Evaluation of capacity to deliver emergency obstetrics and newborn care updated midwifery and reproductive health training curricula in Kenya: Before and after study

Shikuku, Duncan N.; Tallam, Edna; Wako, Ibrahim; Mualuko, Agnes; Waweru, Lucy Mumbi; Nyaga, Lucy; Bashir, Isaak; Ameh, Charles

doi:10.1016/j.ijans.2022.100439

Cited by 10 publications

(20 citation statements)

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“…This nding underscores the value of targeted mentoring as training alone has been shown not su cient to maintain competence (13,35). Evidence from studies has shown that training alone improves knowledge and skills immediately after training but for retention and improved competence, short, targeted mentoring sessions are recommended for sustained improvement (13,31,32,35). There is need to strengthen capacity of educators regularly through continuous professional development opportunities for effective teaching and learning.…”

Section: Discussionmentioning

confidence: 99%

“…Through the MoH-led Pre-service Taskforce, LSTM supported a detailed review of the national nursing and midwifery syllabus at the Nursing Council of Kenya and curriculum at Kenya Medical Training College (KMTC). Curriculum content integrating EmONC and teaching methods were updated (32) consistent with the WHO and ICM competencies for midwifery educators. The aim of the review was to facilitate a shift from the largely theoretical training to a competency-based skills training of an EmONC enhanced curriculum.…”

Section: Strengthened Midwifery Curriculum and Faculty In Kenyamentioning

confidence: 99%

“…Part 1 was a two-day virtual workshop for the theoretical component (including an additional module on 'facilitating online teaching' as part of the COVID-19 containment measure and modi cation to pre-service teaching). Additional details on the virtual training are reported in a separate paper (32). Part 2 was a two-day face-to-face workshop for the skills-based component.…”

Section: Training Of Midwifery Educators On the Updated Midwifery Cur...mentioning

confidence: 99%

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An evaluation of the effectiveness of an updated pre-service midwifery curriculum integrated with emergency obstetrics and newborn care in Kenya: a cluster randomised controlled trial

Shikuku,

Mwaura,

Nandikove

et al. 2024

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Introduction Quality midwifery education is central to improving midwifery service delivery and maternal and newborn health outcomes. In many settings, midwifery educators insufficiently prepared for their teaching role and deficient curriculum compared to international standards affect the quality of midwifery graduates. This study assessed the effectiveness of an EmONC enhanced midwifery curriculum delivered by trained and mentored midwifery educators on the quality of education and student performance in Kenya. Methods A cluster randomised controlled trial (ISRCTN 14203188) in 20 midwifery colleges (12 intervention and 8 control colleges). Educators in both arms received training in teaching/EmONC skills to deliver the updated national midwifery curriculum, with those in the intervention arm receiving additional mentoring every three months after training for 12 months. Educators’ knowledge and confidence in EmONC/teaching skills was assessed before and after training and at 3, 6, 9 and 12 months. Teaching skills observations at baseline and endline in both study arms were also assessed using a checklist. Knowledge, confidence and three selected EmONC practical skills among final year midwifery students were assessed. Linear mixed effects models were used to evaluate the effect of intervention on educators and students. Results The intervention arm had 45 educators and 91 students while the control arm had 29 educators and 55 students in the study. Immediately after training educators’ knowledge improved (61.3–73.3%, p < 0.001) and confidence to teach EmONC (3.1 to 4.2 out of 5, p < 0.001) improved. No evidence of a difference in either knowledge or confidence was detected for period or study arm (p > 0.05). The observed teaching skill scores of educators in the intervention arm were significantly higher compared with those of controls at endline (mean difference, 16.5; 95%CI, 3.2–29.8, p = 0.02). Scores for students in the intervention arm were significantly higher than those in controls for knowledge (mean difference, 8.3 [1.6–15.0]) and the three skills assessed (mean difference (95%CI): 22.4 (10.8–33.9) for shoulder dystocia, 17.9 (2.0-33.9) for newborn resuscitation and 17.0 (8.0–26.0) for maternal resuscitation. Shortage of faculty and inadequate support in clinical placement were major challenges for quality midwifery education. Conclusion Knowledge and confidence of educators in teaching EmONC was improved immediately after training. Mentoring was effective in improving the quality of educators’ EmONC teaching skills. Students in intervention arm had higher performance in EmONC knowledge and skills. Institutional investments are needed for quality delivery of an EmONC-enhanced curriculum.

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Section: Discussionmentioning

confidence: 99%

Section: Strengthened Midwifery Curriculum and Faculty In Kenyamentioning

confidence: 99%

Section: Training Of Midwifery Educators On the Updated Midwifery Cur...mentioning

confidence: 99%

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An evaluation of the effectiveness of an updated pre-service midwifery curriculum integrated with emergency obstetrics and newborn care in Kenya: a cluster randomised controlled trial

Shikuku,

Mwaura,

Nandikove

et al. 2024

Preprint

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“…A 3-point Likert scale with the alternatives 'not confident' , 'somewhat confident' or 'extremely confident' -for rating their confidence in using the six items was provided. The self-rating scale for the perceived confidence of midwifery educators to teach the updated curriculum was adapted from the formerly developed 7-item tool that was used for the evaluation of 51 midwifery and clinical medicine (reproductive health specialty) educators at the mid-level training colleges in Kenya [19]. One component -facilitating online teaching -was excluded in this assessment as the university educators' training did not have an online/ virtual training component.…”

Section: Data Collection Toolsmentioning

confidence: 99%

Improving midwifery educators’ capacity to teach emergency obstetrics and newborn care in Kenya universities: a pre-post study

et al. 2022

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Background: International Confederation of Midwives and World Health Organization recommend core competencies for midwifery educators for effective theory and practical teaching and practice. Deficient curricula and lack of skilled midwifery educators are important factors affecting the quality of graduates from midwifery programmes. The objective of the study was to assess the capacity of university midwifery educators to deliver the updated competency-based curriculum after the capacity strengthening workshop in Kenya. Methods: The study used a quasi-experimental (pre-post) design. A four-day training to strengthen the capacity of educators to deliver emergency obstetrics and newborn care (EmONC) within the updated curriculum was conducted for 30 midwifery educators from 27 universities in Kenya. Before-after training assessments in knowledge, two EmONC skills and self-perceived confidence in using different teaching methodologies to deliver the competency-based curricula were conducted. Wilcoxon signed-rank test was used to compare the before-after knowledge and skills mean scores. McNemar test was used to compare differences in the proportion of educators’ self-reported confidence in applying the different teaching pedagogies. P-values < 0.05 were considered statistically significant. Findings: Thirty educators (7 males and 23 females) participated, of whom only 11 (37%) had participated in a previous hands-on basic EmONC training – with 10 (91%) having had the training over two years beforehand. Performance mean scores increased significantly for knowledge (60.3% − 88. %), shoulder dystocia management (51.4 – 88.3%), newborn resuscitation (37.9 − 89.1%), and overall skill score (44.7 − 88.7%), p < 0.0001. The proportion of educators with confidence in using different stimulatory participatory teaching methods increased significantly for simulation (36.7 – 70%, p = 0.006), scenarios (53.3 – 80%, p = 0.039) and peer teaching and support (33.3 – 63.3%, p = 0.022). There was improvement in use of lecture method (80 – 90%, p = 0.289), small group discussions (73.3 – 86.7%, p = 0.344) and giving effective feedback (60 – 80%, p = 0.146), although this was not statistically significant. Conclusion: Training improved midwifery educators’ knowledge, skills and confidence to deliver the updated EmONC-enhanced curriculum. To ensure that midwifery educators maintain their competence, there is need for structured regular mentoring and continuous professional development. Besides, there is need to cascade the capacity strengthening to reach more midwifery educators for a competent midwifery workforce.

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“…However, the survey identi ed that none of the educators felt con dent in all of WHO's midwifery educator core competencies (5). Further evidence shows that many midwifery educators are more con dent with theoretical classroom teaching than clinical teaching despite advances in teaching methods and have low con dence in facilitating online/virtual teaching and learning (4,8,9). To remain competent, design and deliver competency-based curriculum and strengthen midwifery practice, ICM and WHO emphasize that midwifery faculty should engage in ongoing professional development as a midwifery practitioner, teacher/lecturer and leader (6,10,11).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the feasibility of a midwifery educator continuous professional development (CPD) programme in Kenya and Nigeria: a mixed methods study

Shikuku,

Mohammed,

Mwanzia

et al. 2024

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Background Midwifery education is under-invested in developing countries with limited opportunities for midwifery educators to improve/maintain their core professional competencies. To improve the quality of midwifery education and capacity for educators to update their competencies, a blended midwifery educator-specific continuous professional development (CPD) programme was designed with key stakeholders. This study evaluated the feasibility of this programme in Kenya and Nigeria. Methods This was a mixed methods intervention study using a concurrent nested design. 120 randomly selected midwifery educators from 81 pre-service training institutions were recruited. Educators completed four self-directed online learning (SDL) modules and three-day practical training of the blended CPD programme on teaching methods (theory and clinical skills), assessments, effective feedback and digital innovations in teaching and learning. Pre- and post-training knowledge using multiple choice questions in SDL; confidence (on a 0–4 Likert scale) and practical skills in preparing a teaching a plan and microteaching (against a checklist) were measured. Differences in knowledge, confidence and skills were analysed. Participants’ reaction to the programme (relevance and satisfaction assessed on a 0–4 Likert scale, what they liked and challenges) were collected. Key informant interviews with nursing and midwifery councils and institutions’ managers were conducted. Thematic framework analysis was conducted for qualitative data. Results 116 (96.7%) and 108 (90%) educators completed the SDL and practical components respectively. Mean knowledge scores in SDL modules improved from 52.4% (± 10.4) to 80.4% (± 8.1), preparing teaching plan median scores improved from 63.6% (IQR 45.5) to 81.8% (IQR 27.3), and confidence in applying selected pedagogy skills improved from 2.7 to 3.7, p < 0.001. Participants rated the SDL and practical components of the programme high for relevance and satisfaction (median, 4 out of 4 for both). After training, 51.4% and 57.9% of the participants scored 75% or higher in preparing teaching plans and microteaching assessments. Country, training institution type or educator characteristics had no significant associations with overall competence in preparing teaching plans and microteaching (p > 0.05). Qualitatively, educators found the programme educative, flexible, convenient, motivating, and interactive for learning. Internet connectivity, computer technology, costs and time constraints were potential challenges to completing the programme. Conclusion The programme was feasible and effective in improving the knowledge and skills of educators for effective teaching/learning. For successful roll-out, policy framework for mandatory midwifery educator specific CPD programme is needed.

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Evaluation of capacity to deliver emergency obstetrics and newborn care updated midwifery and reproductive health training curricula in Kenya: Before and after study

Cited by 10 publications

References 6 publications

An evaluation of the effectiveness of an updated pre-service midwifery curriculum integrated with emergency obstetrics and newborn care in Kenya: a cluster randomised controlled trial

An evaluation of the effectiveness of an updated pre-service midwifery curriculum integrated with emergency obstetrics and newborn care in Kenya: a cluster randomised controlled trial

Improving midwifery educators’ capacity to teach emergency obstetrics and newborn care in Kenya universities: a pre-post study

Evaluation of the feasibility of a midwifery educator continuous professional development (CPD) programme in Kenya and Nigeria: a mixed methods study

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