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Kiguli-Malwadde E, Forster M, Eliaz A, Celentano J, Chilembe E, Couper ID, Dassah ET, De Villiers MR, Gachuno O, Haruzivishe C, Khanyola J, Martin S, Motlhatlhedi K, Mubuuke R, Mteta KA, Moabi P, Rodrigues A, Sears D, Semitala F, von Zinkernagel D, Reid MJA, Suleman F. Comparing in-person, blended and virtual training interventions; a real-world evaluation of HIV capacity building programs in 16 countries in sub-Saharan Africa. PLOS Glob Public Health 2023; 3:e0001654. [PMID: 37486898 PMCID: PMC10365303 DOI: 10.1371/journal.pgph.0001654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 06/05/2023] [Indexed: 07/26/2023]
Abstract
We sought to evaluate the impact of transitioning a multi-country HIV training program from in-person to online by comparing digital training approaches implemented during the pandemic with in-person approaches employed before COVID-19. We evaluated mean changes in pre-and post-course knowledge scores and self-reported confidence scores for learners who participated in (1) in-person workshops (between October 2019 and March 2020), (2) entirely asynchronous, Virtual Workshops [VW] (between May 2021 and January 2022), and (3) a blended Online Course [OC] (between May 2021 and January 2022) across 16 SSA countries. Learning objectives and evaluation tools were the same for all three groups. Across 16 SSA countries, 3023 participants enrolled in the in-person course, 2193 learners participated in the virtual workshop, and 527 in the online course. The proportions of women who participated in the VW and OC were greater than the proportion who participated in the in-person course (60.1% and 63.6%, p<0.001). Nursing and midwives constituted the largest learner group overall (1145 [37.9%] vs. 949 [43.3%] vs. 107 [20.5%]). Across all domains of HIV knowledge and self-perceived confidence, there was a mean increase between pre- and post-course assessments, regardless of how training was delivered. The greatest percent increase in knowledge scores was among those participating in the in-person course compared to VW or OC formats (13.6% increase vs. 6.0% and 7.6%, p<0.001). Gains in self-reported confidence were greater among learners who participated in the in-person course compared to VW or OC formats, regardless of training level (p<0.001) or professional cadre (p<0.001). In this multi-country capacity HIV training program, in-person, online synchronous, and blended synchronous/asynchronous strategies were effective means of training learners from diverse clinical settings. Online learning approaches facilitated participation from more women and more diverse cadres. However, gains in knowledge and clinical confidence were greater among those participating in in-person learning programs.
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Affiliation(s)
- E Kiguli-Malwadde
- African Center for Global Health and Social Transformation, Kampala, Uganda
| | - M Forster
- Institute for Global Health Sciences, University of California, San Francisco, California, United States of America
| | - A Eliaz
- Department of Medicine, Stanford University School of Medicine, Stanford, California, United States of America
| | - J Celentano
- Institute for Global Health Sciences, University of California, San Francisco, California, United States of America
| | - E Chilembe
- Kamuzu College of Nursing, University of Malawi, Kamuzu, Malawi
| | - I D Couper
- Department of Global Health, Ukwanda Centre for Rural Health, Stellenbosch University, Stellenbosch, South Africa
| | - E T Dassah
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - M R De Villiers
- Department of Global Health, Ukwanda Centre for Rural Health, Stellenbosch University, Stellenbosch, South Africa
| | - O Gachuno
- Faculty of Medicine, Department of Obstetrics and Gynecology, University of Nairobi, Nairobi, Kenya
| | - C Haruzivishe
- Faculty of Health Sciences, University of Zimbabwe College of Health Sciences, Harare, Zimbabwe
| | - J Khanyola
- University of Global Health Equity, Kigali, Rwanda
| | - S Martin
- Institute for Global Health Sciences, University of California, San Francisco, California, United States of America
| | - K Motlhatlhedi
- Faculty of Medicine, Department of Family Medicine and Public Health, University of Botswana, Botswana
| | - R Mubuuke
- School of Medicine, Makerere University, Kampala, Uganda
| | - K A Mteta
- Kilimanjaro Christian Medical University College, Kilimanjaro, Tanzania
| | - P Moabi
- Scott College of Nursing, Morija, Lesotho
| | - A Rodrigues
- Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
| | - D Sears
- Department of Medicine, Division of Infectious Diseases, University of California, San Francisco, California, United States of America
| | - F Semitala
- Faculty of Medicine, Department of Family Medicine and Public Health, University of Botswana, Botswana
| | - D von Zinkernagel
- Institute for Global Health Sciences, University of California, San Francisco, California, United States of America
| | - M J A Reid
- Institute for Global Health Sciences, University of California, San Francisco, California, United States of America
- Department of Medicine, Division of Infectious Diseases, University of California, San Francisco, California, United States of America
| | - F Suleman
- School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
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Kiguli-Malwadde E, Budak JZ, Chilemba E, Semitala F, Von Zinkernagel D, Mosepele M, Conradie H, Khanyola J, Haruruvizhe C, Martin S, Kazembe A, De Villiers M, Reid MJA. Developing an interprofessional transition course to improve team-based HIV care for sub-Saharan Africa. BMC Med Educ 2020; 20:499. [PMID: 33298029 PMCID: PMC7725217 DOI: 10.1186/s12909-020-02420-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 12/03/2020] [Indexed: 05/08/2023]
Abstract
BACKGROUND With funding from the United States Health Resources Service Administration (HRSA), a consortium of health professional training institutions from Africa developed HIV-specific, interprofessional, team-based educational resources to better support trainees during the transition period between pre-service training and professional practice. METHODS Ten faculty members representing nine medical and nursing schools in sub-Saharan Africa (SSA) developed a training package of modules focused on core clinical, public health, interprofessional education (IPE), and quality improvement (QI) domains related to HIV service delivery. Curriculum development was informed by a rapid needs assessment of existing tools and future needs for HIV education across 27 SSA health professions training institutions. A total of 17 modules were developed, targeted at newly qualified health care professionals to be taught in a series of two-day workshops meant to complement existing institution specific HIV-curricula. RESULTS Between April and July 2019, a comprehensive case-based HIV training package was developed to support trainees in transition from pre-service training to independent professional practice. Each module, addressing different elements of interprofessional practice, was intended to be delivered in an interprofessional format. Thus far, 70 health professions training institutions in 14 countries have implemented the program; 547 educators facilitated STRIPE workshops, with a total of 5027 learners trained between September 2019 and September 2020. CONCLUSIONS To our knowledge this is the first IPE HIV-specific curriculum explicitly focused on enhancing the quality of training provided to graduating health care professionals working in SSA. The collaborative, cross-institutional, interprofessional approach to curriculum development provides a benchmark for how best-practice approaches to education can be disseminated in SSA.
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Affiliation(s)
- E Kiguli-Malwadde
- African Centre for Global Health and Social Transformation (ACHEST), Kampala, Uganda
| | - J Z Budak
- Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA, USA
| | - E Chilemba
- University of Malawi, College of Nursing, Zomba, Malawi
| | | | | | - M Mosepele
- University of Botswana, Gaborone, Botswana
| | - H Conradie
- Stellenbosch University, Stellenbosch, South Africa
| | - J Khanyola
- University of Global Health Equity , Kigali, Rwanda
| | | | - S Martin
- University of California, San Francisco, USA
| | - A Kazembe
- University of Malawi, College of Nursing, Zomba, Malawi
| | | | - M J A Reid
- University of California, San Francisco, USA.
- Global Health Delivery, Diplomacy & Economics, Institute for Global Health Sciences | UCSF, 550 16th Street, 3rd Floor, San Francisco, CA, 94158, USA.
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Rosa WE, Fitzgerald M, Davis S, Farley JE, Khanyola J, Kwong J, Moreland PJ, Rogers M, Sibanda B, Turale S. Leveraging nurse practitioner capacities to achieve global health for all: COVID-19 and beyond. Int Nurs Rev 2020; 67:554-559. [PMID: 33006173 PMCID: PMC7537537 DOI: 10.1111/inr.12632] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 08/28/2020] [Accepted: 09/02/2020] [Indexed: 11/28/2022]
Abstract
Aim To argue that nurse practitioners have been under‐utilized generally in the current global health environment, creating barriers to achieving universal health coverage and the Sustainable Development Goals. Background Nurse practitioners are advanced practice nurses possessing expert knowledge and leadership skills that can be optimized to narrow disparities and ensure access to high‐quality health care globally. Nurses worldwide have been challenged to meet global public health needs in the context of COVID‐19 (SARS‐CoV‐2 virus), and there are early indications that nurse practitioners are being called upon to the full extent of their capabilities in the current pandemic. Sources of evidence PubMed; Google Scholar; the International Council of Nurses; World Health Organization; United Nations; and the experiences of the authors. Discussion Several international reports, nursing and health organizations have called for continued investment in and development of nursing to improve mechanisms that promote cost‐effective and universally accessible care. Expanding nurse practitioner scopes of practice across nations will leverage their clinical capacities, policy and advocacy skills, and talents to lead at all levels. Conclusion Ongoing empirical data and policy change is needed to enable the full scope and strategic utilization of nurse practitioners across healthcare systems and contexts. Implications for nursing practice, and nursing and health policy Widespread education regarding nurse practitioner capacities for interdisciplinary partners, policymakers and the public is needed. Policies that safely expand their roles are critical. Role titles and remuneration reflective of their scope and service are required to lead, sustain and grow the workforce internationally.
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Affiliation(s)
- W E Rosa
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - M Fitzgerald
- Fitzgerald Health Education Associates, LLC, North Andover, MA, USA
| | - S Davis
- Partners In Health, Boston, MA, USA
| | - J E Farley
- School of Nursing, Johns Hopkins University, Baltimore, MD, USA
| | - J Khanyola
- University of Global Health Equity, Kigali, Rwanda
| | - J Kwong
- Division of Advanced Practice, School of Nursing, The State University of New Jersey, Rutgers, NJ, USA
| | - P J Moreland
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | - M Rogers
- University Teaching Fellow for Advanced Practice and Advanced Nurse Practitioner, University of Huddersfield, Queensgate, Huddersfield, UK
| | - B Sibanda
- Anglophone Africa Advanced Practice Nursing Coalition (Zimbabwe), Queen's University, Belfast, Northern Ireland, UK
| | - S Turale
- Chiang Mai University Faculty of Nursing, Chiang Mai, Thailand
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