 (IQR, 22-24), respectively. Compared with pretraining scores, immediate post- and 90-day post-training scores on both exams were significantly improved ( P < .0001 for all comparisons). CONCLUSION Our curriculum produced a sustained improvement in nurses’ BC-related knowledge and clinical skills, including identification of possible early cancers. Our results resemble those among similarly trained Rwandan nurses, suggesting that the curriculum may generally benefit front-line health care providers and patients in sub-Saharan Africa.

Use of simulation as a needs assessment to develop a focused team leader training curriculum for resuscitation teams

BackgroundMany inpatients experience cardiac arrest and mortality in this population is extremely high. Simulation is frequently used to train code teams with the goal of improving these outcomes. A key step in designing such a training curriculum is to perform a needs assessment. We report on the effectiveness of a simulation-based training program for residents designed using unannounced in-situ simulation cardiac arrest data as a needs assessment.MethodsIn order to develop the curriculum for training, a needs assessment was done using in-situ simulation. Prior to instruction, residents were assessed in their ability to lead a simulated resuscitation using a standardized checklist. During the intervention phase, residents participated in didactic and team training. The didactic training consisted of pharmacology review, ACLS update and TeamSTEPPS training. Residents took turns as code team leader in three simulation sessions. Rapid cycle deliberate practice (RCDP) was employed as part of simulation sessions. All residents returned, for post-intervention assessment. Mean pre-post test scores were analyzed to determine if there was a significant difference.ResultsTwenty-seven residents participated. Mean pre-training assessment score was 47.6 (95% CI 37.5-57.9). The mean post-training assessment score was 84.4 (95% CI 79.0-89.5). The mean time to defibrillation after pads were placed in scenario with shockable rhythm decreased from 102.2 seconds (95% CI 74.0-130.5) to 56.3 (95% CI 32.7-79.8).ConclusionUsing unannounced in-situ cardiac arrest simulations as a needs assessment, a simulation-based training program was developed that significantly improved resident performance as team leader. Future work is needed to determine if this improvement translates into patient benefits and is sustainable. However, in-situ simulation is a promising tool for curriculum development.

Impact of training of primary healthcare workers on integrated community case management of childhood illnesses in North-West district of Benue State, Nigeria

The World Health Organization and United Nations Children’s Fund has introduced Integrated Community Case Management of childhood illness (ICCM) in order to train health workers at community level on how to treat children below 5 years who have pneumonia, diarrhoea and malaria. Since Primary Health Care workers in Benue State are actively involved in caring for sick children at community level, there is every need for them to be trained on ICCM. The objective of this study is to find out if training of primary health care workers in North-West district of Benue State can improve their knowledge on ICCM. The study was carried out in Benue North-west where Gboko Local government was randomly selected out of seven local governments. Health Officers’ in-charge of 38 Primary Health Care Clinics were selected for the study and were trained based on our adapted ICCM training manual. The Pre and Post training assessment test for this study was designed based on the training manual. A paired sample t-test was conducted to find out if there were any significant difference in the knowledge of primary health care workers before and after receiving training. There was significant difference in the pre training scores ( x1 = 136.684, S1 = 37.370) and post-training scores (x2 =177.895, 2 S =14.469) at (t=6.783, P=0.000). This result strongly indicates that the teaching intervention has improved the knowledge of the Primary Health Care workers on ICCM in Gboko Local Government.
 Keywords: ICCM; Pneumonia; Malaria; Diarrhoea

Changing the Narrative; Peer Based Training on Reproductive Health: A Six Year Experience [08G

INTRODUCTION: Despite the American College of Obstetricians & Gynecologists recommendations, many medical students are not taught to counsel patients on their reproductive health options. Since 2013, medical students at the University of Miami, under faculty guidance, implemented a curriculum for volunteers who wish to help women in South Florida access long-acting reversible contraception and abortion services. METHODS: Students in their third- and fourth-year designed a training program. Second-year students who had undergone the training and had at least one year of experience as a Reproductive Health Advocate (RHA) led the program. The learning objectives were to train new RHAs in contraception, pregnancy termination, patient counseling, laws and finances. Pre- and post-training surveys assessed knowledge, attitudes, and barriers regarding reproductive health. RESULTS: Over the past six years, eighty-seven students with an average age of 24 years completed pre-training and post-training surveys. The cohort includes five males, eighty females and two declined to identify gender. Reproductive health knowledge scores improved with a pre-training average score of 58.6% and a post-training score of 83.2%, P<.008. Attitudes towards abortion also changed. Before training, 53% of students “strongly agreed” that abortion is safe; after training 86% “strongly agreed.” Prior to training, only 41% of the students strongly agreed that “abortion access is a problem in the hospital I train.” Post-training assessments showed that 63% of students strongly agreed. CONCLUSION: Student-run training improved medical students' understanding of reproductive health and barriers accessing care. To determine generalizability, future studies should replicate this training at different institutions.

Single-Day Simulation-Based Training Improves Communication and Psychiatric Skills of Medical Students.

BackgroundUse of standardized (or simulated) patients (SP) is considered an effective teaching method for improving clinical and communication skills. This study assesses the effect of a single-day simulated patients (SP)-based training course on medical students’ communication and basic skills in clinical psychiatry during their psychiatry rotation in a university-affiliated tertiary medical center.MethodsForty-two third-year medical students participated. Communication and basic skills in clinical psychiatry were evaluated by a modified Four Habits Coding Scale (4HCS) and the psychiatric interview coding scale before and after SP training. An actual patient interview by the students 1 week after the training was evaluated by an attending psychiatrist blinded to the student’s score during the SP-based training. Self-report questionnaires on satisfaction from the training and its impact on their self-confidence were administered at the end of training.FindingsThe mean pre-training 4HCS score of 33.9 increased to 52.3 post-training (p < 0.001). The mean psychiatric interview coding scale score increased from 4.33 to 5.36 (p = 0.002). The self-report questionnaire yielded a mean score of 4.21 on a 1–5 Likert scale, implying high levels of satisfaction and self-confidence.ConclusionsA single SP-based training course of medical students sufficed to improve clinical and communication skills in psychiatric settings and enhance their subjective perception of those skills.

A training program for primary health care nurses on timely diagnosis and management of dementia in general practice: An evaluation study

BackgroundPrimary health care nurses can play an important role in assisting the diagnosis and management of dementia. This study describes the evaluation outcome of a training program developed on the ‘Four Steps to Building Dementia Practice in Primary Care’. ObjectiveTo evaluate a training program for primary health care nurses by assessing change in current practice and future intention; and their knowledge, confidence, and perceived importance about dementia diagnosis and management. DesignA longitudinal survey. Participants were surveyed at three time points: pre-training, immediately post-training and six months (+/- 3 months) following their training. SettingAll states and territories in Australia. ParticipantsPrimary health care nurses (n = 1,290). MethodsA face-to-face and online training program on timely diagnosis and management of dementia was offered to primary health care nurses. A questionnaire was administered face-to-face and online to assess whether certain processes and services were ‘currently in practice’, ‘working towards’, or ‘not in current practice’ in their primary care facility. Three 10-point Likert scales were created to assess self-perceived levels of importance, knowledge and confidence about the diagnosis and management of dementia. A paired t-test was used to examine the differences between (a) post and pre-scores, and (b) follow-up and post scores. Linear regressions were used to identify the significant factors associated with pre-training scores for importance, confidence and knowledge. ResultsOf 1290 primary health care nurses who participated in the training, 471 attended face-to-face and 819 participated online. Participants demonstrated improvements in all items in all four steps of the survey, with considerably higher improvement in the face-to-face mode. The average post-training score was significantly higher than the pre-training score for perceived importance, knowledge and confidence. The average follow-up score was significantly higher than the post-training score for perceived knowledge and confidence but not for perceived importance. Primary health care nurses who had 20 or more years of experience reported significantly more knowledge in attending patients with dementia than those with less than five years of experience (0.56, 95% CI: 0.11-1.01). ConclusionsWith a growing ageing population, the demand for dementia care is rising. Primary health care nurses can lead practice change and promote the timely diagnosis and management of dementia in general practice. Training programs of this kind that build knowledge, confidence, awareness and skills should be made available to the primary care nursing workforce. Further research is recommended to examine the translation of this training outcome into practice.

Neonatal brain ultrasound training for beginners: Could a head phantom be useful?

The traditional method of teaching the technique of neonatal brain ultrasonography is based upon the interaction between the practitioner and the neonate under the supervision of a tutor. This approach has disadvantages in that it may result in a longer imaging examination and the patient may become agitated. As demand for ultrasound services escalates and departments get busier, this often means that the trainee and supervisor are under pressure to work rapidly. Such environments are common but not conducive to the development of adequate skills and competencies. A neonatal head phantom used as part of a dedicated study day could help the beginner to learn basic elements of the ultrasound examination within a safe stress-free environment. It offers the opportunity to repeat the examination as often as the trainee wishes without time pressures and the distraction of a moving and potentially very sick baby. The aim of this study is to evaluate the efficacy of a commercial phantom as a means for the practitioner to acquire the fundamental principles of neonatal brain ultrasound. A total of 17 participants attending a one day neonatal ultrasound course aimed at beginners were invited to complete a short two-part questionnaire that assessed their perceived improvement in scanning ability before and after using a commercially available head phantom. Of the 14 returned questionnaires, the overall perceived understanding, ability and confidence improved and anxiety levels about the procedure fell. The median pre-training score was 9.0 compared with the median post-training score of 12.0 (P = 0.005, Wilcoxon signed-rank test). At least 79% (up to 86%) of participants valued their experience with the phantom and would recommend the course to colleagues. Furthermore, about two-thirds reported that they would like to have additional practise with the phantom. Preliminary data from this study suggest that beginners found the head phantom useful for mastering some of the early skills required for neonatal brain ultrasound examinations, which in turn improved their confidence and reduced anxiety.

Erratum: This Article Corrects: "Effectiveness of a Pediatric Emergency Medicine Curriculum in a Public Tanzanian Referral Hospital".

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.

Learning disability training and probation officer knowledge

Purpose Knowledge about learning disabilities has found to be limited in both health and social care staff. To improve the treatment of individuals with learning disabilities and mental health problems within the criminal justice system (CJS), Lord Bradley recommends that professionals receive mental health and learning disability awareness training. However, little is known about the impact of training on the knowledge of professionals in the CJS. This study aims to investigate the impact of a 3-h learning disability training session on the knowledge of probation officers. Design/methodology/approach Using a repeated measures design, the impact of a 3-h learning disability training session on the knowledge of 12 probation officers was analysed. Findings In support of this study’s hypothesis, a repeated measures t-test revealed a significant difference between participants pre-training and post-training learning disability knowledge questionnaire (LDKQ) scores. Participants scored significantly higher on the LDKQ post-training compared to pre-training. A linear regression revealed that years worked in probation did not significantly predict participant’s difference scores. Research limitations/implications Limitations of this study and directions for future studies are discussed. Originality/value This paper demonstrates that learning disability training can significantly improve the knowledge of probation officers.

The impact of education on attachment skills in the promotion of happiness among women with unplanned pregnancy.

BACKGROUND:Happiness is among the factors that promote mental health in mothers with unplanned pregnancy. The present study aimed to determine the impact of attachment skills training on happiness among women with unplanned pregnancy.MATERIALS AND METHODS:This clinical trial was conducted on 84 women with unplanned pregnancy referred to three prenatal clinics in Shiraz in 2018. The participants were randomly divided into an intervention group and a control group using permutation block. At first, the participants were requested to sign written informed consent form, demographic information form, and mental health questionnaire. Then, they were asked to complete Oxford Happiness Questionnaire and Cranley's Maternal-Fetal Attachment Scale. The intervention group received attachment training through six 90-min sessions, while the control group underwent the hospital's routine care. The two groups were required to fill out the study questionnaires once more after 4 weeks after the intervention. After all, the data were analyzed using Chi-square test, Fisher's exact test, independent t-test, and ANOVA.RESULTS:There was a significant difference between the two groups' pretest and posttest mean scores of happiness (P = 0.0001). The results showed that in the experimental group, pretraining and posttraining period mean scores were 89.64 (7.2) and 93.13 (6.09), respectively; while in the control group, pretraining and posttraining period mean scores were, respectively, 91.69 (9.96) and 91 (8.82). The difference between the two groups was statistically significant. No significant relationship was observed between happiness and the couples' occupations, number of pregnancies, and number of miscarriages in the two groups (P > 0.05).CONCLUSION:The mean score of happiness increased after the training, being significantly different from that in the control group. Therefore, happiness is a changeable feature that can be promoted among pregnant women via interventional methods.

Mindful Mentors: Is a Longitudinal Mind-Body Skills Training Pilot Program Feasible for Pediatric Cardiology Staff?

Stress and burnout among medical professionals are common and costly, placing professionals, organizations, and patients at risk. To determine feasibility and acceptability of a longitudinal mind-body skills training initiative to help staff decrease stress and burnout, improve well-being, and empower them to utilize basic mindfulness methods with coworkers, patients, and families. Prospective cohort, mixed methods approach. Nurses, doctors, technicians, social workers, child life specialists were eligible to participate. The 12-month curriculum consisted of 16 hours of intensive education/practice over 2 days, with training in mindfulness skills, self-compassion, nonviolent communication, overcoming barriers to practice, and mindful listening/speaking, followed by monthly 1 hour booster/debriefing sessions. A total of 37 staff participated (RN = 18, MD = 5, Technician = 6, Social Worker = 3, Child life = 3, others = 2) in the initial training, and 24 (65%) completed the 3- and 12-month follow-up surveys. Compared with pretraining scores, there were significant improvements 3 to 12 months after the initial training in stress (P < .0001), distress (P ≤ .04), anxiety (P = .01), self-efficacy in providing non-drug therapies (P < .0001), mindfulness (P = .002), burnout (P < .0001), and confidence in providing compassionate care (P < .0001). In addition, 25 (67%) participants initiated projects incorporating what they learned into staff/patient wellness activities. This longitudinal pilot program was feasible and was associated with improvements in measures of psychological well-being over the 12-month intervention. The innovative approach of training participants to teach basic techniques to coworkers and other staff can increase the impact of this program beyond any individual participant. Future research will investigate the aspects of implementation and potential effects on patient care and experience.

Evaluation of skills transfer in short-term phacoemulsification surgery training program by International Council of Ophthalmology -Ophthalmology Surgical Competency Assessment Rubrics (ICO-OSCAR) and assessment of efficacy of ICO-OSCAR for objective evaluation of skills transfer.

Purpose:To evaluate skills transfer in short-term phacoemulsification surgery training program by International Council of Ophthalmology -Ophthalmology Surgical Competency Assessment Rubrics (ICO-OSCAR) and assessment of efficacy of ICO-OSCAR for objective evaluation of skills transfer.Methods:Prospective analysis of total 1300 phacoemulsification surgeries performed by 52 phacoemulsification trainees divided into three groups based on the previous cataract surgical experience. The pretraining and posttraining average mean scores, independent completion rates (ICR), and complication rates among the groups were calculated and statistically analyzed.Results:Mean age of trainees (N = 52) was found to be 30.98 ± 2.44 years. Mean pretraining scores in the three groups were 42.8 ± 0.2, 46.6 ± 0.2, and 50.1 ± 0.1, respectively, and posttraining mean scores of the groups were 88.4 ± 0.2, 92.3 ± 0.2, and 94.3 ± 0.2, respectively, out of 100. Pretraining independent completion rates (%) were 22.1 ± 2.5, 52.1 ± 2.5, and 62 ± 3.7, respectively, and posttraining independent completion rates (%) were 74.8 ± 3, 79.7 ± 3, and 90.6 ± 3.5, respectively. Learning curves of all groups were noted to be steep. Rate of complications was within acceptable range, overall complication rate being 12.30% (160 out of 1300 cases). OSCAR scores correlate significantly (P = 0.0004) with ICR.Conclusion:Steep learning curve for phacoemulsification can be made easy by the use of standardized rubrics, proper techniques, expert guidance, and adequate surgical volume. The previous SICS experience provides smoother learning curve. ICO-OSCAR is indicator of proficiency and provides constructive feedback and objective evaluation immediately after surgery as well as at the end of training. Short-term (1 Month) training program is an effective, efficient, and safe approach to progressively master phacoemulsification skills for trainees with SICS experience.

Effectiveness of a Pediatric Emergency Medicine Curriculum in a Public Tanzanian Referral Hospital.

IntroductionThe 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.MethodsFifteen 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.ResultsParticipant-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.ConclusionThis 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.

&lt;p&gt;Perioperative Provider and Staff Competency in Providing Culturally Competent LGBTQ Healthcare in Pediatric Setting&lt;/p&gt;

IntroductionChildren and adolescents identifying as lesbian, gay, bisexual, transgender, or queer/questioning (LGBTQ) may feel reluctant to seek medical care due to stigma and the possibility of negative interactions with health care providers. Due to the short duration of the perioperative period, the interaction in this setting is limited and providers may not have the time to develop a rapport with the patient. It is imperative that staff are trained to address the patient and family in a culturally competent manner.MethodsWe undertook surveys before and after a 2 part educational series among the pediatric perioperative staff to understand the impact of providing education and cultural competency training regarding caring for patients who identify as LGBTQ. Providers self-reported their knowledge and comfort on a 1–5 point scale (5 being most knowledgeable or comfortable) in 6 domains of caring for LGBTQ patients. Objective knowledge of LGBTQ issues was assessed using 7 questions based on lecture material. On objective assessment, knowledge of LGBTQ issues improved after cultural competency training.ResultsThe analysis included 90 responses. Before training, median ratings of knowledge and comfort were 3 or 4 out of a maximum of 5 for each domain. The pre-training median score on the 7-item test of LGBTQ cultural competency was 5 (IQR: 4, 6). After training, knowledge and comfort self-ratings did not improve, but the score on the objective knowledge test increased to a median of 6 (IQR: 4, 7; p=0.011) of 7 possible points.DiscussionAnesthesia providers participating in LGBTQ cultural competency training self-reported high levels of knowledge and comfort with providing care to LGBTQ patients even before formal training was provided. On objective assessment, knowledge of LGBTQ issues improved after cultural competency training.

Abstract 448: Impact of Novel Healthcare Facility First Responder Training on Resuscitation Task Self-Efficacy Measures

Introduction: When sudden cardiac arrest occurs in non-resuscitation focused care settings, bedside clinicians may not intervene prior to dedicated resuscitation team arrival. As perceived self-efficacy (SE) contributes to cognitive functioning, facilitating effective intervention, we developed and evaluated a mock code training approach, First Five (FF) , to enhance bedside responders’ resuscitation task SE using an entity’s defibrillator and manikin. Self-efficacy is knowing that one can perform actions in principle and envision performing the steps to reach a goal. Hypotheses: Participants’ resuscitation SE will improve after FF training; 2) Inpatient (IP) and Ambulatory Care Center (ACC) providers will differ in their pre-SE and post-SE in response to FF training. Methods: Participants enrolled from ACCs and medical-surgical IP units at a large, urban tertiary care hospital from May 2018 to April 2019 completed a de-identified 10-point Likert-scale SE survey before and after they were trained to perform initial bedside resuscitation tasks (Figure 1 x-axis labels). Matched, complete, pre/post data for 85 in-hospital and 107 ACC participants were analyzed via repeated measures multivariate analysis of variance. Results: Patterns of reported change in the seven resuscitation task SE measures of IP personnel differed significantly from those of ACC personnel [Pillai’s Trace = .222, F(7,184)=7.483, p=.0005, partial η 2 = .222]. In both settings, post-session SE measures increased significantly from pre-session SE measures [Pillai’s Trace = .588, F(7,184)=37.438, p=.0005, partial η 2 = .588]. Moreover, though ACC providers consistently reported lower pre-training SE resuscitation task scores, post-training scores from both settings were comparable (Figure 1). Conclusions: First Five training is effective in enhancing resuscitation task SE among inpatient and ambulatory care setting providers that are not resuscitation-focused.

Uberty Health Education and Female Students’ Self-efficacy

Background: Adolescence is an essential period in every human’s life. The lack of knowledge on puberty issues may adversely impact an adolescent’s future mental health and self-efficacy. The present study aimed to determine the effect of puberty health education on the general self-efficacy of female students. Methods: This was a quasi-experimental study with a pre-test; post-test and a control group design. This study was conducted on 100 female students of public schools with the onset of menstruation in 2018 in Ghaemshahr City, Iran. To prevent data contamination, the control group was selected from another similar public school. The required data were collected by Sherer General Self-efficacy Questionnaire and analyzed by SPSS using statistics, including mean, standard deviation, Chi-squared test, Fisher’s Exact test, one-way Analysis of Variance (ANOVA), and Paired Samples t-test. Results: The study groups were matched for demographic variables except for the mother’s age (P=0.01) and father’s education (P=0.001). Self-efficacy was not low in any of the groups before and after the training. Mean±SD pre-training self-efficacy scores in the intervention (63.68±9.72) and control (65.3±8.78) groups were not statistically significant (P=0.69). Comparing the students’ self-efficacy mean Pre-test-Post-test scores revealed a significant difference in the intervention group (P=0.017); however, there was no significant change in the control group (P=0.284) in this respect. Comparing between-group mean self-efficacy changes concerning before and after the intervention values suggested no significant difference (P=0.294). Conclusion: Puberty health education was effective in promoting the explored female students’ self-efficacy. Accordingly, it is recommended to include puberty education in female students’ courses. In addition, community health nurses are suggested to include this training in their programs.

Empowering healthcare providers through smoking cessation training in Malaysia: a preintervention and postintervention evaluation on the improvement of knowledge, attitude and self-efficacy

ObjectivesHealthcare providers are ideally positioned to advise their patients to quit smoking by providing effective smoking cessation intervention. Thus, we evaluate the effectiveness of a 1-day training programme in changing...

Effectiveness of a Quality Improvement Program Using Difference-in-Difference Analysis for Home Based Newborn Care - Results of a Community Intervention Trial.

To present evaluation of a quality improvement program for Accredited Social Health Activists (ASHAs). This community intervention trial was conducted in Ballabgarh, India during 2012-2014 with two Primary Health Center (PHC) areas being the intervention areas and two PHC areas being non-intervention areas receiving standard care. Interventions included two-day training in technical and communication skills of ASHAs followed by supportive supervision in the field. Intervention was evaluated by comparing pre and post training scores, feedback from postnatal mothers and a difference-in-difference (DID) analysis on baseline and endline knowledge-practice survey of recently delivered mothers with 95% confidence intervals. Only 11.1% ASHAs addressed specific barriers for adopting healthy behaviors. Sixty eight (91.8%) ASHAs attended the training after which knowledge improved by 33.3% (p < 0.001). ASHAs in intervention areas were rated by mothers (n = 69) to have better communication skills (81.2% vs. 59.7%, p = 0.005), make more postnatal visits (52.2% vs. 22.2%; p < 0.001), give advice on newborn care (64% vs. 50.5%; p < 0.001) as compared to standard care area ASHAs. Endline survey (n = 1360) showed a significant improvement in frequency of antenatal visits (0.26;0.19-0.33), knowledge about free transport (0.12;0.05-0.18), better cord-care practices (0.15;0.07-0.22), kangaroo mother care (0.19;0.13-0.25), delayed first bath (0.13;0.06-0.20), restrictive handling (0.11;0.06-0.15) and hand-washing (0.19;0.13-0.25). Quality improvement program can help improve ASHA's performance which in turn can address higher neonatal mortality in India.

Beyond the clinical team: evaluating the human factors-oriented training of non-clinical professionals working in healthcare contexts

BackgroundAs clinical simulation has evolved, it is increasingly used to educate staff who work in healthcare contexts (e.g. hospital administrators) or frequently encounter clinical populations as part of their work (e.g. police officers) but are not healthcare professionals. This is in recognition of the important role such individuals play in the patients’ experience of healthcare, frequently being a patients’ first point of contact with health services. The aim of the training is to improve the ability of the team to communicate and co-ordinate their actions, but there is no validated instrument to evaluate the human factors learning of non-clinical staff. Our aim was to develop, pilot and evaluate an adapted version of the Human Factors Skills for Healthcare Instrument, for non-clinical professionals.MethodThe 18-item instrument was developed reflecting the human factors skills of situation awareness, decision making, communication, teamwork, leadership, care and compassion and stress and fatigue management. The instrument was piloted pre- and post-training with non-healthcare professionals (n = 188) attending mental health simulation training within an 11-month period (June 2017–April 2018). Trainees were hospital/primary care administrators (n = 53, 28%), police officers (n = 112, 59%), probation officers (n = 13, 7%) and social workers (n = 10, 5%). Most participants were female (n = 110, 59%) and from White ethnic backgrounds (n = 144, 77%).ResultsSix items were removed, five were not sufficiently sensitive to change (d < .3) and one showed poor reliability. The remaining 12 items revealed a Cronbach’s alpha of .93. An exploratory factor analysis revealed a one-factor solution, which explained 58.3% of the variance. The final 12-item instrument was sensitive to change post-training (p < .0001) with large effect sizes (d > .7). Cluster analysis revealed that participants with lower pre-training scores showed the greatest improvement.DiscussionThe Human Factors Skills for Healthcare Instrument-Auxiliary version (HuFSHI-A) provides a reliable and valid instrument for the evaluation of human factors skills learning following training of non-clinical populations working in healthcare contexts. Although this instrument has been developed and evaluated with training courses specifically focusing on mental health topics, HuFSHI-A is applicable for any training where teamwork and co-ordination between clinical and non-clinical professionals is considered.

The impact of "health promotion program" on health perception and healthy life style applied to a group of adolescent students

&lt;br/&gt;&lt;b&gt;Purpose:&lt;/b&gt; This study was carried out to evaluate the effect of health education on adolescents' healthy lifestyle and health perceptions given an adolescent group. &lt;br/&gt;&lt;b&gt;Materials and methods:&lt;/b&gt; The study's universe constitutes a total of 234 students attending the 9th grade of a high school. The study was constructed according to the single-group pre-test, quasi-experimental research model, in the 9th class in a high school. Data collection form, Adolescent lifestyle scale(ALS) and health perception scale were applied to the adolescents as a pre-test during the first phase of the study. The adolescents who were below the median score of ALS were accepted as the risk group and taken to the experimental group. Adolescents in the experimental group received a 6-week "Health Promotion Program" and a final test was given to the adolescents at the end of the training sessions. Descriptive statistics, Paired-t-test, independent-, and correlation were used in the evaluation of the data. &lt;br/&gt;&lt;b&gt;Results:&lt;/b&gt; ALS total score was 94.52±9.53 before adolescents' health promotion education and 104.05±15.4 after education. The relationship between them was statistically significant(p&lt;0.05). It was determined that the health perception of adolescents included in the study decreased after post-training total scores compared to the pre-training scores and that this relationship was statistically significant(p&lt;0.05). &lt;br/&gt;&lt;b&gt;Conclusion:&lt;/b&gt; Public health nurses may be recommended to develop healthy lifestyle behaviours by raising healthy adolescents by providing more adolescent education through school health services.