Evaluation of an educational program for essential newborn care in resource-limited settings: Essential Care for Every Baby

Abstract Background Essential Care for Every Baby (ECEB) is an evidence-based educational program designed to increase cognitive knowledge and develop skills of health care professionals in essential newborn care in low-resource areas. The course focuses on the immediate care of the newborn after birth and during the first day or until discharge from the health facility. This study assessed the overall design of the course; the ability of facilitators to teach the course; and the knowledge and skills acquired by the learners. Methods Testing occurred at 2 global sites. Data from a facilitator evaluation survey, a learner satisfaction survey, a multiple choice question (MCQ) examination, performance on two objective structured clinical evaluations (OSCE), and pre- and post-course confidence assessments were analyzed using descriptive statistics. Pre-post course differences were examined. Comments on the evaluation form and post-course group discussions were analyzed to identify potential program improvements. Results Using ECEB course material, master trainers taught 12 facilitators in India and 11 in Kenya who subsequently taught 62 providers of newborn care in India and 64 in Kenya. Facilitators and learners were satisfied with their ability to teach and learn from the program. Confidence (3.5 to 5) and MCQ scores (India: pre 19.4, post 24.8; Kenya: pre 20.8, post 25.0) improved (p < 0.001). Most participants demonstrated satisfactory skills on the OSCEs. Qualitative data suggested the course was effective, but also identified areas for course improvement. These included additional time for hands-on practice, including practice in a clinical setting, the addition of video learning aids and the adaptation of content to conform to locally recommended practices. Conclusion ECEB program was highly acceptable, demonstrated improved confidence, improved knowledge and developed skills. ECEB may improve newborn care in low resource settings if it is part of an overall implementation plan that addresses local needs and serves to further strengthen health systems

Medical problem solving and post-problem reflection

This study examined diagnostic problem solving and post-problem reflection in medical students, residents, and experts. Participants worked on three internal medicine cases from the computer-based learning environment, BioWorld. The analyses focused on general performance measures, problem solving operators and knowledge states, and post-problem reflection activities. Verbal protocol data was collected and examined using a coding scheme developed and implemented with the N-Vivo software. Students and residents differed in overall diagnostic accuracy, and significant differences were found in solution time and the number of utterances made for cases of varying difficulty. Differences in the use of operators and knowledge states are highlighted, although the groups were quite similar on many measures. The experts spent considerably more time working on case history information, consistently engaged in planning, and always generated the correct diagnosis (among others) in response to case history information. During post-problem reflection students used more case history data than residents. Expert models highlight the experts' problem solving cycle that consisted of reviewing data, identifying hypotheses, and planning. Post-questionnaire results indicate that participants found the cases to be interesting, useful for learning, but not especially difficult. Finally, several implications are drawn for the future development of BioWorld for medical training

Identifying human tutoring strategies for effective instruction in internal medicine

Medicine, as a discipline, has a long-standing tradition of modeling expertise through tutorials provided inclinical practice. As lay-people many of us have witnessed first hand the bedside teaching that physiciansprovide to medical students, or we have viewed the Hollywood version of modern day medical practicethrough ER or other popular series. There is a great deal of variation in the type and quality of medicaltutorials, particularly in terms of the pedagogical theory that guides the learning experience. We areinterested in documenting these naturally occurring tutorial dialogues as a first step in developing a modelfor scaffolding learning in small group problem based settings in medicine. Our long-range goal is todevelop this tutorial model into a computer based learning environment that can help internal medicinestudents in their clinical problem solving skills

Promoting Self-Regulation in Medical Students Through the Use of Technology

This paper presents recent research aimed at the improvement of instruction and assessment in science and medicine, focusing on the development of computer-based learning environments. Our research has examined the possibilities for these environments to support cognitive activities and processes in the context of problem solving, including self-regulation, hypothesis generation and revision, planning, self-assessment, and teaching others. The BioWorld, SICUn, and Case2Solve environments are discussed

Evaluation of an educational program for essential newborn care in resource-limited settings: Essential Care for Every Baby

Background: Essential Care for Every Baby (ECEB) is an evidence-based educational program designed to increase cognitive knowledge and develop skills of health care professionals in essential newborn care in low-resource areas. The course focuses on the immediate care of the newborn after birth and during the first day or until discharge from the health facility. This study assessed the overall design of the course; the ability of facilitators to teach the course; and the knowledge and skills acquired by the learners. Methods: Testing occurred at 2 global sites. Data from a facilitator evaluation survey, a learner satisfaction survey, a multiple choice question (MCQ) examination, performance on two objective structured clinical evaluations (OSCE), and pre- and post-course confidence assessments were analyzed using descriptive statistics. Pre-post course differences were examined. Comments on the evaluation form and post-course group discussions were analyzed to identify potential program improvements. Results: Using ECEB course material, master trainers taught 12 facilitators in India and 11 in Kenya who subsequently taught 62 providers of newborn care in India and 64 in Kenya. Facilitators and learners were satisfied with their ability to teach and learn from the program. Confidence (3.5 to 5) and MCQ scores (India: pre 19.4, post 24.8; Kenya: pre 20.8, post 25.0) improved (p < 0.001). Most participants demonstrated satisfactory skills on the OSCEs. Qualitative data suggested the course was effective, but also identified areas for course improvement. These included additional time for hands-on practice, including practice in a clinical setting, the addition of video learning aids and the adaptation of content to conform to locally recommended practices. Conclusion: ECEB program was highly acceptable, demonstrated improved confidence, improved knowledge and developed skills. ECEB may improve newborn care in low resource settings if it is part of an overall implementation plan that addresses local needs and serves to further strengthen health systems

Ego identity development in physicians: a cross-cultural comparison using a mixed method approach

Article deposited according to agreement with BMC, December 6, 2010.YesFunding provided by the Open Access Authors Fund

Evaluation of an educational program for essential newborn care in resource-limited settings: Essential Care for Every Baby

Background Essential Care for Every Baby (ECEB) is an evidence-based educational program designed to increase cognitive knowledge and develop skills of health care professionals in essential newborn care in low-resource areas. The course focuses on the immediate care of the newborn after birth and during the first day or until discharge from the health facility. This study assessed the overall design of the course; the ability of facilitators to teach the course; and the knowledge and skills acquired by the learners. Methods Testing occurred at 2 global sites. Data from a facilitator evaluation survey, a learner satisfaction survey, a multiple choice question (MCQ) examination, performance on two objective structured clinical evaluations (OSCE), and pre- and post-course confidence assessments were analyzed using descriptive statistics. Pre-post course differences were examined. Comments on the evaluation form and post-course group discussions were analyzed to identify potential program improvements. Results Using ECEB course material, master trainers taught 12 facilitators in India and 11 in Kenya who subsequently taught 62 providers of newborn care in India and 64 in Kenya. Facilitators and learners were satisfied with their ability to teach and learn from the program. Confidence (3.5 to 5) and MCQ scores (India: pre 19.4, post 24.8; Kenya: pre 20.8, post 25.0) improved (p < 0.001). Most participants demonstrated satisfactory skills on the OSCEs. Qualitative data suggested the course was effective, but also identified areas for course improvement. These included additional time for hands-on practice, including practice in a clinical setting, the addition of video learning aids and the adaptation of content to conform to locally recommended practices. Conclusion ECEB program was highly acceptable, demonstrated improved confidence, improved knowledge and developed skills. ECEB may improve newborn care in low resource settings if it is part of an overall implementation plan that addresses local needs and serves to further strengthen health systems