Completed

NCT Number: NCT06414629

An Implementation Research of Simulation Based Mentorship Program

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

Completed

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Key information

Conditions

Maternal Health Neonatal Health

Age range

18 year–49 year

Sex eligibility

Female

Study type

Interventional

Phase

Not applicable

Primary location

One Heart Worldwide

Kathmandu, Bagmati, Nepal

About this study

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

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

Effectiveness

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

Adoption

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

Implementation

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

Maintenance

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

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

Nurses working in selected Birthing Centers during the baseline enrollment

Exclusion criteria

Newly recruited nurses by the Birthing Centers

Treatment and study plan

Simulation Based Mentorship Program

Other

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:

Infection prevention
Antenatal care and counseling
Essential care of labor and birth
Helping babies breathe
Bleeding after birth
Essential care of labor and birth
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

Primary outcomes

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.

Sponsors and collaborators

Lead sponsor

One Heart Worldwide

Other

Registry information

Official study title

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

Acronym: SBMP

Important dates

Study start: 2020
Primary completion: 2023
Study completion: 2023
First posted: May 16, 2024
Registry last updated: May 16, 2024

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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Completed