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Needs Assessment for Simulation Training for Prehospital Providers in Botswana

  • Nicolaus W. Glomb (a1), Adeola A. Kosoko (a2), Cara B. Doughty (a3), Marideth C. Rus (a3), Manish I. Shah (a3), Megan Cox (a4), Cafen Galapi (a5), Presley S. Parkes (a6), Shelley Kumar (a7) and Bushe Laba (a5)...

Abstract

Background

In June 2012, the Botswana Ministry of Health and Wellness (MOHW; Gaborone, Botswana) initiated a national Emergency Medical Services (EMS) system in response to significant morbidity and mortality associated with prehospital emergencies. The MOHW requested external expertise to train its developing workforce. Simulation-based training was planned to equip these health care providers with clinical knowledge, procedural skills, and communication techniques.

Objective

The objective of this study was to assess the educational needs of the pioneer Botswana MOHW EMS providers based on retrospective EMS logbook review and EMS provider feedback to guide development of a novel educational curriculum.

Methods

Data were abstracted from a representative sample of the Gaborone, Botswana MOHW EMS response log from 2013-2014 and were quantified into the five most common call types for both adults and children. Informal focus groups with health professionals and EMS staff, as well as surveys, were used to rank common response call types and self-perceived educational needs.

Results

Based on 1,506 calls, the most common adult response calls were for obstetric emergencies, altered mental status, gastrointestinal/abdominal pain, trauma, gynecological emergencies, and cardiovascular and respiratory distress-related emergencies. The most common pediatric response calls were for respiratory distress, gastrointestinal complaints/dehydration, trauma and musculoskeletal injuries, newborn delivery, seizures, and toxic ingestion/exposure. The EMS providers identified these same chief complaints as priorities for training using the qualitative approach. A locally relevant, simulation-based curriculum for the Botswana MOHW EMS system was developed and implemented based on these data.

Conclusions

: Trauma, respiratory distress, gastrointestinal complaints, and puerperal/perinatal emergencies were common conditions for all age groups. Other age-specific conditions were also identified as educational needs based on epidemiologic data and provider feedback. This needs assessment may be useful when designing locally relevant EMS curricula in other low-income and middle-income countries.GlombNW, KosokoAA, DoughtyCB, RusMC, ShahMI, CoxM, GalapiC, ParkesPS, KumarS, LabaB.Needs Assessment for Simulation Training for Prehospital Providers in Botswana. Prehosp Disaster Med. 2018;33(6):621626.

Copyright

Corresponding author

Correspondence: NW Glomb, MD, MPH UCSF Benioff Children’s Hospital 550 16th Street #5153 Box 0632 San Francisco, California 94143 USA E-mail: Nicolaus.glomb@ucsf.edu

Footnotes

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Conflicts of interest/funding/disclosures: The authors have no conflicts of interest or financial disclosures to report. All funding for this training program was provided by a Texas Children’s Hospital and Baylor College of Medicine, Department of Pediatrics Educational Award (Houston, Texas USA). All authors contributed to this manuscript and have approved the version submitted for publication.

Footnotes

References

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1. Mould-Millman, NK, Dixon, JM, Sefa, N, et al. The state of Emergency Medical Services (EMS) systems in Africa. Prehosp Disaster Med. 2017;32(3):273-283.
2. Laba, B. Chief Health Officer, Botswana MOHW EMS. Personal communication on October 30, 2014.
3. Abelsson, A, Rystedt, I, Suserud, B-O, Lindwall, L. Mapping the use of simulation in prehospital care – a literature review. Scand J Trauma, Resusc Emerg Med. 2014;22:22.
4. Lammers, RL, Byrwa, MJ, Fales, WD, Hale, RA. Simulation-based assessment of paramedic resuscitation skills. Prehosp Emerg Care. 2009;13(3):345-356.
5. Shah, MI, Carey, JM, Rapp, S, et al. The Impact of a novel, high-fidelity pediatric simulation course on paramedic seizure management. Prehosp Emerg Care. 2016;20(4):499-507.
6. Mould-Millman, NK, Oteng, R, Zakariah, A, et al. Assessment of Emergency Medical Services in the Ashanti region of Ghana. Ghana Medical Journal. 2015;49(3):126-135.
7. de Ramirez, SS, Dull, J, Carle, S, et al. Emergency response in resource-poor settings: a review of a newly-implemented EMS system in rural Uganda. Prehosp Disaster Med. 2014;29(3):311-316.
8. World Health Organization. Global health estimates 2015: estimated deaths by age, sex, and cause. December 2016. http://www.who.int/healthinfo/global_burden_disease/en/. Accessed May 1, 2018.
9. The United Nations International Children’s Emergency Fund (UNICEF) Global Databases. Child morality estimates: global and regional child deaths by cause. http://data.unicef.org. Accessed May 1, 2018.
10. World Health Organization. The Health of the People- What Works: The African Regional Health Report. 2014. http://www.who.int/bulletin/africanhealth/en/. Accessed May 1, 2018.

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