The Effectiveness of a ‘Train the Trainer’ Model of Resuscitation Education for Rural Peripheral Hospital Doctors in Sri Lanka

Abstract

BackgroundSri Lankan rural doctors based in isolated peripheral hospitals routinely resuscitate critically ill patients but have difficulty accessing training. We tested a train-the-trainer model that could be utilised in isolated rural hospitals.MethodsEight selected rural hospital non-specialist doctors attended a 2-day instructor course. These “trained trainers” educated their colleagues in advanced cardiac life support at peripheral hospital workshops and we tested their students in resuscitation knowledge and skills pre and post training, and at 6- and 12-weeks. Knowledge was assessed through 30 multiple choice questions (MCQ), and resuscitation skills were assessed by performance in a video recorded simulated scenario of a cardiac arrest using a Resuci Anne Skill Trainer mannequin.Results/Discussion/ConclusionFifty seven doctors were trained. Pre and post training assessment was possible in 51 participants, and 6-week and 12-week follow up was possible for 43, and 38 participants respectively. Mean MCQ scores significantly improved over time (p<0.001), and a significant improvement was noted in “average ventilation volume”, “compression count”, and “compressions with no error”, “adequate depth”, “average depth”, and “compression rate” (p<0.01). The proportion of participants with compression depth ≥40mm increased post intervention (p<0.05) and at 12-week follow up (p<0.05), and proportion of ventilation volumes between 400-1000mls increased post intervention (p<0.001). A significant increase in the proportion of participants who “checked for responsiveness”, “opened the airway”, “performed a breathing check”, who used the “correct compression ratio”, and who used an “appropriate facemask technique” was also noted (p<0.001). A train-the-trainer model of resuscitation education was effective in improving resuscitation knowledge and skills in Sri Lankan rural peripheral hospital doctors. Improvement was sustained to 12 weeks for most components of resuscitation knowledge and skills. Further research is needed to identify which components of training are most effective in leading to sustained improvement in resuscitation.

Evaluating the effectiveness of in-service training program of Amhara Public Health Institute Dessie Branch, Northeast Ethiopia: a concurrent nested mixed quantitative/qualitative facility based cross sectional study

“…In the second level of our evaluation, majority of our participants really stated an improvement in their knowledge and skills after training. In agreement to this, a study done in Sweden and Sri Lankan also pointed out the effectiveness of training in improving trainee's knowledge and skills [10,14]. Moreover, another systematic review emphasized the importance of training to health professionals in order to enrich their pre-existing knowledge and skills [15].…”

Physician perspectives on the management of viral hepatitis and hepatocellular carcinoma in Myanmar

“…In fact, studies which have used this concept have had great success in reaching and training rural physicians. Follow-up has shown significant knowledge retention in most areas of training, but does suggest that rural physicians need a mechanism to reach out to experts when dealing with more difficult patients [ 13 , 14 , 15 ]. This type of advocacy for education may also lead to improved retention of healthcare providers in the rural areas of Myanmar, which is disadvantaged by a shortage of healthcare workers [ 8 ].…”

Knowledge of Primary Health Care Nurses in Providing First Aid in Life-Threatening Emergencies

“…It turns out that training organized according to the standards of the International Liaison Committee on Resuscitation (ILCOR) considerably increases the knowledge and skills of the participants. As a result, the qualifications relating to consciousness assessment, as well as restoring respiratory system patency and chest compressions depth rise by 61 and 79%, respectively (Rajapakse et al 2013). It is argued that BLS training should be repeated every 12-24 months.…”