Rwanda Successfully Pilots Heart Failure Training Model that Will Facilitate PEN-Plus Scale-up Across the Network

Participants in PEN-Plus heart failure course evaluate and discuss cardiac ultrasound images.

A training model that combines in-person classroom instruction with a digital, e-learning platform has been successfully piloted in Rwanda to train PEN-Plus nurses and physicians in the knowledge, skills, and competencies to diagnose and treat heart failure. The training model and corresponding learning materials are being developed and tested as part of a PEN-Plus curriculum that can be adapted by NCDI Poverty Network countries as they initiate and scale-up implementation of PEN-Plus services.  

Initial survey data and focus group feedback suggests that the new training model is an effective way to convey knowledge about the causes, symptoms, and treatment protocols for heart failure, and to acquire and practice skills required for diagnosis and treatment. Rwanda will continue to utilize the new training model as a means of scaling-up PEN-Plus nationally, and plans are being made to test the same cardiology training model in Liberia and Malawi.  

After completing two weeks of online training modules, 20 trainees from five rural, district hospitals spread across the country met with six facilitators at the Partners in Health training site in Rwinkwavu between 1-5 November for the first in-person component of the training model. After spending that week practicing new skills and discussing case studies as a group, pairs of newly trained nurses and physicians returned to their hospitals with master trainers for an additional week of supervised in-person training and mentoring.  

The online portion of the training, developed by the e-learning and training team of the NCDI Poverty Network Secretariat, covered topics such as cardiac anatomy and physiology, causes of heart failure, and ways to diagnose and treat cardiomyopathy, congenital heart disease, and right heart failure. The online course also included knowledge checks as well as a pre- and post-course exam. Additional advanced modules covering prosthetic heart valves and anticoagulation medication are currently under development.    

Congenital heart disease is one of the topics covered in the eight online heart failure training modules.

The in-person portion of the training focused on skills-based learning. By first introducing topics online as part of a flipped classroom model, in-person instructors can focus their attention on leading hands-on training exercises in which trainees apply their knowledge in practice. During the in-person portion of the training model, participants learned and practiced new skills, like how to perform and interpret an echocardiogram, and discussed challenging cases with mentors.  

Participant feedback and e-learning data are currently under review. The results will be used to improve both the online and in-person portions of the training model and will assist the NCDI Poverty team as they develop training modules for other conditions covered by PEN-Plus, such as type 1 diabetes and sickle cell disease.   

“The highlight of this training is identifying a successful training model that could potentially be used to scale-up PEN-Plus in other Network countries,” said Dr. Sheila Klassen, a cardiologist who works with the NCDI Poverty Secretariat on curriculum development and training. “Having this training go so well and know we could possibly replicate with similar success is very exciting.”