Document Type
Article
Department
School of Nursing and Midwifery, East Africa
Abstract
Introduction Quality midwifery education is central to improving midwifery service delivery and maternal and newborn health outcomes. In many settings, midwifery educators insufciently prepared for their teaching role and defcient curriculum compared to international standards afect the quality of healthcare provided by the midwifery graduates. This study assessed the efectiveness of an EmONC enhanced midwifery curriculum delivered by trained and mentored midwifery educators on the quality of education and student performance in Kenya.
Methods A cluster randomised controlled trial in 20 midwifery colleges (12 intervention, 8 control colleges). Educators in both arms received training in teaching/EmONC skills to deliver the updated national midwifery curriculum. The intervention arm received additional 3-monthly post-training mentoring for 12 months. Educators’ knowledge and confdence in EmONC/teaching skills was assessed before and after training and at 3, 6, 9 and 12 months. Teaching skills observations at baseline and endline in both study arms were also assessed. Knowledge, self-rated confdence and three OSCE in EmONC practical skills among fnal year midwifery students were assessed. Linear mixed efects models were used to evaluate the efect of intervention on educators and students.
Results Seventy four educators and 146 students participated. Training signifcantly improved educators’ mean knowledge (61.3%-73.3%) and confdence to teach EmONC (3.1–4.2 out of 5). Observed teaching skills mean scores of educators in the intervention arm were signifcantly higher compared to those of controls at endline (89.4%-vs72.2%, mean diference 17.2 [95%CI, 3.2–29.8]). Mean scores for students in the intervention arm were signifcantly higher than those in controls for knowledge (59.6%-vs-51.3%, mean diference 8.3 [95%CI, 1.6–15.0]) and the three skills assessed (means; mean diference (95%CI): shoulder dystocia (64.5%-vs-42.7%; 21.8 (10.8–33.9); newborn resuscitation (43.9% vs 26.1%; 17.8 (2.0–33.9); and maternal shock resuscitation (56.5%-vs-39.2%; 17.3 (8.0–26.0) and combined average skills scores (55.0%-vs-36.0; 19.0 (8.7–29.5).
Conclusion Training and supportive mentoring improved the quality of educators’ teaching pedagogy and EmONC skills and enhanced students’ learning. Overall performance in EmONC knowledge and skills was signifcantly higher for students who were taught by trained and mentored educators compared to those who received training alone. Thus, a local mentoring system is efective to enhance learning and efectiveness of an EmONC-updated midwifery curriculum.
Publication (Name of Journal)
BMC Medical Education
DOI
https://doi.org/10.1186/s12909-024-06581-x
Recommended Citation
Shikuku, D. N.,
Mwaura, C.,
Nandikove, P.,
Uyara, A.,
Allott, H.,
Waweru, L.,
Nyaga, L.,
Tallam, E.,
Bashir, I.,
Ndirangu, E.
(2024). An evaluation of the effectiveness of an updated pre-service midwifery curriculum integrated with emergency obstetric and newborn care in Kenya: a cluster randomised controlled trial. BMC Medical Education, 24(1562), 1-23.
Available at:
https://ecommons.aku.edu/eastafrica_fhs_sonam/548
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This work is licensed under a Creative Commons Attribution 4.0 International License.