https://orcid.org/0000-0002-7839-4148
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ABSTRACT
Background
Various trainings are designed to educate nurses to become simulation educators. However, there are no good strategies to sustain their learnings and keep them engaged. We developed a series of 10 interactive digital storytelling comic episodes ‘The Adventures of Super Divya (SD)’ to strengthen simulation educator’s facilitation knowledge, skills, confidence, and engagement. This endline evaluation presents results on the change in knowledge after watching the episodes and retention of that knowledge over 10 months.
Objectives
The objectives of this pilot study are to: 1) assess the change in knowledge between the baseline and post-episode surveys; and 2) understand the retention of knowledge between the post-episode and the endline survey.
Methods
A human-centred design was used to create the episodes grounded in the lived experience of nurse simulation educators. The heroine of the comic is Divya, a ‘Super Facilitator’ and her nemesis is Professor Agni who wants to derail simulation as an educational strategy inside obstetric facilities. Professor Agni’s schemes represent real-life challenges; and SD uses effective facilitation and communication to overcome them. The episodes were shared with a group of nurse mentors (NM) and nurse mentor supervisors (NMS) who were trained to be champion simulation educators in their own facilities. To assess change in knowledge, we conducted a baseline, nine post-episode surveys and an endline survey between May 2021 and February 2022.
Results
A total 110 NM and 50 NMS watched all 10 episodes and completed all of the surveys. On average, knowledge scores increased by 7–9 percentage points after watching the episodes. Comparison of survey responses obtained between 1 and 10 months suggest that the gain in knowledge was largely retained over time.
Conclusions
Findings suggest that this interactive comic series was successful in a resource limited setting at engaging simulation educators and helped to maintain their facilitation knowledge over time.
Responsible Editor Jennifer Stewart Williams
Responsible Editor Jennifer Stewart Williams
Supplemental data
Supplemental data for this article can be accessed online at https://doi.org/10.1080/16549716.2023.2185365.
Acknowledgments
We would like to acknowledge the contribution of Jami Baayd, University of Utah and Greg Cravens for their contribution towards the development of the Super Divya comic series. In addition, we are most grateful of Anika Kalra, Sunny Lin, Solange Madriz, Kimberly Calkins, Ojung Longkumer, Nisha Mayur, Liya Susan Jose, Manju Siju, Rohit Srivastava and Sudha Murugesan for their special contribution in this programme. We extend our wholehearted thanks to CARE staff for their support in implementation of simulation and team training as part of AMANAT and AMANAT Jyoti programmes. We are inspired to have had the opportunity to work with the countless nurses and other health providers from public health facilities in Bihar. Last but not the least, our deepest gratitude to pregnant and birthing individuals for whom we are striving to make a small difference.
Author contributions
Conceptualisation – Rakesh Ghosh, Alisa Jenny, Susanna R. Cohen and Dilys Walker; Designing and developing the intervention – Susanna R. Cohen, Mikelle Lloyd, Kevin Thorn, Nidhi Subramaniam and Seema Handu; Survey development – Alisa Jenny, Susanna R. Cohen and Dilys Walker; Data curation – Nidhi Subramaniam, and Divya Vincent; Formal analysis – Nidhi Subramaniam, Divya Vincent, and Rakesh Ghosh; Funding acquisition – Dilys Walker; Project administration – Alisa Jenny, Rakesh Ghosh, Seema Handu, Susanna R. Cohen, Heidi Breeze-Harris and Dilys Walker; Writing (Original Draft Preparation) – Rakesh Ghosh, Nidhi Subramaniam, and Divya Vincent; Writing (Review and Editing) – Seema Handu, Alisa Jenny, Mikelle Lloyd, Kevin Thorn, Heidi Breeze-Harris, Susanna R. Cohen and Dilys Walker. All the authors have read and agreed to the submission of the manuscript.
Disclosure statement
Dilys Walker and Susanna R. Cohen are founding members of PRONTO International (a non-governmental organization) and sit on its board of directors. None of the other authors have any conflicts of interest to declare, neither there is any financial interest associated with this work.
Informed consent statement
Informed verbal consent was obtained from each participant prior to participation in the study. The consent form was approved by the Institutional Review Board of the University of California, San Francisco.
Institutional review board statement
This programme was reviewed and deemed exempt by the Institutional Review Board of the University of California, San Francisco (IRB Ref No. 19–29715). In-country ethics approval was obtained by CARE India from the All India Institute of Medical Sciences, Patna (Ref No. AIIMS/Pat/IEC/2020/700). All participants provided written informed consent before participation in the study.
Paper context
Comics have been successfully used to teach clinicians a range of topics from empathy to anatomy. However, there is scant evidence about their use with frontline nurses in low-resource settings. To our knowledge, this is the first study that demonstrates use of interactive digital storytelling comics with labour and delivery care nurses in the public health facilities in Bihar, India. The comics were popular and appear to have improved knowledge of this group.