Impact of short basic emergency medicine training in introducing emergency medicine as a specialty in Sub-Saharan Africa: Experience from Tanzania

• Type of Material: Article
• Authors: Peter S. Mabula, University of Dar Es Salaam; Hendry R. Sawe, University of Dar Es Salaam; Victor Mwafongo, University of Dar Es Salaam; Juma A. Mfinanga, Muhimbili National Hospital; Michael S. Runyon, University of Dar Es Salaam; Brittany Murray, Emory University
• Language: English
• Date: 2019-01-11
• Publisher: BMC (part of Springer Nature)
• Publication Version: Final Published Version
• Copyright Statement: © 2019 The Author(s).
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1186/s12245-018-0218-3
• Title of Journal or Parent Work: International Journal of Emergency Medicine
• ISSN: 1865-1372
• Volume: 12
• Issue: 1
• Grant/Funding Information: This was a non-funded project; the principal investigators used their own funds to support the data collection and logistics.
• Keywords: Tertiary hospitals; Emergency Medicine; Basic EM training in Tanzania
• Research Categories: Health Sciences, Health Care Management

Abstract

Background: Emergency medicine (EM) is a new specialty in Tanzania. Little is known about how to introduce EM to health care providers (HCPs) in hospitals without EM. We determined the impact of a 2-day EM training program on the understanding, perception, and choice of EM as a career amongst HCPs at hospitals in Tanzania without EM. Methods: This was a pre- and post-training interventional study including randomly selected HCPs from four tertiary hospitals in Tanzania without EM. Understanding, perception, and desirability of EM as a career were assessed before and after a 2-day university-accredited basic EM short-course training given by EM physicians. A paper-based Likert scale (out of 5) questionnaire was used, which were analyzed by T tests, Mann-Whitney, and Kruskal-Wallis tests. Results: During the study period, 96 health care providers (100% capture) in the four tertiary hospitals participated in the study. The median age of participants was 34 years (IQR 28-43); 35 (36.0%) were males. Sixty (63%) were nurses, 26 (27%) doctors, and 3 (3%) were administrators. The four hospitals were equally represented. Median pre-training scores for all Likert questions were 3.49 (IQR 3.3-3.9); understanding 3.3 (IQR 3.0-3.7), perception 3.40 (IQR 3.1-3.7), and career decision-making 3.7 (IQR 3.3-4.0). Post-training scores improved with median scores of 4.6 (IQR 4.5-4.7) overall, 4.7 (IQR 4.0-4.7) for understanding, 4.6 (IQR 4.5-4.9) for perception, and 4.7 (IQR 4.3-4.8) for career decision-making (all p < 0.01). Conclusion: A 2-day training in basic EM care had a positive impact on understanding, perception, and career decisions regarding EM amongst Tanzania HCPs that work in hospitals without EM. Follow-up to assess long-term impact, and expansion of this program, is recommended to foster EM in countries where this is a new specialty.