TY - JOUR
T1 - Assessing provider performance of intrapartum care using simulated encounters and clinical vignettes
T2 - A comparison study from Tanzania
AU - Young, Anna Marie P.
AU - Marx, Melissa A.
AU - Frost, Emily
AU - Hazel, Elizabeth
AU - Kabanywanyi, Abdunoor M.
AU - Mohan, Diwakar
N1 - Funding Information:
We would like to thank all the intrapartum care providers in Simitu who took the time to participate in this study. We would also like thank our colleagues from Amref, Ifakara Health Institute, and Johns Hopkins Bloomberg School of Public Health who were invaluable in conducting the study: Bakar Fakih, Mwifadhi Mrisho, Bianca Jackson, Fatuma Manzi, Omar Lweno, Frida Ngalesoni, Imani Irema, Abdalla Mkopi, Jerome Mackay, Serafina Mkuwa, Jasmine Vallve. We extend our gratitude to Tanzania' MoH staffs who participated in our study results interpretations workshop for their inputs. We would also like to acknowledge the contribution of Patricia Gomez who provided feedback on the manuscript.
Publisher Copyright:
© 2021 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.
PY - 2022/7
Y1 - 2022/7
N2 - Objective: To compare clinical vignettes and objective structured clinical examinations (OSCE) as methods for assessing the quality of intrapartum care among skilled providers in rural primary-level health facilities in Tanzania. Methods: Cross-sectional study conducted at six health facilities in the Simiyu region of Tanzania. Providers were assessed using OSCE and clinical vignettes in spontaneous delivery, neonatal resuscitation, and management of postpartum hemorrhage. Trained researchers used a structured clinical checklist. The frequencies of items are presented as percentages and the agreement of the methods of assessment are reported using kappa statistics (high: kappa > 0.80, moderate: kappa = 0.60–0.80, low: kappa < 0.60). Results: Most healthcare providers were female (60.7%), registered nurses by training (29.0%), and worked in a dispensary (56.1%), with an average age of 33 years and an average of 7.4 years of experience in their respective professions. Five items had high agreement between OSCE and clinical vignettes: postpartum vital signs every 15 min, oxytocin within 1 min of birth, diagnosis of postpartum hemorrhage, elevating legs of the mother, and deciding on manual compression of the uterus. Conclusion: OSCE and clinical vignettes should be viewed as complimentary to one another in the assessment of provider knowledge and skill, with priority given to OSCE, particularly in intrapartum care.
AB - Objective: To compare clinical vignettes and objective structured clinical examinations (OSCE) as methods for assessing the quality of intrapartum care among skilled providers in rural primary-level health facilities in Tanzania. Methods: Cross-sectional study conducted at six health facilities in the Simiyu region of Tanzania. Providers were assessed using OSCE and clinical vignettes in spontaneous delivery, neonatal resuscitation, and management of postpartum hemorrhage. Trained researchers used a structured clinical checklist. The frequencies of items are presented as percentages and the agreement of the methods of assessment are reported using kappa statistics (high: kappa > 0.80, moderate: kappa = 0.60–0.80, low: kappa < 0.60). Results: Most healthcare providers were female (60.7%), registered nurses by training (29.0%), and worked in a dispensary (56.1%), with an average age of 33 years and an average of 7.4 years of experience in their respective professions. Five items had high agreement between OSCE and clinical vignettes: postpartum vital signs every 15 min, oxytocin within 1 min of birth, diagnosis of postpartum hemorrhage, elevating legs of the mother, and deciding on manual compression of the uterus. Conclusion: OSCE and clinical vignettes should be viewed as complimentary to one another in the assessment of provider knowledge and skill, with priority given to OSCE, particularly in intrapartum care.
KW - Tanzania
KW - clinical vignettes
KW - intrapartum care
KW - measurement of quality
KW - objective structured clinical examination
KW - quality of care
KW - simulated encounters
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U2 - 10.1002/ijgo.13947
DO - 10.1002/ijgo.13947
M3 - Article
C2 - 34559888
AN - SCOPUS:85117022353
SN - 0020-7292
VL - 158
SP - 57
EP - 63
JO - International Journal of Gynecology and Obstetrics
JF - International Journal of Gynecology and Obstetrics
IS - 1
ER -