A low resource simulation-based training package leads to increased knowledge and skill retention post Basic Emergency Obstetric and Neonatal Care in rural Tanzania: A Quasi-experimental research design 

A low resource simulation-based training package leads to increased knowledge and skill retention post Basic Emergency Obstetric and Neonatal Care in rural Tanzania: A Quasi-experimental research design | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article A low resource simulation-based training package leads to increased knowledge and skill retention post Basic Emergency Obstetric and Neonatal Care in rural Tanzania: A Quasi-experimental research design Dismas Matovelo, Jennifer L. Brenner, Nalini Singhal, Alberto NettelAguirre, and 4 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4560296/v1 This work is licensed under a CC BY 4.0 License Status: Under Revision Version 1 posted 13 You are reading this latest preprint version Abstract Background: Neonatal and Maternal mortality remain alarmingly high in rural areas like Kwimba Tanzania. The Basic Emergency Obstetric and Neonatal Care (BEmONC) training program aims to decrease these rates by improving healthcare provider knowledge and skill. Literature supports improvement in knowledge and skill immediately after training, but skill decay is reported as early as 1 month if healthcare providers are not afforded further facility-based opportunities to practice. The purpose of this study was to examine a low-cost resource option, a simulation package, for its impact on retention of knowledge and skills over a one-year period. Methods: A quasi-experimental research design was used to test the intervention; 5-day BEmONC training plus a facility-based simulation package: (1) low dose high frequency peer to peer simulation practice using peer cards and (3) clinical mentorship. Participants were midwives/nurses, clinical officers, and medical officers from local hospitals and health centers in Kwimba, Tanzania. Facilities were purposely assigned to one of the two clusters. After initial BEmONC training. Cluster A was supported with the simulation package whereas access to the simulation package was delayed until after the 6-month assessment for Cluster B. Knowledge and skill were analyzed using the training program OSCE’s at baseline, post workshop, at 6 months and at 12 months using the r core statistics; p -values < 0.05 were considered statistically significant. Results: All participants demonstrated significant knowledge and skill improvements post-initial workshop. At 6 months, Cluster A’s aggregate skill scores were significantly higher than Cluster B, who showed skill decay. At 12 months, aggregate skill scores between Cluster A and Cluster B were similar. Conclusion : There was a significant relationship between clusters receiving component two and three of the interventions and retention of skill sets at 6 and 12 months. This is the first study to report skill retention at 12 months after BEmONC training. Peer learning using detailed peer learning cards, with mentorship visits by the clinical expert every 3 months is a low resource educational option that in this context supported skill retention. More research is needed to assess generalizability and link like initiatives with clinical outcomes. simulation peer-peer learning clinical mentorship BEmONC Low dose high frequency simulation maternal health newborn health Full Text Additional Declarations No competing interests reported. Supplementary Files TableS1100324BMCsupplementaryfile.docx Cite Share Download PDF Status: Under Revision Version 1 posted Editorial decision: Revision requested 21 Mar, 2025 Reviews received at journal 05 Sep, 2024 Reviews received at journal 31 Aug, 2024 Reviewers agreed at journal 22 Aug, 2024 Reviewers agreed at journal 21 Aug, 2024 Reviewers agreed at journal 15 Aug, 2024 Reviews received at journal 12 Aug, 2024 Reviewers agreed at journal 12 Aug, 2024 Reviewers invited by journal 07 Aug, 2024 Editor invited by journal 14 Jun, 2024 Editor assigned by journal 14 Jun, 2024 Submission checks completed at journal 11 Jun, 2024 First submitted to journal 10 Jun, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4560296","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":316493731,"identity":"ffeda6cf-456d-4c49-8493-f66dfeb3bf14","order_by":0,"name":"Dismas Matovelo","email":"","orcid":"","institution":"Catholic University of Health \u0026 Allied Sciences (Mwanza","correspondingAuthor":false,"prefix":"","firstName":"Dismas","middleName":"","lastName":"Matovelo","suffix":""},{"id":316493732,"identity":"243a467d-c0cf-40e5-813d-27dc7e186f51","order_by":1,"name":"Jennifer L. 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","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-health-services-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bhsr","sideBox":"Learn more about [BMC Health Services Research](http://bmchealthservres.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/BHSR/default.aspx","title":"BMC Health Services Research","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"simulation, peer-peer learning, clinical mentorship, BEmONC, Low dose high frequency simulation, maternal health, newborn health","lastPublishedDoi":"10.21203/rs.3.rs-4560296/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4560296/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e Neonatal and Maternal mortality remain alarmingly high in rural areas like Kwimba Tanzania. The Basic Emergency Obstetric and Neonatal Care (BEmONC) training program aims to decrease these rates by improving healthcare provider knowledge and skill. Literature supports improvement in knowledge and skill immediately after training, but skill decay is reported as early as 1 month if healthcare providers are not afforded further facility-based opportunities to practice. The purpose of this study was to examine a low-cost resource option, a simulation package, for its impact on retention of knowledge and skills over a one-year period.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e \u0026nbsp;A quasi-experimental research design was used to test the intervention; 5-day BEmONC training plus a facility-based simulation package: (1) low dose high frequency peer to peer simulation practice using peer cards and (3) clinical mentorship. Participants were midwives/nurses, clinical officers, and medical officers from local hospitals and health centers in Kwimba, Tanzania. Facilities were purposely assigned to one of the two clusters. After initial BEmONC training. Cluster A was supported with the simulation package whereas access to the simulation package was delayed until after the 6-month assessment for Cluster B. \u0026nbsp;Knowledge and skill were analyzed using the training program OSCE’s at baseline, post workshop, at 6 months and at 12 months using the r core statistics; \u003cem\u003ep\u003c/em\u003e-values \u0026lt; 0.05 were considered statistically significant.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults: \u003c/strong\u003eAll participants demonstrated significant knowledge and skill improvements post-initial workshop. At 6 months, Cluster A’s aggregate skill scores were significantly higher than Cluster B, who showed skill decay. At 12 months, aggregate skill scores between Cluster A and Cluster B were similar.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e: There was a significant relationship between clusters receiving component two and three of the interventions and retention of skill sets at 6 and 12 months. This is the first study to report skill retention at 12 months after BEmONC training. Peer learning using detailed peer learning cards, with mentorship visits by the clinical expert every 3 months is a low resource educational option that in this context supported skill retention. More research is needed to assess generalizability and link like initiatives with clinical outcomes.\u003c/p\u003e","manuscriptTitle":"A low resource simulation-based training package leads to increased knowledge and skill retention post Basic Emergency Obstetric and Neonatal Care in rural Tanzania: A Quasi-experimental research design ","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-06-27 10:22:46","doi":"10.21203/rs.3.rs-4560296/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-03-21T09:18:21+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-09-05T10:27:31+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-08-31T12:21:29+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"204530017916760179856418013573456195906","date":"2024-08-22T08:24:18+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"3481593144069886694955350222645878054","date":"2024-08-21T15:15:16+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"62601594726960928357887250119960156007","date":"2024-08-15T04:00:28+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-08-12T13:08:47+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"331272203471476078006306862519559561393","date":"2024-08-12T10:13:05+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2024-08-07T08:27:53+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2024-06-14T11:46:25+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-06-14T11:16:55+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-06-12T03:33:41+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Health Services Research","date":"2024-06-10T23:14:16+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-health-services-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bhsr","sideBox":"Learn more about [BMC Health Services Research](http://bmchealthservres.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/BHSR/default.aspx","title":"BMC Health Services Research","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"3ddabf1b-d364-4fd8-a44d-2a864d2be443","owner":[],"postedDate":"June 27th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"in-revision","subjectAreas":[],"tags":[],"updatedAt":"2026-05-27T10:55:31+00:00","versionOfRecord":[],"versionCreatedAt":"2024-06-27 10:22:46","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4560296","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4560296","identity":"rs-4560296","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}