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Atout Coeur Design Group

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Anaesthesia Osce Download !!INSTALL!!.zip

OSPE/OSCE should be designed in such a way that it assesses the skills with validity. For instance, asking a student to write down how to give an inferior dental nerve block anaesthesia would not be a valid way of assessing the skill. Instead, the examiner should observe a student as she/he gives the anaesthesia on a patient or a manikin.20 Table 1 shows various skills tested in OSCE/OSPE and a valid method of assessing them.

Anaesthesia Osce

According to the FGs, undergraduate orthodontics curriculum being theory based did not require assessment of clinical skills in OSCE. In contrast, Oral Surgery OSCE underscores the assessment of skills such as local anaesthesia administration, behavioural management and extractions, however they were not evaluated. Although FGs did explain that these skills were tested in their clinical rotations during the academic year. This simply translates into the fact that it is important how the OSCE stations are designed. The OSCE purports to assess psychomotor skills of the students. If the stations do not have any design to assess clinical skills, the purpose of conducting the OSCE may not be fully achieved. Such kind of OSCE is not a good tool to assess skills as it lacks the clinical authenticity and subsequently, may mislead to judge the competencies of the student.29

The Anaesthesia Heritage Centre tells the remarkable story of anaesthesia, from its first public demonstration in 1846 to modern day anaesthetists working in the aftermath of wars and terrorist attacks.

elearning Anaesthesia (e-LA) is an online course that supports specialty anaesthesia training and continuing professional development for doctors, nurses and other anaesthesia practitioners across the globe.

This high-quality anaesthesia course has been developed in the UK by the Royal College of Anaesthetists and Health Education England elearning for healthcare. So, it meets the highest training standards. The team of 400 authors and editors regularly reviews and updates this online anaesthesia course.

Following an introduction, core training covers topics such as consolidating basic clinical practice, an introduction to critical care, obstetrics, paediatrics, anaesthesia in the elderly, pain and regional anaesthesia.

Competency-based curricula for assistant medical officers' (AMOs) training in CEmOC, and for nurses, midwives and clinical officers in anaesthesia and operation theatre etiquette were developed and implemented in Ifakara, Tanzania. The required key competencies were identified, taught and objectively assessed. The training involved hands-on sessions, lectures and discussions. Participants were purposely selected in teams from remote health centres where CEmOC services were planned. Monthly supportive supervision after graduation was carried out in the upgraded health centres

A total of 43 care providers from 12 health centres located in 11 rural districts in Tanzania and 2 from Somalia were trained from June 2009 to April 2010. Of these 14 were AMOs trained in CEmOC and 31 nurse-midwives and clinical officers trained in anaesthesia. During training, participants performed 278 major obstetric surgeries, 141 manual removal of placenta and evacuation of incomplete and septic abortions, and 1161 anaesthetic procedures under supervision. The first 8 months after introduction of CEmOC services in 3 health centres resulted in 179 caesarean sections, a remarkable increase of institutional deliveries by up to 300%, decreased fresh stillbirth rate (OR: 0.4; 95% CI: 0.1-1.7) and reduced obstetric referrals (OR: 0.2; 95% CI: 0.1-0.4)). There were two maternal deaths, both arriving in a moribund condition.

Recently, the government of Tanzania revised the National Health Policy with a goal to improve the health and well being of all Tanzanians with a focus on those most at risk, and to encourage the health system to be more responsive to the needs of the people [8]. One of its strategies is to upgrade health centres and use NPCs to improve accessibility to CEmOC in remote rural areas where the majority (77%) of Tanzanians live [1, 5]. It is with this background that we took up the challenge to develop and launch three months postgraduate training programmes for AMOs in CEmOC, and for CO and NM in anaesthesia. Our research questions were: does this three months training of AMOs in CEmOC better address workplace needs compared to current training, and can a three months comprehensive training of NM and COs in anaesthesia result in acceptable quality of care?

While there are seven AMO schools with an average annual output of 200 there is only one medical school in the country where graduate doctors are trained to specialize in anaesthesia. Currently, there are only 17 specialists in anaesthesia in the whole country. The majority (14) work in Dar es Salaam hospitals. There is one institution where AMOs specialize in anaesthesia and another one where NM and COs are trained as anaesthetic nurses (anaesthetic assistants). These AMO and nurse anaesthetists only partially relieve the shortage. To meet the need for the upgraded health centres, AMOs were trained in comprehensive emergency obstetrical care while COs and NMs, as anaesthetic assistants, were trained to give spinal anaesthesia and ketamine general anaesthesia. The trainees were recruited in teams which comprised of at least one AMO and two NMs or COs from the same facility. The concept of team training was devised in order to ensure inclusion of key categories of staff able to perform obstetric surgeries and anaesthesia.

The training took place in two collaborating institutions: Tanzanian Training Centre for International Health (TTCIH) and Saint Francis Designated District Hospital (SFDDH). TTCIH is a non profit semi-autonomous institution that offers short international courses in health and a long course for AMOs. The two institutions (TTCIH and SFDDH) have had long experiences in health related training and health care service delivery. SFDDH, a hospital with a 372-bed capacity, receives referred patients from primary health facilities (dispensaries and health centres) in Ulanga and Kilombero districts. The mean annual delivery and caesarean section rates from 2005 to 2008 were 4,987 and 25% respectively. The key technical staff for the programmes included one medical curriculum expert, two obstetricians, one paediatrician, two generalist doctors and one senior AMO - all with vast experience in maternal and perinatal care. The training in anaesthesia was conducted by a consultant anaesthetist from Muhimbili National Hospital (MNH), one AMO specialized in anaesthesia and two senior anaesthetic nurses from SFDDH. The training programmes were built on the framework of human resources, pedagogical and technological materials available in the two institutions.

Competency-based training curricula for CEmOC and anaesthesia were developed. The process of curriculum development included: occupational profiling, assessment of the employers' needs in maternal health, clarification of objectives including required competencies, description of the methodology for implementation of the curricula, establishment of financial implications and documentation of the human and physical resources needed for effective learning and teaching.

The training programmes took three months and involved both hands-on and theory. All trainees for both (CEmOC and anaesthesia) programmes were included in night duty rosters in groups of two attached to more experienced hospital staff. The scope of working activities under supervision was outlined. The CEmOC trainees were also included in the day-time labour ward duty roster and were also involved in routine teaching ward rounds in the maternity which were carried out by the hospital obstetric team thrice a week. During these ward rounds and when they were on call, the CEmOC programme participants were included in the decision making for patients requiring surgical interventions. They were also involved in elective and emergency obstetric surgeries, either as assistant or operating independently. Elective obstetric surgeries were performed twice a week. Participants for the anaesthesia programme took part in all surgical, obstetric and gynaecological elective and emergency operations, either as assistant to a qualified anaesthetist or giving anaesthesia under supervision.

Demonstrations of procedures were made during actual performance as well as using available manikins and video films at TTCIH's Clinical Skills Laboratory with ample opportunity to practice these using the manikins. Procedures were supervised and candidates reached the level of proficiency before they were allowed to manage patients. These included resuscitation of the newborn, vacuum extraction, caesarean section, abdominal aorta compression and condom tamponade for management of postpartum haemorrhage and intubation. Interactive lectures were conducted on every working day (five days a week) for at least 2 hours, from 14:00 to 16:00. Teaching emphasis for AMOs was put on all elements of CEmOC; clinical presentations; diagnosis; complications; and treatment and prevention of complications of pregnancy and childbirth. Other areas included peri-operative care, resuscitation and infection prevention. The training in anaesthesia emphasized the use of spinal anaesthesia and ketamine, and covered a wide range of topics including classification, methods, indications, contraindications, potential complications and management. Various available anaesthetic drugs were discussed. Problems unique to anaesthesia in obstetrics - along with medical conditions related to obstetrics, including haemorrhage, anaemia, (pre) eclampsia and respiratory diseases - were dealt with. Other areas included resuscitation, oxygen therapy, peri-operative care, sterilization, infection prevention and operating room etiquette (scrubbing, masks, gloving and catheterization). Adult learning and teaching methods were encouraged to improve the learning processes for both programmes. 350c69d7ab


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