Peer to peer review and mentoring

Medical and nursing staff in the UK now have to undergo annual appraisals, usually with a peer who coaches them through their appraisal paperwork, discussing issues and highlights of the year with them and helping them to develop themselves as a health professional.  Although there’s always a mad rush at the end of the year to get all the relevant bits of paper uploaded to one’s appraisal file in time for the allotted meeting, the process if done well encourages the health worker to focus on their goals for the next year, helps to prevent burn out and allows us all the space to reflect on our own practice.

Agnes, instructor in Liberia

This process is in its infancy in Liberia and Cameroon.  Jarlath has put together a draft form which gathers information about skills and confidence decay, provides a method of assessing someone’s on-going competence and allows a structure for peer mentoring.  We are not quite sure how this will work in the field but will be rolling it out over the next few years in Cameroon while we work out how to help support local instructors in the long term.

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Breastfeeding workshop

The Neonatal Care Course (NCC) is an educationally robust product.  We teach about the four main areas that the World Health Organisation identifies as contributing maximally to neonatal mortality rates: resuscitation at birth, early breast-feeding, keeping babies warm and early recognition and management of sepsis.  https://www.who.int/maternal_child_adolescent/topics/newborn/enap_consultation/en/).  Our feedback forms show increased confidence of learners in all 4 of these areas. Increased clinical confidence correlates with increased performance over time.

Here is Grace, a one time NCC learner and now in-country NICHE champion and convener of their own independent NCCs, delivering a workshop on breastfeeding to local midwives.  This is what empowerment of local health professionals does.  This is our legacy and we are proud of it and very grateful to all who donate time, money and expertise to our charity.

Cameroon Instructor Development Days

We have been busy putting together suitable programmes for our on-going development and support of the local instructors in both Cameroon and Liberia.  We have been asked by Grace and her team in Cameroon to return there once a year for the next 3 years to take them from Step 8 of the “10-steps to sustainability” plan to Step 10 (where they can train their own instructors).  We are actively fundraising for this project at the moment if anyone wants to help out – https://www.nicheinternational.org.uk/ways-to-donate/.

We have begun to put together a tentative programme for a 2-day instructor development course, termed CIDD, which will be delivered in-country to ensure instructors are up to date in both the content and delivery of their provider course, the Neonatal Care Course (NCC), and to furnish them with the skills needed to keep themselves developing professionally after 2023.

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Independent Neonatal Care Course

Midwives in Bamenda this week (North West region of Cameroon) learning how to tie a “Kalafong” wrap for skin-to-skin mother care as part of their 2 day Neonatal Care Course.  22 learners with 100% pass rate in a town which is at the centre of the current sociopolitical unrest in Cameroon and to which UK instructors are no longer allowed to travel.  Hats off to Grace and her team for running their first independent course and thanks to our partners, the Cameroon Baptist Convention Health Services, for their support and encouragement.

“Apart from getting money, are we not also blessed?” [Kola on the “noble” profession of nursing]

Kola’s turns of phrase when he’s lecturing have been delighting Jo and I all day.  The title of this and the previous posts are good examples of the fervour with which he plays his role as MCAI’s on the ground neonatal trainer.  And he is not alone.  Gertrude, Agnes and Christina are equally dedicated to their patients and their unit, totally committed to the patients they look after.  And totally engaged in their roles today as instructor candidates on the Newborn Care Course.

Gertrude doing Stage 2 of the 4-stage procedure in how to tie a kalafong wrap for the baby to be skin-to-skin with its mother.
Christina overseeing resuscitation skills training.
Agnes (gesticulating with her hands) running an animated discussion workshop on pain in babies and how to manage the baby who won’t live long.

“God put all these good things into titty water so why are we deviating?” [Kola on being asked about using formula milk]

There is nothing, nothing so heartening as watching someone you’ve just trained as an instructor teaching better than you.

This is Kola putting his all into his lectures, carrying his learners with him on a wave of enthusiasm.  A truly inspirational educator.

He was good last year but, not only is he even better this year now that’s he been trained but he also keeps to time!  Just about….

 

 

First GIC courses in Liberia successfully completed!

Here are our 4 local instructors with their certificates of completion of the Generic Instructor Course in Zwedru. Well deserved. They put so much energy into the course and really developed as teachers over the 2 days.
And here are the 5 newly trained instructors in Monrovia where Colin and Alistair are running parallel courses to Jo and Julia. 1 X GIC followed by 2 x NCCs.

 

 

 

 

 

 

 

 

 

 

 

 

These neonatal clinicians and 1 doctor now have to teach on two Newborn Care Courses supervised in order to complete their training as instructors.  The NICHE International volunteer instructors should be able to complete this whole process in the one 10-day trip.  We will also be leaving a teaching set (4 manikins, scenario teaching sets and a projector) with the new Liberian faculty so that they can start to organise and run their own courses.  It would be nice to be invited back to help out though!

Sustainability, here we come!

Julia recently spoke at a national conference on “The challenge of sustainability” in newborn care training.  NICHE International’s vision of the Holy Grail of sustainability is in the slide below:

There is much written on skills decay over time and the lack of sustainability in the model of flying outside instructors to a country for a week to teach resuscitation skills and expect attitudes and habits to change as a result. That is why we concentrate on training local instructors and have developed our 10-step path to sustainability (see under sustainability section of the website).  That is also why we are so excited about the course currently running in Yaounde, Cameroon.

These workshops and lectures are being delivered by people we trained as instructors last year:

Mentoring in Yaounde, Cameroon

This is Alison and Jarlath, busy in Cameroon mentoring 12 local instructors through their instructor candidate newborn care courses. We use the UK model for training instructors. They first have to do a two day very intense instructor training course known as the generic instructor course (GIC). Then they have to teach on 2 newborn care courses but are supervised during that time by a more senior instructor. At the end of this they are fully fledged newborn care course instructors. It is quite demanding training, the same as the UK advanced life support instructors go through, but is one of the best short instructor training courses available. The NICHE instructors are on site this week to complete the training of the 12 local instructors who did their generic instructor course this time last year. As a team, we are very heartened by this step. It is step 8 in our sustainability plan and means that we can remove ourselves from Cameroon for a few years. Step 9 and 10 will take place when the trained local instructors have done enough courses to start training as instructor trainers themselves. We hope to be invited back for that stage in two or three years time.