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Mkonyi E, Silla NB, Rohloff CT, Lukumay GG, Ross MW, Kohli N, Mgopa LR, Massae AF, Mohammed IS, Mushy SE, Mwakawanga DL, Rosser BRS, Trent M. Not Lost in Translation: The Use of Standardized Patients Technology among Health Professional Students in Tanzania. East Afr J Health Sci 2023; 6:149-161. [PMID: 38046829 PMCID: PMC10691444 DOI: 10.37284/eajhs.6.1.1243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
Health professionals in Tanzania report a perceived need for sexual and reproductive health communication training to meet patient needs and reduce disparities. Simulation optimizes clinical performance and public entrustment. The study describes the development, feasibility, and acceptability measures of evidence-based, Afrocentric, standardized patient scenarios to train nursing, medical, and midwifery students in sexual and reproductive health in Tanzania. Standardized patient simulation cases with embedded cultural, language, gender, age, sexuality, and legal complexity issues were identified by stakeholders in Dar es Salaam centering on;1) adolescent health, 2) women's health, and 3) male health cases. Twenty-four health professional students evenly split across nursing, midwifery, and medicine were recruited and enrolled to participate in a pilot trial of the standardized patient simulations conducted in Kiswahili and the results recorded. Videos were evaluated by trained bilingual research staff using standardized behavioral checklists. Descriptive statistics and bivariate analyses were used to assess the pilot data. The study found that seventy-five percent (N =18) of baseline participants (N=24) returned for the 3-month follow-up simulation assessment. While not powered for statistical significance, students showed improvement in all cases and a significant improvement in the male erectile dysfunction concerns case for both interpersonal communication (t (17) = -3.445, p < .005) and medical history taking checklist (t(17)= -3.259, p < .005). Further, most students found the opportunity to practice using the simulations helpful or very helpful in their sexual and reproductive health education. It was therefore concluded that preliminary sexual and reproductive health simulation data using standardized patients demonstrated feasibility and acceptability among student participants.
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Affiliation(s)
- Ever Mkonyi
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 S. 2 St., Minneapolis, MN, 55454 USA
| | - Ndeye Boury Silla
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St Suite E8527, Baltimore, MD 21205, USA
| | - Corissa T. Rohloff
- Department of Educational Psychology, University of Minnesota, 250 Education Sciences Bldg, 56 E River Rd, Minneapolis, MN 55455, USA
| | - Gift Gadiel Lukumay
- Department of Community Health Nursing, School of Nursing, Muhimbili University of Health and Allied, Sciences (MUHAS), United Nations Rd, Dar es Salaam, Tanzania
| | - Michael W. Ross
- Program in Human Sexuality, Department of Family Medicine, University of Minnesota, 420 Delaware St. SE. Minneapolis, MN, 55455 USA
| | - Nidhi Kohli
- Department of Educational Psychology, University of Minnesota, 250 Education Sciences Bldg, 56 E River Rd, Minneapolis, MN 55455, USA
| | - Lucy Raphael Mgopa
- Department of Psychiatry, School of Medicine, Muhimbili University of Health and Allied Sciences, United Nations Rd, Dar Es Salaam, Tanzania
| | - Agnes Fredrick Massae
- Department of Community Health Nursing, School of Nursing, Muhimbili University of Health and Allied, Sciences (MUHAS), United Nations Rd, Dar es Salaam, Tanzania
| | - Inari S. Mohammed
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 S. 2 St., Minneapolis, MN, 55454 USA
| | - Stella Emmanuel Mushy
- Department of Community Health Nursing, School of Nursing, Muhimbili University of Health and Allied, Sciences (MUHAS), United Nations Rd, Dar es Salaam, Tanzania
| | - Dorkasi L. Mwakawanga
- Department of Community Health Nursing, School of Nursing, Muhimbili University of Health and Allied, Sciences (MUHAS), United Nations Rd, Dar es Salaam, Tanzania
| | - Brian Robert Simon Rosser
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 S. 2 St., Minneapolis, MN, 55454 USA
| | - Maria Trent
- Division of Adolescent and Young Adult Medicine, Johns Hopkins University Schools of Medicine, 1800 Orleans Street Baltimore, MD, 21287 USA
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Mkonyi E, Trent M, Mwakawanga DL, Massae AF, Ross MW, Bonilla ZE, Mohammed IS, Lukumay GG, Mushy SE, Mgopa LR, Wadley J, Mkoka DA, Simon Rosser BR. Evaluating the History-Taking Process of Sexual Reproductive Health Problems in Tanzania: Lessons from a Study of Health Students and Practitioners. East Afr J Health Sci 2023; 6:133-148. [PMID: 38013881 PMCID: PMC10680495 DOI: 10.37284/eajhs.6.1.1239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
Building trust and therapeutic relationships between healthcare providers and patients are crucial for delivering high-quality, comprehensive sexual and reproductive health (SRH) services. Yet, while patients face substantial SRH disparities in Tanzania, little is known about health care professionals' [HCPs] SRH history-taking practices and experiences. This paper describes HCPs' interdisciplinary practices, experience in conducting SRH taking, and the critical lessons learned to optimize quality SRH care. We conducted 18 focus group discussions in June 2019 in Dar es Salaam, Tanzania, with 60 healthcare practitioners and 61 students in midwifery, nursing, and medicine. We implemented a purposive, stratified sampling design to explore the experiences and perspectives of HCPs regarding providing sexual health services. We employed a grounded theory approach to perform the analysis. We provided seven scenarios to participants to discuss how they would manage SRH health problems. The scenarios helped us evaluate the practice and experience of SRH in Tanzania. Four broad themes and sub-themes emerged during the discussion; 1) SRH history-taking practices and experiences in the health care facilities; 2) the perceived benefit of effective SRH history-taking; 3) Factors hindering the SRH history-taking process; 4) The power of confidence. These findings have implications for strengthening a sexual health curriculum for medical students and continuing education programs for practicing health professionals designed to address the observed health disparities in Tanzania. These findings affirm that proper SRH history-taking requires a conducive environment, knowledge of relevant SRH-related laws and regulations; application of evidence-based techniques; and giving patients autonomy to make decisions for their health while making recommendations regarding standard care. Comprehensive SRH history-taking identifies critical data for illness diagnosis, provides foundational information for risk-reduction behavioural change counselling, and reduces medical costs. Therefore, the primary goal is to optimize health professional training on SRH issues and history-taking skills within the medical interview.
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Affiliation(s)
- Ever Mkonyi
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 S. 2nd St., Minneapolis, MN, 55454 USA
| | - Maria Trent
- Division of Adolescent and Young Adult Medicine, Johns Hopkins University Schools of Medicine, 1800 Orleans Street Baltimore, MD, 21287 USA
| | - Dorkasi L. Mwakawanga
- Department of Community Health Nursing, School of Nursing, Muhimbili University of Health and Allied, Sciences (MUHAS), United Nations Rd, Dar es Salaam, Tanzania
| | - Agnes Fredrick Massae
- Department of Community Health Nursing, School of Nursing, Muhimbili University of Health and Allied, Sciences (MUHAS), United Nations Rd, Dar es Salaam, Tanzania
| | - Michael W. Ross
- Program in Human Sexuality, Department of Family Medicine, University of Minnesota, 420 Delaware St. SE. Minneapolis, MN, 55455 USA
| | - Zobeida E. Bonilla
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 S. 2nd St., Minneapolis, MN, 55454 USA
| | - Inari S. Mohammed
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 S. 2nd St., Minneapolis, MN, 55454 USA
| | - Gift Gadiel Lukumay
- Department of Community Health Nursing, School of Nursing, Muhimbili University of Health and Allied, Sciences (MUHAS), United Nations Rd, Dar es Salaam, Tanzania
| | - Stella Emmanuel Mushy
- Department of Community Health Nursing, School of Nursing, Muhimbili University of Health and Allied, Sciences (MUHAS), United Nations Rd, Dar es Salaam, Tanzania
| | - Lucy Raphael Mgopa
- Department of Psychiatry, School of Medicine, Muhimbili University of Health and Allied Sciences, United Nations Rd, Dar Es Salaam, Tanzania
| | - James Wadley
- Department of Human Service, School of Adult & Continuing Education, 1570 Baltimore Pike Lincoln University, Philadelphia, PA, 19352 USA
| | - Dickson Ally Mkoka
- Department of Community Health Nursing, School of Nursing, Muhimbili University of Health and Allied, Sciences (MUHAS), United Nations Rd, Dar es Salaam, Tanzania
| | - Brian Robert Simon Rosser
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 S. 2nd St., Minneapolis, MN, 55454 USA
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