Improving childcare staff management of acute asthma exacerbation - An Australian pilot study

Role of technology in improving knowledge and confidence in asthma management in school staff

Objective: To investigate the effectiveness of technology enabled learning in improving asthma first aid knowledge and self-confidence in providing asthma first aid to children in staff within a school setting. Study Design: A prospective randomized parallel study using a pre and post test design was conducted across Metropolitan schools of New South Wales (NSW), Australia. School staff in selected schools were randomly assigned to receive first aid asthma management training via a self-directed multimedia eBook learning resource or standard face-to-face training. Staff completed a 14 item validated Asthma First Aid Knowledge Questionnaire and a 4 item, 10-point Likert-scale asthma management self-confidence questionnaire immediately pre and post training. Results: 148 school staff from 46 schools were recruited with a total of 59 (78%) staff completing the eBook training and 62 (86%) completing face-to-face training. The mean asthma first aid knowledge score and self-confidence score in managing asthma increased significantly (p < 0.0001) in the eBook training group post training. There was no significant difference in the increase in the mean scores post training between the eBook and face-to-face training groups (p = 0.11). Conclusion: Asthma management knowledge and self-confidence increased in school staff following the eBook training. In school settings where human resources for health education are limited, technology enabled learning may be substituted to provide a self-directed approach to asthma first aid management training.

The effectiveness of an online training programme to prepare teachers to provide asthma first aid

AIM

Asthma is prevalent in our primary (elementary) school population. Training in asthma management for school staff should be relevant and focused on the recognition and management of an acute severe exacerbation of asthma. Evidence suggests that online training can be as effective as face-to-face training for medical education; however, there is little information regarding the effectiveness of online asthma education.

METHODS

University students in the final year of their primary education degree completed the asthma first aid (AFA) knowledge questionnaire before undertaking a 1-h online training course in asthma management. After 3 weeks, participants underwent a second AFA knowledge questionnaire followed by an AFA scenario-based skills assessment. This skills assessment required the student to describe and demonstrate how they would manage a child having a severe exacerbation of asthma using the AFA equipment provided. Skills scores were further analysed to establish AFA competency.

RESULTS

AFA knowledge scores improved significantly after the asthma online training (64-79%), z = -6.11 (P < 0.001). The mean AFA skills score after the training was 20.5 (79%); however, the proportion of students who achieved a level of competency sufficient to save the life of a child having a severe exacerbation of asthma was only 29%.

CONCLUSION

This research has revealed that online asthma management training was effective in increasing the knowledge needed for AFA. This knowledge did not translate into effective AFA skills, with only 29% of participants deemed competent to save the life of a child in an asthma emergency.

Impact of scenario based training on asthma first aid knowledge and skills in school staff: an open label, three-arm, parallel-group repeated measures study

Objective: To test the hypothesis that scenario-based skills training is more effective than knowledge training alone in improving the asthma first aid skills of school personnel. Education developed specifically for non-primary caregivers such as school staff is vital to minimize the risk of mortality associated with asthma. Methods: Schools were allocated to one of three arms to compare AFA knowledge and AFA skills. Arm 1 underwent conventional asthma training, arm 2 underwent scenario-based training and arm 3 had a combination of the two. Conventional asthma training involved a didactic oral presentation. The scenario-based skills training required the participant to describe and demonstrate how they would manage a child having a severe exacerbation of asthma using equipment provided. Follow-up occurred at 3 weeks post baseline and again between 3-7 months after the first training/education visit. Results: Nineteen primary schools (204 participants) were recruited. One-way ANOVA and Bonferroni Post-Hoc Tests showed there was a significant difference in AFA skills scores between the study arms who underwent scenario-based training; arms 2 and 3 (91.5% and 91.1%) and arm 1 who underwent conventional asthma training (77.3%) (p < 0.001). AFA knowledge improved significantly in all study arms with no differences between study arms. Improvements seen in both AFA knowledge and AFA skills were maintained over time. Conclusions: Scenario-based training was superior to conventional didactic asthma training for AFA skills acquisition and overall competency in the administration of AFA and should be included in future asthma training programs.

Systematic review and content analysis of asthma knowledge questionnaires: A focus on the knowledge surrounding acute exacerbation management

OBJECTIVES

Asthma education is a key component of asthma management. Asthma education around the management of a person who is having an acute exacerbation of asthma (often referred to as asthma first aid (AFA) training) is important, particularly in a school setting. There is no gold standard assessment of asthma knowledge and also there is no specific tool to measure the knowledge of AFA. Our aim was to identify asthma knowledge questionnaires and perform a content analysis. We were interested in evaluating the number, the type and the format of AFA questions.

METHOD

A literature search was performed to identify the instruments which were able to assess asthma knowledge of people with asthma and/or caregivers of people with asthma. An electronic database search was performed in EMBASE, IPA, MEDLINE and PUBMED. Articles which described the development or psychometric testing of an asthma knowledge questionnaire were included. The content of questions in each instrument was analysed and categorised using the NVivo software, and a secondary analysis was performed to identify knowledge questions relevant to the management of an acute asthma exacerbation.

RESULTS

Forty-four papers with 37 different instruments met the inclusion criteria. The majority of the instruments contained a relatively low proportion of questions related to the management of acute asthma, i.e., only 162 of the 780 questions (21%). No questionnaire had sufficient specific emphasis on acute asthma management knowledge to test the impact of AFA training.

CONCLUSION

There is a scope to develop an up-to-date validated acute asthma management knowledge questionnaire for use in research and clinical settings.