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Assessing provider performance of intrapartum care using simulated encounters and clinical vignettes: A comparison study from Tanzania
Author(s) -
Young Anna Marie P.,
Marx Melissa A.,
Frost Emily,
Hazel Elizabeth,
Kabanywanyi Abdunoor M.,
Mohan Diwakar
Publication year - 2022
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.13947
Subject(s) - medicine , tanzania , checklist , cohen's kappa , objective structured clinical examination , family medicine , kappa , nursing , obstetrics , health facility , population , environmental health , health services , psychology , linguistics , philosophy , environmental science , environmental planning , machine learning , computer science , cognitive psychology
Objective To compare clinical vignettes and objective structured clinical examinations (OSCE) as methods for assessing the quality of intrapartum care among skilled providers in rural primary‐level health facilities in Tanzania. Methods Cross‐sectional study conducted at six health facilities in the Simiyu region of Tanzania. Providers were assessed using OSCE and clinical vignettes in spontaneous delivery, neonatal resuscitation, and management of postpartum hemorrhage. Trained researchers used a structured clinical checklist. The frequencies of items are presented as percentages and the agreement of the methods of assessment are reported using kappa statistics (high: kappa > 0.80, moderate: kappa = 0.60–0.80, low: kappa < 0.60). Results Most healthcare providers were female (60.7%), registered nurses by training (29.0%), and worked in a dispensary (56.1%), with an average age of 33 years and an average of 7.4 years of experience in their respective professions. Five items had high agreement between OSCE and clinical vignettes: postpartum vital signs every 15 min, oxytocin within 1 min of birth, diagnosis of postpartum hemorrhage, elevating legs of the mother, and deciding on manual compression of the uterus. Conclusion OSCE and clinical vignettes should be viewed as complimentary to one another in the assessment of provider knowledge and skill, with priority given to OSCE, particularly in intrapartum care.