Evaluating the effectiveness of the Emergency Neurological Life Support educational framework in low-income countries. Issue 2 (1st March 2018)

• Record Type: Journal Article
• Authors: McCredie, Victoria A; Shrestha, Gentle S; Acharya, Subhash; Bellini, Antonio; Singh, Jeffrey M; Hemphill, J Claude; Goffi, Alberto
• Is Part Of: International health. Volume 10:Issue 2(2018)
• Page Start: 116
• Page End: 124
• Publication Date: 2018-03-01
• Subjects: Educational course -- Knowledge assessment -- Low-income countries -- Neurocritical care -- Neurological emergencies; World health -- Periodicals; Public health -- Developing countries -- Periodicals; Medical care -- Developing countries -- Periodicals; Medical policy -- Developing countries -- Periodicals; 362.1091724
• DOI: 10.1093/inthealth/ihy003
• Languages: English
• ISSNs: 1876-3413

Abstract

Abstract: Background: The Emergency Neurological Life Support (ENLS) is an educational initiative designed to improve the acute management of neurological injuries. However, the applicability of the course in low-income countries in unknown. We evaluated the impact of the course on knowledge, decision-making skills and preparedness to manage neurological emergencies in a resource-limited country. Methods: A prospective cohort study design was implemented for the first ENLS course held in Asia. Knowledge and decision-making skills for neurological emergencies were assessed at baseline, post-course and at 6 months following course completion. To determine perceived knowledge and preparedness, data were collected using surveys administered immediately post-course and 6 months later. Results: A total of 34 acute care physicians from across Nepal attended the course. Knowledge and decision-making skills significantly improved following the course (p=0.0008). Knowledge and decision-making skills remained significantly improved after 6 months, compared with before the course (p=0.02), with no significant loss of skills immediately following the course to the 6-month follow-up (p=0.16). At 6 months, the willingness to participate in continuing medical education activities remained evident, with 77% (10/13) of participants reporting a change in their clinical practice and decision-making, with the repeated use of ENLS protocols as the main driver of change. Conclusions: Using the ENLS framework, neurocritical care education can be delivered in low-income countries to improve knowledge uptake, with evidence of knowledge retention up to 6 months.