Implementation and Evaluation of an Innovative Leadership and Teacher Training Program for Non-Physician Emergency Medicine Practitioners in Uganda

Abstract

Background: Strong leadership and teaching skills are essential traits for faculty being trained as the first emergency medicine (EM) providers in their country. In Uganda, EM is not established as a specialty and the only EM providers are non-physician clinicians (NPCs) being trained by a foreign NGO, Global Emergency Care (GEC). The curriculum focuses on clinical knowledge and skills and there is no leadership or teacher training component. Methods: A week long course on leadership and teaching is described and evaluated for success using Kirkpatrick’s framework for learner-centered outcomes. The course was proposed by GEC and implemented as continuing education for professional development purposes. Course participants consisted of all 15 of the current NPCs trained in Uganda by GEC. Participants attended the week-long course which consisted of lectures, role-playing, and small group discussions, as well as completion and analysis of a personality self-assessment. The evaluation process consisted of an immediate post-course survey to measure learner satisfaction, a retrospective, pre/post self-assessment with a Likert-type scoring tool to measure knowledge gains, and a three-month follow up survey and structured interviews to measure knowledge retention and behavior change in practice. Results: All 15 NPCs participated in the course and evaluation process. Learner satisfaction was high with an average rating of 9.3 (on a 1-10 scale) for course content, amount learned, and use of time. The difference in pre-course and post-course scores were positive for all 23 competencies measured demonstrating positive knowledge gains across all content presented. Lastly, all 15 participants shared detailed examples of using different competencies in practice three months after the course finished. The most frequently mentioned themes were “giving and receiving feedback,” “delegating and assigning tasks,” and “communication.” Discussion/Conclusion: This course was a successful CE intervention in this setting as measured by Kirkpatrick’s framework. The most frequently mentioned concepts being used in practice point to the NPCs ability to take on leadership roles in this setting and shift the department away from the traditional physician-led culture. Further research and evaluation methods focused on the influence of culture and personalities on leadership education and translation into practice in an EM setting is needed.