Supervised instructors in full swing at Cameroon Neonatal Care Courses

Newly trained NCC instructors teaching their first course

It is always a great moment as an instructor trainer to watch someone you have just trained stand up and deliver a lecture, facilitate a workshop or teach a skill in the way that the Resus Council’s Generic Instructor Course (GIC) suggests. In the UK, we don’t often have the privilege of seeing this beautiful transition from student to teacher as people disperse after a GIC and teach on their provider courses at a different time. Because of the financial and environmental cost of NICHE volunteers travelling long distances to the countries where we are active, we now attach 2 NCCs to the end of every GIC to complete the new instructors’ training. And the rewards for the exhausted team of trainers are immense.

Keen midwives and nurses being trained in newborn care on the NCC currently going on in Yaoundé

These 16 healthcare professionals are learning about the care of the newborn infant in the first 28 days of life. (There should have been 4 more but it was too dangerous for them to travel down from Bamenda in the North West region of Cameroon which still has a significant amount of civil unrest). The learners are also providing the new instructors with the means to complete their training as instructors as each newly trained instructor has to teach on 2 NCCs, supervised by more senior instructors, in order to be fully fledged instructors themselves.

The NICHE team of 4 has been working very hard this week to deliver a GIC and these 2 NCCs. They started the week by running a one day instructor update for the established NCC faculty in Cameroon who have been courageously continuing the project throughout their country’s period of civil unrest and the pandemic.

You can read more about our first Instructor Development Day below.

“I am sending them out to blow their trumpets”

3rd Cameroonian GIC completed and the first 2 local GIC instructors have begun their training

This is what our programme manager for newborn training in Cameroon said today, as we were coming to the end of their successful “train the trainers” course.

Dr Ferenc Sari, European Resuscitation Council educator, and our educator on this week’s GIC course in Cameroon, has been impressed by the progress of the participants over the 2 days. We are privileged to be able to witness and support their first teaching experience which will occur when they teach on Neonatal Care Courses later in the week.

A GIC candidate taking Alison through a resuscitation scenario
GIC candidates discussing peer-to-peer learning

The Learning Conversation in Cameroon

The circle of trust

The learning conversation is a term used in adult education, and is a skill required for giving feedback to learners on their performance. A well-managed learning conversation should leave learners feeling “relieved, valued and clear about their next steps”. It is not an easy skill to master, and requires practice.

In Cameroon this week, NICHE instructors have spent a day refreshing the skills of newly qualified local Neonatal Care Course instructors. The learning conversation was one of the skills we spent time on together. During these sessions we sat in a circle with the candidates, sometimes know as “circle of trust”. This was a new concept to them, but they embraced the principles. The exercise emphasised the importance of trust, particularly as we all come from such different cultures and backgrounds.

Instructor Development Day, yaounde

Dr Alison Earley

This is the group of 11 Instructors who attended the first Instructor Development Day that NICHE has run. They came from 5 different Regions in Cameroon, and did their instructor training in 2016 and 2018. They are a mixture of doctors, nurses and midwives. All were keen to refresh and develop their skills as trainers and the course was lively and enjoyed by everyone.

En route to Cameroon after being grounded for 2 years!

Skelleftea Airport in north Sweden

We are delighted to be welcoming Dr Ferenc Sari to the team for this week’s trip to Cameroon. An emergency department doctor and an educator with the European Resuscitation Council, he has lots of experience of living, working and teaching overseas. We were on tenterhooks for his Covid PCR result as he has only recently recovered from the illness but all 4 instructors had negative results yesterday and are now en route to Yaoundé from Sweden, Northern Ireland and the UK.

Ferenc’s journey is probably the longest

The team has a heavy week ahead of them. They are facilitating the first ever Instructors Development Day (IDD) as well as a Generic Instructor Course (GIC) followed by two Neonatal Care Courses (NCC).

Back to cameroon later this month

Julia’s been packing up teaching equipment again

NICHE Instructors are excited to be returning to Cameroon later this month. We are piloting a specially written Instructors’ Development Day for the faculty members there to support their Continuing Professional Development. This will be followed by a Generic Instructor Course with two of the Cameroonian faculty beginning to train as instructor trainers themselves (see step 9 of the “10-steps to sustainability” plan) and two more Neonatal Care Courses (NCCs).

Over 300 healthcare professionals in Cameroon have been trained in the care of the newborn infant in the first 28 days of life and the team is beginning to see the positive effect on their neonatal mortality figures.

Bwindi feedback

There were 29 feedback forms from the first two NCCs in Uganda. All candidates were frontline healthcare workers and 25 (86%) of them had had previous experience of neonatal resuscitation.

A good multidisciplinary mix

Proving that neonatal mortality is falling as a result of our project is our long-term aim but measuring this outcome is a challenge.  There are so many confounding factors in any clean data that is actually collected that it is almost impossible to prove that one intervention like this has any statistically significant effect on neonatal mortality. 

It is more productive to measure shorter term outcomes which are known to correlate positively with an improvement in neonatal survival.  We gather feedback from our learners on the usefulness of the course, their prior experience, suggestions for the future etc. but also on their increase in confidence levels in the practice of various skills taught on the course.  The template for our feedback forms is based on one promoted by the UK’s Royal College of Paediatrics and Child Health for use on training courses.

Variations in self-confidence are known to influence motivation and tend to predict performance success. The percentage of learners in Bwindi in February feeling “very confident” in keeping babies warm increased from 17% to 100%, in giving breastfeeding advice, an increase from 24% to 100% post-course and in resuscitation skills, 7% to 93% feeling “very confident” after the course. Having the confidence to try and resuscitate an unconscious newborn baby is more likely to lead to a positive outcome than not having the confidence to make the attempt. Our data consistently show an increase in confidence in the essential skills pertaining to neonatal care identified by WHO. See: for a screenshot of the questionnaires we use.

Analysis of 29 feedback forms from the first NCCs in Uganda