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Nexø MA, Kingod NR, Eshøj SH, Kjærulff EM, Nørgaard O, Andersen TH. The impact of train-the-trainer programs on the continued professional development of nurses: a systematic review. BMC MEDICAL EDUCATION 2024; 24:30. [PMID: 38178050 PMCID: PMC10768131 DOI: 10.1186/s12909-023-04998-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 12/20/2023] [Indexed: 01/06/2024]
Abstract
BACKGROUND Train-the-trainer (TTT) programs are widely applied to disseminate knowledge within healthcare systems, but evidence of the effectiveness of this educational model remains unclear. We systematically reviewed studies evaluating the impact of train-the-trainer models on the learning outcomes of nurses. METHODS The reporting of our systematic review followed PRISMA 2020 checklist. Records identified from MEDLINE, Embase, CINAHL, and ERIC were independently screened by two researchers and deemed eligible if studies evaluated learning outcomes of a train-the-trainer intervention for trainers or trainees targeting nurses. Study quality was assessed with Joanna Briggs Institute's critical appraisal tools and data of study characteristics extracted (objective, design, population, outcomes, results). Heterogeneity of outcomes ruled out meta-analysis; a narrative synthesis and vote counting based on direction of effects (p < 0.05) synthesized the results. All records were uploaded and organized in EPPI-Reviewer. RESULTS Of the 3800 identified records 11 studies were included. The included studies were published between 1998 and 2021 and mostly performed in the US or Northern Europe. Nine studies had quasi-experimental designs and two were randomized controlled trials. All evaluated effects on nurses of which two also included nurses' assistants. The direction of effects of the 13 outcomes (knowledge, n = 10; skills, n = 2; practice, n = 1) measured in the 11 included studies were all beneficial. The statistical analysis of the vote counting showed that train-the-trainer programs could significantly (p < 0.05) improve trainees' knowledge, but the number of outcomes measuring impact on skills or practice was insufficient for synthesis. CONCLUSIONS Train-the-trainer models can successfully disseminate knowledge to nurses within healthcare systems. Considering the nurse shortages faced by most Western healthcare systems, train-the-trainer models can be a timesaving and sustainable way of delivering education. However, new comparative studies that evaluate practice outcomes are needed to conclude whether TTT programs are more effective, affordable and timesaving alternatives to other training programs. TRIAL REGISTRATION The protocol was registered in Research Registry ( https://www.researchregistry.com , unique identifying number 941, 29 June 2020).
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Affiliation(s)
- Mette Andersen Nexø
- Department of Education, Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Borgmester Ib Juuls Vej 83, Herlev, Denmark.
| | - Natassia Rosewood Kingod
- Department of Education, Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Borgmester Ib Juuls Vej 83, Herlev, Denmark
| | - Signe Hornsleth Eshøj
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Øster Farimagsgade 5, Building 24 Q, 1 Floor, Copenhagen K, Denmark
| | - Emilie Mølholm Kjærulff
- Department of Education, Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Borgmester Ib Juuls Vej 83, Herlev, Denmark
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Øster Farimagsgade 5, Building 24 Q, 1 Floor, Copenhagen K, Denmark
| | - Ole Nørgaard
- Department of Education, Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Borgmester Ib Juuls Vej 83, Herlev, Denmark
| | - Tue Helms Andersen
- Department of Education, Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Borgmester Ib Juuls Vej 83, Herlev, Denmark
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Qi L, Zhou Y, Wang R, Wang Y, Liu Y, Zeng L. Perceived quality of primary healthcare services and its association with institutional trust among caregivers of persons diagnosed with a severe mental illness in China. J Psychiatr Ment Health Nurs 2021; 28:394-408. [PMID: 32881201 DOI: 10.1111/jpm.12687] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 07/08/2020] [Accepted: 08/11/2020] [Indexed: 11/29/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT Low utilization of the family-oriented community rehabilitation services is a threatening challenge facing low- and middle- income countries. Family caregiver's trust in community healthcare providers is the precondition of service utilization and is shaped by their perceived quality of primary healthcare services from previous experience. Most of the studies concerning the relationship between perceived quality and institutional trust were conducted in western countries, resulting in limited attention paid to conditions in non-western countries. Which aspect of quality predicts institutional trust in China has not been studied yet. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE In China's context, institutional trust was generally associated with communication, worry relief and risk of privacy leak, but not with technical competence. Significant rural-urban disparity was observed: among rural respondents, institutional trust was associated with technical competence, communication and risk of privacy leak, but not with worry relief; institutional trust was only associated with worry relief in urban respondents. WHAT ARE THE IMPLICATIONS FOR PRACTICE Mental health nurses training or working with community healthcare workers may improve their technical and communicative competence. Priorities may differ between rural and urban areas. Mental health nurses or community healthcare workers may provide more family-oriented psycho-education to rural families, and more emotional support to urban families. Wider public anti-stigma initiatives are needed to reduce the affiliated stigma of families of persons diagnosed with a severe mental illness. ABSTRACT Introduction Prior studies suggested that caregiver's trust in community healthcare providers is the precondition of the utilization of community-based rehabilitation services and is shaped by their perceived quality of primary healthcare services. Nevertheless, the research conducted in non-western countries is scarce, and which aspect of quality is associated with institutional trust in China has not been studied. Aim To explore the association between perceived quality of primary healthcare services and institutional trust in China's context. Methods This cross-sectional study was conducted with 796 family caregivers from Eastern, Central and Western China between August 2018 and October 2019. Perceived quality of primary healthcare services was measured by technical competence, communication, worry relief and risk of privacy leak. Results Institutional trust was generally associated with communication, worry relief and risk of privacy leak, but not with technical competence. Among rural respondents, institutional trust was associated with technical competence, communication and risk of privacy leak, but not with worry relief. Contrary finding was observed in urban respondents. Discussion and implications for practice With rural-urban disparity considered, strategies such as improving the technical and communicative competence of community healthcare workers, providing family-oriented psycho-education and emotional support, and promoting public anti-stigma initiatives may be worth consideration.
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Affiliation(s)
- Ling Qi
- School of Health Science and Nursing, Wuhan Polytechnic University, Wuhan, China
| | | | - Ruoxi Wang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Research Center for Rural Health Services, Hubei Province Key Research Institute of Humanities and Social Sciences, Wuhan, China
| | - Yang Wang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yifeng Liu
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
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Osborn D, Burton A, Walters K, Nazareth I, Heinkel S, Atkins L, Blackburn R, Holt R, Hunter R, King M, Marston L, Michie S, Morris R, Morris S, Omar R, Peveler R, Pinfold V, Zomer E, Barnes T, Craig T, Gilbert H, Grey B, Johnston C, Leibowitz J, Petersen I, Stevenson F, Hardy S, Robinson V. Evaluating the clinical and cost effectiveness of a behaviour change intervention for lowering cardiovascular disease risk for people with severe mental illnesses in primary care (PRIMROSE study): study protocol for a cluster randomised controlled trial. Trials 2016; 17:80. [PMID: 26868949 PMCID: PMC4751703 DOI: 10.1186/s13063-016-1176-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Accepted: 01/15/2016] [Indexed: 12/24/2022] Open
Abstract
Background People with severe mental illnesses die up to 20 years earlier than the general population, with cardiovascular disease being the leading cause of death. National guidelines recommend that the physical care of people with severe mental illnesses should be the responsibility of primary care; however, little is known about effective interventions to lower cardiovascular disease risk in this population and setting. Following extensive peer review, funding was secured from the United Kingdom National Institute for Health Research (NIHR) to deliver the proposed study. The aim of the trial is to test the effectiveness of a behavioural intervention to lower cardiovascular disease risk in people with severe mental illnesses in United Kingdom General Practices. Methods/Design The study is a cluster randomised controlled trial in 70 GP practices for people with severe mental illnesses, aged 30 to 75 years old, with elevated cardiovascular disease risk factors. The trial will compare the effectiveness of a behavioural intervention designed to lower cardiovascular disease risk and delivered by a practice nurse or healthcare assistant, with standard care offered in General Practice. A total of 350 people will be recruited and followed up at 6 and 12 months. The primary outcome is total cholesterol level at the 12-month follow-up and secondary outcomes include blood pressure, body mass index, waist circumference, smoking status, quality of life, adherence to treatments and services and behavioural measures for diet, physical activity and alcohol use. An economic evaluation will be carried out to determine the cost effectiveness of the intervention compared with standard care. Discussion The results of this pragmatic trial will provide evidence on the clinical and cost effectiveness of the intervention on lowering total cholesterol and addressing multiple cardiovascular disease risk factors in people with severe mental illnesses in GP Practices. Trial registration Current Controlled Trials ISRCTN13762819. Date of Registration: 25 February 2013. Date and Version Number: 27 August 2014 Version 5.
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Affiliation(s)
- David Osborn
- Division of Psychiatry, Epidemiology and Applied Clinical Research Department, Faculty of Brain Sciences, University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK. .,Camden and Islington NHS Foundation Trust, 4th Floor, East Wing, St Pancras Hospital, 4 St Pancras Way, London, NW1 0PE, UK.
| | - Alexandra Burton
- Division of Psychiatry, Epidemiology and Applied Clinical Research Department, Faculty of Brain Sciences, University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK.
| | - Kate Walters
- Department of Primary Care and Population Health, Institute of Epidemiology and Health Care, University College London, Rowland Hill St, London, NW3 2PF, UK.
| | - Irwin Nazareth
- Department of Primary Care and Population Health, Institute of Epidemiology and Health Care, University College London, Rowland Hill St, London, NW3 2PF, UK.
| | - Samira Heinkel
- Division of Psychiatry, Epidemiology and Applied Clinical Research Department, Faculty of Brain Sciences, University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK.
| | - Lou Atkins
- Division of Psychology and Language Sciences, Centre for Behaviour Change, Department of Clinical, Educational and Health Psychology, Faculty of Brain Sciences, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.
| | - Ruth Blackburn
- Division of Psychiatry, Epidemiology and Applied Clinical Research Department, Faculty of Brain Sciences, University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK.
| | - Richard Holt
- Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, University Rd, Southampton, SO17 1BJ, UK.
| | - Racheal Hunter
- Department of Primary Care and Population Health, Institute of Epidemiology and Health Care, University College London, Rowland Hill St, London, NW3 2PF, UK.
| | - Michael King
- Division of Psychiatry, Epidemiology and Applied Clinical Research Department, Faculty of Brain Sciences, University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK.
| | - Louise Marston
- Department of Primary Care and Population Health, Institute of Epidemiology and Health Care, University College London, Rowland Hill St, London, NW3 2PF, UK.
| | - Susan Michie
- Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, University Rd, Southampton, SO17 1BJ, UK.
| | - Richard Morris
- UCL Department of Applied Health Research, Institute of Epidemiology and Health Care, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.
| | - Steve Morris
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.
| | - Rumana Omar
- Department of Primary Care and Population Health, Institute of Epidemiology and Health Care, University College London, Rowland Hill St, London, NW3 2PF, UK.
| | - Robert Peveler
- Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, University Rd, Southampton, SO17 1BJ, UK.
| | - Vanessa Pinfold
- The McPin Foundation, 32-36 Loman Street, London, SE1 0EH, UK.
| | - Ella Zomer
- Department of Primary Care and Population Health, Institute of Epidemiology and Health Care, University College London, Rowland Hill St, London, NW3 2PF, UK.
| | - Thomas Barnes
- Department of Medicine, Faculty of Medicine, Imperial College London, Commonwealth Building, Hammersmith Campus, Du Cane Road, London, W12 0NN, UK.
| | - Tom Craig
- Institute of Psychiatry, Psychology & Neuroscience, Kings College London, 16 De Crespigny Park, London, SE5 8AF, UK.
| | - Hazel Gilbert
- Department of Primary Care and Population Health, Institute of Epidemiology and Health Care, University College London, Rowland Hill St, London, NW3 2PF, UK.
| | - Ben Grey
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.
| | - Claire Johnston
- Camden and Islington NHS Foundation Trust, 4th Floor, East Wing, St Pancras Hospital, 4 St Pancras Way, London, NW1 0PE, UK.
| | - Judy Leibowitz
- Camden and Islington NHS Foundation Trust, 4th Floor, East Wing, St Pancras Hospital, 4 St Pancras Way, London, NW1 0PE, UK.
| | - Irene Petersen
- Department of Primary Care and Population Health, Institute of Epidemiology and Health Care, University College London, Rowland Hill St, London, NW3 2PF, UK.
| | - Fiona Stevenson
- Department of Primary Care and Population Health, Institute of Epidemiology and Health Care, University College London, Rowland Hill St, London, NW3 2PF, UK.
| | - Sheila Hardy
- University of Northampton, Berrywood Hospital, Berrywood Drive, Upton, Northampton, NN5 6UD, UK.
| | - Vanessa Robinson
- Rethink Mental Illness, 89 Albert Embankment, London, SE1 7TP, UK.
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