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Introduction With a large number of births occurring outside the formal health system, it is difficult to determine the number of pregnant women in rural regions of Liberia. The exponential growth of mobile phone use in developing countries provides a potential avenue for data collection on maternal and child health in such rural, remote regions. Methods A pre-, post-, and one-year posttest design was used to collect data on knowledge and skill retention for 7 essential items required for mobile phone use among traditional birth attendants (TBAs) trained in a short message service (SMS) texting data collection protocol (N = 99) in rural Liberia. Results Sixty-three participants (63.6% retention) completed the one-year posttest and displayed evidence of statistically significant knowledge and skill retention in 6 of the 7 tasks ( P < .005), including the ability to: 1) turn on the phone, 2) use the mobile phone to make a call, 3) recognize that they have coverage, 4) recognize that the mobile phone is charged, 5) create a SMS text message without help, and 6) send a SMS text message without help. The TBAs continued to have difficulty with more complex tasks such as adding minutes to a phone. Discussion The mobile phone data-collection protocol proved feasible with TBAs demonstrating knowledge retention in a one-year posttest; however, clinical significance needs further investigation. The protocol increased communication and collaboration among TBAs, certified midwives, and clinic staff. [ABSTRACT FROM AUTHOR]

Purpose: To report findings on knowledge and skill acquisition following a 3-day training session in the use of short message service (SMS) texting with non- and low-literacy traditional midwives. Design: A pre- and post-test study design was used to assess knowledge and skill acquisition with 99 traditional midwives on the use of SMS texting for real-time, remote data collection in rural Liberia, West Africa. Methods: Paired sample t-tests were conducted to establish if overall mean scores varied significantly from pre-test to immediate post-test. Analysis of variance was used to compare means across groups. The nonparametric McNemar's test was used to determine significant differences between the pre-test and post-test values of each individual step involved in SMS texting. Pearson's chi-square test of independence was used to examine the association between ownership of cell phones within a family and achievement of the seven tasks. Findings: The mean increase in cell phone knowledge scores was 3.67, with a 95% confidence interval ranging from 3.39 to 3.95. Participants with a cell phone in the family did significantly better on three of the seven tasks in the pre-test: 'turns cell on without help' (χ2(1) = 9.15, p= .003); 'identifies cell phone coverage' (χ2(1) = 5.37, p= .024); and 'identifies cell phone is charged' (χ2(1) = 4.40, p= .042). Conclusions: A 3-day cell phone training session with low- and nonliterate traditional midwives in rural Liberia improved their ability to use mobile technology for SMS texting. Clinical Relevance: Mobile technology can improve data collection accessibility and be used for numerous health care and public health issues. Cell phone accessibility holds great promise for collecting health data in low-resource areas of the world. Journal of Nursing Scholarship, 2012; 00:0, 1-8. [ABSTRACT FROM AUTHOR]

Introduction: Bimanual uterine compression may provide a reasonable treatment option for controlling or arresting postpartum hemorrhage in areas where access to care and advanced medical interventions are limited. Preliminary evidence suggests that correctly performed bimanual uterine compression is unsustainable for more than a few minutes, despite empirical evidence and practice recommendations that support extended compression for optimal effect. The objective of this study was to examine the impact of team-based (pairs) bimanual uterine compression for managing postpartum hemorrhage from uterine atony. Methods: Obstetricians, nurse-midwives, midwifery students, and unskilled birth attendants (N = 30) in Ghana performed bimanual uterine compression using a simulator with objective performance feedback (6 lights) corresponding to pressure sensors on the uterus. For each participant, we tracked the degree and duration of maintained uterine compression. Birth attendants were then paired (15 pairs) and were similarly assessed performing the technique as a team, with 1 attendant providing external compression to the uterine fundus using 2 hands and the other providing internal pressure against the body of the uterus with a single hand. Results: Individuals were unable to fully compress the uterus and maintain compression for more than 150 seconds without fatiguing. All paired teams were able to fully compress the uterus and maintain the compression for the maximum allotted time of 5 minutes. Discussion: Results suggest that bimanual uterine compression is more effective when performed by a team, with a primary attendant maintaining internal lower uterine segment pressure and monitoring the patient's condition and a partner applying external pressure to the uterine fundus. For cases where access to advanced medical care is limited or delayed, team-applied bimanual uterine compression could enhance the ability to control or arrest postpartum hemorrhage and increase the likelihood of maternal survival. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the use of cell phones by professional and traditional birth attendants in rural Africa for reporting postpartum hemorrhage (PPH) data.Methods: Ten birth attendants from the remote Sene District of Ghana participated in the study. Subjects were trained to send Short Message Service text messages from cell phones using a simple numeric protocol to report data regarding PPH: maternal age; PPH; use of bimanual uterine compression; maternal and neonatal mortality; and prenatal care. Participants sent texts to a pre-programmed number to report data for all births they attended over a 90-day period.Results: In total, 425 births and 13 (3.1%) cases of PPH were reported during the 90-day period after training. All attendants followed the reporting protocol correctly, although with uncertain data integrity.Conclusion: The results indicate that it is possible to train professional and traditional birth attendants to use cell phones to report health-related outcome data via a specified protocol. Reporting from rural-based providers may present a more accurate picture of what occurs in remote communities because it happens in real time. These findings could be exportable to other program evaluation or population-monitoring applications (healthcare and other) where rural outcome tracking is necessary. [ABSTRACT FROM AUTHOR]

ACADEMIC EMERGENCY MEDICINE 2010; 17:870–876 © 2010 by the Society for Academic Emergency Medicine Objectives: The objective of this study was to compare the relative impact of two simulation-based methods for training emergency medicine (EM) residents in disaster triage using the Simple Triage and Rapid Treatment (START) algorithm, full-immersion virtual reality (VR), and standardized patient (SP) drill. Specifically, are there differences between the triage performances and posttest results of the two groups, and do both methods differentiate between learners of variable experience levels? Methods: Fifteen Postgraduate Year 1 (PGY1) to PGY4 EM residents were randomly assigned to two groups: VR or SP. In the VR group, the learners were effectively surrounded by a virtual mass disaster environment projected on four walls, ceiling, and floor and performed triage by interacting with virtual patients in avatar form. The second group performed likewise in a live disaster drill using SP victims. Setting and patient presentations were identical between the two modalities. Resident performance of triage during the drills and knowledge of the START triage algorithm pre/post drill completion were assessed. Analyses included descriptive statistics and measures of association (effect size). Results: The mean pretest scores were similar between the SP and VR groups. There were no significant differences between the triage performances of the VR and SP groups, but the data showed an effect in favor of the SP group performance on the posttest. Conclusions: Virtual reality can provide a feasible alternative for training EM personnel in mass disaster triage, comparing favorably to SP drills. Virtual reality provides flexible, consistent, on-demand training options, using a stable, repeatable platform essential for the development of assessment protocols and performance standards. [ABSTRACT FROM AUTHOR]

Context The term ‘validity’ is used pervasively in medical education, especially as it relates to curriculum, assessment, measurement and instrumentation. Exactly what is meant by the term ‘validity’ in the medical education literature is not always clearly defined. Objectives This study attempts to clarify, conceptualise and classify how validity fits within the context of assessment and to provide a framework for medical educators to determine the type and degree of validity evidence required for their specific assessment and evaluation needs. Methods We apply a structure for considering validity, and its association with validation, in medical education. We build this discussion around the use of simulation in medical training because of its rapid growth as a foundation for numeric measurement of performance in the development of clinical skills and reasoning. We explain why validity is inextricably tied to the assessment process in both simulation-based medical training and traditional medical education. Results This logical framework structures the type and degree of validity evidence for various assessment and evaluation needs. We also provide an example for medical educators to reference and follow in collecting and reviewing their own needs for validity evidence in all aspects of medical education. Conclusions Assessment is integral to measurement and decision making in medical education. The implications of assessment results are variably dependent on the inferences and decisions made from them. As such, validity evidence is critical, but is also flexibly tied to those decisions and not all assessments require the same degree of validity rigor. The framework described herein reinforces a model for medical educators to use in developing their assessment and evaluation needs and associated requirements for validity evidence. [ABSTRACT FROM AUTHOR]

Objectives There is growing appreciation of the value of early preparation of future medical educators. Staff development programmes, conferences and workshops pertaining to the training of educators may be crucial to the pursuit of a school’s larger educational mission to educate students, doctors and scholars and to provide comprehensive knowledge, research, patient care and service. This study examined the efficacy of a 1-week educational intervention aimed at preparing medical students to become effective doctor educators by building skills early in their careers. The study asked whether participation in a 5-day teacher training programme led to increased knowledge of instructional methods, more favourable attitudes towards teaching, and the integration of structured instructional design methods in a student-developed teaching project. Methods A mixed methods research design was employed with quantitative data captured through pre- and post-test inventories, qualitative components captured through written comments, and a 2-year post-intervention survey. Quantitative analyses included pre-/post-intervention repeated measures with calculated effect sizes. Qualitative analysis was conducted using constant comparative methods. Results Subjects demonstrated improved content knowledge and more positive attitudes towards motivation, teaching confidence, teacher roles, varied pedagogy, and use of assessment, instructional planning, and evaluation. Subjects were able to incorporate the programme’s teaching theory and methods into their teaching projects and assessment of peers’ and others’ teaching in their own institutions 2 years post-training. Conclusions This study demonstrates that a well-designed programme for teacher preparation can be pedagogically effective for training medical students to become better educators and that this learning can be incorporated into long-term practice. [ABSTRACT FROM AUTHOR]

The article discusses the administration of a multiple-choice question (MCQ) examination and survey to first year postgraduate trainees during hospital orientation to assess their knowledge and educational exposure. The findings regarding knowledge of patient safety include 86.2% percent of first year trainees from 69 U.S. schools received patient safety training in medical school. It concludes the need to reinforce knowledge about how to identify and manage material for postgraduate doctors.