Global Advocacy for Women: Impact of Simulation-based Training
AAPA ePoster library. Rota M. 05/17/17; 180501; 111
Michael Rota
Michael Rota
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Abstract
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Purpose: Latin America is plagued by high maternal and infant mortality rates, often attributed to limited maternal healthcare provided by traditional birth attendants, or comadronas. This led to our development of a simulation-based culturally sensitive educational program specifically for these providers. Description: A simulation-based culturally-sensitive training program was offered to comadronas in Guatemala. The training began with an oral presentation (English, Spanish, and Mayan), emphasizing key points of the normal birthing process and the management of complications such as post-partum hemorrhage (PPH). Visual aids and simulation manikins afforded hands-on opportunities to practice key points. Pre- and post-training surveys were distributed to comadronas reflecting on knowledge, opinions of birthing practices, and ability to prevent and manage complications. The surveys consisted of twenty-five questions divided into four sections reflecting on: demographics and current birthing practices, medical knowledge, opinions on the handling of complicated deliveries, and feedback on the learning process. Results: PA faculty and students piloted a simulation-based culturally-sensitive training program with two groups of comadronas in two rural locations of Guatemala. The results indicated that the knowledge of the comadronas improved from pre- to post-training surveys regardless of formal education, language, or age. Improvements per question ranged from 4-54%. Significant improvements were noted with specific questions such as 'amount of blood loss requiring medical treatment' (p < 0.001) and 'signs of placental separation' (p < 0.001). The opinions of the comadronas with respect to management of the normal birthing process and possible complications also showed a positive change overall (p < 0.005), but with age contributing to statistically significant differences in results. Although knowledge improved irrespective of age, older comadronas were less likely than younger comadronas to change their opinions on their practices. Conclusion: We believe that our novel use of simulation manikins may have strongly contributed to our outcomes. We look forward to implementing a more expansive study and hope that this endeavor will result in a positive impact on lowering the rate of maternal mortality in Guatemala and the other countries in Latin America that we will be visiting....
Purpose: Latin America is plagued by high maternal and infant mortality rates, often attributed to limited maternal healthcare provided by traditional birth attendants, or comadronas. This led to our development of a simulation-based culturally sensitive educational program specifically for these providers. Description: A simulation-based culturally-sensitive training program was offered to comadronas in Guatemala. The training began with an oral presentation (English, Spanish, and Mayan), emphasizing key points of the normal birthing process and the management of complications such as post-partum hemorrhage (PPH). Visual aids and simulation manikins afforded hands-on opportunities to practice key points. Pre- and post-training surveys were distributed to comadronas reflecting on knowledge, opinions of birthing practices, and ability to prevent and manage complications. The surveys consisted of twenty-five questions divided into four sections reflecting on: demographics and current birthing practices, medical knowledge, opinions on the handling of complicated deliveries, and feedback on the learning process. Results: PA faculty and students piloted a simulation-based culturally-sensitive training program with two groups of comadronas in two rural locations of Guatemala. The results indicated that the knowledge of the comadronas improved from pre- to post-training surveys regardless of formal education, language, or age. Improvements per question ranged from 4-54%. Significant improvements were noted with specific questions such as 'amount of blood loss requiring medical treatment' (p < 0.001) and 'signs of placental separation' (p < 0.001). The opinions of the comadronas with respect to management of the normal birthing process and possible complications also showed a positive change overall (p < 0.005), but with age contributing to statistically significant differences in results. Although knowledge improved irrespective of age, older comadronas were less likely than younger comadronas to change their opinions on their practices. Conclusion: We believe that our novel use of simulation manikins may have strongly contributed to our outcomes. We look forward to implementing a more expansive study and hope that this endeavor will result in a positive impact on lowering the rate of maternal mortality in Guatemala and the other countries in Latin America that we will be visiting....
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