A curriculum model for multidisciplinary training of midwife sonographers in a low resource setting

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Study Justification:
– In low-resource settings, access to ultrasound during pregnancy is limited, leading to difficulties in determining gestational age and detecting pregnancy-related anomalies.
– The traditional approach of increasing the number of qualified radiologists, gynaecologists, and sonographers is not feasible in these settings.
– An innovative Human Resource for Health (HRH) task sharing and maternal child health (MCH) workforce training initiative was designed to address these challenges.
– The study aimed to develop and test a curriculum to train midwife sonographers using a teleradiology innovation platform and a partnership between specialist radiologists, sonographers, and midwives.
Highlights:
– The study was conducted at a tertiary-level private university hospital in Nairobi, with implementation in three outreach locations.
– Specialist radiologists and ultrasonographers provided direct oversight, support, and supervision during the training period and project implementation.
– Midwives were trained through an interactive e-learning module, lectures, hands-on practical experience, role modeling, and mentoring.
– Assessments included written examinations, practical assessments, and a final exit examination to demonstrate competency.
– The pilot was highly successful, with midwives achieving an image interpretation accuracy of 99.63%.
Recommendations:
– Scale up the training program to other low-resource settings to improve access to ultrasound during pregnancy.
– Develop a standardized curriculum outline, pedagogical framework, teaching methods, assessment processes, and credentialing procedures for training midwife sonographers.
– Ensure ongoing quality control and patient safety measures in the training and implementation process.
Key Role Players:
– Specialist radiologists and ultrasonographers for oversight, support, and supervision.
– Midwives for training and implementation.
– Curriculum developers and educators for curriculum development and teaching.
– Healthcare administrators and policymakers for program planning and implementation.
Cost Items for Planning Recommendations:
– Development of curriculum materials and e-learning modules.
– Training and supervision of specialist radiologists and ultrasonographers.
– Equipment and resources for hands-on practical experience.
– Assessment and credentialing processes.
– Ongoing quality control and patient safety measures.

In many low-resource settings, less than 5% of pregnant women can access ultrasound during pregnancy. Thus, gestational age is often difficult to determine, multiple pregnancies are diagnosed late and foetal and pregnancy-related anomalies can go undetected. A pilot solution was designed beyond the traditional approach of increasing numbers of qualified radiologists, gynaecologists and sonographers. An innovative Human Resource for Health (HRH) task sharing, and maternal child health (MCH) workforce training and capacity building initiative was designed, involving development and testing of a curriculum to train midwife sonographers via a teleradiology innovation platform and a partnership between specialist radiologists, sonographers and midwives. The setting was a tertiary-level private university hospital in Nairobi with implementation in three outreach locations. Direct oversight, support and supervision of specialist radiologists and ultrasonographers effectively addressed issues of quality and safety across the 3-week training period and project implementation. Concepts from sociocultural learning theory informed an initial interactive e-learning module for each midwife at their respective site. Midwives were introduced to ultrasound equipment with a series of didactic and interactive lectures delivered by an expert sonographer at the tertiary hospital teaching site. Lectures were supported by hands-on practical experience, role modelling and mentoring over a four-week period. Assessments included both written examination and practical assessment with an exit examination requiring demonstration of competency in both written and practical format. Final confirmation of scanning accuracy was confirmed with post-delivery verification of results. The pilot was highly successful with an image interpretation accuracy of 99.63% for the midwives. Lessons from this initiative provides guidance in the curriculum development process along with a curriculum outline; pedagogical framework; teaching methods; assessment processes; credentialing; resourcing; and other considerations in scaling up the program. Importantly, the paper details processes for maintaining a high level of quality control and patient safety.

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The publication titled “A curriculum model for multidisciplinary training of midwife sonographers in a low resource setting” proposes an innovative approach to improve access to maternal health services in low-resource settings. The recommendation suggests the use of a Human Resource for Health (HRH) task sharing and maternal child health (MCH) workforce training and capacity building initiative to train midwife sonographers.

The innovation involves the development and testing of a curriculum to train midwife sonographers using a teleradiology innovation platform and a partnership between specialist radiologists, sonographers, and midwives. The training program includes interactive e-learning modules, didactic and interactive lectures, hands-on practical experience, role modeling, mentoring, and assessments.

The pilot implementation of this initiative in a tertiary-level private university hospital in Nairobi and three outreach locations was highly successful, with midwives achieving a 99.63% accuracy rate in image interpretation. The paper provides guidance on curriculum development, pedagogical framework, teaching methods, assessment processes, credentialing, resourcing, and other considerations for scaling up the program. It also emphasizes the importance of maintaining a high level of quality control and patient safety.

By implementing this innovation, more midwives can be trained to perform ultrasound examinations, improving access to maternal health services in low-resource settings. This approach goes beyond the traditional approach of relying solely on qualified radiologists, gynecologists, and sonographers, and instead utilizes task sharing and capacity building to address the shortage of skilled healthcare professionals.
AI Innovations Description
The recommendation described in the publication titled “A curriculum model for multidisciplinary training of midwife sonographers in a low resource setting” can be developed into an innovation to improve access to maternal health. The recommendation suggests the use of a Human Resource for Health (HRH) task sharing and maternal child health (MCH) workforce training and capacity building initiative to train midwife sonographers in low-resource settings.

The innovation involves the development and testing of a curriculum to train midwife sonographers using a teleradiology innovation platform and a partnership between specialist radiologists, sonographers, and midwives. The training program includes interactive e-learning modules, didactic and interactive lectures, hands-on practical experience, role modeling, mentoring, and assessments.

The pilot implementation of this initiative in a tertiary-level private university hospital in Nairobi and three outreach locations was highly successful, with midwives achieving a 99.63% accuracy rate in image interpretation. The paper provides guidance on curriculum development, pedagogical framework, teaching methods, assessment processes, credentialing, resourcing, and other considerations for scaling up the program. It also emphasizes the importance of maintaining a high level of quality control and patient safety.

By implementing this innovation, more midwives can be trained to perform ultrasound examinations, improving access to maternal health services in low-resource settings. This approach goes beyond the traditional approach of relying solely on qualified radiologists, gynecologists, and sonographers, and instead utilizes task sharing and capacity building to address the shortage of skilled healthcare professionals.
AI Innovations Methodology
To simulate the impact of the recommendations described in the abstract on improving access to maternal health, you could follow these steps:

1. Identify the target low-resource setting: Select a specific low-resource setting where access to ultrasound during pregnancy is limited, and where there is a shortage of qualified radiologists, gynecologists, and sonographers.

2. Establish partnerships and resources: Form partnerships between specialist radiologists, sonographers, and midwives, similar to the model described in the publication. Ensure access to necessary resources such as ultrasound equipment, a teleradiology innovation platform, and a tertiary-level private university hospital for training and oversight.

3. Develop a curriculum: Adapt and develop a curriculum based on the guidance provided in the publication. This curriculum should include interactive e-learning modules, didactic and interactive lectures, hands-on practical experience, role modeling, mentoring, and assessments.

4. Implement the training program: Conduct the training program for midwife sonographers, following the curriculum developed. Provide direct oversight, support, and supervision from specialist radiologists and sonographers to ensure quality and safety throughout the training period.

5. Assess competency: Evaluate the competency of midwife sonographers through written examinations and practical assessments. Use an exit examination to confirm their competency in both written and practical formats. Additionally, verify the accuracy of their image interpretation through post-delivery verification of results.

6. Measure impact: Collect data on the impact of the training program on access to maternal health services. This could include metrics such as the number of ultrasound examinations performed by midwife sonographers, the accuracy of their image interpretation, and the number of pregnant women who receive ultrasound services.

7. Analyze and evaluate results: Analyze the data collected to assess the effectiveness of the training program in improving access to maternal health. Evaluate the accuracy of image interpretation by midwife sonographers and compare it to the baseline data from before the program implementation.

8. Scale up the program: If the results indicate a positive impact, consider scaling up the program to reach more midwives and expand access to maternal health services in the low-resource setting. Use the guidance provided in the publication to address considerations for scaling up, including curriculum development, pedagogical framework, teaching methods, assessment processes, credentialing, and resourcing.

By following this methodology, you can simulate the impact of the recommendations described in the abstract and assess their effectiveness in improving access to maternal health in a low-resource setting.

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