An Implementation Research of Simulation Based Mentorship Program (SBMP)

May 9, 2024 updated by: One Heart Worldwide

Implementation and Evaluation of Simulation-Based Mentorship Program (SBMP) in Nepal Using the RE-AIM Framework

The goal of this research was to evaluate the effectiveness and implementation outcomes of the Simulation Based Mentorship Program (SBMP) which was implemented in four districts of Nepal. The main questions it aims to answer are:

  1. What is the reach of the Simulation Based Mentorship Program?
  2. What is the effect of Simulation Based Based Mentorship Program on knowledge, clinical skills, and confidence of nurses working in Birthing Centers of four district of Nepal?
  3. How was the program adopted by the Birthing Centers?
  4. How was the program implemented?
  5. What is the perception regarding the maintenance of the program?

The nurses working in the Birthing Centers were the study participants, and they received simulation-based monthly mentorship on following seven modules related to essential obstetric and newborn care every month:

  1. Infection prevention
  2. Antenatal care and counseling
  3. Essential care of labor and birth
  4. Helping babies breathe
  5. Bleeding after birth
  6. Pre-eclampsia and eclampsia management
  7. Postnatal care and counseling

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

As the evidence showed gaps in the knowledge and skills of existing maternal and newborn health providers, we designed a Simulation-Based Mentorship Program (SBMP) to bridge the gaps. In this program, local-level mentors were developed to provide regular mentorship using a low-dose high-frequency approach in contrast to one-time coaching in a long gap. This program combined the existing package of the continuum of care along with Helping Babies Survive (HBS) & Helping Mothers Survive (HMS) guidelines, adopting a simulation-based onsite mentoring and coaching approach.

The main aim of this mentorship program was to improve the quality of essential obstetric and newborn care provided by the nurses and Auxiliary Nurse Midwives (ANMs) irrespective of their pre-service and in-service training exposure by identifying gaps, providing regular technical support on the site, building close relationships between mentors and mentees, and increasing communication, backed up by regular practice in simulation labs to help in skill retention. In this mentorship program, mentorship was provided to both the Skilled Birth Assistants (SBAs) and non-Skilled Birth Attendants in their workstations to capacitate them in promoting mother and newborn health outcomes.

Reach, Effectiveness, Adoption, Implementation, and Maintenance (REAIM) Dimensions in the study were:

Reach

  1. Number and percentage of Birthing centers intervened in the district
  2. Number and percentage of nurses trained as district-level mentors
  3. Number and percentage of nurses (and Auxiliary Nurse Midwives) receiving the intervention (simulation-based mentorship)
  4. Perception regarding the representativeness of participants in the program

Effectiveness

  1. Immediate change in knowledge, skills, and confidence (midline results)- compared with control group
  2. Perceived reasons for program effectiveness

Adoption

  1. Number and percentage of intervention sites completing all 6 monthly sessions
  2. Number and percentage of mentees participating in all 6 monthly sessions
  3. Number and percentage of mentees participating in weekly sessions
  4. Reasons for participation/ non-participation

Implementation

  1. Plan vs. actual implementation (duration between monthly sessions)
  2. Perception regarding various components of the program (content, teaching and learning methods, mentors)
  3. Challenges encountered during implementation, adaptations made/ mitigation measures adopted

Maintenance

  1. Number and percentage of mentors and mentees remaining after 4 to 6 months of Simulation Based Mentorship Program (SBMP) implementation (end-line)
  2. Retention of knowledge, skills, and confidence 4 to 6 months after completion of the intervention (end-line results) compared with the control group
  3. Capital cost and recurrent cost required for continuation at government level
  4. Application of learnings in a real setting (during and after the program implementation)
  5. Willingness to implement the program in the health facilities of Simulation Based Mentorship Program (SBMP) implemented local levels after completion of the intervention
  6. Continuation of mentoring/ learning in the simulation labs/ using manikins after completion of monthly sessions by mentors and mentees
  7. Challenges and recommendations for continuation

Study Type

Interventional

Enrollment (Actual)

326

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Nepal
    • Bagmati
      • Kathmandu, Bagmati, Nepal
        • One Heart Worldwide

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Nurses working in selected Birthing Centers during the baseline enrollment

Exclusion Criteria:

  • Newly recruited nurses by the Birthing Centers

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Health Services Research
  • Allocation: Non-Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Intervention Group/ Intervention Birthing Center
The nurses working in the Intervention Birthing Centers received the Simulation Based Mentorship Program.
Other: Simulation Based Mentorship Program

In this program, local level mentors were developed to provide regular mentorship on low-dose high-frequency approach in contrast to one-time coaching in a long gap. This program combined the existing package of the continuum of care along with Helping Babies Survive (HBS) & Helping Mothers Survive (HMS) guidelines, adopting a simulation-based onsite mentoring and coaching approach. The mentors provided monthly mentorship on following seven modules topics to the nurses of the intervention birthing centers:

  1. Infection prevention
  2. Antenatal care and counseling
  3. Essential care of labor and birth
  4. Helping babies breathe
  5. Bleeding after birth
  6. Essential care of labor and birth
  7. Postnatal care and counseling

Every monthly session was followed by four weekly practice sessions. The nurses from intervention birthing centers were also called mentees.

Other Names:
  • SBMP
No Intervention: Control Group/ Control Birthing Center
The nurses working in the Intervention Birthing Centers did not receive the Simulation Based Mentorship Program.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Knowledge, confidence and skills on seven modules
Time Frame: 1 year
The knowledge and confidence scores of intervention and control group's nurses in all seven modules were compared before and after the study. However, skills scores of seven modules were measured only in intervention group's nurses. The overall maximum obtainable score was 127 points for knowledge assessment, 210 points for confidence assessment, and 340 points for skills assessment. The scores obtained by the participants were expressed as percentage, and a mean score was calculated for each module. A score of 80% or more was considered to be appropriate. High scores indicated better outcome, and low scores indicated poor outcome.
1 year

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

One Heart Worldwide

Investigators

  • Study Director: Surya Bhatta, MHCDS, One Heart Worldwide

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

November 1, 2020

Primary Completion (Actual)

December 31, 2023

Study Completion (Actual)

December 31, 2023

Study Registration Dates

First Submitted

May 6, 2024

First Submitted That Met QC Criteria

May 9, 2024

First Posted (Actual)

May 16, 2024

Study Record Updates

Last Update Posted (Actual)

May 16, 2024

Last Update Submitted That Met QC Criteria

May 9, 2024

Last Verified

May 1, 2024

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • OHW1

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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