Multimodal learning for emergency department triage implementation: experiences from Papua New Guinea during the COVID-19 pandemicResearch in context
Summary: Background: Triage implementation in resource-limited emergency departments (EDs) has traditionally relied on intensive in-person training. This study sought to evaluate the impact of a novel digital-based learning strategy focused on the Interagency Integrated Triage Tool, a three-tier tr...
| Main Authors: | , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2023-04-01
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| Series: | The Lancet Regional Health. Western Pacific |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666606523000019 |
| _version_ | 1811169474831712256 |
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| author | Rob Mitchell Sarah Bornstein Donna Piamnok Wilma Sebby Carl Kingston Rayleen Tefatu Mangu Kendino Betty Josaiah Jasper Pole Sylvia Kuk Sarah Körver Jean-Philippe Miller Travis Cole Andrew Erbs Gerard O'Reilly Peter Cameron Duncan Sengiromo Colin Banks |
| author_facet | Rob Mitchell Sarah Bornstein Donna Piamnok Wilma Sebby Carl Kingston Rayleen Tefatu Mangu Kendino Betty Josaiah Jasper Pole Sylvia Kuk Sarah Körver Jean-Philippe Miller Travis Cole Andrew Erbs Gerard O'Reilly Peter Cameron Duncan Sengiromo Colin Banks |
| author_sort | Rob Mitchell |
| collection | DOAJ |
| description | Summary: Background: Triage implementation in resource-limited emergency departments (EDs) has traditionally relied on intensive in-person training. This study sought to evaluate the impact of a novel digital-based learning strategy focused on the Interagency Integrated Triage Tool, a three-tier triage instrument recommended by the World Health Organization. Methods: A mixed methods study utilising pre-post intervention methods was conducted in two EDs in Papua New Guinea. The primary outcome was the mean change in knowledge before and after completion of a voluntary, multimodal training program, primarily delivered through a digital learning platform accessible via smartphone. Secondary outcomes included the change in confidence to perform selected clinical tasks, and acceptability of the learning methods. Findings: Among 136 eligible ED staff, 91 (66.9%) completed the digital learning program. The mean knowledge score on the post-training exam was 87.5% (SD 10.4), a mean increase of 12.9% (95% CI 10.7–15.1%, p < 0.0001) from the pre-training exam. There were statistically significant improvements in confidence for 13 of 15 clinical tasks, including undertaking a triage assessment and identifying an unwell patient.In an evaluation survey, 100% of 30 respondents agreed or strongly agreed the online learning platform was easy to access, use and navigate, and that the digital teaching methods were appropriate for their learning needs. In qualitative feedback, respondents reported that limited internet access and a lack of dedicated training time were barriers to participation. Interpretation: The use of digital learning to support triage implementation in resource-limited EDs is feasible and effective when accompanied by in-person mentoring. Adequate internet access is an essential pre-requisite. Funding: Development of the Kumul Helt Skul learning platform was undertaken as part of the Clinical Support Program (Phase II), facilitated by Johnstaff International Development on behalf of the Australian Government Department of Foreign Affairs and Trade through the PNG-Australia Partnership. RM is supported by a National Health and Medical Research Council Postgraduate Scholarship and a Monash Graduate Excellence Scholarship, while PC is supported by a Medical Research Future Fund Practitioner Fellowship. Funders had no role in study design, results analysis or manuscript preparation. |
| first_indexed | 2024-04-10T16:43:01Z |
| format | Article |
| id | doaj.art-2cafc52f2e5147db92c2901274db77c2 |
| institution | Directory Open Access Journal |
| issn | 2666-6065 |
| language | English |
| last_indexed | 2024-04-10T16:43:01Z |
| publishDate | 2023-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | The Lancet Regional Health. Western Pacific |
| spelling | doaj.art-2cafc52f2e5147db92c2901274db77c22023-02-08T04:17:45ZengElsevierThe Lancet Regional Health. Western Pacific2666-60652023-04-0133100683Multimodal learning for emergency department triage implementation: experiences from Papua New Guinea during the COVID-19 pandemicResearch in contextRob Mitchell0Sarah Bornstein1Donna Piamnok2Wilma Sebby3Carl Kingston4Rayleen Tefatu5Mangu Kendino6Betty Josaiah7Jasper Pole8Sylvia Kuk9Sarah Körver10Jean-Philippe Miller11Travis Cole12Andrew Erbs13Gerard O'Reilly14Peter Cameron15Duncan Sengiromo16Colin Banks17Emergency & Trauma Centre, Alfred Health, Australia; School of Public Health & Preventive Medicine, Monash University, Australia; Corresponding author. Emergency & Trauma Centre, Alfred Health, Commercial Rd, Melbourne, Australia.Johnstaff International Development, AustraliaEmergency Department, ANGAU Memorial Hospital, Papua New GuineaEmergency Department, ANGAU Memorial Hospital, Papua New GuineaEmergency Department, Port Moresby General Hospital, Papua New GuineaEmergency Department, Port Moresby General Hospital, Papua New GuineaEmergency Department, Port Moresby General Hospital, Papua New GuineaEmergency Department, Port Moresby General Hospital, Papua New GuineaEmergency Department, Port Moresby General Hospital, Papua New GuineaEmergency Department, Port Moresby General Hospital, Papua New GuineaAustralasian College for Emergency Medicine, AustraliaJohnstaff International Development, AustraliaJohnstaff International Development, AustraliaCatalpa International, AustraliaEmergency & Trauma Centre, Alfred Health, Australia; School of Public Health & Preventive Medicine, Monash University, AustraliaEmergency & Trauma Centre, Alfred Health, Australia; School of Public Health & Preventive Medicine, Monash University, AustraliaEmergency Department, Port Moresby General Hospital, Papua New GuineaTownsville University Hospital, Australia; College of Medicine and Dentistry, James Cook University, AustraliaSummary: Background: Triage implementation in resource-limited emergency departments (EDs) has traditionally relied on intensive in-person training. This study sought to evaluate the impact of a novel digital-based learning strategy focused on the Interagency Integrated Triage Tool, a three-tier triage instrument recommended by the World Health Organization. Methods: A mixed methods study utilising pre-post intervention methods was conducted in two EDs in Papua New Guinea. The primary outcome was the mean change in knowledge before and after completion of a voluntary, multimodal training program, primarily delivered through a digital learning platform accessible via smartphone. Secondary outcomes included the change in confidence to perform selected clinical tasks, and acceptability of the learning methods. Findings: Among 136 eligible ED staff, 91 (66.9%) completed the digital learning program. The mean knowledge score on the post-training exam was 87.5% (SD 10.4), a mean increase of 12.9% (95% CI 10.7–15.1%, p < 0.0001) from the pre-training exam. There were statistically significant improvements in confidence for 13 of 15 clinical tasks, including undertaking a triage assessment and identifying an unwell patient.In an evaluation survey, 100% of 30 respondents agreed or strongly agreed the online learning platform was easy to access, use and navigate, and that the digital teaching methods were appropriate for their learning needs. In qualitative feedback, respondents reported that limited internet access and a lack of dedicated training time were barriers to participation. Interpretation: The use of digital learning to support triage implementation in resource-limited EDs is feasible and effective when accompanied by in-person mentoring. Adequate internet access is an essential pre-requisite. Funding: Development of the Kumul Helt Skul learning platform was undertaken as part of the Clinical Support Program (Phase II), facilitated by Johnstaff International Development on behalf of the Australian Government Department of Foreign Affairs and Trade through the PNG-Australia Partnership. RM is supported by a National Health and Medical Research Council Postgraduate Scholarship and a Monash Graduate Excellence Scholarship, while PC is supported by a Medical Research Future Fund Practitioner Fellowship. Funders had no role in study design, results analysis or manuscript preparation.http://www.sciencedirect.com/science/article/pii/S2666606523000019TriageEmergency careDigital learningPapua New Guinea |
| spellingShingle | Rob Mitchell Sarah Bornstein Donna Piamnok Wilma Sebby Carl Kingston Rayleen Tefatu Mangu Kendino Betty Josaiah Jasper Pole Sylvia Kuk Sarah Körver Jean-Philippe Miller Travis Cole Andrew Erbs Gerard O'Reilly Peter Cameron Duncan Sengiromo Colin Banks Multimodal learning for emergency department triage implementation: experiences from Papua New Guinea during the COVID-19 pandemicResearch in context The Lancet Regional Health. Western Pacific Triage Emergency care Digital learning Papua New Guinea |
| title | Multimodal learning for emergency department triage implementation: experiences from Papua New Guinea during the COVID-19 pandemicResearch in context |
| title_full | Multimodal learning for emergency department triage implementation: experiences from Papua New Guinea during the COVID-19 pandemicResearch in context |
| title_fullStr | Multimodal learning for emergency department triage implementation: experiences from Papua New Guinea during the COVID-19 pandemicResearch in context |
| title_full_unstemmed | Multimodal learning for emergency department triage implementation: experiences from Papua New Guinea during the COVID-19 pandemicResearch in context |
| title_short | Multimodal learning for emergency department triage implementation: experiences from Papua New Guinea during the COVID-19 pandemicResearch in context |
| title_sort | multimodal learning for emergency department triage implementation experiences from papua new guinea during the covid 19 pandemicresearch in context |
| topic | Triage Emergency care Digital learning Papua New Guinea |
| url | http://www.sciencedirect.com/science/article/pii/S2666606523000019 |
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