An evaluation of obstetric ultrasound education program in Nepal using the RE-AIM framework

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An evaluation of obstetric ultrasound education program in Nepal using the RE-AIM framework


JournalBMC Medical Education
Article typeJournal research article – Clinical research
Publication date – Jan – 2021
Authors – Jieun Kim, Prabin Raj Shakya, Sugy Choi, Joong Shin Park, Suman Raj Tamrakar, Jongho Heo & Woong-Han Kim
Keywordseducation, Global education, LMIC, Obstetric ultrasound, Program evaluation, RE-AIM
Open access – Yes
SpecialityObstetrics and Gynaecology, Surgical Education
World region Southern Asia
Country: Nepal
Language – English
Submitted to the One Surgery Index on January 24, 2021 at 2:59 am
Abstract:

Background
Nepal has a high prevalence of congenital anomaly contributing to high infant mortality. Ultrasound, an important tool to detect congenital anomalies and manage maternity-related risk factors, is not properly used in Nepal because Nepali doctors have limited opportunities for learning ultrasound techniques. Hence, we developed and implemented an ultrasound education program from 2016 to 2018. The objective of this study is to evaluate the education program using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework.

Methods
We conducted a mixed-method study to evaluate each component of RE-AIM. The team collected quantitative data from administrative records, tests, surveys, and an online follow-up survey. Qualitative data were collected from individual in-depth interviews at least a year after the program. The proportions, means, and t-tests were used for quantitative data, and thematic coding for qualitative data.

Results
A total of 228 healthcare workers representing 27.3% of the districts of Nepal were reached from 2016 to 2018. The program improved participants’ knowledge (29.3, 8.7, and 23.8 increases out of 100, each year, p< 0.001, n=85) and self-confidence (0.6, 0.3, 1.3 increases out of 4.0, p< 0.01, n=111). The participants were highly satisfied with the program (4.2, 4.1, and 4.0 out of 5.0, n=162). Among the respondents of the online follow-up survey (n=28), 60.7% had used ultrasound in their daily practice after the education program, and a medical institution established an ultrasound training center. The absence of clear accreditation and practical guidelines in ultrasound use were presented as barriers for adoption and maintenance.

Conclusion
The program was successful in improving participant’s knowledge and self-confidence in ultrasound techniques and showed great potential for the adoption and maintenance of the techniques in their practice. Continuous implementation of the program and institutional policy changes to facilitate ultrasound use may increase the ultrasound use and improve ultrasound service quality in Nepal.

OSI Number – 20894

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