ORCID Profile
0000-0002-7491-517X
Current Organisation
University of South Australia
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Publisher: Wiley
Date: 10-2021
DOI: 10.1002/UOG.24042
Publisher: Informa UK Limited
Date: 05-04-2022
DOI: 10.1080/10872981.2022.2041366
Abstract: There is limited access to life-saving antenatal ultrasound in rural and low-resource settings largely due to shortages in skilled staff. Studies have shown healthcare practitioners can be upskilled in PoCUS through focused training, offering a viable solution to this deficit. However, standards for training and competency assessment are unclear and regulation surrounding practice is lacking. We aimed to review published literature examining antenatal PoCUS training programs, comparing teaching approaches and study methodologies. A search of electronic databases EMBASE, MEDLINE and Google Scholar was conducted. Original research articles evaluating antenatal PoCUS training of healthcare professionals worldwide were identified for analysis. Articles with limited detail on the PoCUS training intervention and those describing comprehensive diagnostic training programs were excluded. Evaluations were compared against the Kirkpatrick Evaluation Framework (KEF). Twenty-seven studies were included from an initial search result of 484 articles. There was considerable heterogeneity between the PoCUS training programs described. Course duration ranged from 3 hours to 2 years, with 11 of the 27 studies delivering obstetric-exclusive content. 44% trained multidisciplinary groups of health professionals. Long-term follow-up training and skills assessments were lacking in over half of the reviewed studies. Study quality and reporting detail varied, but overall beneficial outcomes were reported with 3/4s of the studies reaching upper KEF levels 3 and 4. PoCUS performed by upskilled healthcare professionals offers an attractive solution to the problem of inequitable access to antenatal ultrasound. A review of available literature highlighted a paucity of comparable high-quality studies needed to establish a stronger evidence base for antenatal PoCUS, and a need to standardise training and competency assessment. This review may inform educators, researchers and policy-makers on existing training formats and methodologies to assist in establishing best practice antenatal PoCUS training methods for safe service delivery by remote healthcare professionals.
Publisher: Wiley
Date: 19-07-2007
DOI: 10.1111/J.1365-2656.2007.01273.X
Abstract: 1. Few studies have experimentally quantified the costs and benefits of female egg-guarding behaviour in arthropods under field conditions. Moreover, there is also a lack of studies assessing separately the survival and fecundity costs associated with this behavioural trait. 2. Here we employ field experimental manipulations and capture-mark-recapture methods to identify and quantify the costs and benefits of egg-guarding behaviour for females of the harvestman Acutisoma proximum Mello-Leitão, a maternal species from south-eastern Brazil. 3. In a female removal experiment that lasted 14 days, eggs left unattended under natural conditions survived 75.6% less than guarded eggs, revealing the importance of female presence preventing egg predation. 4. By monitoring females' reproductive success for 2 years, we show that females experimentally prevented from guarding their eggs produced new clutches more frequently and had mean lifetime fecundity 18% higher than that of control guarding females. 5. Regarding survival, our capture-mark-recapture study does not show any difference between the survival rates of females prevented from caring and that of control guarding females. 6. We found that experimentally females prevented from guarding their eggs have a greater probability to produce another clutch (0.41) than females that cared for the offspring (0.34), regardless of their probability of surviving long enough to do that. 7. Our approach isolates the ecological costs of egg-guarding that would affect survival, such as increased risk of predation, and suggests that maternal egg-guarding also constrains fecundity through physiological costs of egg production. 8. Weighting costs and benefits of egg-guarding we demonstrate that the female's decision to desert would imply an average reduction of 73.3% in their lifetime fitness. Despite the verified fecundity costs of egg-guarding, this behaviour increases female fitness due to the crucial importance of female presence aimed to prevent egg predation.
Publisher: Wiley
Date: 10-2018
DOI: 10.1002/UOG.19420
Publisher: Springer Science and Business Media LLC
Date: 30-12-2022
DOI: 10.1186/S12909-022-03888-5
Abstract: There is limited access to life-saving antenatal ultrasound in low-resource rural and remote settings worldwide, including Australia, mainly due to shortages in skilled staff. Point-of-care ultrasound (PoCUS) offers a viable solution to this service deficit, however, rural clinicians face many barriers accessing training and professional development critical to advancing their clinical practice. Standards for PoCUS training and competency assessment are unclear. Regulation is lacking globally, allowing untrained and inexperienced clinicians to practice PoCUS clinically. This prospective single cohort study aimed to evaluate antenatal PoCUS training workshops for General Practitioners (GPs) and Midwives/Nurses (M/Ns) from rural/remote Australia, assessing the impact of the training on trainees’ knowledge, confidence and translation of PoCUS into clinical practice. Two-day antenatal ultrasound workshops were delivered at the University of South Australia (UniSA) in 2018 and 2019 to 41 rural/remote clinicians . The training was designed and evaluated using the New world Kirkpatrick Evaluation Framework. Sixteen GPs and 25 M/Ns with mixed prior ultrasound experience were funded to attend. The course consisted of lectures interspaced with hands-on training sessions using high-fidelity simulators and live pregnant models. Pre- and post-knowledge assessments were performed. Post-workshop evaluation and follow-up surveys (3- and 6-month post-training) assessed the workshops and changes to trainees’ clinical practice. A 2-day follow-up training session was conducted 12 months after the workshops for 9 trainees. Pre ost knowledge testing demonstrated a 22% mean score improvement (95% CI 17.1 to 27.8, P 0.0001). At 6 months, 62% of trainees were performing PoCUS that had assisted in patient management and clinical diagnosis, and 46% reported earlier diagnosis and changes to patient management. 74% of trainees had increased scanning frequency and 93% reported improved scanning confidence. This study demonstrated intensive 2-day workshops can equip clinicians with valuable antenatal PoCUS skills, offering a viable solution to assist in the assessment and management of pregnant women in the rural/resource-poor setting where access to ultrasound services is limited or non-existent. Geographical isolation and lack of onsite specialist supervision poses an ongoing challenge to the continuing professional development of remote trainees and the implementation of PoCUS.
Publisher: Wiley
Date: 12-03-2019
DOI: 10.1002/AJUM.12138
Publisher: Oxford University Press (OUP)
Date: 07-03-2008
Publisher: Springer Nature Singapore
Date: 2019
No related grants have been discovered for Amber Bidner.