Evaluating the effect of interventions for strengthening non-physician anesthetists’ education in Ethiopia: a pre- and post-evaluation study
Abstract Background Access to safe surgery has been recognized as an indispensable component of universal health coverage. A competent anesthesia workforce is a prerequisite for safe surgical care. In Ethiopia, non-physician anesthetists are the main anesthesia service providers. The Government of E...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-08-01
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| Series: | BMC Medical Education |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12909-021-02851-0 |
| _version_ | 1818916045535051776 |
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| author | Yohannes Molla Asemu Tegbar Yigzaw Firew Ayalew Desta Fedde Scheele Thomas van den Akker |
| author_facet | Yohannes Molla Asemu Tegbar Yigzaw Firew Ayalew Desta Fedde Scheele Thomas van den Akker |
| author_sort | Yohannes Molla Asemu |
| collection | DOAJ |
| description | Abstract Background Access to safe surgery has been recognized as an indispensable component of universal health coverage. A competent anesthesia workforce is a prerequisite for safe surgical care. In Ethiopia, non-physician anesthetists are the main anesthesia service providers. The Government of Ethiopia implemented a program intervention to improve the quality of non-physician anesthetists’ education, which included faculty development, curricula strengthening, student support, educational resources, improved infrastructure and upgraded regulations. This study aimed to assess changes following the implementation of this program. Methods A pre-and post-evaluation design was employed to evaluate improvement in the quality of non-physician anesthetists’ education. A 10-station objective structured clinical examination (OSCE) was administered to graduating class anesthetists of 2016 (n = 104) to assess changes in competence from a baseline study performed in 2013 (n = 122). Moreover, a self-administered questionnaire was used to collect data on students’ perceptions of the learning environment. Results The overall competence score of 2016 graduates was significantly higher than the 2013 class (65.7% vs. 61.5%, mean score difference = 4.2, 95% CI = 1.24–7.22, p < 0.05). Although we found increases in competence scores for 6 out of 10 stations, the improvement was statistically significant for three tasks only (pre-operative assessment, postoperative complication, and anesthesia machine check). Moreover, the competence score in neonatal resuscitation declined significantly from baseline (from 74.4 to 68.9%, mean score difference = − 5.5, 95% CI = -10.5 to − 0.5, p < 0.05). Initial gender-based performance differences disappeared (66.3% vs. 65.3%, mean score difference = − 1.0, 95% CI = − 6.11-3.9, p > 0.05 in favor of females), and female students scored better in some stations. Student perceptions of the learning environment improved significantly for almost all items, with the largest percentage point increase in the availability of instructors from 38.5 to 70.2% (OR = 3.76, 95% CI = 2.15–6.55, p < 0.05). Conclusion The results suggest that the quality of non-physician anesthetists’ education has improved. Stagnation in competence scores of some stations and student perceptions of the simulated learning environment require specific attention. |
| first_indexed | 2024-12-20T00:11:56Z |
| format | Article |
| id | doaj.art-cf6383af935c4a378bcbfea86a81b393 |
| institution | Directory Open Access Journal |
| issn | 1472-6920 |
| language | English |
| last_indexed | 2024-12-20T00:11:56Z |
| publishDate | 2021-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medical Education |
| spelling | doaj.art-cf6383af935c4a378bcbfea86a81b3932022-12-21T20:00:29ZengBMCBMC Medical Education1472-69202021-08-0121111110.1186/s12909-021-02851-0Evaluating the effect of interventions for strengthening non-physician anesthetists’ education in Ethiopia: a pre- and post-evaluation studyYohannes Molla Asemu0Tegbar Yigzaw1Firew Ayalew Desta2Fedde Scheele3Thomas van den Akker4Jhpiego, An affiliate of Johns Hopkins UniversityJhpiego, An affiliate of Johns Hopkins UniversityJhpiego, An affiliate of Johns Hopkins UniversityAthena Institute for Transdisciplinary ResearchAthena Institute, Faculty of Science, Vrije Universiteit AmsterdamAbstract Background Access to safe surgery has been recognized as an indispensable component of universal health coverage. A competent anesthesia workforce is a prerequisite for safe surgical care. In Ethiopia, non-physician anesthetists are the main anesthesia service providers. The Government of Ethiopia implemented a program intervention to improve the quality of non-physician anesthetists’ education, which included faculty development, curricula strengthening, student support, educational resources, improved infrastructure and upgraded regulations. This study aimed to assess changes following the implementation of this program. Methods A pre-and post-evaluation design was employed to evaluate improvement in the quality of non-physician anesthetists’ education. A 10-station objective structured clinical examination (OSCE) was administered to graduating class anesthetists of 2016 (n = 104) to assess changes in competence from a baseline study performed in 2013 (n = 122). Moreover, a self-administered questionnaire was used to collect data on students’ perceptions of the learning environment. Results The overall competence score of 2016 graduates was significantly higher than the 2013 class (65.7% vs. 61.5%, mean score difference = 4.2, 95% CI = 1.24–7.22, p < 0.05). Although we found increases in competence scores for 6 out of 10 stations, the improvement was statistically significant for three tasks only (pre-operative assessment, postoperative complication, and anesthesia machine check). Moreover, the competence score in neonatal resuscitation declined significantly from baseline (from 74.4 to 68.9%, mean score difference = − 5.5, 95% CI = -10.5 to − 0.5, p < 0.05). Initial gender-based performance differences disappeared (66.3% vs. 65.3%, mean score difference = − 1.0, 95% CI = − 6.11-3.9, p > 0.05 in favor of females), and female students scored better in some stations. Student perceptions of the learning environment improved significantly for almost all items, with the largest percentage point increase in the availability of instructors from 38.5 to 70.2% (OR = 3.76, 95% CI = 2.15–6.55, p < 0.05). Conclusion The results suggest that the quality of non-physician anesthetists’ education has improved. Stagnation in competence scores of some stations and student perceptions of the simulated learning environment require specific attention.https://doi.org/10.1186/s12909-021-02851-0AnesthesiaNon-physician anesthetistsEthiopiaEducation qualityObjective structured clinical examinationCompetence |
| spellingShingle | Yohannes Molla Asemu Tegbar Yigzaw Firew Ayalew Desta Fedde Scheele Thomas van den Akker Evaluating the effect of interventions for strengthening non-physician anesthetists’ education in Ethiopia: a pre- and post-evaluation study BMC Medical Education Anesthesia Non-physician anesthetists Ethiopia Education quality Objective structured clinical examination Competence |
| title | Evaluating the effect of interventions for strengthening non-physician anesthetists’ education in Ethiopia: a pre- and post-evaluation study |
| title_full | Evaluating the effect of interventions for strengthening non-physician anesthetists’ education in Ethiopia: a pre- and post-evaluation study |
| title_fullStr | Evaluating the effect of interventions for strengthening non-physician anesthetists’ education in Ethiopia: a pre- and post-evaluation study |
| title_full_unstemmed | Evaluating the effect of interventions for strengthening non-physician anesthetists’ education in Ethiopia: a pre- and post-evaluation study |
| title_short | Evaluating the effect of interventions for strengthening non-physician anesthetists’ education in Ethiopia: a pre- and post-evaluation study |
| title_sort | evaluating the effect of interventions for strengthening non physician anesthetists education in ethiopia a pre and post evaluation study |
| topic | Anesthesia Non-physician anesthetists Ethiopia Education quality Objective structured clinical examination Competence |
| url | https://doi.org/10.1186/s12909-021-02851-0 |
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