The Impact of Basic Emergency Medicine Training on the Understanding, Perception and Career Decision-making towards Emergency Medicine amongst Healthcare Providers in Tertiary Referral Hospitals in Tanzania

Abstract

Background: Emergency Medicine (EM) is a new specialty in Tanzania. Little is known about how to introduce EM to healthcare providers (HCPs) in hospitals without EM. Aim: To determine the impact of a 2-day EM training on the understanding, perception and career decision-making towards EM amongst HCPs at four tertiary level hospitals in Tanzania that do not have EM. Methodology: This was an interventional study including HCPs from four tertiary hospitals in Tanzania that do not have EM. Understanding, perceptions, and decision making regarding EM as a career was assessed before and after a 2-day basic EM training using a paper questionnaire. Quantitative data was obtained using Likert scale (out of 5) and was analyzed by T-tests, Mann-Whitney test and Kruskal Wallis test. Qualitative data was analyzed for content and themes by an inductive, iterative approach. Results: 96 HCPs participated in the study; the four hospitals were equally represented. Median pretraining scores for all Likert questions was 3.49 (IQR3.26-3.91); understanding 3.33 (IQR3.00-3.66), perception 3.40 (IQR3.14-3.71), and career decision making 3.66 (IQR3.33-4.00). Post-training scores showed improvement with median scores of 4.61 (IQR4.45-4.72) overall, 4.66 (IQR4.00-4.66) for understanding, 4.63 (IQR4.50-4.87) for perception and 4.66 (IQR4.33-4.83) for career decision making (all p<0.01). Themes addressed by participants included whether EM physicians were needed, whether they had sufficient career possibilities, and whether or not doctors should be encouraged to pursue EM as a career. Conclusion & Recommendation A 2-day EM training had a positive impact on understanding, perception and career decision-making towards EM amongst Tanzania HCPs that work in hospitals without EM. Long-term follow up to ascertain retention is recommended.