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Afr J Emerg Med. 2020 Mar;10(1):30-34. doi: 10.1016/j.afjem.2019.11.003. Epub 2020 Jan 23.

Novel educational adjuncts for the World Health Organization Basic Emergency Care Course: A prospective cohort study.

African journal of emergency medicine : Revue africaine de la medecine d'urgence

Steven Straube, Julia Chang-Bullick, Paulina Nicholaus, Juma Mfinanga, Christian Rose, Taylor Nichols, Daniel Hackner, Shelby Murphy, Hendry Sawe, Andrea Tenner

Affiliations

  1. Department of Emergency Medicine, 533, University of California, San Francisco, 533 Parnassus Avenue, San Francisco, CA, USA.
  2. Department of Emergency Medicine, Muhimbili National Hospital, Malik Road, Dar es Salaam, Tanzania.
  3. LLC, 1442 16th Ave, San Francisco, CA 94122.

PMID: 32161709 PMCID: PMC7058880 DOI: 10.1016/j.afjem.2019.11.003

Abstract

INTRODUCTION: The World Health Organization's (WHO) Basic Emergency Care Course (BEC) is a five day, in-person course covering basic assessment and life-saving interventions. We developed two novel adjuncts for the WHO BEC: a suite of clinical cases (BEC-Cases) to simulate patient care and a mobile phone application (BEC-App) for reference. The purpose was to determine whether the use of these educational adjuncts in a flipped classroom approach improves knowledge acquisition and retention among healthcare workers in a low-resource setting.

METHODS: We conducted a prospective, cohort study from October 2017 through February 2018 at two district hospitals in the Pwani Region of Tanzania. Descriptive statistics, Fisher's exact t-tests, and Wilcoxon ranked-sum tests were used to examine whether the use of these adjuncts resulted in improved learner knowledge. Participants were enrolled based on location into two arms; Arm 1 received the BEC course and Arm 2 received the BEC-Cases and BEC-App in addition to the BEC course. Both Arms were tested before and after the BEC course, as well as a 7-month follow-up exam. All participants were invited to focus groups on the course and adjuncts.

RESULTS: A total of 24 participants were included, 12 (50%) of whom were followed to completion. Mean pre-test scores in Arm 1 (50%) were similar to Arm 2 (53%) (p=0.52). Both arms had improved test scores after the BEC Course Arm 1 (74%) and Arm 2 (87%), (p=0.03). At 7-month follow-up, though with significant participant loss to follow up, Arm 1 had a mean follow-up exam score of 66%, and Arm 2, 74%.

DISCUSSION: Implementation of flipped classroom educational adjuncts for the WHO BEC course is feasible and may improve healthcare worker learning in low resource settings. Our focus- group feedback suggest that the course and adjuncts are user friendly and culturally appropriate.

© 2020 African Federation for Emergency Medicine. Publishing services provided by Elsevier.

Keywords: Education; Emergency care; Flipped classroom; Open access educational resources; Point-of-care; online

Conflict of interest statement

The authors declared no conflicts of interest.

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