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. 2017 Aug 31;17(1):149.
doi: 10.1186/s12909-017-0975-3.

Video-based feedback as a method for training rural healthcare workers to manage medical emergencies: a pilot study

Zainab Oseni  1 , Hla Hla Than  2 , Edyta Kolakowska  2 , Lauren Chalmers  2 , Borimas Hanboonkunupakarn  3 , Rose McGready  2   4
Affiliations

Video-based feedback as a method for training rural healthcare workers to manage medical emergencies: a pilot study

Zainab Oseni et al. BMC Med Educ. .

Abstract

Background: Video-based feedback has been shown to aid knowledge retention, skills learning and improve team functionality. We explored the use of video-based feedback and low fidelity simulation for training rural healthcare workers along the Thailand-Myanmar border and Papua New Guinea (PNG) to manage medical emergencies effectively.

Methods: Twenty-four study participants were recruited from three Shoklo Malaria Research Unit clinics along the Thailand-Myanmar border and eight participants from Kudjip Nazarene Hospital, PNG. The teams were recorded on video managing a simulated medical emergency scenario and the video was used to aid feedback and assess performance using Observed Structured Clinical Examination (OSCE) scoring and Team Emergency Assessment Measure (TEAM) questionnaire. The process was repeated post-feedback at both sites and at 6 weeks at the Thailand-Myanmar border site. Thailand-Myanmar border participants' individual confidence levels and baseline knowledge (using OSCE scoring) were assessed before team assessment and feedback at week 1 and repeated post-feedback and at 6 weeks. Focus group discussions (FGD) were held at each Thailand-Myanmar border clinic at week 1 (8 participants at each clinic).

Results: Individual paired tests of OSCE scores showed significant improvement post-feedback at week 1 (p < 0.001) and week 6 (p < 0.001) compared to baseline OSCE scores. There was a trend for increased team OSCE scores compared to baseline at week 1 (p = 0.068) and week 6 (p = 0.109) although not significant. Thailand-Myanmar border TEAM scores demonstrated improvement post-feedback mainly in leadership, teamwork and task management which was sustained up to week 6. PNG showed an improvement mainly in teamwork and task management. The global rating of the teams' non-technical performance at both sites improved post feedback and at week 6 on the Thailand-Myanmar border site. Self-rated confidence scores by Thailand-Myanmar border participants increased significantly from baseline following training at week 1 (p = 0.020), and while higher at 6 weeks follow up than at baseline, this was not significant (p = 0.471). The FGD revealed majority of participants felt that watching the video recording of their performance and the video-based feedback contributed most to their learning.

Conclusion: Video-assisted feedback resulted in an improvement in clinical knowledge, confidence and quality of teamwork for managing medical emergencies in two low resource medical facilities in South East Asia and the South Pacific.

Keywords: Confidence; Direct observation; Feedback; Self-assessment; Video.

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Conflict of interest statement

Ethics approval and consent to participate

No formal ethical approval was sought for this pilot exploration of educational methods. As part of standard process the details of this project were presented, discussed and approved by the local Community Advisory Board (TCAB-311-12,016), Mae Sot Thailand. On both the Thailand-Myanmar border and in PNG, participants were verbally asked if they would like to participate in a training where they would be videoed and assessed. Consent was limited to those rostered for the shift on the day. The results of their assessments have been used anonymously.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Map of the study settings (created using ArcGIS 10.2 by Daniel Parker)
Fig. 2
Fig. 2
Study flow chart
Fig. 3
Fig. 3
Confidence levels at all study sites. Footnote: 1 = not confident through to 5 = extremely confident
See this image and copyright information in PMC

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