By Heidi Breeze-Harris, Executive Director, PRONTO International
PRONTO International works to optimize the birthing experience for mothers, babies and their providers in limited resource settings. We do this by training simulation and team training educators that are able to provide low-cost, high-fidelity simulation education to even the most remote health facilities in LMICs.
Healthcare providers experience mental health and burnout issues that have become even more dire during the COVID pandemic. Provider mental health affects quality of care which in turn affects health outcomes. In maternal health cases, the provision of respectful care can be challenging when the providers themselves are stretched thin with workload, low pay, managing hierarchy-driven mistreatment, etc.
PRONTO’s training programs are focused on the clinical educator – health facility-based clinicians who help fellow providers to learn, grow, and manage their patient’s care by providing innovative trainings. We have found that most trainings for providers focus on technical skills but few focus on the health and well-being of the providers or their mentors.
To get a taste of Super Divya’s virtual environment, the video above shows her work to defeat “the bugs” that her nemesis, Professor Agni, sends to ruin a clinical education session. You’ll see Super Divya teach the viewer about the genuine self and using empathy goggles.
Meet Super Divya! She is a comic-book-style superhero – complete with her own nemesis named Professor Agni – that teaches clinical education through virtual, self-paced learning modules. India recently made the commitment to invest in a new national cadre of midwives.
As part of this process, innovative midwifery education is taking center stage in the country. PRONTO is proud to be a part of this movement. In Feb/March 2022 PRONTO’s Super Divya modules were used during a midwifery educator training, funded by UNICEF India. Midwifery educator participants were from the state of Telangana and the Fernandez Foundation, one of the leading midwifery education institutions in India. Super Divya offers the opportunity to connect with cadres of clinical educators at scale which is critical for India.
Super Divya has adventures in a virtual interactive comic environment which was built with and for local providers. Super Divya teaches her students about a set of tools designed for the health and well-being of clinical educators and the clinicians that they teach. From the standpoint of mental health, Super Divya normalizes the idea that clinical providers and educators can and should take time to care for themselves, which will result in higher quality care for patients and less burnout for them.
This educational format was chosen because comics can communicate complex ideas about health as the medium conveys nuanced concepts, explores emotional and social issues, and allows readers to develop a level of empathy beyond what can be achieved through textbooks.
Several of Super Divya’s self-care tools include:
“Genuine Self” Practices – This tools help the teacher and student connect with their body, calm their mind, and focus on the present moment. This tool also leads to other practices taught by Super Divya such as breathing, asking for help from colleagues and friends, and preparing ahead for how to manage emotions in difficult situations.
Empathy Goggles – To help mentors recognize clues from student body language and facial expressions. These clues help mentors understand what providers might be feeling and meet those feelings with appropriate teaching techniques.
Curiosity Antenna – This helps mentors and students approach complex situations with an open flexible mind and ask questions to students and patients more often.
These tools are taught through 10 self-paced virtual modules. All 10 modules have been piloted with 205 nurses in India. A publication with the results of this initial study, Super Divya, an Interactive Digital Storytelling Instructional Comic Series to Sustain Facilitation Skills of Labor and Delivery Nurse Mentors in Bihar, India—A Pilot Study, was published on February 25, 2022 in the International Journal of Environmental Research and Public Health. The study found that the modules were appreciated by nurses, feasible to use, and improved knowledge of important teaching skills. The study also showed there is ample room for PRONTO to continue innovations on abstract concepts that could affect provider mental health. For example, learning to “name” emotions and identify one’s “genuine self” were abstract concepts that need continued explanation and reinforcement.
The development of Super Divya began in 2019 with funds from the Bill and Melinda Gates Foundation. The work was done by a team called LINQED – Leading Innovation in Quality-of-Care Education Development. The LINQED team’s members include: University of California, San Francisco and the Bixby Center for Global Health Research, University of Utah and the Lift Simulation Design Lab, and the PRONTO International teams in both the US and India. PRONTO plans to add more superheroes from different countries and contexts along with modules on issues like the provision of respectful maternity care.