BACKGROUND:
Sub-Saharan Africa faces some of the highest maternal mortality rates globally and the greatest shortage of midwives. Strengthening midwifery education and clinical training is one of the most impactful interventions to reduce maternal mortality. Global reports cite a lack of investment in educators, limited skills and knowledge in contemporary teaching methods, and limited clinical experience for students as key barriers.

OBJECTIVES:
To address these gaps, a six-month, low-dose, high frequency midwifery preceptor course was developed and piloted in Sierra Leone. This study aims to evaluate the program’s effectiveness in strengthening preceptors’ clinical and precepting competence and confidence.

METHODS:
Two midwifery schools in Sierra Leone participated in this intervention, each with n=10 midwife preceptors (N=20). A pre-post-test design was used to evaluate participants at the end of the intervention (6-months). Eighteen objective structured clinical examinations (OSCEs) were used to determine mean differences between scores. Paired t-tests were used for each of the OSCEs with a preset alpha of 0.05. Wilcoxon signed-rank tests examined the average difference in median pre- and post-scores for self-assessments of competence and confidence in precepting with participants answering 5-item Likert scale questions.

RESULTS:
All OSCEs had significant improvement from pre- to post-test. The largest mean difference was for incomplete abortion/manual vacuum aspiration (mean: 0.4576, SD: 0.1547) while the smallest mean difference was in repair of perineal tears (mean: 0.0926, SD:0.1191). Self-assessed confidence and competence were also significant with average median scores increasing 1.43 points (IQR: 0.85, p=0.002) and 1.32 points (IQR: 0.80, p=0.0002) respectively.

CONCLUSIONS:
Preceptors in the midwifery preceptor program showed significant improvements in clinical and teaching competence and confidence. This effective program may be a useful strategy in strengthening midwifery education and maternal healthcare in a region with the highest burden of maternal mortality.

KEY MESSAGE:
This novel low-dose, high-frequency preceptor program was found to be highly effective across all midwifery domains. Poster session 3 (Group B)