Table 2 Training on disability effect estimates for healthcare workers reported in systematic reviews (2015–2022)
From: Co-development of a training programme on disability for healthcare workers in Uganda
Primary author, Year [Ref] | Target disability | Studies N | Countries [LMICs] Country name | Target cadre (n) | Target outcome (n) | Pedagogical methodology (n) | Measurement tools/ Evaluation methodology (n) | Participants trained N | Evidence of impact | Confidence rating |
|---|---|---|---|---|---|---|---|---|---|---|
Adirim Z, 2021 [27] | Intellectual and developmental disabilities | 16 | 2 [0] USA (14) Canada (2) | Pediatrics (12) Psychiatry (3) Family Medicine (1) | Awareness (6) Knowledge (13) Other/unclear (1) | Clinical rotation: (9/16) theoretical/ pedagogical: (14/16) didactic or seminar: (12/14) clinical practice: (10/11), simulation, (1/11). Immersive experiences: (7/16) interactive approaches (5/16) | Knowledge assessment (9/16) self-reported learning: (9/16) evaluation of intervention (3/16) clinical changes (2/16) observed behavioural change (1) | Not reported | Narrative summary: improved knowledge, skills, competence, positive attitudes | Low |
Booth A, 2017 [28] | Mental health | 2 | 2 [0] USA (2) | a) Child welfare case officers b) Community practitioners | Knowledge and referral | Face-to-face, didactic and interactive training with video demonstrations of available evidence based practice | 54 item questionnaire developed by study team to evaluate knowledge of mental health conditions | a) 67 b) 182 | Intervention group had significantly increased awareness of evidence based practice | Medium |
Cox A, 2015 [29] | Intellectual disabilities | 19 | Not reported | Direct care, psychologist, manager not reported (8) | 1) Health outcome: Improvement in client behaviour: (9/19) | Not reported | 1) Direct observation of client behaviour (8) (Combination of two study groups) 2) questionnaires (9) | Not reported | Narrative summary: trend toward change in behaviour of clients | Low |
Ioerger M, 2019 [30] | All disabilities | 77 | 12 [4] USA (36) UK (19) Canada (6) Australia (7) Brazil (1) Nigeria (1) Pakistan (1) S.Africa (2) Croatia (1) Ireland (1) Israel (1) New Zealand (1) | Medical students | Students’ disability knowledge (35), skills (28), or attitudes (35) | Lectures most common (36), followed by reflection (25) and small group discussions (25). | 1) Attitude change 2) Skills acquired 3) Knowledge 4) General feedback | 5982 (15 studies did not report) | Before after studies, no improvements reported | Low |
Mukadam N, 2015 [31] | Dementia | 13 | 5 [0] Denmark (1) UK (1) USA (2) Germany (1) France (1) | GPs and primary care clinics | 1) Behaviour, performance or practice - dementia detection and adherence to guidelines 2) Knowledge 3) Attitude | One-to-one (4), Group setting (5), Written information (3), Training to use screening tools (2), Decision support (4), Patient education (1), Specialist consultation (1) | 1) Questionnaire: Patient reported healthcare outcomes 2) Knowledge questionnaire: healthcare worker 3) review of medical record notes | 1,312 participants and 9 clinics | Cluster RCT (5), controlled before after (1): Improved healthcare outcomes when intervention included both education and structured care management | High |
Piot MA, 2021 [32] | Mental health | 11 in meta-analysis | Not reported | Nurses | Nurses skills, attitudes and behaviours and mental health outcomes | Simulation: Simulated patient (55) Role-play (40) Virtual reality (12) Manikin (10) Voice simulation (9) | Pre-post tests: Satisfaction (4) Attitudes (88) Skills (25) Knowledge (43) Behaviours (20) Mental health outcomes (7) | Not reported | Randomized and non-randomized controlled studies and single group pre/post studies. Attitude: simulation and inactive control - immediately post test (0.22; 95% CI [0.06; 0.38]), 2–4 month follow up: (0.60; [0.15; 1.0) Skills: simulation and active control − (1.12; [0.39; 1.86]), | High |
Rotenberg S, 2022 [11] | All disabilities | 78 | Reported by region | Medics (37) Nurses (17) Allied Health Professionals (31) Dentists (7) Psychologists (4) Personal Care Workers (5) Community Healthcare workers (2) Pharmacists (2) | Knowledge (57) Competence (42) Attitudes (31) Knowledge (57) Competence (42) Attitudes (31) Confidence (24) Comfort (15) Communication skills (12) Self-Efficacy (11) | Lecture/didactic methods (65) Case study (28) Clinical encounter (26) Placements, experiential, and community-based learning (25) Simulation (24) People with disabilities as a teacher (19) | 70% of studies designed their own instruments | Not reported | Narrative review: Use of multiple teaching methods and multi-pronged approaches that emphasise mainstreaming disability in health curricula, sustained approaches that promote systemic change | High |
van der Meer L, 2016 [33] | Intellectual disabilities | 22 | Not reported | Staff’ | 1) Develop communication plans 2) Improve interaction skills 3) Implement intervention plans 4) Use augmented communication | Presentation/instruction/manual, discussion, modelling/demonstration, role play/practice, video analysis/examples, feedback, self-monitoring/examination | 1) Change in behaviour and knowledge/belief of staff, 2) Change in outcomes of people with intellectual disabilities (communication and behaviour) | 432 participants | Systematic review: 14 studies provided emerging evidence, with one study proviA9:P10ding conclusive evidence: (number choice opportunities provided increased) | Medium |