The goal of this clinical trial is to evaluate whether the integration of in-person skills practice (ISP) with an adaptive e-learning platform can improve refresher learning progress (RLP) among healthcare providers in pediatric care settings in Tanzania.
The main questions it aims to answer are:
Can healthcare providers who participate in ISP sessions facilitated by clinical champions achieve greater improvements in refresher learning progress (RLP)? Will providers in the intervention group demonstrate improved metacognition and practical skill performance compared to those in the control group? Researchers will compare healthcare providers using the ISP digital platform (Rhapsode Capable™) to providers using paper-based ISP to see if the digital platform results in significantly higher RLP and fewer skill-based errors.
Participants will:
Complete adaptive e-learning modules focused on pediatric care topics (e.g., newborn resuscitation, severe malnutrition).
Participate in ISP sessions where clinical champions provide feedback and assess performance.
Healthcare providers actively involved in pediatric care at one of the selected healthcare centers.
Completion of core Pediatric Acute Care Education (PACE) adaptive learning modules prior to study participation.
Willingness to participate in In-Person Skills Practice (ISP) sessions.
Ability to engage with either the Rhapsode Capable™ platform (intervention group) or paper-based ISP methods (control group).
Healthcare providers not involved in pediatric or newborn clinical care at the time of recruitment.
Providers unable or unwilling to attend ISP sessions facilitated by clinical champions.
Individuals with no prior engagement in the PACE program.
Providers with significant technological barriers that prevent the use of the Rhapsode Capable™ platform (for the intervention group only).
Parallel
Rhapsode Capable™ Platform (Intervention Group)
BehavioralParticipants in the intervention group will use the Rhapsode Capable™ platform to facilitate In-Person Skills Practice (ISP) sessions. The platform allows for scheduling ISP sessions, providing real-time performance feedback, and tracking progress. The platform integrates with the PACE adaptive learning modules, which cover pediatric acute care topics. The goal is to improve skills retention and performance in pediatric care through a blended learning approach.
Paper-based ISP (Control Group)
BehavioralParticipants in the control group will also receive In-Person Skills Practice (ISP) sessions facilitated by clinical champions, but without the use of the digital platform. The ISP sessions will be tracked and scheduled using paper-based assessments. Feedback will be provided verbally or manually, and progress will be documented using paper forms. Both groups will receive the same PACE adaptive learning modules, but the method of ISP implementation differs between the groups.
Median Refresher Learning Progress (RLP) Among Providers
The percentage of refresher learning modules completed by healthcare providers with an initial learning progress (ILP) score of 95% or greater, who also complete at least one In-Person Skills Practice (ISP) session per month. The RLP will be measured as the progress in refresher module completion and adherence to ISP sessions, indicating the effectiveness of combining adaptive e-learning with in-person skills practice.
Improvement in Metacognition (Conscious Competence)
The degree of improvement in metacognition will be assessed using Howell's metacognition categories, which include conscious competence, unconscious competence, conscious incompetence, and unconscious incompetence. Providers will be evaluated on their ability to accurately recognize their clinical skills and knowledge across these categories. The focus will be on shifts from unconscious incompetence and conscious incompetence to conscious competence and unconscious competence as providers progress through the intervention.
Total ISP Score Improvement
The overall improvement in ISP (In-Person Skills Practice) performance scores. ISP sessions will be evaluated using structured observation forms, and improvements will be tracked across multiple pediatric clinical skills, such as newborn resuscitation and management of severe pediatric conditions. Scores will be based on specific skill proficiency and adherence to pediatric care protocols.
Reduction in Common ISP Errors
The frequency and type of common errors observed during ISP sessions. Clinical champions will document provider errors during ISP sessions, and the data will be analyzed to determine whether the intervention reduces the number of skill-based errors over time compared to the control group.
Proportion of Healthy Providers (HPs)
The proportion of healthcare providers who achieve and maintain an Initial Learning Progress (ILP) of 95% or greater and participate in at least one ISP session per month. A \"healthy provider\" is defined as one who consistently meets these criteria over the course of the study.
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Stanford University
Lead sponsor
Catholic University of Health and Allied Sciences
Collaborator
London School of Hygiene and Tropical Medicine
Collaborator
National Institutes of Health (NIH)
Collaborator
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