Basic ENT training for enhanced healthcare worker knowledge, attitudes and practices in a resource-limited setting: a pre-post and post-post cross-sectional study

Introduction Diagnostic errors in ear, nose and throat (ENT) diseases are prevalent among healthcare workers (HCWs) in resource-limited settings, yet comprehensive data that describe HCW knowledge, attitudes and practices (KAP) regarding ENT disease management remains scarce. Further, the impact of...

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Main Authors: Chester Kalinda, Colleen Aldous, Charles Michelo, Lufunda Lukama, Sinoya Mbewe
Format: Article
Language:English
Published: BMJ Publishing Group 2024-12-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/14/12/e086684.full
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author Chester Kalinda
Colleen Aldous
Charles Michelo
Lufunda Lukama
Sinoya Mbewe
author_facet Chester Kalinda
Colleen Aldous
Charles Michelo
Lufunda Lukama
Sinoya Mbewe
author_sort Chester Kalinda
collection DOAJ
description Introduction Diagnostic errors in ear, nose and throat (ENT) diseases are prevalent among healthcare workers (HCWs) in resource-limited settings, yet comprehensive data that describe HCW knowledge, attitudes and practices (KAP) regarding ENT disease management remains scarce. Further, the impact of basic ENT training on HCW KAP in such settings is largely undetermined.Objective We assessed HCW KAP before and after basic training in ENT disease management.Methods This questionnaire-based pre-post-test cross-sectional survey employed HCW training in public hospitals in a resource-limited setting. We conducted a 2-day training, preceded by a pretraining survey, followed by immediate and 5-month post-training assessments using a prevalidated questionnaire. 416 HCWs participated and were selected through probability-proportionate-to-size random sampling. Wilcoxon matched-pairs signed-rank and Kruskal-Wallis tests were used to assess pre-post training KAP variations.Results At baseline, the median (IQR) percentage knowledge scores for HCWs in general ENT, ear, sinonasal and head and neck disease management were 60 (40), 55 (18), 58.3 (25) and 56 (22.6), respectively. Only 33.8% (133/394) of HCWs had access to an otoscope, 25.5% (101/396) to a headlight and 12.1% (48/397) to a nasal speculum. While 99.2% (390/393) of HCWs considered ENT important, 57.8% (226/391) of them lacked the confidence to correctly diagnose and manage most ENT conditions. At the immediate post-training assessment, HCWs’ median knowledge scores increased by 20%, 18%, 25% and 33% for general ENT, ear, sinonasal and head and neck disease management, respectively (p<0.001). Further, the proportions of HCWs consistently performing otoscopy and using ENT guidelines increased from 15.1% (43/284) and 13.8% (48/282) to 35.5 (44/124) and 23.9% (27/113) 5 months post-training.Conclusions This study underscores the critical need for continuous medical education (CME) to address knowledge gaps and improve HCW attitudes and practices. The findings provide valuable insights for policymakers aiming to enhance ENT healthcare delivery in resource-limited settings.
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spelling doaj-art-5360b5ca43cf4300996b5769f8f697c92025-08-20T02:43:28ZengBMJ Publishing GroupBMJ Open2044-60552024-12-01141210.1136/bmjopen-2024-086684Basic ENT training for enhanced healthcare worker knowledge, attitudes and practices in a resource-limited setting: a pre-post and post-post cross-sectional studyChester Kalinda0Colleen Aldous1Charles Michelo2Lufunda Lukama3Sinoya Mbewe46 Bill and Joyce Cummings Institute of Global Health, University of Global Health Equity, Kigali, Rwanda3 Department of Clinical Medicine, Nelson R Mandela School of Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa5 Global Health Institute, Nkwazi Research University, Lusaka, Zambia1 Department of Otorhinolaryngology, Head and Neck Surgery, Nelson R Mandela School of Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa4 Department of Audiology, Arthur Davison Children`s Hospital, Ndola, ZambiaIntroduction Diagnostic errors in ear, nose and throat (ENT) diseases are prevalent among healthcare workers (HCWs) in resource-limited settings, yet comprehensive data that describe HCW knowledge, attitudes and practices (KAP) regarding ENT disease management remains scarce. Further, the impact of basic ENT training on HCW KAP in such settings is largely undetermined.Objective We assessed HCW KAP before and after basic training in ENT disease management.Methods This questionnaire-based pre-post-test cross-sectional survey employed HCW training in public hospitals in a resource-limited setting. We conducted a 2-day training, preceded by a pretraining survey, followed by immediate and 5-month post-training assessments using a prevalidated questionnaire. 416 HCWs participated and were selected through probability-proportionate-to-size random sampling. Wilcoxon matched-pairs signed-rank and Kruskal-Wallis tests were used to assess pre-post training KAP variations.Results At baseline, the median (IQR) percentage knowledge scores for HCWs in general ENT, ear, sinonasal and head and neck disease management were 60 (40), 55 (18), 58.3 (25) and 56 (22.6), respectively. Only 33.8% (133/394) of HCWs had access to an otoscope, 25.5% (101/396) to a headlight and 12.1% (48/397) to a nasal speculum. While 99.2% (390/393) of HCWs considered ENT important, 57.8% (226/391) of them lacked the confidence to correctly diagnose and manage most ENT conditions. At the immediate post-training assessment, HCWs’ median knowledge scores increased by 20%, 18%, 25% and 33% for general ENT, ear, sinonasal and head and neck disease management, respectively (p<0.001). Further, the proportions of HCWs consistently performing otoscopy and using ENT guidelines increased from 15.1% (43/284) and 13.8% (48/282) to 35.5 (44/124) and 23.9% (27/113) 5 months post-training.Conclusions This study underscores the critical need for continuous medical education (CME) to address knowledge gaps and improve HCW attitudes and practices. The findings provide valuable insights for policymakers aiming to enhance ENT healthcare delivery in resource-limited settings.https://bmjopen.bmj.com/content/14/12/e086684.full
spellingShingle Chester Kalinda
Colleen Aldous
Charles Michelo
Lufunda Lukama
Sinoya Mbewe
Basic ENT training for enhanced healthcare worker knowledge, attitudes and practices in a resource-limited setting: a pre-post and post-post cross-sectional study
BMJ Open
title Basic ENT training for enhanced healthcare worker knowledge, attitudes and practices in a resource-limited setting: a pre-post and post-post cross-sectional study
title_full Basic ENT training for enhanced healthcare worker knowledge, attitudes and practices in a resource-limited setting: a pre-post and post-post cross-sectional study
title_fullStr Basic ENT training for enhanced healthcare worker knowledge, attitudes and practices in a resource-limited setting: a pre-post and post-post cross-sectional study
title_full_unstemmed Basic ENT training for enhanced healthcare worker knowledge, attitudes and practices in a resource-limited setting: a pre-post and post-post cross-sectional study
title_short Basic ENT training for enhanced healthcare worker knowledge, attitudes and practices in a resource-limited setting: a pre-post and post-post cross-sectional study
title_sort basic ent training for enhanced healthcare worker knowledge attitudes and practices in a resource limited setting a pre post and post post cross sectional study
url https://bmjopen.bmj.com/content/14/12/e086684.full
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