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BMC Med Educ. 2015 Jul 24;15:117. doi: 10.1186/s12909-015-0401-7.

A process evaluation of PRONTO simulation training for obstetric and neonatal emergency response teams in Guatemala.

Author information

1
Department of Obstetrics and Gynecology, University of Washington, Seattle, WA, 98104, USA. dilys@uw.edu.
2
Department of Global Health, University of Washington, 325 9th Ave, Box 359931, Seattle, WA, 98104, USA. dilys@uw.edu.
3
Department of Global Health, University of Washington, 325 9th Ave, Box 359931, Seattle, WA, 98104, USA. holemf@uw.edu.
4
Department of Global Health, University of Washington, 325 9th Ave, Box 359931, Seattle, WA, 98104, USA. stz2@uw.edu.
5
Division of Reproductive Health, Research Center for Population Health, National Institute of Public Health, Universidad No 655, Col Santa Maria Ahuacatitlan, CP 62100, Cuernavaca, Morelos, Mexico. marisela.olvera@insp.mx.
6
Division of Reproductive Health, Research Center for Population Health, National Institute of Public Health, Universidad No 655, Col Santa Maria Ahuacatitlan, CP 62100, Cuernavaca, Morelos, Mexico. alejandra.montoya@insp.mx.
7
Division of Reproductive Health, Research Center for Population Health, National Institute of Public Health, Universidad No 655, Col Santa Maria Ahuacatitlan, CP 62100, Cuernavaca, Morelos, Mexico. jimena.fritz@insp.mx.
8
Department of Obstetrics and Gynecology, University of Maryland School of Medicine, 22 S Green St, Baltimore, MD, 12201, USA. jfahey@fpi.umaryland.edu.
9
College of Nursing, University of Utah, 10 South 2000 East Salt, Lake City, UT, 84112, USA. hlamadrid@insp.mx.
10
Division of Reproductive Health, Research Center for Population Health, National Institute of Public Health, Universidad No 655, Col Santa Maria Ahuacatitlan, CP 62100, Cuernavaca, Morelos, Mexico. susanna.cohen@nurs.utah.edu.
11
Epidemiological Research Center in Sexual and Reproductive Health (CIESAR), Guatemala City, Guatemala. ekestler@ciesar.org.gt.

Abstract

BACKGROUND:

Despite expanding access to institutional birth in Guatemala, maternal mortality remains largely unchanged over the last ten years. Enhancing the quality of emergency obstetric and neonatal care is one important strategy to decrease mortality. An innovative, low-tech, simulation-based team training program (PRONTO) aims to optimize care provided during obstetric and neonatal emergencies in low-resource settings.

METHODS:

We conducted PRONTO simulation training between July 2012 and December 2012 in 15 clinics in Alta Verapaz, Huehuetenango, San Marcos, and Quiche, Guatemala. These clinics received PRONTO as part of a larger pair-matched cluster randomized trial of a comprehensive intervention package. Training participants were obstetric and neonatal care providers that completed pre- and post- training assessments for the two PRONTO training modules, which evaluated knowledge of evidence-based practice and self-efficacy in obstetric and neonatal topics. Part of the training included a session for trained teams to establish strategic goals to improve clinical practice. We utilized a pre/post-test design to evaluate the impact of the course on both knowledge and self-efficacy with longitudinal fixed effects linear regression with robust standard errors. Pearson correlation coefficients were used to assess the correlation between knowledge and self-efficacy. Poisson regression was used to assess the association between the number of goals achieved and knowledge, self-efficacy, and identified facility-level factors.

RESULTS:

Knowledge and self-efficacy scores improved significantly in all areas of teaching. Scores were correlated for all topics overall at training completion. More than 60 % of goals set to improve clinic functioning and emergency care were achieved. No predictors of goal achievement were identified.

CONCLUSIONS:

PRONTO training is effective at improving provider knowledge and self-efficacy in training areas. Further research is needed to evaluate the impact of the training on provider use of evidence-based practices and on maternal and neonatal health outcomes.

TRIAL REGISTRATION:

NCT01653626.

PMID:
26206373
PMCID:
PMC4513701
DOI:
10.1186/s12909-015-0401-7
[Indexed for MEDLINE]
Free PMC Article

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