Correlates of Performance of Healthcare Workers in Emergency, Triage, Assessment and Treatment plus Admission Care (ETAT+) Course in Rwanda: Context Matters

The Emergency, Triage, Assessment and Treatment plus Admission care (ETAT+) course, a comprehensive advanced pediatric life support course, was introduced in Rwanda in 2010 to facilitate the achievement of the fourth Millennium Development Goal. The impact of the course on improving healthcare worke...

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Bibliographic Details
Published in:PloS one 2016-03, Vol.11 (3), p.e0152882-e0152882
Main Authors: Hategekimana, Celestin, Shoveller, Jeannie, Tuyisenge, Lisine, Kenyon, Cynthia, Cechetto, David F, Lynd, Larry D
Format: Article
Language:English
Subjects:
Archives & records
Beliefs, opinions and attitudes
Biology and Life Sciences
Child death
Children
Clinical medicine
Clustering
Collaboration
Confidence intervals
Education, Medical, Continuing
Emergency management
Emergency medical care
Emergency Medical Services
Emergency preparedness
Female
Health care
Health care facilities
Health care policy
Health Personnel - education
Hospital facilities
Hospitals
Human resources
Humans
Knowledge
Male
Medical interns
Medical personnel
Medical referrals
Medicine
Medicine and Health Sciences
Models, Theoretical
Mortality
Neonates
Newborn babies
Nurses
Occupational health
Patient Admission
Pediatrics
People and Places
Pharmaceutical sciences
Physicians
Practice
Prevention
Public health
Regression analysis
Regression models
Risk factors
Rwanda
Skills
Social Sciences
Statistical analysis
Training
Workers
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Summary:The Emergency, Triage, Assessment and Treatment plus Admission care (ETAT+) course, a comprehensive advanced pediatric life support course, was introduced in Rwanda in 2010 to facilitate the achievement of the fourth Millennium Development Goal. The impact of the course on improving healthcare workers (HCWs) knowledge and practical skills related to providing emergency care to severely ill newborns and children in Rwanda has not been studied. To evaluate the impact of the ETAT+ course on HCWs knowledge and practical skills, and to identify factors associated with greater improvement in knowledge and skills. We used a one group, pre-post test study using data collected during ETAT+ course implementation from 2010 to 2013. The paired t-test was used to assess the effect of ETAT+ course on knowledge improvement in participating HCWs. Mixed effects linear and logistic regression models were fitted to explore factors associated with HCWs performance in ETAT+ course knowledge and practical skills assessments, while accounting for clustering of HCWs in hospitals. 374 HCWs were included in the analysis. On average, knowledge scores improved by 22.8/100 (95% confidence interval (CI) 20.5, 25.1). In adjusted models, bilingual (French & English) participants had a greater improvement in knowledge 7.3 (95% CI 4.3, 10.2) and higher odds of passing the practical skills assessment (adjusted odds ratio (aOR) = 2.60; 95% CI 1.25, 5.40) than those who were solely proficient in French. Participants who attended a course outside of their health facility had higher odds of passing the skills assessment (aOR = 2.11; 95% CI 1.01, 4.44) than those who attended one within their health facility. The current study shows a positive impact of ETAT+ course on improving participants' knowledge and skills related to managing emergency pediatric and neonatal care conditions. The findings regarding key factors influencing ETAT+ course outcomes demonstrate the importance of considering key contextual factors (e.g., language barriers) that might affect HCWs performance in this type of continuous medical education.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0152882