Primary health care nurse training in Kwazulu. An evaluation of diagnostic flow charts versus a conventional training method.
Diagnostic flow charts have been adapted for the training of primary health care (PHC) nurses in a rural area of South Africa. We designed a randomized controlled trial to assess whether nurses' clinical competence differed if they were trained using flow charts or using conventional patient-centered teaching. Although clinical competence improved during the training programme, this improvement did not differ significantly according to which of the two training methods was used. The nurses in this trial had considerable earlier experience and some training in primary care. Before the trial they had a high level of clinical competence and may already have developed their own diagnostic strategies. We therefore cannot make inferences from our study about whether or not flow charts will be a valuable addition in PHC. Flow charts need to be adapted to take into account where, by whom, and for what purpose they will be used. They must then be tested to ensure that they only rarely result in incorrect diagnosis and treatment. A decision on the use of flow charts in the training of PHC nurses should be based on further educational trials and long-term follow-up of trained health workers. Nurses should participate in educational trials at the start of their careers in PHC. The additional value of flow charts in the auditing of competence and assessment of educational needs should also be explored.
D000554:Ambulatory Care Facilities; D004509:Education, Nursing, Continuing; D005069:Evaluation Studies as Topic; D006801:Humans; D009730:Nursing Assessment / Q000379:methods*; D009736:Nursing Process / Q000379:methods*; D011321:Primary Nursing; D012424:Rural Population; D013664:Teaching Materials; D014941:Work Simplification