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Boutros P, Kassem N, Nieder J, Jaramillo C, von Petersdorff J, Walsh FJ, Bärnighausen T, Barteit S. Education and Training Adaptations for Health Workers during the COVID-19 Pandemic: A Scoping Review of Lessons Learned and Innovations. Healthcare (Basel) 2023; 11:2902. [PMID: 37958046 PMCID: PMC10649637 DOI: 10.3390/healthcare11212902] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 10/25/2023] [Accepted: 11/02/2023] [Indexed: 11/15/2023] Open
Abstract
Introduction: The COVID-19 pandemic has considerably impacted the clinical education and training of health workers globally, causing severe disruptions to learning environments in healthcare facilities and limiting the acquisition of new clinical skills. Consequently, urgent adaptation measures, including simulation training and e-learning, have been implemented to mitigate the adverse effects of clinical education. This scoping review aims to assess the impact of COVID-19 on medical education and training, examine the implemented adaptation measures, and evaluate their effectiveness in improving health workers' education and training during the pandemic. Methods: Employing the PRISMA-ScR framework and Arksey and O'Malley's methodological guidance, we conducted a scoping review, systematically searching PubMed, medRxiv, Google, and DuckDuckGo databases to account for the grey literature. The search included studies published between 1 December 2019 and 13 October 2021, yielding 10,323 results. Of these, 88 studies focused on health worker education and training during the pandemic. Results: Our review incorporated 31,268 participants, including physicians, medical trainees, nurses, paramedics, students, and health educators. Most studies (71/88, 81%) were conducted in high-income and lower-middle-income countries. The pandemic's effects on health workers' clinical skills and abilities have necessitated training period extensions in some cases. We identified several positive outcomes from the implementation of simulation training and e-learning as adaptation strategies, such as enhanced technical and clinical performance, increased confidence and comfort, and an expanded global educational outreach. Conclusions: Despite challenges like insufficient practical experience, limited interpersonal interaction opportunities, and internet connectivity issues, simulation training, e-learning, and virtual training have proven effective in improving clinical education and training during the COVID-19 pandemic. Further research is required to bolster preparedness for future pandemics or similar situations.
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Affiliation(s)
- Perla Boutros
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine, Heidelberg University Hospital, Heidelberg University, 69120 Heidelberg, Germany
| | - Nour Kassem
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine, Heidelberg University Hospital, Heidelberg University, 69120 Heidelberg, Germany
| | - Jessica Nieder
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine, Heidelberg University Hospital, Heidelberg University, 69120 Heidelberg, Germany
| | - Catalina Jaramillo
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine, Heidelberg University Hospital, Heidelberg University, 69120 Heidelberg, Germany
| | - Jakob von Petersdorff
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine, Heidelberg University Hospital, Heidelberg University, 69120 Heidelberg, Germany
| | - Fiona J Walsh
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine, Heidelberg University Hospital, Heidelberg University, 69120 Heidelberg, Germany
| | - Till Bärnighausen
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine, Heidelberg University Hospital, Heidelberg University, 69120 Heidelberg, Germany
- Africa Health Research Institute (AHRI), Somkhele, Mtubatuba 3935, KwaZulu-Natal, South Africa
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Sandra Barteit
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine, Heidelberg University Hospital, Heidelberg University, 69120 Heidelberg, Germany
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Jewell T, Gillespie KH, Schmuhl NB, Gilbert S, Grant B, Watts L, Ehrenthal DB. Caring for community members during the COVID-19 pandemic: results of a statewide survey. ZEITSCHRIFT FUR GESUNDHEITSWISSENSCHAFTEN = JOURNAL OF PUBLIC HEALTH 2023:1-10. [PMID: 37361316 PMCID: PMC10233524 DOI: 10.1007/s10389-023-01953-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 05/12/2023] [Indexed: 06/28/2023]
Abstract
Aim Community health workers (CHWs) and home visitors (HVs) are members of the public health workforce who are uniquely poised to support vulnerable populations during the COVID-19 pandemic. In this study, we assess the experiences of CHWs and HVs in Wisconsin during the early stages of the COVID-19 pandemic to learn about their experiences related to mitigation strategies and vaccination efforts. Subject and methods Working closely with community partners, we recruited CHWs and HVs via email to complete an online survey between June 24 and August 10, 2021. Participants were eligible if they worked at any time since March 25, 2020, when the Safer at Home Order was put into place. The survey asked CHWs and HVs about their experiences during the COVID-19 pandemic and vaccination efforts. Results Eligible respondents included 48 HVs and 26 CHWs. Most CHWs (96%) and HVs (85%) reported discussing the COVID-19 vaccine with clients, and 46% of HVs and 85% of CHWs said they planned to encourage their clients to vaccinate themselves against COVID-19. We found that many CHWs and HVs identified the COVID-19 pandemic as a threat to the health of the US population, and many reported that they thought mitigation strategies were effective at keeping people safe from COVID-19. There was inconsistency in regard to respondents plans to encourage their clients to receive vaccination for COVID-19. Conclusion Future study, training, and support for CHWs and HVs should focus on facilitating vaccination efforts and other emerging public health interventions.
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Affiliation(s)
- Tess Jewell
- University of Wisconsin School of Medicine and Public Health, Madison, WI USA
| | | | | | - Sharon Gilbert
- Wisconsin Department of Health Services, WI Madison, USA
| | | | | | - Deborah B. Ehrenthal
- Social Science Research Institute (SSRI), The Pennsylvania State University, University Park, PA USA
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Gore M, Kawade A, Smith P, Pinnock H, Juvekar S. Working as frontline health facilitators, service providers, program supporters, and social health activists in Indian hilly terrain areas: A qualitative study of accredited social health activists' experiences before and during the COVID-19 pandemic. J Glob Health 2022; 12:05052. [PMID: 36579668 PMCID: PMC9798346 DOI: 10.7189/jogh.12.05052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Background Community health workers (CHW) contribute to achieving health targets of the Sustainable Development Goals (SDG) and Universal Health Care (UHC) in low- and middle-income countries (LMICs). In India, accredited social health activists (ASHAs) function as health facilitators, service providers, and programme supporters for rural and tribal communities and are at the frontline during the COVID-19 pandemic. We aimed to describe the ASHAs' work roles both before and during the COVID-19 pandemic, explore the tasks ASHAs performed throughout the pandemic, and understand its effects on the evolving role of ASHAs. Methods We used qualitative data from a pre-COVID-19 study conducted in 2018-2019 including face-to-face interviews with purposively sampled ASHAs and their health care supervisors (n = 18) from rural Maharashtra state (India), and a follow-up study during the COVID-19 pandemic using telephonic interviews with a subset of participants from the pre-COVID-study (n = 8). Data were analysed thematically using MAXQDA v11.00. Results The primary theme in the pre-COVID-19 study was ASHAs' role as described above, except as social health activists, linking beneficiaries to the local maternal and child health care services, distributing medicines for common illnesses, access to government schemes, and engaging in multiple health surveys. During the pandemic, raising awareness, screening of at-risk populations, arranging referrals, providing treatment and follow-up to COVID-19 patients, and supporting their family members. These activities increased the workload and health risks to ASHAs and their family, causing stress and tension among them. However, they had effectively carried out the new duties. ASHAs have improved their status, earning praise from families, society, and the government. They were honoured with the Global Health Leaders Award at the 75th World Health Assembly. Conclusion ASHAs' contribution to the health system improved the indicators related to maternal and child health during the pre-COVID-19 pandemic. Additionally, they maintained frontline health care during the COVID-19 pandemic, demonstrating resilience despite the challenges of increased workload and stress. However, the COVID-19 pandemic highlights the need to respond to and understand the implications of ASHAs' evolving roles.
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Affiliation(s)
- Manisha Gore
- Symbiosis Community Outreach Programme and Extension, Faculty of Health Sciences, Symbiosis International (Deemed) University, Lavale, Pune, India
| | - Anand Kawade
- KEM Hospital Research Centre, Vadu Rural Health Program, Rasta Peth, Pune, India
| | - Pam Smith
- Nursing Studies, School of Health in Social Science, NIHR Global Health Research Unit on Respiratory Health, University of Edinburgh, Edinburgh, United Kingdom
| | - Hilary Pinnock
- NIHR Global Health Research Unit on Respiratory Health, Usher Institute, University of Edinburgh, Doorway 3, Medical School, Edinburgh, United Kingdom
| | - Sanjay Juvekar
- KEM Hospital Research Centre, Vadu Rural Health Program, Rasta Peth, Pune, India
| | - RESPIRE Collaboration
- Symbiosis Community Outreach Programme and Extension, Faculty of Health Sciences, Symbiosis International (Deemed) University, Lavale, Pune, India
- KEM Hospital Research Centre, Vadu Rural Health Program, Rasta Peth, Pune, India
- Nursing Studies, School of Health in Social Science, NIHR Global Health Research Unit on Respiratory Health, University of Edinburgh, Edinburgh, United Kingdom
- NIHR Global Health Research Unit on Respiratory Health, Usher Institute, University of Edinburgh, Doorway 3, Medical School, Edinburgh, United Kingdom
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Community health workers and promotoras' perspectives of a research best practice course: A focus group study. J Clin Transl Sci 2022; 6:e137. [PMID: 36590350 PMCID: PMC9794952 DOI: 10.1017/cts.2022.464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 09/07/2022] [Accepted: 09/12/2022] [Indexed: 01/04/2023] Open
Abstract
Introduction Community Health Workers and Promotoras (CHW/Ps) are valued for their role in helping to engage community members in research. CHW/Ps have traditionally received variable training in research fundamentals, including importance and promotion of research rigor to establish consistency in the methods used over time. Research best practices training exists for research professionals, but no standard training is provided as part of the CHW/P job role. To develop this CHW/P research best practices training, our team engaged English- and Spanish-speaking CHW/Ps to watch an early version of an online module and to examine perceptions of the relevance of such a training and optimal delivery methods. Methods Six virtual focus group discussions were conducted (three in English and three in Spanish) across different US geographic regions with currently employed CHW/Ps. Results Forty CHW/Ps participated (95% female, mean age 44 years, 58% identifying as Hispanic/Latino). Four themes emerged: relevance of training, benefits of providing a certificate of completion, flexible training delivery modalities, and peer-led training. Discussion With participation from representatives of the intended learner group of CHW/Ps, our team found that CHW/Ps valued learning about research best practices. They perceived culturally- and linguistically appropriate health research training to be highly relevant to their role, particularly for communicating key information to community members about their participation in health research. Additionally, participants provided input on effective dissemination of the training including the benefit of having proof of course completion, involvement of peer trainers, and value of providing the option to participate in online training.
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John JS, Hernández-Gordon W, Martínez S, Hernández I. Community Health Workers Connecting Communities During COVID-19: A Case Study From Chicago. J Ambul Care Manage 2022; 45:2-12. [PMID: 34581312 DOI: 10.1097/jac.0000000000000401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Coronavirus disease-2019 (COVID-19) has adversely impacted vulnerable communities. Community health workers (CHWs) are an evidence-based solution for helping communities navigate challenges and barriers. This case study describes the work of CHWs in a large Hispanic Chicago neighborhood who experienced a disproportionate number of COVID-19 cases. Methods included semistructured interviews and conventional qualitative content analysis. Results describe the problem; the situation; CHWs' roles, motivations and actions; outcomes; lessons learned; and recommendations. The case study concludes with a discussion of effective CHW engagement-particularly for underresourced communities-and presents recommendations for CHW workforce development and policies to strengthen the health care and public health systems.
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Affiliation(s)
- Julie St John
- Graduate School of Biomedical Sciences, and Julia Jones Matthews Department of Public Health, Texas Tech University Health Sciences Center, Abilene (Dr St. John); HealthConnect One, Chicago, Illinois (Ms Hernández-Gordon); and Enlace Chicago, Chicago, Illinois (Mss Martínez and Hernández)
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