Scaling up pediatric nurse specialist education in Ghana – a longitudinal, mixed methods evaluation

Abstract

Background Inadequate health human resources is a key challenge to advancing child survival in Ghana. Nurses are an essential human resource to target because they represent the largest portion of the health workforce. Building on lessons learned from our pilot pediatric nurse training project and World Health Organization guidelines for transforming and scaling up health professional education, this project aimed to; train 500 pediatric nurse specialists through a one-year training program; develop and integrate a critical mass of pediatric nursing faculty and establish a national standardized pediatric nursing curriculum. This study aimed to evaluate the effectiveness of a national pediatric nurse training program in Ghana at the end of 4 years, including eight cohorts with 330 graduates. Methods This was a mixed-method evaluation with surveys, focus groups and a pre-test/post-test design. Before and after surveys were used to measure knowledge and confidence at baseline and graduation. Objective Structured Clinical Examinations (OSCE) were used to measure clinical skills at baseline, graduation, and 14 months follow-up. At the end of every module, surveys were used to measure students’ satisfaction. Focus groups at graduation qualitatively measured program outcomes. Repeat focus groups and surveys at 14 months after graduation captured the graduates’ career progress, experiences reintegrating into the health system and long-term program outcomes. Results Overall, the graduates completed the program with significantly increased knowledge, confidence, and clinical skills. They also had increased job satisfaction and were able to apply what they learned to their jobs, including leadership skills and gender-sensitive care. Data from 14-month follow-up OSCEs showed that all graduates remained competent in communication, physical assessment, and emergency care, although some obtained a lower mark compared to their performance at graduation. This finding is linked with the observation that the amount of mentorship, support from leadership and equipment that the graduates accessed from their respective facilities varied. Conclusions Mixed-methods evaluations demonstrated significant increases in knowledge confidence and skills by completing the program and maintenance of skills more than 1 year after graduation. Findings have implications for those working on the design, implementation, and evaluation of nursing education interventions in low- and middle-income countries.

Creating and implementing objective structured clinical exams for use in pediatric nursing education in Ghana: Reflections and lessons learned

“…The curriculum was found to effectively increase graduates' knowledge, confidence, and clinical skill in pediatric nursing. [17] PNEP formally completed in September 2020, although the curriculum continues to be used by GCNM to train pediatric RNs.…”

“…Details on the effectiveness of the curriculum and the use of OSCEs for assessing clinical skills to evaluate program effectiveness have been published elsewhere. [17] 2. METHODS…”

World Health Organization and knowledge translation in maternal, newborn, child and adolescent health and nutrition

“…Such a course would be open to general nurses, nurses with experience in paediatrics, midwives and even non-medical clinical officers working in child health, for which there are often no ongoing career pathways. Many countries need an accreditation process for any new course and healthcare worker credentialing 15 16…”

“…Many countries need an accreditation process for any new course and healthcare worker credentialing. 15 16 Develop more multimedia outputs including videos in multiple languages : WHO should explore capacity to be more creative, engaging and multilingual in its communication using this medium to communicate science-based public health information. More videos could target an audience that includes healthcare workers in the field, families and communities.…”

“…Many countries need an accreditation process for any new course and healthcare worker credentialing. 15 16 …”