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Development and implementation of a multiple stage emergency care training program in Kono, Sierra Leone: a
Michael Shen1, Fenty Benk Sankoh2, Pranali Sheth3
1Section of Emergency Medicine, University of Chicago, Chicago, IL, USA. michaelshen1993@gmail.com.
Background:
Low- and middle-income countries (LMICs) face a disproportionate burden of acute diseases exacerbated by limited emergency care infrastructure and severe deficiencies in emergency care education. To address this critical need in Sierra Leone, we implemented an emergency care training program at Koidu Government Hospital (KGH) targeted at Clinical Health Officers (CHOs) and nurses. We further developed an educator training curriculum aimed at transitioning program graduates into clinician-educators.
Methods:
Alumni of an emergency care course previously conducted at this site were eligible for inclusion in the study. Participants underwent a multidimensional knowledge and skills assessment; those that passed were selected to participate in the Emergency Medical Educator Development (EMED) course. Participants completing the EMED course were evaluated using a knowledge and skills assessment. The cohort's teaching self-efficacy was then compared to that of a baseline group, and student feedback on the cohort's teaching performance in an Advanced Emergency Training (AET) course was compared to consultant instructors. All materials including the preliminary multidimensional assessment, EMED course, and EMED student assessment were developed by the authors with incorporation of key stakeholder input and consideration of contextual factors. Data analysis was performed using SPSS.
Results:
Four CHOs and three nurses completed the EMED course. All but one student passed the final knowledge assessment. Evaluation of didactic and clinical teaching skills demonstrated adequate to good performance. Self-efficacy scores in both didactic and clinical teaching were significantly higher in the EMED cohort compared to a baseline group. Although students in the AET course scored lower compared to consultant instructors, subjective reviews were positive overall.
Conclusions:
Despite significant technological barriers and limited prior educational experience, we successfully trained a cohort of educators who demonstrated markedly improved self-efficacy and received strong reviews from students. Moving forward, our goal is to transition the cohort to more autonomous roles while reducing reliance on international assistance. We believe this model offers a promising approach to sustainable emergency care development in resource-limited settings by building local educational capacity.
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