It’s just our first week, and my colleagues and I are lucky enough to be able to attend and help run a bCPAP training course for Malawian medical professionals at Queen’s! I have always been interested in learning more about the implementation side of medical devices in low resource settings. Being able to witness this first hand is my main motivation for being here.
The training began with a few presentations that focused on respiratory distress syndrome, its mortality rate in Malawi, how to select the proper candidate to place on bCPAP, and how to put together the device for use. I had learned all of these things in the previous work days, so I could focus less on the information and more on how these doctors and nurses are learning about the bCPAP. The presentation concerning how to put the bCPAP together itself was short and to the point, and as someone well acquainted with the device followed it easily. But I wondered how well people new to this device retained this important information. Little did I know, that’s when the real learning began. The next portion of the training course was a practical skills session where the doctors and nurses would have to practice putting together and using the machine as a team. There were two bCPAPs, three overseers, and about ten participants. So each group had about five people, a mixture of doctors and nurses, at each machine with a bCPAP nurse/doctor to help the participants learn to use this device correctly.
Group of medical interns during the practical skills session
The third overseer, a consultant for the pediatric department, went between each of the teams and gave them different scenarios concerning the baby’s breathing and its symptoms and would ask how the doctor or nurse would respond in this situation. He came back and forth between the two teams and asked things like: “What do you do if the baby’s O2 saturation isn’t increasing?” “The baby’s heart rate is still too high and the baby has been on CPAP for 24 hours. What’s the next step?” This forced the nurses and doctors to think critically about the patient while interacting with the machine. If the answer would to be to increase pressure, then the medical professional would physically go through that step with the machine to save the baby (or baby doll, in this case). Beyond that, each nurse and doctor in the group had to show that they could put the machine together properly to their group and the CPAP overseer. Watching each team member go through the same steps over and over clearly cemented the process in their heads. The first person to go in the group was usually pretty uncertain with timid suggestions by their colleagues, but by the time the 5th person went, it was practically muscle memory.
This was a truly amazing thing to see in action. I bounced back and forth between the two groups and got to see nurses and doctors who had learned from mistakes in their own turn, coach colleagues about using the bCPAP. This really convinced me that each person taking part was learning and retaining the information in this training session. Seeing everyone work together also helped me see not only how these doctors and nurses learn, but how they will teach others in their ward.