期刊
BJU INTERNATIONAL
卷 119, 期 4, 页码 631-637出版社
WILEY
DOI: 10.1111/bju.13685
关键词
EIMC; infant circumcision; Mogen clamp; Rakia; training non-physicians
资金
- National Institutes of Health (NIH)/National Institute of Allergy and Infectious Diseases (NIAID) [5U01A1100031-02]
Objective To assess acquisition of knowledge and competence in performing Early Infant Male Circumcision (EIMC) by nonphysicians trained using a structured curriculum. Subjects and Methods Training in provision of EIMC using the Mogen clamp was conducted for 10 Clinical Officers (COs) and 10 Registered Nurse Midwives (RNMWs), in Rakai, Uganda. Healthy infants whose mothers consented to study participation were assigned to the trainees, each of whom performed at least 10 EIMCs. Ongoing assessment and feedback for competency were done, and safety assessed by adverse events. Results Despite similar baseline knowledge, COs acquired more didactic knowledge than RNMWs (P = 0.043). In all, 100 EIMCs were assessed for gain in competency. The greatest improvement in competency was between the first and third procedures, and all trainees achieved 80% competency and retention of skills by the seventh procedure. The median (interquartile range) time to complete a procedure was 14.5 (10-47) min for the COs, and 15 (10-50) min for the RNMWs (P = 0.180). The procedure times declined by 2.2 min for each subsequent EIMC (P = 0.005), and rates of improvement were similar for COs and RNMWs. Adverse events were comparable between providers (3.5%), of which 1% were of moderate severity. Conclusion Competence-based training of non-physicians improved knowledge and competency in EIMC performed by COs and RNMWs in Uganda.
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