Publication: A tool to improve competence in the management of emergency patients by rural clinic health workers: a pilot assessment on the Thai-Myanmar border.
1
Accepted Date
2015-03-12
Issued Date
2015-04-13
Copyright Date
2015
Resource Type
Language
eng
ISSN
1752-1505 (electronic)
Rights
Mahidol University
Rights Holder(s)
BioMed Central
Bibliographic Citation
Stanley L, Min TH, Than HH, Stolbrink M, McGregor K, Chu C, et al. A tool to improve competence in the management of emergency patients by rural clinic health workers: a pilot assessment on the Thai-Myanmar border. Confl Health. 2015 Apr 13;9:11.
Suggested Citation
Stanley, Lilian, Min, Thaw Htwe, Than, Hla Hla, Stolbrink, Marie, McGregor, Kathryn, Chu, Cindy, Nosten, François H, McGready, Rose A tool to improve competence in the management of emergency patients by rural clinic health workers: a pilot assessment on the Thai-Myanmar border.. Stanley L, Min TH, Than HH, Stolbrink M, McGregor K, Chu C, et al. A tool to improve competence in the management of emergency patients by rural clinic health workers: a pilot assessment on the Thai-Myanmar border. Confl Health. 2015 Apr 13;9:11.. doi:10.1186/s13031-015-0041-x Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/808
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Title
A tool to improve competence in the management of emergency patients by rural clinic health workers: a pilot assessment on the Thai-Myanmar border.
Corresponding Author(s)
Abstract
BACKGROUND: Shoklo Malaria Research Unit has been providing health care in remote
clinics on the Thai-Myanmar border to refugee and migrant populations since 1986
and 1995, respectively. Clinics are staffed by local health workers with a
variety of training and experience. The need for a tool to improve the competence
of local health workers in basic emergency assessment and management was
recognised by medical faculty after observing the case mix seen at the clinic and
reviewing the teaching programme that had been delivered in the past year (Jan-13
to March-14).
AIMS: To pilot the development and evaluation of a simple teaching tool to
improve competence in the assessment and management of acutely unwell patients by
local health workers that can be delivered onsite with minimal resources.
METHODS: A structured approach to common emergencies presenting to rural clinics
and utilizing equipment available in the clinics was developed. A prospective
repeated-measures observed structured clinical examination (OSCE) assessment
design was used to score participants in their competence to assess and manage a
scenario based 'emergency patient' at baseline, immediately post-course, and
8 weeks after the delivery of the teaching course. The assessment was conducted
at 3 clinic sites and staff participation was voluntary. Participants filled out
questionnaires on their confidence with different scenario based emergency
patients.
RESULTS: All staff who underwent the baseline assessment failed to carry out the
essential steps in initial emergency assessment and management of an unconscious
patient scenario. Following delivery of the teaching session, all groups showed
improved competence in both objective assessment and subjective confidence
levels.
CONCLUSIONS: Structured and practical teaching and learning with minimal theory
in this resource limited setting had a positive short-term effect on the
competence of individual staff to carry out an initial assessment and manage an
acutely unwell patient. Health-worker confidence likewise improved. Workplace
assessments are needed to determine if this type of skills training impacts upon
mortality or near miss mortality patients at the clinic.