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
Abstract Introduction Quality midwifery education is central to improving midwifery service delivery and maternal and newborn health outcomes. In many settings, midwifery educators insufficiently prepared for their teaching role and deficient curriculum compared to international standards affect the...
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2024-12-01
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| Online Access: | https://doi.org/10.1186/s12909-024-06581-x |
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| author | Duncan N. Shikuku Catherine Mwaura Peter Nandikove Alphonce Uyara Helen Allott Lucy Waweru Lucy Nyaga Edna Tallam Issak Bashir Eunice Ndirangu Carol Bedwell Sarah Bar-Zeev Charles Ameh |
| author_facet | Duncan N. Shikuku Catherine Mwaura Peter Nandikove Alphonce Uyara Helen Allott Lucy Waweru Lucy Nyaga Edna Tallam Issak Bashir Eunice Ndirangu Carol Bedwell Sarah Bar-Zeev Charles Ameh |
| author_sort | Duncan N. Shikuku |
| collection | DOAJ |
| description | Abstract Introduction Quality midwifery education is central to improving midwifery service delivery and maternal and newborn health outcomes. In many settings, midwifery educators insufficiently prepared for their teaching role and deficient curriculum compared to international standards affect the quality of healthcare provided by the midwifery graduates. This study assessed the effectiveness 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 confidence 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 confidence and three OSCE in EmONC practical skills among final year midwifery students were assessed. Linear mixed effects models were used to evaluate the effect of intervention on educators and students. Results Seventy four educators and 146 students participated. Training significantly improved educators’ mean knowledge (61.3%-73.3%) and confidence to teach EmONC (3.1–4.2 out of 5). Observed teaching skills mean scores of educators in the intervention arm were significantly higher compared to those of controls at endline (89.4%-vs-72.2%, mean difference 17.2 [95%CI, 3.2–29.8]). Mean scores for students in the intervention arm were significantly higher than those in controls for knowledge (59.6%-vs-51.3%, mean difference 8.3 [95%CI, 1.6–15.0]) and the three skills assessed (means; mean difference (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 significantly higher for students who were taught by trained and mentored educators compared to those who received training alone. Thus, a local mentoring system is effective to enhance learning and effectiveness of an EmONC-updated midwifery curriculum. |
| format | Article |
| id | doaj-art-e05facc348db4b42b4e3f664552bdaa0 |
| institution | Kabale University |
| issn | 1472-6920 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | BMC |
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| series | BMC Medical Education |
| spelling | doaj-art-e05facc348db4b42b4e3f664552bdaa02025-01-05T12:33:54ZengBMCBMC Medical Education1472-69202024-12-0124112310.1186/s12909-024-06581-xAn evaluation of the effectiveness of an updated pre-service midwifery curriculum integrated with emergency obstetric and newborn care in Kenya: a cluster randomised controlled trialDuncan N. Shikuku0Catherine Mwaura1Peter Nandikove2Alphonce Uyara3Helen Allott4Lucy Waweru5Lucy Nyaga6Edna Tallam7Issak Bashir8Eunice Ndirangu9Carol Bedwell10Sarah Bar-Zeev11Charles Ameh12Liverpool School of Tropical Medicine (Kenya)Kenya Medical Training CollegeMasinde Muliro University of Science and TechnologyMaseno UniversityLiverpool School of Tropical Medicine (UK)Kenya Medical Training CollegeLiverpool School of Tropical Medicine (Kenya)Nursing Council of KenyaDepartment of Family Health, Ministry of Health (KenyaAga Khan University of East AfricaLiverpool School of Tropical Medicine (UK)Burnet InstituteLiverpool School of Tropical Medicine (UK)Abstract Introduction Quality midwifery education is central to improving midwifery service delivery and maternal and newborn health outcomes. In many settings, midwifery educators insufficiently prepared for their teaching role and deficient curriculum compared to international standards affect the quality of healthcare provided by the midwifery graduates. This study assessed the effectiveness 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 confidence 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 confidence and three OSCE in EmONC practical skills among final year midwifery students were assessed. Linear mixed effects models were used to evaluate the effect of intervention on educators and students. Results Seventy four educators and 146 students participated. Training significantly improved educators’ mean knowledge (61.3%-73.3%) and confidence to teach EmONC (3.1–4.2 out of 5). Observed teaching skills mean scores of educators in the intervention arm were significantly higher compared to those of controls at endline (89.4%-vs-72.2%, mean difference 17.2 [95%CI, 3.2–29.8]). Mean scores for students in the intervention arm were significantly higher than those in controls for knowledge (59.6%-vs-51.3%, mean difference 8.3 [95%CI, 1.6–15.0]) and the three skills assessed (means; mean difference (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 significantly higher for students who were taught by trained and mentored educators compared to those who received training alone. Thus, a local mentoring system is effective to enhance learning and effectiveness of an EmONC-updated midwifery curriculum.https://doi.org/10.1186/s12909-024-06581-xMidwiferyEmergency obstetrics and newborn careCurriculumEducationKenya |
| spellingShingle | Duncan N. Shikuku Catherine Mwaura Peter Nandikove Alphonce Uyara Helen Allott Lucy Waweru Lucy Nyaga Edna Tallam Issak Bashir Eunice Ndirangu Carol Bedwell Sarah Bar-Zeev Charles Ameh 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 Midwifery Emergency obstetrics and newborn care Curriculum Education Kenya |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | Midwifery Emergency obstetrics and newborn care Curriculum Education Kenya |
| url | https://doi.org/10.1186/s12909-024-06581-x |
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