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Feasibility and integration of an intensive emergency pediatric care curriculum in Armenia

Authors
  • Baghdassarian, Aline1, 2
  • Best, Al M.1
  • Virabyan, Anushavan3
  • Alexanian, Claire4
  • Shekherdimian, Shant5
  • Santen, Sally A.1
  • Simonyan, Hambartzum6
  • 1 Virginia Commonwealth University School of Medicine, 1250 East Marshall Street, Main Hospital, 2nd Floor, Suite-600, Richmond, VA, 23298, USA , Richmond (United States)
  • 2 Department of Emergency Medicine Inova Fairfax Campus, 3300 Gallows Road, Falls Church, VA, 22042, USA , Falls Church (United States)
  • 3 Yerevan State Medical University, Yerevan, Armenia , Yerevan (Armenia)
  • 4 Georgetown University School of Medicine (M’19), Washington, DC, USA , Washington (United States)
  • 5 University of California Los Angeles, Los Angeles, CA, USA , Los Angeles (United States)
  • 6 Fund for Armenian Relief 2, Khorenatsi Street, Yerevan, Armenia , Yerevan (Armenia)
Type
Published Article
Journal
International Journal of Emergency Medicine
Publisher
Springer Berlin Heidelberg
Publication Date
Jan 06, 2021
Volume
14
Issue
1
Identifiers
DOI: 10.1186/s12245-020-00320-x
Source
Springer Nature
Keywords
License
Green

Abstract

BackgroundEmergency pediatric care curriculum (EPCC) was developed to address the need for pediatric rapid assessment and resuscitation skills among out-of-hospital emergency providers in Armenia. This study was designed to evaluate the effectiveness of EPCC in increasing physicians’ knowledge when instruction transitioned to local instructors. We hypothesize that (1) EPCC will have a positive impact on post-test knowledge, (2) this effect will be maintained when local trainers teach the course, and (3) curriculum will satisfy participants.MethodsThis is a quasi-experimental, pre-test/post-test study over a 4-year period from October 2014‑November 2017. Train-the-trainer model was used. Primary outcomes are immediate knowledge acquisition each year and comparison of knowledge acquisition between two cohorts based on North American vs local instructors. Descriptive statistics was used to summarize results. Pre-post change and differences across years were analyzed using repeated measures mixed models.ResultsTest scores improved from pretest mean of 51% (95% CI 49.6 to 53.0%) to post-test mean of 78% (95% CI 77.0 to 79.6%, p < 0.001). Average increase from pre- to post-test each year was 27% (95% CI 25.3 to 28.7%). Improvement was sustained when local instructors taught the course (p = 0.74). There was no difference in improvement when experience in critical care, EMS, and other specialties were compared (p = 0.23). Participants reported satisfaction and wanted the course repeated. In 2017, EPCC was integrated within the Emergency Medicine residency program in Armenia.DiscussionThis program was effective at impacting immediate knowledge as well as participant satisfaction and intentions to change practice. This knowledge acquisition and reported satisfaction remained constant even when the instruction was transitioned to the local instructors after 2 years. Through a partnership between the USA and Armenia, we provided OH-EPs in Armenia with an intensive educational experience to attain knowledge and skills necessary to manage acutely ill or injured children in the out-of-hospital setting.ConclusionsEPCC resulted in significant improvement in knowledge and was well received by participants. This is a viable and sustainable model to train providers who have otherwise not had formal education in this field.

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