RESUMO
BACKGROUND: The Basic Emergency Care: Approach to the acutely ill and injured course was developed to train health care providers to recognize, stabilize, and treat critically ill patients in resource-limited settings. This study evaluates the Basic Emergency Care course as a tool for improving the emergency medicine knowledge and skills of medical students in a lower-middle income country. METHODS: This prospective study was conducted with senior medical students at the University of Nairobi School of Medicine in October 2021. Participants' knowledge was assessed with multiple choice pre- and post-course examinations. Pre- and post-course surveys assessed participants' confidence in managing acutely ill and injured patients using a 4-point Likert scale. RESULTS: A total of 30 students from the graduating medical school class participated in the study. Post-course examination scores (mean 94.5%, range 80-100%) showed a significant improvement (p < 0.05) compared to pre-course examination scores (mean 82%, range 64-96%). Participants' comfort and confidence in providing emergency care and performing critical emergency skills significantly increased (p < 0.05) between the pre- and post-course surveys. CONCLUSION: These findings suggest that the Basic Emergency Care course is effective in providing senior medical students with basic emergency medicine knowledge and increasing their confidence to identify and address life-threatening conditions prior to their intern year.
RESUMO
Background: Resource limited settings have an ongoing need for access to quality emergency care. The World Health Organization - International Committee of the Red Cross Basic Emergency Care (BEC) course is one mechanism to address this need. Training of BEC trainers has been challenging due to barriers including cost, travel logistics, scheduling, and more recently, social distancing regulations related to the coronavirus pandemic. Objective: We seek to determine if an online virtual format is an effective way to train additional trainers while overcoming these barriers. Methods: The BEC Training-of-Trainers (ToT) course was adapted to a virtual format and delivered entirely online. Participants were assessed with a multiple choice pre- and post-test and completed a course feedback form upon completion. Results from the virtual course were then compared to the results from an in-person ToT course. Findings: The in-person course pre- and post-tests were completed by 121 participants with a pre-test mean of 87% (range 60-100%) and a post-test mean of 95% (range: 75-100; p < 0.05). Virtual course pre- and post-tests by 27 participants were analyzed with a pre-test mean of 89% (range 75-100%) and a post-test mean of 96% (range: 79-100; p < 0.05). No difference in test improvements between the courses was detected (z = -0.485; p = 0.627). The course feedback was completed by 93 in-person participants and 28 virtual participants. Feedback survey responses were similar for all questions except for course length, with in-person participant responses trending towards the course being too long. Conclusions: A virtual format BEC ToT course is effective, feasible, and acceptable. When compared to an in-person course, no difference was detected in nearly all metrics for the virtual format. Utilizing this format for future courses can assist in scaling both the BEC ToT and, by extension, the BEC course globally, particularly in regions facing barriers to in-person training.
