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COURSE REPORT
ZIMBABWE
2nd – 6th March 2015
Report Presented by: Dr Josephat Chiripanyanga
COSECSA Oxford Orthopaedic Link (COOL)This Primary Trauma Care course is part of a project funded through the HealthPartnership Scheme, which is funded by the UK Department for InternationalDevelopment (DFID) for the benefit of the UK and partner country health sectors andmanaged by the Tropical Health Education Trust (THET). The project is called theCOSECSA Oxford Orthopaedic Link (COOL). More information is available atwww.ndorms.ox.ac.uk/cool.php.
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PTC
COURSE
ZIMBABWE
2 – 6 March 2015
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Table of Contents
1. Executive Summary
2. Purpose of the Training
3. Key Staff
4. Course Instructors
5. Activities
6. Day 1 & 2
7. Instructor Course
8. Day 4 & 5
9. Equipment
10. Conclusion
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1) Executive Summary
This is a Post PTC Course narrative report for the second locally organized PTC
course in Zimbabwe which was conducted from the 2nd to the 6th of March 2015.
The purpose of this report is to give feedback on all the events that transpired
during this first training session of 2015 i.e. key staff involved in planning and
coordinating the course, course instructors, course participants, instructors course
instructors and participants, content taught, multiple choice questions summary,
equipment used and conclusion.
2) Purpose of the Training
The training sought to increase the confidence levels of both the instructors’ and
participants in managing trauma patients. We also sought to empower health
professionals at various levels in their careers with the knowledge and skills to save
life and to preserve limbs.
3) Key Staff
The key staff involved in the planning and coordination of this PTC course from the
Zimbabwean side are Dr Farai Madzimbamuto, Dr Max Gova, Dr Josephat
Chiripanyanga and Ms Shale J. Kasambira who is one of the Secretaries for the
Department of Health Profession Education, University of Zimbabwe College of
Health Sciences where the course was hosted and Mr Joel Mugota the chief
technician in the department of surgery.
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Dr Farai Madzimbamuto
Consultant Anaesthetist
Lecturer University of Zimbabwe Department of Anaesthesia and
Intensive Care
Dr Max Gova
Consultant Trauma and Orthopaedics
Lecturer University of Zimbabwe Department of Orthopaedics
Dr Josephat Chiripanyanga
Registrar Cardiothoracics
From the UK, Annette Clark, Mr Charles Clayton and Grace Le were of invaluable
help in the organising and running of this course.
The compilation of this report was done by Dr Josephat Chiripanyanga and Dr
Kudzai Kanyepi with the invaluable guidance provided by Dr Farai Madzimbamuto
and Dr Max Gova.
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4) Course Instructors
There were eight course instructors who had been earmarked for this training and
fortunately all of them found time in their busy schedules to instruct the course.
The instructors were Dr Josephat Chiripanyanga (team leader), Dr Thandiwe
Munaiwa, Dr Kudzai Kanyepi, Dr Abdur-Rehman Shaukatali Patel, Nurse
Anaesthetist Rutendo Dimba, Nurse Nyasha Masvosva, Nurse Pauline Matongo,
Nurse Ndaizivei Garufu. Most of the instructors are based at Parirenyatwa Hospital
the largest health institution in the country handling the most trauma admissions.
The majority of these trainers were trained in our first locally ran PTC instructor
course in October 2014.
Dr Joe Chiripanyanga Registrar Cardiothoracics Parirenyatwa
Rutendo Dimba Nurse anaesthetist Parirenyatwa
Dr Kudzai Kanyepi Senior House Officer Accident & emergency Parirenyatwa
Ndaizivei Garufu Nurse in Orthopedic ward, Parirenytwa
Thandiwe Munaiwa Senior House officer Accident & Emergency Parirenyatwa
Patel Senior House officer Orthopedics Harare Hospital
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5) Activities
The activities of this PTC course started prior to the course itself with a series of
preparatory and planning meetings hosted by Dr Madzimbamuto attended by Dr
Gova and Dr Chiripanyanga.
Part of the pre-course activities involved the purchase and preparation of the goats
which we used as demonstration aides.
The final pre-course activity was on the Friday prior to the training when all the
eight trainers met and checked all the equipment, practiced practical sessions and
scenarios and also lecture delivering. This is when the final topic allocation was
done. Two different teams of 4 instructors each were setup, each team to run its
training course concurrently.
The activities during the training followed the guidelines in the PTC instructor’s
manual which will be outlined on the specific days. However to accommodate 2
sessions we had to adjust the timetable so as to allow both teams access to the
skills room at different times.
Post course activities were mainly hovering around the final aggregation of the
data collected during the training.
Pauline Matongo Theatre Nurse Parirenytwa
Nyasha Masvosva Accident & Emergency Nurse Parirenyatwa
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6) Day 1 & 2
Day 1 started with a welcome note and introductions by Joe and Dr Gova.
Forty one participants attended the PTC Course on the first two days. Two sessions
were run concurrently with 4 instructors in each session. The instructors in team 1
were Pauline, Josephat, Ndaizivei and Patel; team 2 instructors were Thandiwe,
Kudzai, Rutendo and Nyasha.
In total there were 15 female and 26 male participants in the two teams combined.
After the introductions, the participants were given the pre-course test and
questionnaire to fill in.
After the questionnaire and the MCQs a discussion of the local trauma perspective
was held, and then the lectures were delivered in both sessions according to the
timetable set out in the PTC manual.
After the break Team 1 proceeded to do the skills stations; airway management,
surgical airway, chest drain and c-spine & logroll stations.
Ndaizivei showing participants
in Team 1 airway
management techniques
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Team 2 however proceeded with lectures as we only had one skills room. The
following lectures were delivered Secondary Survey and Chest Trauma and a
demonstration scenario was done.
Participants in team 2 listening to a lecture. (From left to right, Coscar, Hosea, Tinashe and Fortune.
Behind Anja, Mobby, Naison (partially obscured) and Ellen)
Patel showing
participants in team 1
how to insert a chest
drain
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The Lunch break for both teams was at the same time. After lunch Team 1 went on
to do the lectures as per schedule while team 2 did the skills stations.
Rutendo showing airway management to Anna and Yemurai
Soon after both teams mangaged to run a few scenarios before concluding the
day.
Joe lunga (patient),
Macdonald, Doreen,
Coscar
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Day 2 was kick started by an address by Mr Charles Clayton.
Day 2 involved both teams giving lectures on Head and Spinal Trauma, followed by
Abdominal and Limb trauma, Trauma in Pregnancy and Children.
Nyasha giving a lecture
in Trauma In pregnancy
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Day 2 activities proceeded relatively unchanged from the PTC manual outline.
All the topics were covered comprehensively and interactively by both teams. Post
course MCQs and questionnaire and a Summary and evaluation were concluded by
Joe and Rutendo.
The Summary of the MCQs is shown in the table below.
LOWEST MARK HIGHEST MARK PRE-COURSE 33,3% 96,7% POST-COURSE 46,7% 100%
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7) Instructors Course
The instructors’ course saw the training of a total of 13 new trainers, 3 females and
10 males by the original 8 instructors.
The instructors’ course content simply followed the PTC instructors’ manual with
essentially no changes.
After the filling in of the pre-course questionnaire, the following topics were
covered how adults learn, how to ask questions, getting feedback. The new
instructors to be were also taught how to give a lecture, lead a discussion group,
run a scenario and how to teach a skill.
In the afternoon the students were asked to do practical sessions in the form of
giving a Lecture, lead a discussion group, teach a skill and run a scenario.
The post course questionnaires were completed and the instructors’ course was
concluded by planning for the last 2days of the training and allocation of topics to
the new instructors.
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8) Day 4 & 5
10 newly trained trainers were available to conduct the training on day 4 and 5
under the supervision of the original eight trainers. A total of 29 participants
attended the training this includes one of the trainees from day 1 and 2 who had
not performed well. There were 12 male and 17 female participants.
Course content was maintained as per PTC manual however the timetable was
changed to allow the two teams to use the skills stations at different times.
One of the new instructors, Tafadzwa giving a lecture while Thandi and Kudzai look on, and John one of
the participants.
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Demonstration scenarios in pictures on Day 4& 5
Above Sanjay (obscured) runs a scenario assisted by Nyasha.
Below Anja runs a scenario with Rutendo looking on
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The Summary of the MCQs is shown in the table below.
LOWEST MARK HIGHEST MARK PRE-COURSE 33.3% 86.7% POST-COURSE 63.3% 96.7%
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9) Equipment
Most of the equipment used for this training was left by the UK instructors team
which came in February 2014 led by Dr Grange. The equipment included
2manikins, a digital projector and a kit box.
From the Department of Surgery we were loaned a flat screen tv which we were
able to use for one of the teams and project slides via an HDMI cable.
Dr Farai Madzimbamuto provided his Laryngoscopy blades and Joe provided his
cervical collar. The rest of the smaller items e.g. cannulas, IV lines, oral airways
were sourced from the hospital.
All the documents were printed locally.
Four goat carcasses was used for the chest drain and advanced airway practical
sessions.
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10) Conclusion To conclude, this second locally coordinated PTC course was very successful and
surpassed the organisers’ anticipation. A total of 69 participants were trained, 32
females and 38 males of these 13 were trained to be instructors 3 females and 10
males.
Participants enjoyed and learnt a lot from the PTC course and some actually vowed
to go and initiate training their colleagues back at their hospitals, under the
leadership of the local PTC team.
The commonest negative feedback was that there wasn’t enough time especially
for the practical sessions.
There are now twenty trainers in the local team who have done both the ToT and
have trained others. There are four other who have done the ToT only. After the
training a committee was set up to be headed by Dr Farai Madzimbamuto and Dr
Max Gova, with Dr Josephat Chiripanyanga, Dr Tasimba Masama, Sr Rutendo
Dimba, Dr Kudzi Kanyepi, Dr Patel, Dr Thandi Munaiwa, Sr Nyasha Masvosva and Sr
Pauline Matongo as committee members.
The way forward for PTC Zimbabwe remains as to start doing trainings in other
towns and provinces and spread the gospel of PTC to the whole nation. As
previously planned PTC is now housed under the department of Health
Professionals education headed by Dr Madzimbamuto’s office.
The main obstacle for the future of PTC in Zimbabwe is still funding and time for
the trainers and trainees. This course was funded by PTC in retrospect after the
submission of all the receipts. We are still exploring other avenues of funding
locally.
Finally the course content, material and methodology of PTC is second only to
none and it should be spread to the four corners of the world and should be the
backbone of management of a trauma patient in any situation. We look forward to
receiving the revised training manuals.
Thank You
God Bless