EPM THET Uganda Project 2018

Location: St Mary’s Hospital, Lacor, and Kumi Hospitals,  Uganda
 
Date: throughout 2018
 
Funded by: Tropical Heath Education Trust (THET)
 
Project outline:
• A 12 month project to run Essential Pain Management (EPM) Workshops across Uganda building on previous visits and expanding the number of local trainers.
• A comprehensive and novel evaluation programme was included.
• The project was run in partnership with the World Federation of Societies of Anaesthesiologists (WFSA), St Mary’s Hospital and Kumi Hospital, Uganda.
 
Project team:
Clare Roques (Clinical Lead, UK)
Ocen Davidson (Clinical Lead, Uganda)
Martin Ogwang (St Mary’s Hospital)
Robert Oluput (Kumi Hospital)
Peter Kayima (St Mary’s Hospital)
Patience Atumanya (EPM Fellow, Uganda)
Andrew Vickers (UK Instructor)
Sarah Aturia (UK Instructor)
Jay Rajan (USA Instructor)
Daniel Waeland (FPM RCoA)
Aaliya Ahmed (WFSA)
Claire Driver (FPM RCoA)
 
Workshop summary:
A combination of one day EPM Workshops and half day EPM Instructor workshops were run over the 12 month project.
In St Mary’s Hospital, Lacor, workshops (including participant and trainer sessions) were run over two weeks (in April and October/November).
In Kumi Hospital workshops (including participant and trainer sessions) were run in one week in September.
 
Course participants:
A total of 432 healthcare workers, including doctors, nurses, midwives and students, attended the one day EPM workshops.
A total of 50 healthcare workers from 18 different hospitals were trained as EPM instructors.
 
Course instructors:
A mixture of local and overseas instructors were involved in the workshop. Where possible, newly trained local instructors were given the opportunity to teach – this occurred for the majority of newly trained instructors during the project.
 
Evaluation:
The usual EPM teaching materials were used. Evaluation was carried out in several ways.
• Routine multiple choice questions (MCQs) used before and after each workshop
• Routine participant and instructor feedback forms were completed
• Key informant questionnaires were completed to assess the level of pain management provision in Uganda and identify sites where more EPM workshops may be of value
• Repeat MCQs for participants (when possible) were repeated several months after their initial attendance at the workshop
• ‘Commitment to change’ forms were piloted. In this exercise, participants were asked, at the end of the workshop, to identify ways in which they could personally improve pain management in their workplace. Some of these participants were then interviewed several months later and their progress was discussed.
 
Regarding the MCQ data collected, most participants demonstrated an improvement in their pain management knowledge after completing the workshop. Of the group who were assessed 6 months after training, most had maintained or improved their knowledge. Improvements in local clinical practice were also identified using the other methods of evaluation identified above. Key informant questionnaires were completed for 9 clinical institutions. There was almost universal agreement that pain treatment is a problem that requires improvement. The vast majority indicated that more education and specifically teaching resources would be helpful.
 
Next Steps:
We are continuing to work in partnership to run EPM workshops across Uganda and to revise our evaluation techniques.
For more information on the full THET Project Report please contact the team at the Faculty of Pain Medicine of the Royal College of Anaesthetists (contact@fpm.ac.uk).