Using the Kirkpatrick Model to Evaluate the Effect of a Primary Trauma Care Course on Health Care Workers' Knowledge, Attitude, and Practice in Two Vietnamese Local Hospitals: Prospective Intervention Study.

IF 3.2 Q1 EDUCATION, SCIENTIFIC DISCIPLINES
Ba Tuan Nguyen, Van Anh Nguyen, Christopher Leigh Blizzard, Andrew Palmer, Huu Tu Nguyen, Thang Cong Quyet, Viet Tran, Marcus Skinner, Haydn Perndt, Mark R Nelson
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引用次数: 0

Abstract

Background: The Primary Trauma Care (PTC) course was originally developed to instruct health care workers in the management of patients with severe injuries in low- and middle-income countries (LMICs) with limited medical resources. PTC has now been taught for more than 25 years. Many studies have demonstrated that the 2-day PTC workshop is useful and informative to frontline health staff and has helped improve knowledge and confidence in trauma management; however, there is little evidence of the effect of the course on changes in clinical practice. The Kirkpatrick model (KM) and the knowledge, attitude, and practice (KAP) model are effective methods to evaluate this question.

Objective: The aim of this study was to investigate how the 2-day PTC course impacts the satisfaction, knowledge, and skills of health care workers in 2 Vietnamese hospitals using a conceptual framework incorporating the KAP model and the 4-level KM as evaluation tools.

Methods: The PTC course was delivered over 2 days in the emergency departments (EDs) of Thanh Hoa and Ninh Binh hospitals in February and March 2022, respectively. This study followed a prospective pre- and postintervention design. We used validated instruments to assess the participants' satisfaction, knowledge, and skills before, immediately after, and 6 months after course delivery. The Fisher exact test and the Wilcoxon matched-pairs signed rank test were used to compare the percentages and mean scores at the pretest, posttest, and 6-month postcourse follow-up time points among course participants.

Results: A total of 80 health care staff members attended the 2-day PTC course and nearly 100% of the participants were satisfied with the course. At level 2 of the KM (knowledge), the scores on multiple-choice questions and the confidence matrix improved significantly from 60% to 77% and from 59% to 71%, respectively (P<.001), and these improvements were seen in both subgroups (nurses and doctors). The focus of level 3 was on practice, demonstrating a significant incremental change, with scenarios checklist points increasing from a mean of 5.9 (SD 1.9) to 9.0 (SD 0.9) and bedside clinical checklist points increasing from a mean of 5 (SD 1.5) to 8.3 (SD 0.8) (both P<.001). At the 6-month follow-up, the scores for multiple-choice questions, the confidence matrix, and scenarios checklist all remained unchanged, except for the multiple-choice question score in the nurse subgroup (P=.005).

Conclusions: The PTC course undertaken in 2 local hospitals in Vietnam was successful in demonstrating improvements at 3 levels of the KM for ED health care staff. The improvements in the confidence matrix and scenarios checklist were maintained for at least 6 months after the course. PTC courses should be effective in providing and sustaining improvement in knowledge and trauma care practice in other LMICs such as Vietnam.

使用柯克帕特里克模型评估初级创伤护理课程对越南两家地方医院医护人员的知识、态度和实践的影响:前瞻性干预研究。
背景:初级创伤护理(PTC)课程最初是为了指导医疗工作者如何在医疗资源有限的中低收入国家(LMICs)救治严重受伤的病人。PTC 的教学至今已超过 25 年。许多研究表明,为期 2 天的 PTC 培训班对一线医护人员非常有用,信息量大,有助于提高他们在创伤管理方面的知识和信心;但是,几乎没有证据表明该课程对临床实践的改变产生了影响。柯克帕特里克模型(KM)和知识、态度与实践模型(KAP)是评估这一问题的有效方法:本研究的目的是使用一个概念框架,将 KAP 模型和 4 级 KM 作为评估工具,调查为期 2 天的 PTC 课程如何影响越南 2 家医院医护人员的满意度、知识和技能:PTC 课程分别于 2022 年 2 月和 3 月在清化医院和宁平医院的急诊科(ED)进行,为期两天。本研究采用前瞻性干预前后设计。我们使用经过验证的工具来评估参与者在课程开始前、课程结束后和课程结束 6 个月后的满意度、知识和技能。我们使用费舍尔精确检验和 Wilcoxon 配对符号秩检验来比较课程参与者在课程前测试、课程后测试和课程后 6 个月随访时间点的百分比和平均得分:共有 80 名医护人员参加了为期 2 天的 PTC 课程,近 100%的学员对课程表示满意。在知识管理第二级(知识)中,多项选择题的得分和信心矩阵的得分分别从 60% 和 59% 显著提高到 77% 和 71%(结论:在两个地方开展的 PTC 课程对医护人员的知识管理水平有显著提高:在越南两家当地医院开展的 PTC 课程成功地提高了急诊室医护人员在知识管理三个级别上的能力。在课程结束后的至少 6 个月内,信心矩阵和情景检查表方面的改进都得以保持。在越南等其他低收入和中等收入国家,PTC 课程应能有效提供并维持知识和创伤护理实践方面的改进。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
JMIR Medical Education
JMIR Medical Education Social Sciences-Education
CiteScore
6.90
自引率
5.60%
发文量
54
审稿时长
8 weeks
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