An Implementation Research of Simulation Based Mentorship Program

NCT ID: NCT06414629

Last Updated: 2024-05-16

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

326 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-11-01

Study Completion Date

2023-12-31

Brief Summary

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The goal of this research was to evaluate the effectiveness and implementation outcomes of the Simulation Based Mentorship Program (SBMP) which was implemented in four districts of Nepal. The main questions it aims to answer are:

1. What is the reach of the Simulation Based Mentorship Program?
2. What is the effect of Simulation Based Based Mentorship Program on knowledge, clinical skills, and confidence of nurses working in Birthing Centers of four district of Nepal?
3. How was the program adopted by the Birthing Centers?
4. How was the program implemented?
5. What is the perception regarding the maintenance of the program?

The nurses working in the Birthing Centers were the study participants, and they received simulation-based monthly mentorship on following seven modules related to essential obstetric and newborn care every month:

1. Infection prevention
2. Antenatal care and counseling
3. Essential care of labor and birth
4. Helping babies breathe
5. Bleeding after birth
6. Pre-eclampsia and eclampsia management
7. Postnatal care and counseling

Detailed Description

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As the evidence showed gaps in the knowledge and skills of existing maternal and newborn health providers, we designed a Simulation-Based Mentorship Program (SBMP) to bridge the gaps. In this program, local-level mentors were developed to provide regular mentorship using a low-dose high-frequency approach in contrast to one-time coaching in a long gap. This program combined the existing package of the continuum of care along with Helping Babies Survive (HBS) \& Helping Mothers Survive (HMS) guidelines, adopting a simulation-based onsite mentoring and coaching approach.

The main aim of this mentorship program was to improve the quality of essential obstetric and newborn care provided by the nurses and Auxiliary Nurse Midwives (ANMs) irrespective of their pre-service and in-service training exposure by identifying gaps, providing regular technical support on the site, building close relationships between mentors and mentees, and increasing communication, backed up by regular practice in simulation labs to help in skill retention. In this mentorship program, mentorship was provided to both the Skilled Birth Assistants (SBAs) and non-Skilled Birth Attendants in their workstations to capacitate them in promoting mother and newborn health outcomes.

Reach, Effectiveness, Adoption, Implementation, and Maintenance (REAIM) Dimensions in the study were:

Reach

1. Number and percentage of Birthing centers intervened in the district
2. Number and percentage of nurses trained as district-level mentors
3. Number and percentage of nurses (and Auxiliary Nurse Midwives) receiving the intervention (simulation-based mentorship)
4. Perception regarding the representativeness of participants in the program

Effectiveness

1. Immediate change in knowledge, skills, and confidence (midline results)- compared with control group
2. Perceived reasons for program effectiveness

Adoption

1. Number and percentage of intervention sites completing all 6 monthly sessions
2. Number and percentage of mentees participating in all 6 monthly sessions
3. Number and percentage of mentees participating in weekly sessions
4. Reasons for participation/ non-participation

Implementation

1. Plan vs. actual implementation (duration between monthly sessions)
2. Perception regarding various components of the program (content, teaching and learning methods, mentors)
3. Challenges encountered during implementation, adaptations made/ mitigation measures adopted

Maintenance

1. Number and percentage of mentors and mentees remaining after 4 to 6 months of Simulation Based Mentorship Program (SBMP) implementation (end-line)
2. Retention of knowledge, skills, and confidence 4 to 6 months after completion of the intervention (end-line results) compared with the control group
3. Capital cost and recurrent cost required for continuation at government level
4. Application of learnings in a real setting (during and after the program implementation)
5. Willingness to implement the program in the health facilities of Simulation Based Mentorship Program (SBMP) implemented local levels after completion of the intervention
6. Continuation of mentoring/ learning in the simulation labs/ using manikins after completion of monthly sessions by mentors and mentees
7. Challenges and recommendations for continuation

Conditions

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Maternal Health Neonatal Health

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

The study Birthing Centers were categorized into Intervention Birthing Center and Control Birthing Center
Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

NONE

Study Groups

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Intervention Group/ Intervention Birthing Center

The nurses working in the Intervention Birthing Centers received the Simulation Based Mentorship Program.

Group Type EXPERIMENTAL

Simulation Based Mentorship Program

Intervention Type OTHER

In this program, local level mentors were developed to provide regular mentorship on low-dose high-frequency approach in contrast to one-time coaching in a long gap. This program combined the existing package of the continuum of care along with Helping Babies Survive (HBS) \& Helping Mothers Survive (HMS) guidelines, adopting a simulation-based onsite mentoring and coaching approach. The mentors provided monthly mentorship on following seven modules topics to the nurses of the intervention birthing centers:

1. Infection prevention
2. Antenatal care and counseling
3. Essential care of labor and birth
4. Helping babies breathe
5. Bleeding after birth
6. Essential care of labor and birth
7. Postnatal care and counseling

Every monthly session was followed by four weekly practice sessions. The nurses from intervention birthing centers were also called mentees.

Control Group/ Control Birthing Center

The nurses working in the Intervention Birthing Centers did not receive the Simulation Based Mentorship Program.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Simulation Based Mentorship Program

In this program, local level mentors were developed to provide regular mentorship on low-dose high-frequency approach in contrast to one-time coaching in a long gap. This program combined the existing package of the continuum of care along with Helping Babies Survive (HBS) \& Helping Mothers Survive (HMS) guidelines, adopting a simulation-based onsite mentoring and coaching approach. The mentors provided monthly mentorship on following seven modules topics to the nurses of the intervention birthing centers:

1. Infection prevention
2. Antenatal care and counseling
3. Essential care of labor and birth
4. Helping babies breathe
5. Bleeding after birth
6. Essential care of labor and birth
7. Postnatal care and counseling

Every monthly session was followed by four weekly practice sessions. The nurses from intervention birthing centers were also called mentees.

Intervention Type OTHER

Other Intervention Names

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SBMP

Eligibility Criteria

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Inclusion Criteria

* Nurses working in selected Birthing Centers during the baseline enrollment

Exclusion Criteria

* Newly recruited nurses by the Birthing Centers
Minimum Eligible Age

18 Years

Maximum Eligible Age

49 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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One Heart Worldwide

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Surya Bhatta, MHCDS

Role: STUDY_DIRECTOR

One Heart Worldwide

Locations

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One Heart Worldwide

Kathmandu, Bagmati, Nepal

Site Status

Countries

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Nepal

References

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Utz B, Siddiqui G, Adegoke A, van den Broek N. Definitions and roles of a skilled birth attendant: a mapping exercise from four South-Asian countries. Acta Obstet Gynecol Scand. 2013 Sep;92(9):1063-9. doi: 10.1111/aogs.12166. Epub 2013 Jun 15.

Reference Type BACKGROUND
PMID: 23656549 (View on PubMed)

Olson KR, Caldwell A, Sihombing M, Guarino AJ, Nelson BD, Petersen R. Assessing self-efficacy of frontline providers to perform newborn resuscitation in a low-resource setting. Resuscitation. 2015 Apr;89:58-63. doi: 10.1016/j.resuscitation.2015.01.008. Epub 2015 Jan 19.

Reference Type BACKGROUND
PMID: 25613363 (View on PubMed)

Alamrani MH, Alammar KA, Alqahtani SS, Salem OA. Comparing the Effects of Simulation-Based and Traditional Teaching Methods on the Critical Thinking Abilities and Self-Confidence of Nursing Students. J Nurs Res. 2018 Jun;26(3):152-157. doi: 10.1097/jnr.0000000000000231.

Reference Type BACKGROUND
PMID: 29016466 (View on PubMed)

Krielen P, Meeuwsen M, Tan ECTH, Schieving JH, Ruijs AJEM, Scherpbier ND. Interprofessional simulation of acute care for nursing and medical students: interprofessional competencies and transfer to the workplace. BMC Med Educ. 2023 Feb 11;23(1):105. doi: 10.1186/s12909-023-04053-2.

Reference Type BACKGROUND
PMID: 36774481 (View on PubMed)

Barre J, Michelet D, Truchot J, Cabon P, Tesniere A. Midwifery students' retention of learning after screen-based simulation training on neonatal resuscitation: a pilot study. BMJ Simul Technol Enhanc Learn. 2020 Apr 6;7(1):31-34. doi: 10.1136/bmjstel-2019-000525. eCollection 2021.

Reference Type BACKGROUND
PMID: 35521074 (View on PubMed)

Cant RP, Cooper SJ. Use of simulation-based learning in undergraduate nurse education: An umbrella systematic review. Nurse Educ Today. 2017 Feb;49:63-71. doi: 10.1016/j.nedt.2016.11.015. Epub 2016 Nov 22.

Reference Type BACKGROUND
PMID: 27902949 (View on PubMed)

Lee BO, Liang HF, Chu TP, Hung CC. Effects of simulation-based learning on nursing student competences and clinical performance. Nurse Educ Pract. 2019 Nov;41:102646. doi: 10.1016/j.nepr.2019.102646. Epub 2019 Oct 23.

Reference Type BACKGROUND
PMID: 31698255 (View on PubMed)

Hung CC, Kao HS, Liu HC, Liang HF, Chu TP, Lee BO. Effects of simulation-based learning on nursing students' perceived competence, self-efficacy, and learning satisfaction: A repeat measurement method. Nurse Educ Today. 2021 Feb;97:104725. doi: 10.1016/j.nedt.2020.104725. Epub 2020 Dec 16.

Reference Type BACKGROUND
PMID: 33373813 (View on PubMed)

Other Identifiers

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OHW1

Identifier Type: -

Identifier Source: org_study_id

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