Evaluating sepsis training for medical students and nonphysicians in Malawi.

STUDY OBJECTIVE: This study aimed to evaluate whether (regarding the Surviving Sepsis Campaign [SSC] guidelines) the training of Malawis scarce medical staff is adequate. Hospitals in Malawi have a severe shortage of human resources and therefore rely heavily on junior staff. Sepsis is a leading cause of admission to hospitals particularly in resource poor countries. It is associated with a high mortality rate. The SSC guidelines have been developed to help frontline staff diagnose and treat patients with sepsis.

DESIGN: A questionnaire consisting of 10 multiple choice questions, which was to be completed before and after a teaching module.

SETTING: Anesthesia courses at the University of Malawi.

INTERVENTION: Participants had to answer the questionnaire before and after their teaching block on anesthetics and critical care. The medical students have a 2-week teaching block, and the nonmedical staff have an intensive 3-day training course. MBBS 1 was asked only once as a baseline.

PARTICIPANTS: 168 medical students and 31 nonphysician staff returned 345 questionnaires (return rate, 97.1%).

MEASUREMENTS: A total of 345 anonymous multiple choice questionnaires were completed. The same questionnaire was then repeated after their teaching block on anesthesia and critical care (not MBBS 1). The aim was for us to assess the knowledge the students had of sepsis. Overall 67% of the questions were answered correctly (2299 correct answers of 3450). The MBBS IV students had an average score of 68% to 72%, and the MBBS I students had a score of 42%. The highest score was achieved by the nonphysician clinical staff after their teaching as they improved by 11% (65%-76%).

CONCLUSIONS: Medical students and health care workers have a lack of knowledge regarding the SSC guidelines which needs to be addressed via training. The medical student teaching was not as effective as the nonphysician clinical staff course, and therefore, we need to think about restructuring their teaching block by having an intensive "Sepsis Day" that focuses on the SSC guidelines.