Jocelyne Bukeyeneza, Medha Goyal, Elif Bilgic, Katelyn MacKenzie, Mohammad Omar Aziz, Kamal El Tobgy, Ipsita Goswami
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引用次数: 0
Abstract
Background
Neonatal encephalopathy (NE), particularly due to hypoxia/ischemia at birth, is a perinatal emergency. Timely diagnosis and initiation of therapeutic hypothermia within a 6-h window from birth are challenging.
Aim
We aimed to explore the challenges community physicians face in the management of NE in our region and to test the feasibility of co-designing and implementing an educational program that addresses their needs.
Methodology
This mixed-method study started with a 1 h semi-structured interview with community pediatricians through an audio-recorded virtual platform. Subsequently, an outreach training workshop was designed and pilot-tested at each participating center.
Data Analysis
Qualitative analysis included the following steps: data familiarization, code and theme generation, and report writing. Descriptive statistics were used to summarize the impact of the curriculum on participants’ knowledge and experience.
Results
Key themes included lack of experience with detailed neurological examination due to infrequent exposure, lack of standardization in management guidelines, and limited access to brain monitoring devices. Diagnosing NE was challenging due to the natural variability in presentation, progression and time-sensitiveness of interventions. Focused skill development workshops were found to be feasible and significantly improved participants’ knowledge of NE. Almost 75% of the participants perceived that the workshop enhanced their comfort levels with the neonatal neurological assessment.
Conclusion
Outreach training education adapted to the local context is feasible and essential for the skill maintenance of community pediatricians who infrequently encounter NE. Future studies will have to study the impact of such workshops on physician behavior and patient outcomes.
期刊介绍:
The Journal of Evaluation in Clinical Practice aims to promote the evaluation and development of clinical practice across medicine, nursing and the allied health professions. All aspects of health services research and public health policy analysis and debate are of interest to the Journal whether studied from a population-based or individual patient-centred perspective. Of particular interest to the Journal are submissions on all aspects of clinical effectiveness and efficiency including evidence-based medicine, clinical practice guidelines, clinical decision making, clinical services organisation, implementation and delivery, health economic evaluation, health process and outcome measurement and new or improved methods (conceptual and statistical) for systematic inquiry into clinical practice. Papers may take a classical quantitative or qualitative approach to investigation (or may utilise both techniques) or may take the form of learned essays, structured/systematic reviews and critiques.