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Effectiveness of a Pediatric Emergency Medicine Curriculum in a Public Tanzanian Referral Hospital

Carol C Chen1, Alexander L Werne2, Katharine A Osborn1,3

  • 1University of California, San Francisco, Section of Pediatric Emergency Medicine, Department of Emergency Medicine, San Francisco, California.

The Western Journal of Emergency Medicine
|January 9, 2020
PubMed

Insights

A new pediatric emergency medicine (PEM) curriculum effectively improved nurses' knowledge and self-efficacy in Tanzania. Further studies are needed to confirm changes in clinical behavior and patient outcomes.

Area of Science:

  • Emergency Medicine
  • Medical Education
  • Global Health

Background:

  • The World Health Organization highlights the critical role of emergency and trauma care.
  • A gap exists in comprehensive pediatric emergency medicine (PEM) curricula, especially for low-resource settings.
  • The African Federation for Emergency Medicine (AFEM) developed a PEM curriculum for nurses.

Purpose of the Study:

  • To pilot-test the AFEM PEM curriculum in a Tanzanian referral hospital.
  • To evaluate the curriculum's effectiveness in improving nurses' knowledge, self-efficacy, and behavior in pediatric emergencies.

Main Methods:

  • A non-randomized, controlled study involving 15 nurses in an intervention group and a matched control group.
  • A two-and-a-half-day curriculum included lectures, skills sessions, and simulations.
  • Pre- and post-training assessments measured knowledge (multiple-choice test) and self-efficacy (Likert surveys); behavior was observed during live pediatric resuscitations.

Main Results:

  • Post-training, the intervention group showed a median increase of 11.5 points in self-efficacy and 3 points in knowledge scores, while the control group showed no significant changes.
  • Observed pediatric resuscitations (n=1192) indicated the intervention group performed three of 27 critical actions at higher rates.
  • Participant-rated pre-training scores were similar between groups.

Conclusions:

  • The AFEM PEM curriculum is effective for knowledge acquisition and enhancing self-efficacy in pediatric emergencies among nurses.
  • Further evaluation is required to determine the curriculum's impact on nurse behavior and patient outcomes.
  • Potential curricular modifications may be necessary to optimize behavioral and patient outcome changes.
Abstract

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