Strategies for specialty training of healthcare professionals in low-resource settings: a systematic review on evidence from stroke care

被引：7

作者：

Habibi, Junaid ^{[1
]}

Bosch, Jackie ^{[2
,3
]}

Bidulka, Patrick ^{[4
]}

Belson, Sarah ^{[5
]}

DePaul, Vincent ^{[6
]}

Gandhi, Dorcas ^{[7
]}

Kumurenzi, Anne ^{[2
]}

Melifonwu, Rita ^{[8
]}

Pandian, Jeyaraj ^{[7
]}

Langhorne, Peter ^{[9
]}

Solomon, John M. ^{[10
]}

Dawar, Dimple ^{[7
]}

Carroll, Sandra ^{[11
]}

Urimubenshi, Gerard ^{[12
]}

Kaddumukasa, Martin ^{[13
]}

Hamilton, Leah ^{[2
]}

机构：

[1] McMaster Univ, Michael G DeGroote Sch Med, Hamilton, ON, Canada

[2] Populat Hlth Res Inst, Hamilton, ON, Canada

[3] McMaster Univ, Sch Rehabil Sci, Hamilton, ON, Canada

[4] London Sch Hyg & Trop Med, London, England

[5] Stroke Assoc, London, England

[6] Queens Univ, Sch Rehabil Therapy, Kingston, ON, Canada

[7] Christian Med Coll & Hosp, Dept Neurol, Ludhiana, Punjab, India

[8] Stroke Act Nigeria, Onitsha, Nigeria

[9] Univ Glasgow, Inst Cardiovasc & Med Sci, Glasgow, Scotland

[10] Manipal Acad Higher Educ, Dept Physiotherapy, Manipal, Karnataka, India

[11] McMaster Univ, Sch Nursing, Hamilton, ON, Canada

[12] Univ Rwanda, Coll Med & Hlth Sci, Kigali, Rwanda

[13] Makerere Univ, Coll Hlth Sci, Sch Med, Dept Med, Kampala, Uganda

来源：

BMC MEDICAL EDUCATION | 2023年 / 23卷 / 01期

关键词：

Low-resource; Stroke; Training; Education; Teaching; Telehealth; Multidisciplinary; Task-shifting; Train-the-trainer; Workshop; KNOWLEDGE; TELESTROKE; WORKERS; BURDEN;

D O I：

10.1186/s12909-023-04431-w

中图分类号：

G40 [教育学];

学科分类号：

040101 ; 120403 ;

摘要：

BackgroundThe greatest mortality and disability from stroke occurs in low- and middle-income countries. A significant barrier to implementation of best stroke care practices in these settings is limited availability of specialized healthcare training. We conducted a systematic review to determine the most effective methods for the provision of speciality stroke care education for hospital-based healthcare professionals in low-resource settings.MethodsWe followed the PRISMA guidelines for systematic reviews and searched PubMed, Web of Science and Scopus for original clinical research articles that described or evaluated stroke care education for hospital-based healthcare professionals in low-resource settings. Two reviewers screened titles/abstracts and then full text articles. Three reviewers critically appraised the articles selected for inclusion.ResultsA total of 1,182 articles were identified and eight were eligible for inclusion in this review; three were randomized controlled trials, four were non-randomized studies, and one was a descriptive study. Most studies used several approaches to education. A "train-the-trainer" approach to education was found to have the most positive clinical outcomes (lower overall complications, lengths of stay in hospital, and clinical vascular events). When used for quality improvement, the "train-the-trainer" approach increased patient reception of eligible performance measures. When technology was used to provide stroke education there was an increased frequency in diagnosis of stroke and use of antithrombotic treatment, reduced door-to-needle times, and increased support for decision making in medication prescription was reported. Task-shifting workshops for non-neurologists improved knowledge of stroke and patient care. Multidimensional education demonstrated an overall care quality improvement and increased prescriptions for evidence-based therapies, although, there were no significant differences in secondary prevention efforts, stroke reoccurrence or mortality rates.ConclusionsThe "train the trainer" approach is likely the most effective strategy for specialist stroke education, while technology is also useful if resources are available to support its development and use. If resources are limited, basic knowledge education should be considered at a minimum and multidimensional training may not be as beneficial. Research into communities of practice, led by those in similar settings, may be helpful to develop educational initiatives with relevance to local contexts.

引用

页数：15

共 33 条

[1]

Akinyemi OR, 2021, NAT REV NEUROL, V17

[2] Knowledge and perception of stroke amongst hospital workers in an African community [J].