A REGIONALIZED PERINATAL CONTINUING-EDUCATION PROGRAM - SUCCESSFUL ADAPTATION TO A FOREIGN HEALTH-CARE SYSTEM AND LANGUAGE

Much of the decline in perinatal mortality over the past two decades i n the United States has been attributed to regionalization of perinata l care. Outreach education from regional medical centres to community hospitals is an essential component of regionalization. The Perinatal Continuing Education Program (PCEP) has been successfully used for out reach education in more than 30 states since 1979. This project tested the efficacy of implementing the PCEP strategy in Poland. PCEP was ad apted to Polish conditions, translated, and implemented in four phases . The scheme allowed gradual transfer of ownership to Polish leaders a nd use of the existing regional structure to disseminate information f rom regional centres to community hospitals. Evaluation included measu res of programme use (participation and completion rates) and acceptan ce (participant evaluation forms), cognitive knowledge (pre- vs. post- tests), and patient care (chart reviews). Of 2093 doctors, nurses and midwives who began, 1615 (77%) completed the programme, with higher co mpletion by regional centre than community hospital staff. All partici pant groups responded favourably to the materials and expressed modera te confidence in their mastery of the information and skills. Test sco res improved significantly for all phases and for all disciplines, wit h baseline and final scores consistent with degrees of previous profes sional education. Large baseline and inter-hospital variations in char t review data restricted analysis of care practices. A comprehensive p erinatal education programme can be successfully transferred to a fore ign health care system. We believe the following to be particularly im portant: multidisciplinary instructors and students; a self-instructio nal format; content aimed at practice rather than theory; and an organ ized implementation strategy co-ordinated by local personnel.