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Chang Chan AYC, van Leeuwen M, Custers E, Bleys R, Ten Cate O. Anatomy education in low-resourced countries: What are challenges and effective and affordable educational strategies? A qualitative study. MEDICAL TEACHER 2024:1-11. [PMID: 39096213 DOI: 10.1080/0142159x.2024.2383373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 07/18/2024] [Indexed: 08/05/2024]
Abstract
PURPOSE With limited means, resource-deprived countries must find ways to organize education to meet standards. Few reports exist about anatomical education in LLMICs. This study explores how anatomy teaching is sustained in countries with few resources and which affordable educational strategies are applied to uphold quality. METHODS A mixed-methods study with anatomy teachers from public medical schools in low or lower-middle income countries (LLMICs) in Africa, Asia, Europe, and Latin-American was performed through survey via email combined with semi-structured online interview with teachers, exploring survey results at a deeper level. RESULTS LLMICs available to be surveyed, 13 and 8 were found to respond to a written survey and oral interview invitation, face significant teaching challenges, primarily due to lack of funds. These are faculty shortages (low salaries and high student-to-teacher ratio) and inadequate infrastructure (internet, electricity, poor classroom conditions). Solutions were associated with didactic strategies (social media, e-learning, image-based learning, applied anatomy), expanding teaching capacity with less qualified and part-time faculty, student-organized education, and self-financing (teaching resources subsidized by teachers and students). Which was triking was teacher commitment despite difficult circumstances. Teachers propose better faculty management, increased anatomy staff recruitment, and collaboration with other institutions. CONCLUSIONS Anatomical education in LLMIC is forced to adapt to the socio-economic context, rather than to trends in medical education worldwide. These adaptations are supported mainly by the teachers 'commitment.'
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Affiliation(s)
- Ana Yoe Cheng Chang Chan
- Independent, Formerly Department of Morphological Sciences, Faculty of Medical Sciences, National Autonomous University of Leon, Leon, Nicaragua
| | - Maarten van Leeuwen
- Independent, Formerly Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Eugene Custers
- Faculty of Education Sciences, Open University, Heerlen, the Netherlands
| | - Ronald Bleys
- Anatomy Department, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Olle Ten Cate
- Education Center, University Medical Center Utrecht, Utrecht, the Netherlands
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Mora Carpio AL, Romero-Reveron R, Vasquez M, Bonilla Castillo JA, Gaitán Concepción L, Pano Carrera R, Liévanos Díaz D, Menéndez Conde BG, Montbrun M, Espinoza-Luna A, Kreiger J, Davis JL, Rochester C, Martin A. Leveraging technology to improve access to medical education in anatomy and physiology in resource-limited settings: A mixed methods study. ANATOMICAL SCIENCES EDUCATION 2024. [PMID: 38954744 DOI: 10.1002/ase.2474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 04/19/2024] [Accepted: 06/03/2024] [Indexed: 07/04/2024]
Abstract
This study assesses the acceptability, appropriateness, feasibility, and efficacy of a novel asynchronous video-based intervention for teaching respiratory physiology and anatomy to medical students in resource-limited settings. A series of short video lectures on pleural anatomy, pulmonary physiology, and pathophysiology was created using Lightboard and screen capture technology. These were uploaded to YouTube and Google Drive and made available to 1st-3rd year medical students at two Latin American universities for 1 week. Employing a parallel-convergent mixed methods design, we conducted surveys, focus groups, interviews, and pre/post testing for qualitative and quantitative data. Thematic Analysis was used to analyze qualitative data and McNemar's test for quantitative analysis. Seventy-six students participated. The videos' short format, interactivity, and Lightboard style were highly valued for their flexibility, time efficiency, and educational impact. Students recognized their clinical relevance and trusted their content, suggesting potential applicability in similar settings. Despite infrastructure and connectivity challenges, the use of flexible streaming and downloadable options facilitated learning. Survey results indicated high levels of feasibility (99%), appropriateness (95%), and acceptability (95%), with significant knowledge gains observed (37% correct pre-test answers vs. 56% post-test, p < 0.0001). Our findings demonstrate high acceptability, appropriateness, feasibility, and efficacy of a targeted asynchronous education centered on short-format videos in resource-limited settings, enabling robust learning despite local barriers. Flexible access is key for overcoming localized barriers. Taking an adaptive, learner-centered approach to content creation and delivery to address constraints was pivotal to success. Our modular videos could serve as versatile models for flexible education in resource-constrained settings.
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Affiliation(s)
- Andres Leonardo Mora Carpio
- Department of Pulmonary, Critical Care and Sleep Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Rafael Romero-Reveron
- Facultad de Medicina, Escuela "José María Vargas", Universidad Central de Venezuela, Caracas, Venezuela
| | - Milagros Vasquez
- Facultad de Medicina, Escuela "José María Vargas", Universidad Central de Venezuela, Caracas, Venezuela
| | | | | | - Romina Pano Carrera
- ALPHA Anahuac, Escuela de Medicina, Universidad de Anahuac, Lomas Anahuac, Mexico
| | - Diego Liévanos Díaz
- ALPHA Anahuac, Escuela de Medicina, Universidad de Anahuac, Lomas Anahuac, Mexico
| | | | - Miryam Montbrun
- Facultad de Medicina, Escuela "José María Vargas", Universidad Central de Venezuela, Caracas, Venezuela
| | - Anabel Espinoza-Luna
- Facultad de Medicina, Escuela "José María Vargas", Universidad Central de Venezuela, Caracas, Venezuela
| | - Joan Kreiger
- Department of Health and Movement Sciences, Southern Connecticut State University, New Haven, Connecticut, USA
| | - John Lucian Davis
- Department Epidemiology of Microbial Diseases and Center for Methods in Implementation, Yale School of Public Health, Yale School of Medicine, New Haven, Connecticut, USA
- Department of Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Carolyn Rochester
- Department of Pulmonary, Critical Care and Sleep Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Andres Martin
- Child Study Center and Center for Medical Education, Yale School of Medicine, New Haven, Connecticut, USA
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Yager PH, Samost-Williams A, Bonilla JA, Guzman L, Hasbun SCA, Rodríguez AEA, Cárdena A, Núñez AML, Jayawardena ADL, Zablah EJ, Callans KM, Hartnick CJ. Sustainable improvement in upstream and downstream outcomes for intubated patients three years after an airway-based educational intervention in a low-resource pediatric intensive care unit. Int J Pediatr Otorhinolaryngol 2024; 182:112011. [PMID: 38865866 DOI: 10.1016/j.ijporl.2024.112011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 05/22/2024] [Accepted: 06/07/2024] [Indexed: 06/14/2024]
Abstract
OBJECTIVE To determine whether implementation of an education-based intervention can sustainably improve upstream and downstream outcomes in intubated patients in a pediatric intensive care unit (PICU) in a low-resource country. DESIGN Quality improvement study comparing airway-related morbidity in two previously studied patient cohorts pre-intervention (Epoch 1) and immediately post-intervention (Epoch 2) with a third cohort thirty-six months post-intervention (Epoch 3). SETTING PICU of the largest public children's hospital in El Salvador. PATIENTS 147 patients under 18 years requiring intubation and mechanical ventilation (MV) met inclusion criteria in the long-term follow-up period and were consecutively sampled without exclusion (Epoch 3) (compared to 98 previously studied patients in the short-term follow-up period (Epoch 2)). INTERVENTION A low-cost, education-based intervention to close knowledge gaps, improve communication among PICU doctors, nurses, and respiratory therapists, and optimize patient outcomes. MEASUREMENTS AND MAIN RESULTS The primary outcome measure was change in unplanned extubation (UE) between Epochs 2 and 3. Other outcomes included use of cuffed endotracheal tubes (ETT), rate of elective ETT change and days of MV. The 17 % decrease in UE previously reported for Epoch 2 was sustained in Epoch 3. There was a statistically significant increase in use of cuffed ETT from 35.7 % in Epoch 2-55.1 % in Epoch 3 (p = 0.003, z-score -2.99). There was also a statistically significant mean difference in rate of elective ETT change per 100 MV days from Epoch 2 to Epoch 3 of 1.7 (p = 0.007; 95 % CI 0.15-0.84). There was no change in MV days from Epoch 2 to Epoch 3 (p-value 0.764; 95 % CI -1.48-2.02). Beyond these quantifiable results, many unanticipated practice changes were observed three years after the initial intervention. CONCLUSIONS Sustained improvement in upstream and downstream outcomes (UE, cuffed ETT use, elective ETT change) for intubated patients in a low-resource PICU were observed three years after a low-cost, low-touch, education-based intervention.
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Affiliation(s)
- Phoebe H Yager
- Massachusetts General Hospital, Department of Pediatrics, 55 Fruit Street, Boston, MA, 02114, USA.
| | - Aubrey Samost-Williams
- University of Texas Health Science Center at Houston, Department of Anesthesia, Critical Care, and Pain Medicine, MSB 5.020, 6431 Fannin St., Houston, TX, 77030, USA.
| | - Jose A Bonilla
- Hospital de Niños y Adolescentes Centro Pediatrico, Department of Pediatric Otolaryngology, Primera Planta Clinica #25, Colonia Medica, San Salvador, El Salvador.
| | - Luis Guzman
- Hospital Centro Pediátrico, Department of Pediatric Critical Care Medicine, Final Diagonal Dr. Luis Edmundo Vásquez, N°222, local N° 32 Colonia Medica, San Salvador, El Salvador.
| | - Susana C A Hasbun
- Hospital Centro Pediátrico, Department of Anesthesiology, Final Diagonal Dr. Luis Edmundo Vásquez, N°222, local N° 32 Colonia Medica, San Salvador, El Salvador.
| | - Angel E A Rodríguez
- Hospital Centro Pediátrico, Department of Pediatrics, Final Diagonal Dr. Luis Edmundo Vásquez, N°222, local N° 32 Colonia Medica, San Salvador, El Salvador
| | - Alejandra Cárdena
- Hospital Centro Pediátrico, Department of Pediatrics, Final Diagonal Dr. Luis Edmundo Vásquez, N°222, local N° 32 Colonia Medica, San Salvador, El Salvador.
| | - Alexia M L Núñez
- Instituto Tecnológico y de Estudios Superiores de Monterrey in Guadalajara, México. Avenida Aviacion 4304, El Real 65-M-1, Zapopan, Jalisco, Mexico
| | - Asitha D L Jayawardena
- Children's Minnesota, ENT & Facial Plastic Clinic, 2530 Chicago Avenue, Suite 450, Minneapolis, MN, 55404, USA.
| | - Evelyn J Zablah
- Massachusetts Eye and Ear Infirmary, Department of Otolaryngology, 243 Charles Street, Boston, MA, 02114, USA.
| | - Kevin Mary Callans
- Massachusetts General Hospital, Department of Pediatrics, 55 Fruit Street, Boston, MA, 02114, USA; Massachusetts Eye and Ear Infirmary, Department of Otolaryngology, 243 Charles Street, Boston, MA, 02114, USA.
| | - Christopher J Hartnick
- Massachusetts Eye and Ear Infirmary, Department of Otolaryngology, 243 Charles Street, Boston, MA, 02114, USA.
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Weishaar H, Pozo-Martin F, Geurts B, Lopez de Abechuco E, Montt-Maray E, Cristea F, Abrokwa SK, Bahr T, Al-Awlaqi S, El Bcheraoui C. Capacity-building during public health emergencies: perceived usefulness and cost savings of an online training on SARS-CoV-2 real-time polymerase chain reaction (qPCR) diagnostics in low- and middle-income settings during the COVID-19 pandemic. Front Public Health 2024; 12:1197729. [PMID: 38912269 PMCID: PMC11192048 DOI: 10.3389/fpubh.2024.1197729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 05/27/2024] [Indexed: 06/25/2024] Open
Abstract
Introduction Upon the onset of the COVID-19 pandemic, the Public Health Laboratory Support Unit (ZIG4) at the Robert Koch Institute (RKI), the German National Public Health Institute, developed and delivered an online training on SARS-CoV-2 qPCR diagnostics to 17 partner countries in low- and middle-income countries (LMIC). This article analyses the usefulness and cost savings of this training. Methods The authors performed a concurrent mixed-methodology study based on key informant interviews, interviewer-administered questionnaires, and document reviews. Economic costs were estimated from the perspective of RKI. Results Responding participants indicated that the course provided good and comprehensive information on up-to-date scientific knowledge and laboratory practice in PCR diagnostics. Respondents appreciated how the technical content of the training enhanced their ability to apply diagnostic methods in their daily work. Interviewees highlighted that the fast implementation and the low threshold of attending an online training had allowed them to quickly build skills that were crucial during, and beyond, the COVID-19 crisis. The total estimated cost of the online SARS-CoV-2 qPCR training was 61,644 euros. The total estimated cost of the equivalent face-to-face training was estimated at 267,592 euros. Programme weaknesses identified included the top-down approaches taken, lack of interactive components and opportunities to directly engage with other course participants and with teachers. Conclusions An online training was developed and implemented to support RKI partner countries in SARS-CoV-2 qPCR diagnostics during the COVID-19 pandemic, thereby strengthening pandemic response and health system resilience. The training incurred in important cost savings compared to the equivalent face-to-face training. Post-pandemic studies could usefully build on these research findings and explore ways to enhance end user involvement and improve interactive features to build stronger communities of learners and facilitate exchange of information and mutual learning.
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Gellisch M, Morosan-Puopolo G, Brand-Saberi B, Schäfer T. Adapting to new challenges in medical education: a three-step digitization approach for blended learning. BMC MEDICAL EDUCATION 2024; 24:585. [PMID: 38807088 PMCID: PMC11134748 DOI: 10.1186/s12909-024-05503-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 05/02/2024] [Indexed: 05/30/2024]
Abstract
This research work focuses on evaluating the development of our three-step digitization approach, designed to transform traditional lectures into engaging digital learning experiences. Aimed at offering an easy-to-use solution for educators, this approach addresses the pressing challenges of modern educational environments by enhancing accessibility, engagement, and effectiveness of learning through digital means.Quantitative analysis demonstrated a notable increase in knowledge gain for students engaged with the digital format (t(230) = -2.795, p = 0.006) over traditional methods. Additionally, it was observed that the online setting significantly improved concentration levels (t(230) = -5.801, p < .001) and reduced distractions (t(230) = 2.848, p = 0.005). Emotional assessments, based on the Achievement Emotions Questionnaire (AEQ), indicated an elevation in enjoyment (t(230) = -4.717, p < .001) and a reduction in anxiety (t(230) = 9.446, p < .001) within the digital learning environment. A substantial preference for the digital course format was expressed by 61.0% of participants, with 71.4% acknowledging its superior efficiency compared to 14.3% for traditional lectures.Qualitative feedback underscored the digital format's flexibility, comprehensive learning experience, and immediate feedback as key benefits. Nevertheless, nuances such as a preferred understanding in face-to-face interactions and the absence of a social component in digital settings were noted.To conclude, the findings from this study illuminate the significant advantages of the three-step digitization approach in meeting contemporary educational challenges. By facilitating an enhanced knowledge acquisition and fostering a supportive emotional climate, this approach signifies a promising direction for the future of medical education and beyond, fusing the convenience of digital solutions with the depth and engagement of traditional learning methodologies.
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Affiliation(s)
- Morris Gellisch
- Center for Medical Education, Ruhr-University Bochum, 44801, Bochum, Germany.
- Department of Anatomy and Molecular Embryology, Institute of Anatomy, Medical Faculty, Ruhr University Bochum, 44801, Bochum, Germany.
| | - Gabriela Morosan-Puopolo
- Department of Anatomy and Molecular Embryology, Institute of Anatomy, Medical Faculty, Ruhr University Bochum, 44801, Bochum, Germany
| | - Beate Brand-Saberi
- Department of Anatomy and Molecular Embryology, Institute of Anatomy, Medical Faculty, Ruhr University Bochum, 44801, Bochum, Germany
| | - Thorsten Schäfer
- Center for Medical Education, Ruhr-University Bochum, 44801, Bochum, Germany
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Brown K, Flores MJ, Haonga B, Chokotho LC, O'Marr JM, Rodarte P, Shearer D, Morshed S. Best Practices for Developing International Academic Partnerships in Orthopaedics. J Bone Joint Surg Am 2024; 106:924-930. [PMID: 37851955 DOI: 10.2106/jbjs.23.00626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2023]
Abstract
ABSTRACT Traumatic and nontraumatic orthopaedic conditions are major contributors to global morbidity and account for the majority of life-years lived with disability worldwide. Additionally, the burden of musculoskeletal injuries has increased substantially over the past 3 decades. Unfortunately, in low and middle-income countries (LMICs), access to orthopaedic care is limited, leading to a disproportionate burden of disease. The Lancet Commission on Global Surgery has emphasized the urgent need for unified international commitment and research collaboration to achieve universal access to safe and affordable surgical care. However, conducting high-quality orthopaedic research in LMICs remains challenging as a result of disparities in training, access to resources, infrastructure, and equipment availability. Partnerships between high-income countries (HICs) and LMICs have emerged in recent decades as an effective approach to combatting some of these challenges. These partnerships aim to bridge the gaps by facilitating collaborative research and knowledge exchange. The establishment of successful partnerships requires a collaborative and reciprocal approach that starts with a clear understanding of mutual research aims and the availability of resources. Despite the potential benefits, various factors can make establishing such partnerships difficult. However, these partnerships can have a substantial impact in delivering quality orthopaedic education and research training, thus improving access to care in resource-limited environments. This paper represents the collaborative effort of multiple international academic orthopaedic surgeons with extensive experience in HIC-LMIC partnerships. Our aims were to outline the best practices for conducting orthopaedic research within these relationships and to provide guidance for future successful collaborations.
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Affiliation(s)
- Kelsey Brown
- Institute for Global Orthopaedics and Traumatology, University of California San Francisco, San Francisco, California
| | - Michael J Flores
- Institute for Global Orthopaedics and Traumatology, University of California San Francisco, San Francisco, California
| | - Billy Haonga
- Muhimbili Orthopedic Institute, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | | | - Jamieson M O'Marr
- Institute for Global Orthopaedics and Traumatology, University of California San Francisco, San Francisco, California
| | - Patricia Rodarte
- Institute for Global Orthopaedics and Traumatology, University of California San Francisco, San Francisco, California
| | - David Shearer
- Institute for Global Orthopaedics and Traumatology, University of California San Francisco, San Francisco, California
| | - Saam Morshed
- Institute for Global Orthopaedics and Traumatology, University of California San Francisco, San Francisco, California
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Doherty M, Abdullah QK. Using Project ECHO to deliver a tele-mentoring and teaching program on palliative care in South Asia: Interpretive description of participants' experiences with a community of practice for learning. Palliat Support Care 2024:1-9. [PMID: 38736371 DOI: 10.1017/s1478951524000762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024]
Abstract
OBJECTIVES To explore the learning experiences of participants (learners and teachers), in a yearlong tele-teaching and mentoring program on pediatric palliative care, which was conducted using the Project ECHO (Extension for Community Healthcare Outcomes) model and consisted of 27 teaching and clinical case discussion sessions for palliative medicine residents in India and Bangladesh. The goal of the study is to explore how participation and learning is motivated and sustained for both residents and teachers, including the motivators and challenges to participation and learning in a novel online format. METHODS Qualitative interviews with ECHO participants, including learners and teachers were conducted. Interviews were recorded and transcribed. Thematic analysis of interview data was conducted within an interpretive description approach. RESULTS Eleven physicians (6 residents, 5 teachers) participated in interviews. Key elements of the ECHO program which participants identified as supporting learning and participation include small group discussions, a flipped classroom, and asynchronous interactions through social media. Individual learner characteristics including effective self-reflection and personal circumstances impact learning. Providing opportunities for a diverse group of learners and teachers, to interact in communities of practice (COP) enhances learning. Three major themes and 6 subthemes describing learning processes were identified. Themes included (1) ECHO program structure, (2) learner characteristics, and (3) COP. Subthemes included flipped classroom, breakout rooms, learning resources, personal circumstances, self-awareness of learning needs, and community interactions. SIGNIFICANCE OF RESULTS Project ECHO suggests a novel model to train health providers, which is effective in low- and middle-income countries. Online learning programs can lead to learning through community of practice when learners and teachers are able to interact and engage in peer support and reflective practice. Educators should consider incorporating small group discussions, a flipped classroom design, and opportunities for asynchronous interactions to enhance learning for participants in online learning programs.
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Affiliation(s)
- Megan Doherty
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- Department of Pediatrics, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
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Mackin C, Shrestha DS, Downe D, Doherty M. Online palliative care education and mentorship in Nepal: Project ECHO - a novel approach to improving knowledge and self-efficacy among interprofessional health-care providers. Palliat Support Care 2024:1-9. [PMID: 38736367 DOI: 10.1017/s1478951524000786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024]
Abstract
BACKGROUND Palliative care access in Nepal is severely limited, with few health-care providers having training and skills to pain management and other key aspects of palliative care. Online education suggests an innovation to increase access to training and mentoring, which addresses common learning barriers in low- and middle-income countries. Project ECHO (Extensions for Community Health Care Outcomes) is a model of online education which supports communities of practices (COPs) and mentoring through online teaching and case discussions. The use of online education and Project ECHO in Nepal has not been described or evaluated. SETTING An online course, consisting of 14 synchronous weekly palliative care training sessions was designed and delivered, using the Project ECHO format. Course participants included health-care professionals from a variety of disciplines and practice settings in Nepal. OBJECTIVES The goal of this study was to evaluate the impact of a virtual palliative care training program in Nepal on knowledge and attitudes of participants. METHODS Pre- and post-course surveys assessed participants' knowledge, comfort, and attitudes toward palliative care and evaluated program acceptability and barriers to learning. RESULTS Forty-two clinicians, including nurses (52%) and physicians (48%), participated in program surveys. Participants reported significant improvements in their knowledge and attitudes toward core palliative care domains. Most participants identified the program as a supportive COP, where they were able to share and learn from faculty and other participants. CONCLUSION Project ECHO is a model of online education which can successfully be implemented in Nepal, enhancing local palliative care capacity. Bringing together palliative care local and international clinical experts and teachers supports learning for participants through COP. Encouraging active participation from participants and ensuring that teaching addresses availability and practicality of treatments in the local health-care context addresses key barriers of online education. SIGNIFICANCE OF RESULTS This study describes a model of structured virtual learning program, which can be implemented in settings with limited access to palliative care to increase knowledge and attitudes toward palliative care. The program equips health-care providers to better address serious health-related suffering, improving the quality of life for patients and their caregivers. The program demonstrates a model of training which can be replicated to support health-care providers in rural and remote settings.
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Affiliation(s)
- Christian Mackin
- Department of Family Medicine, Dalhousie University, Halifax, NS, Canada
| | | | - Danielle Downe
- Faculty of Medicine, University of British Columbia, North Vancouver, BC, Canada
- Two Worlds Cancer Collaboration Foundation, North Vancouver, BC, Canada
| | - Megan Doherty
- Two Worlds Cancer Collaboration Foundation, North Vancouver, BC, Canada
- Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- Department of Pediatrics, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
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Emma-Okon B, Tombs M, Akomolafe R, Ayannuga O. Teaching pre-clinical medical students remotely in Nigeria post Covid-19 pandemic: can past experiences shape future directions? BMC MEDICAL EDUCATION 2024; 24:515. [PMID: 38724974 PMCID: PMC11083797 DOI: 10.1186/s12909-024-05508-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 05/02/2024] [Indexed: 05/12/2024]
Abstract
PURPOSE Online teaching has gained popularity in recent years, but changes have been slower to implement in Lower or Medium Income Countries (LMIC). The aim of this research was to build upon educators' experiences of remote teaching during Covid-19 to inform the development of a blended learning approach for teaching pre-clinical subjects at the Faculty of Biomedical Sciences at Obafemi Awolowo University, Ile-Ife, Nigeria (OAU). METHODS The Critical Incident Technique (CIT) was used in this exploratory study. Participants were invited to either complete an online qualitative questionnaire or take part in an online structured interview, which were hosted on Microsoft platforms. Data were obtained from eighteen educators and were analyzed using thematic analysis. RESULTS Findings suggest that most educators (72%) continued to engage with remote teaching post-pandemic. All lab-based practical topics returned to being in-person, and teachers' experiences highlighted that a new blended learning approach should focus on asynchronized online teaching of didactic subjects. Five main themes captured educators' experiences and lessons learned regarding online teaching including: skills and training, teachers' motivation and attitudes, internet and connectivity, learners' behaviors, and socio-economic constraints. CONCLUSION Findings provided additional evidence on the way in which educators in LMIC would like to build upon the positive aspects of online teaching and move towards a blended learning model. However, the implementation of such an approach should consider students' and faculty's needs and socio-economic constraints.
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Affiliation(s)
- Beatrice Emma-Okon
- Faculty of Basic Medical Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Michal Tombs
- Centre for Medical Education, School of Medicine, Cardiff University, Cardiff, UK.
| | - Rufus Akomolafe
- Faculty of Basic Medical Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Olugbenga Ayannuga
- Faculty of Basic Medical Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
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Cassum LA, Lakhani A, Sachwani S, Salim Z, Feroz R, Cassum S. Beyond the classroom walls: Stakeholder experiences with remote instruction in Post RN baccalaureate nursing program during the COVID-19 pandemic: A qualitative inquiry. PLoS One 2024; 19:e0300007. [PMID: 38573927 PMCID: PMC10994296 DOI: 10.1371/journal.pone.0300007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 02/19/2024] [Indexed: 04/06/2024] Open
Abstract
The COVID-19 pandemic led to the closure of educational campuses and the suspension of conventional classroom teaching globally and locally, and many switched overnight to an online modality. The change was experienced differently by varied audiences, given the availability of resources. The study aimed to examine stakeholders' experiences of emergency remote instructions in the Post-RN Baccalaureate Nursing Program during the COVID-19 pandemic. A qualitative descriptive exploratory design with a purposive sampling technique was used at a private nursing university in Karachi, Pakistan. Focus group discussions with students and faculty were conducted separately, while in-depth interviews with key informants were held using semi-structured interview guides. The focus group discussions and in-depth interviews were recorded electronically and transcribed and translated, coded, and analysed manually. Findings uncovered two major themes. (a) Remote teaching and learning-a paradigm shift; and (b) Remote learning ecosystem-a challenging team sport. The first theme denotes a major shift in pedagogical approach migrating from blended learning model to a complete online modality. Theme two uncovers the efforts and teamwork of the various stakeholders who assisted in mitigating the challenges collaboratively when migrating to virtual learning environment. Findings suggest that to continue to thrive in the post-COVID world, faculty, students, and key informants must collegially enhance the teaching, learning, and assessment strategies and student-teacher interaction, capitalising on evidence-based practices, trial and error, multi-level support mechanisms, and partnerships. The study recommends building resilience in instructional and administrative infrastructure to prepare for future events like pandemics and suggests development of evidence-informed blended and online nursing programmes in the region.
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Affiliation(s)
| | - Arusa Lakhani
- Aga Khan University, School of Nursing and Midwifery, Karachi, Pakistan
| | - Saima Sachwani
- Aga Khan University, School of Nursing and Midwifery, Karachi, Pakistan
| | - Zeenar Salim
- Syracuse University, Syracuse, New York, United States of America
| | | | - Shanaz Cassum
- Aga Khan University, School of Nursing and Midwifery, Karachi, Pakistan
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Zarei M, Eftekhari Mamaghani H, Abbasi A, Hosseini MS. Application of artificial intelligence in medical education: A review of benefits, challenges, and solutions. MEDICINA CLÍNICA PRÁCTICA 2024; 7:100422. [DOI: 10.1016/j.mcpsp.2023.100422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
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12
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MacKechnie MC, Miclau E, MacKechnie MA, Miclau T. Leadership development training for orthopaedic trauma surgeons: an international survey. OTA Int 2024; 7:e302. [PMID: 38155733 PMCID: PMC10752451 DOI: 10.1097/oi9.0000000000000302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 08/29/2023] [Accepted: 11/13/2023] [Indexed: 12/30/2023]
Abstract
Purpose This study examined the leadership development themes that global orthopaedic surgeons in differently resourced countries perceive as essential components and evaluated barriers to attending leadership development programs. Methods This multinational, 45-question survey engaged orthopaedic surgeons (one expert per country). The questionnaire collected participants' demographics, perception of effective leadership traits, and valuation of various leadership themes based on importance and interest. Results The survey was completed by 110 orthopaedic surgeons worldwide. Respondents most commonly reported holding a leadership position (87%) in hospital settings (62%), clinical settings (47%), and national orthopaedic societies (46%). The greatest proportion of participants reported having never attended a leadership course (42%). Participants regarded "high performing team-building," "professional ethics," and "organizational structure and ability to lead" as the most important leadership themes. No significant (P ≤ 0.05) differences were identified among perceived importance or interest in leadership themes between income levels; however, statistically significant differences were identified in the questionnaire; respondents in low- and middle-income countries (LICs/LMICs) demonstrated a stronger interest in attending a leadership course than those in high-income countries (HICs) (98% vs. 79%, P = 0.013), and fewer surgeons in LICs/LMICs had taken personality assessment tests than those in HICs (22% vs. 49%, P = 0.019). The most common barriers to attending leadership courses were lack of opportunities and invitations (57%), difficulty missing work (22%), and cost of course attendance (22%). Conclusions These findings can better inform the development of effective curricula and provide a framework for a successful model for the future. Level of Evidence V.
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Affiliation(s)
- Madeline C. MacKechnie
- Department of Orthopaedic Surgery, Orthopaedic Trauma Institute, Institute for Global Orthopaedics and Traumatology, University of California, San Francisco, School of Medicine, Zuckerberg San Francisco General Hospital, San Francisco, CA
| | | | | | - Theodore Miclau
- Department of Orthopaedic Surgery, Orthopaedic Trauma Institute, Institute for Global Orthopaedics and Traumatology, University of California, San Francisco, School of Medicine, Zuckerberg San Francisco General Hospital, San Francisco, CA
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Gerk A, Naus A, Carroll M, Ponte L, Salgado LS, Marrazzo E, Secanho M, Botelho F, Mooney D, Ferreira R, Ferreira JL. Perceived Impact of Coronavirus Disease 2019 on Surgical Training: A Brazilian Survey. J Surg Res 2024; 295:619-630. [PMID: 38101108 DOI: 10.1016/j.jss.2023.10.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 09/22/2023] [Accepted: 10/27/2023] [Indexed: 12/17/2023]
Abstract
INTRODUCTION Recent studies revealed that coronavirus disease 2019 (COVID-19) negatively impacted residency programs worldwide, particularly procedure-based programs. However, most studies are from high-income countries, with scarce data from low- and middle-income countries. Pandemic effects on surgical training were likely worse in strictly apprenticeship models relying heavily on surgical volume as opposed to competency-based programs. Notably, training programs in Brazil and other low- and middle-income countries follow these strict apprenticeship style frameworks. In this study, we aimed to evaluate the trainees' perceptions of the impact of COVID-19 on their Brazilian surgical programs. METHODS A cross-sectional study was performed using an anonymous survey in Portuguese, distributed via social media platforms to surgical residents enrolled in Brazilian surgery programs. Data collection took place from August 2021 to May 2022. The survey contained 30 questions on the perception of the impact of COVID-19 on surgical training. RESULTS One-hundred sixty-two residents from 17 different surgical specialties and all five regions of Brazil responded to the survey. Of 162 residents, 145 (89%) believed the pandemic negatively impacted their surgical training. Furthermore, of 162 residents, 153 (94%) reported that elective surgical volume decreased during the pandemic and 91 (56%) were redeployed to assist with COVID-19 management. As a result, 102 of 162 (63%) residents believed their surgical skills were negatively impacted by COVID-19. Yet, 95 of 162 (59%) residents reported their residency programs did not offer resources to mitigate the pandemic's impact on training. Of 162 residents, 57 (35%) reported they did not feel on track for graduation, with no statistical difference between responses by year of residency (P = 0.083). Additionally, 124 of 162 (77%) residents reported that the pandemic negatively affected their mental health, most commonly related to stress at work, stress about transmitting COVID-19, and loss in surgical training. CONCLUSIONS Most of the surveyed Brazilian surgical residents felt the COVID-19 pandemic negatively impacted their training. This leads to believe that the detrimental impacts of the pandemic exposed preexisting weaknesses in the Brazilian surgical training model's dependence on a strict apprenticeship model. Our findings suggest a crucial need to redesign surgical education programs to make residency programs more prepared for changes in surgical volume, evolve the apprenticeship model to competency-based approaches, and unify surgical training standards in low- and middle-income countries.
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Affiliation(s)
- Ayla Gerk
- Universidad Católica Argentina, Buenos Aires, Argentina; Harvard Medical School, Program in Global Surgery and Social Change, Boston, Massachusetts
| | - Abbie Naus
- Harvard Medical School, Program in Global Surgery and Social Change, Boston, Massachusetts; Boston Children's Hospital, Boston, Massachusetts
| | - Madeleine Carroll
- Harvard Medical School, Program in Global Surgery and Social Change, Boston, Massachusetts
| | - Lucas Ponte
- School of Medicine, University of Fortaleza, Fortaleza, Ceará, Brazil
| | | | - Enzzo Marrazzo
- Faculty of Medicine, Institute of Biological Sciences, Pontifícia Universidade Católica de Minas Gerais Poços de Caldas, Poços de Caldas, Minas Gerais, Brazil
| | - Murilo Secanho
- Faculty of Medical Sciences of Botucatu, UNESP Botucatu, Botucatu, São Paulo, Brazil
| | - Fabio Botelho
- Harvey E. Beardmore Division of Pediatric Surgery, The Montreal Childrens' Hospital, McGill University, Montreal, Quebec, Canada
| | - David Mooney
- Harvard Medical School, Program in Global Surgery and Social Change, Boston, Massachusetts; Boston Children's Hospital, Boston, Massachusetts
| | - Roseanne Ferreira
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Júlia Loyola Ferreira
- Harvey E. Beardmore Division of Pediatric Surgery, The Montreal Childrens' Hospital, McGill University, Montreal, Quebec, Canada.
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Rooks EA, Nayiga J, Rousslang LK, Meldrum JT, Ishikawa K, DeStigter KK, Rooks VJ. A pilot program evaluating WhatsApp as an interactive educational tool for pediatric radiology in Eastern Africa. Pediatr Radiol 2024; 54:400-406. [PMID: 37086289 PMCID: PMC10122084 DOI: 10.1007/s00247-023-05658-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 03/24/2023] [Accepted: 03/27/2023] [Indexed: 04/23/2023]
Abstract
The widespread use of WhatsApp as a communication tool makes it a candidate platform to facilitate the delivery of educational materials to radiology trainees in Eastern Africa. The aim of this pilot program is to assess the novel approach of using WhatsApp as a learning tool in pediatric radiology for residents in Kenya, Rwanda, Tanzania and Uganda. We recruited radiology residents to participate in a 3-month case-based pediatric radiology learning module that was delivered through WhatsApp to personal cell phones. Residents were presented with a multiple choice question once a week. Once they submitted their answer, the correct answer and explanations for each choice were provided. Questionnaires investigated comfort with reading pediatric radiology imaging, perception of the module content and convenience of the approach. Of the 72 participants, 40 (56%) responded to all 12 questions and both questionnaires, of whom 22 (55%) reported little to no comfort before the module and feeling very comfortable after. Confidence decreased with the number of incorrect answers. There was no correlation between the number of correct answers and the year level of the resident. Participants reported that the module was useful for learning pediatric radiology, found the material moderately difficult and found the application convenient for learning. Pediatric radiology educational content delivered over WhatsApp to residents in Eastern Africa is perceived as beneficial and convenient. This interactive learning platform provides opportunities for mentorship and enhanced learning of pediatric radiology.
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Affiliation(s)
- Elizabeth A Rooks
- John A. Burns School of Medicine, University of Hawaii, 651 Ilali Street, Honolulu, HI, 96813, USA.
| | - Joyce Nayiga
- Department of Radiology, Makerere University, Kampala, Uganda
| | - Lee K Rousslang
- Department of Radiology, Tripler Army Medical Center, Honolulu, HI, USA
| | - Jaren T Meldrum
- Department of Radiology, Alaska Native Medical Center, Anchorage, AK, USA
| | - Kyle Ishikawa
- Department of Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA
| | - Kristen K DeStigter
- Department of Radiology, University of Vermont Medical Center, Burlington, VT, USA
| | - V J Rooks
- Department of Radiology, Tripler Army Medical Center, Honolulu, HI, USA
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Kumar D, Mathur M, Sarkar A, Chauhan M. E-classroom as a Blended Learning Tool: A Structural Equation Modelling Analysis Using Modified Technology Acceptance Model. Cureus 2024; 16:e56925. [PMID: 38665756 PMCID: PMC11043220 DOI: 10.7759/cureus.56925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND E-classrooms help teachers save time, keep classes organized, and improve communication with students. This study aims to assess Google Classroom's usefulness in enhancing medical students' knowledge and acceptance of new technology for in-depth learning. MATERIAL AND METHOD This educational interventional study was carried out on 100 students in the 3rd year of the M.B.B.S., Part 1. After a briefing about Google Classroom and educational topics, enrolled students and faculty were allowed to discuss the topic for two months. Following this, the descriptive approach was utilized to describe the respondents' technology acceptance through the administration of the technology acceptance model (TAM) survey questionnaire. RESULTS Students were actively involved in discussion, with a 67% response rate. Nearly 85% of students agreed that Google Classroom is a satisfactory way for in-depth knowledge acquisition. On factor analysis, it was observed that the goodness of fit was 0.985, suggesting that the model is acceptable. It was also found that perceived usefulness (PU) had a significant positive effect on motivation towards self-directed learning (SDL), and perceived ease of use (PEOU) had a positive effect on both behavioural intention and actual use. CONCLUSION Google Classroom is a valuable tool for learning that can enhance active self-learning and increase behavioural intention and actual use. It should be incorporated into day-to-day teaching activities to overcome time constraints.
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Affiliation(s)
- Dilip Kumar
- Community Medicine, Pacific Institute of Medical Sciences (PIMS), Udaipur, IND
| | - Medha Mathur
- Community Medicine, Geetanjali Medical College and Hospital (GMCH), Udaipur, IND
| | - Amrita Sarkar
- Community Medicine, Tomo Riba Institute of Health and Medical Sciences (TRIHMS), Naharlagun, IND
| | - Meet Chauhan
- Community Medicine, Shantabaa Medical College, Amreli, IND
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Meaney PA, Hokororo A, Ndosi H, Dahlen A, Jacob T, Mwanga JR, Kalabamu FS, Joyce CL, Mediratta R, Rozenfeld B, Berg M, Smith ZH, Chami N, Mkopi N, Mwanga C, Diocles E, Agweyu A. Implementing adaptive e-learning for newborn care in Tanzania: an observational study of provider engagement and knowledge gains. BMJ Open 2024; 14:e077834. [PMID: 38309746 PMCID: PMC10840034 DOI: 10.1136/bmjopen-2023-077834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 01/09/2024] [Indexed: 02/05/2024] Open
Abstract
INTRODUCTION To improve healthcare provider knowledge of Tanzanian newborn care guidelines, we developed adaptive Essential and Sick Newborn Care (aESNC), an adaptive e-learning environment. The objectives of this study were to (1) assess implementation success with use of in-person support and nudging strategy and (2) describe baseline provider knowledge and metacognition. METHODS 6-month observational study at one zonal hospital and three health centres in Mwanza, Tanzania. To assess implementation success, we used the Reach, Efficacy, Adoption, Implementation and Maintenance framework and to describe baseline provider knowledge and metacognition we used Howell's conscious-competence model. Additionally, we explored provider characteristics associated with initial learning completion or persistent activity. RESULTS aESNC reached 85% (195/231) of providers: 75 medical, 53 nursing and 21 clinical officers; 110 (56%) were at the zonal hospital and 85 (44%) at health centres. Median clinical experience was 4 years (IQR 1-9) and 45 (23%) had previous in-service training for both newborn essential and sick newborn care. Efficacy was 42% (SD ±17%). Providers averaged 78% (SD ±31%) completion of initial learning and 7% (SD ±11%) of refresher assignments. 130 (67%) providers had ≥1 episode of inactivity >30 day, no episodes were due to lack of internet access. Baseline conscious-competence was 53% (IQR: 38%-63%), unconscious-incompetence 32% (IQR: 23%-42%), conscious-incompetence 7% (IQR: 2%-15%), and unconscious-competence 2% (IQR: 0%-3%). Higher baseline conscious-competence (OR 31.6 (95% CI 5.8 to 183.5)) and being a nursing officer (aOR: 5.6 (95% CI 1.8 to 18.1)), compared with medical officer, were associated with initial learning completion or persistent activity. CONCLUSION aESNC reach was high in a population of frontline providers across diverse levels of care in Tanzania. Use of in-person support and nudging increased reach, initial learning and refresher assignment completion, but refresher assignment completion remains low. Providers were often unaware of knowledge gaps, and lower baseline knowledge may decrease initial learning completion or activity. Further study to identify barriers to adaptive e-learning normalisation is needed.
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Affiliation(s)
- Peter Andrew Meaney
- Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA
- Critical Care, Lucile Salter Packard Children's Hospital at Stanford, Palo Alto, California, USA
| | - Adolfine Hokororo
- Pediatrics and Child Health, Bugando Consultant and Referral Hospital, Mwanza, Tanzania
- Pediatrics and Child Health, Catholic University of Health and Allied Sciences Bugando, Mwanza, Tanzania
| | - Hanston Ndosi
- Pediatrics and Child Health, Catholic University of Health and Allied Sciences Bugando, Mwanza, Tanzania
| | - Alex Dahlen
- New York University Division of Biostatistics, New York, New York, USA
| | | | - Joseph R Mwanga
- Epidemiology, Biostatistics, and Behavioural Sciences School of Public Health, Catholic University of Health and Allied Sciences Bugando, Mwanza, Tanzania
| | | | - Christine Lynn Joyce
- Critical Care, Cornell University Department of Pediatrics, New York, New York, USA
| | - Rishi Mediratta
- Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA
| | | | - Marc Berg
- Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA
- Critical Care, Lucile Salter Packard Children's Hospital at Stanford, Palo Alto, California, USA
| | - Zachary Haines Smith
- Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA
| | - Neema Chami
- Pediatrics and Child Health, Bugando Consultant and Referral Hospital, Mwanza, Tanzania
- Pediatrics and Child Health, Catholic University of Health and Allied Sciences Bugando, Mwanza, Tanzania
| | - Namala Mkopi
- Pediatric Critical Care, Muhimbili National Hospital, Dar es Salaam, Tanzania
| | | | - Enock Diocles
- Nursing, Mwanza College of Health and Allied Sciences, Mwanza, Tanzania
| | - Ambrose Agweyu
- Epidemiology and Demography, KEMRI-Wellcome Trust Research Institute, Nairobi, Kenya
- London School of Hygiene & Tropical Medicine, London, UK
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Zengin D, Uzsen H, Ardahan Sevgili S, Bal Yılmaz H. The effect of COVID-19 fear level on nursing students' attitudes towards E-learning. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024; 34:874-884. [PMID: 36843001 DOI: 10.1080/09603123.2023.2182409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 02/15/2023] [Indexed: 06/18/2023]
Abstract
The COVID-19 pandemic has affected the educational, social, and psychological lives of children and young people. Many countries have transitioned to online education because of the pandemic. This study aimed to examine the levels of fear of nursing students about COVID-19 and their attitudes towards e-learning. This study was designed as a cross-sectional and descriptive study. The data were collected using the COVID-19 Phobia Scale and the Attitude Scale Towards E-learning. This research was conducted with nursing students (n = 301) who received online education due to the COVID-19 pandemic. The students' mean COVID-19 Phobia Scale score was 49.26 ± 15.88; the mean Attitude Scale Towards E-learning score was 59.46 ± 17.00, and a significantly positive relationship was found between the participants' scores on both scales (r = 0.122; p < 0.034). The COVID-19 pandemic has caused students to experience psychological and social problems. It is essential to have sufficient infrastructure to effectively maintain online education.
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Affiliation(s)
- Dilek Zengin
- Department of Pediatric Nursing, Nursing Faculty, Ege University, İzmir, Turkey
| | - Hatice Uzsen
- Department of Pediatric Nursing, Health Sciences Faculty, Ondokuz Mayıs University, Samsun, Turkey
| | | | - Hatice Bal Yılmaz
- Department of Pediatric Nursing, Nursing Faculty, Ege University, İzmir, Turkey
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Faghir Ganji M, Jafari Malvajerd A, Moradi A, Amanollahi A, Ansari-Moghaddam A, Basir Ghafouri H. Teachers and managers experiences of virtual learning during the COVID-19 pandemic: A qualitative study. Heliyon 2024; 10:e24118. [PMID: 38293531 PMCID: PMC10827459 DOI: 10.1016/j.heliyon.2024.e24118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 12/08/2023] [Accepted: 01/03/2024] [Indexed: 02/01/2024] Open
Abstract
The closure of universities and schools interrupted learning outcomes and deprived students from growth and development opportunities as well as hindering their academic progress. Indeed, the COVID-19 Pandemic changed educational mechanism from traditional method to staying at home and virtual education globally. On the other hand, the educators and student particularly in developing countries faced shortage of necessary software and hardware infrastructures. Accordingly, introduction of virtual education along with some organizational and regional obstacles as well as poor planning caused low-quality online courses. Therefore, the present study extrapolated teachers' virtual education experiences during the COVID-19 pandemic. This qualitative study conducted on Iranian teachers using the conventional content analysis method in 2022. To do this, the targeted sampling method with maximum variation continued until data saturation. Hence, a total of 17 teachers (10 women and 7 men) included in the study. Data collected through five focus group discussions on the Sky room platform and two individual in-depth interviews. Male teachers had an average age of 44.42 years, while female ones had an average age of 47.80 years. The qualitative analysis categorized 22 themes as virtual education's pros and cons. Mental, physical, and social injuries; economic problems; insufficient virtual teaching skills; lack of virtual infrastructure; lack of motivation were identified as the main disadvantages of virtual education. Virtual education benefits included familiarity with modern science and education, time management, the durability of video and course topics, and not forcing students to attend class. Removing structural barriers (like creating a good platform for practical education and stopping new restrictive policies) and individual barriers (like economic and family problems, lack of motivation, psychological pressures, and occupational stress) could possibly improve virtual education. Virtual education should be different from face-to-face teaching because it can only meet some students' needs.
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Affiliation(s)
- Monireh Faghir Ganji
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | | | - Ahmad Moradi
- Student Research Committee, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Alireza Amanollahi
- Trauma and Injury Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Alireza Ansari-Moghaddam
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran 6-Department of Emergency Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Hamed Basir Ghafouri
- Trauma and Injury Research Center, Iran University of Medical Sciences, Tehran, Iran
- Department of Emergency Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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Niromand E, Mansoory MS, Ramezani G, Khazaei MR. Design, implementation and evaluation of e-learning program for common diseases to smartphone-based medical students: at a developing university. BMC MEDICAL EDUCATION 2024; 24:52. [PMID: 38200462 PMCID: PMC10782709 DOI: 10.1186/s12909-023-05023-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 12/31/2023] [Indexed: 01/12/2024]
Abstract
OBJECTIVE Mobile-based educational software offers a wealth of resources that can foster the growth of learners and facilitate the creation of an interactive learning environment. This environment encourages both students and instructors to engage in exploration and the examination of various medical issues. The objective of this study is to design, implement, and evaluate an electronic educational program focused on common medical conditions, specifically tailored for medical students and accessible through mobile phones. METHOD The study was conducted following an action research approach, which comprised four key stages: needs assessment, application design, training, and evaluation. This research took place at the Kermanshah University of Medical Sciences' Medical School. In the needs assessment phase, a formal survey was distributed to the teaching faculty members, requesting them to identify diseases and medical issues of high importance for medical interns' education that were suitable for virtual teaching. Each faculty member was asked to prioritize a minimum of three and a maximum of seven cases. Subsequently, 10 faculty members from various departments completed the survey, leading to the identification of 47 common diseases after eliminating duplicates. These 47 cases were then presented to 30 medical interns, who were asked to select the 20 most significant cases. The 20 diseases with the highest statistical frequency were selected for further development due to resource constraints. The mobile application was developed for the Android platform using the Java programming language and the Android Studio development environment. To assess the application's effectiveness from the students' perspective, a questionnaire was designed, encompassing 25 questions across five domains: satisfaction, performance, learning, usability, and educational effectiveness. The questionnaire employed a Likert scale, with response options ranging from 'completely disagree' to 'completely agree,' scored from 1 to 5. One hundred medical interns and trainees were invited to participate in the evaluation, with 92 of them completing the questionnaires. RESULTS The findings revealed a significant disparity in the average scores between students who underwent traditional teaching methods and those who engaged in mobile-based app-assisted education. This discrepancy was statistically significant across all three examined components. CONCLUSION Mobile-based learning represents a burgeoning educational approach with profound implications for healthcare education and the enhancement of patient care quality. The widespread integration of mobile phones into the educational framework offers a flexible teaching paradigm, fostering the potential for continuous lifelong learning.
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Affiliation(s)
- Elham Niromand
- Fertility and Infertility Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, 0000-0001-6406-6779, Iran
| | - Meysam Siyah Mansoory
- Department of Biomedical Engineering, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, 0000-0002-8160-7618, Iran
| | - Ghobad Ramezani
- Education Development Center, Kermanshah University of Medical Sciences, Kermanshah, 0000-0002-8192-5587, Iran
| | - Mohammad Rasool Khazaei
- Fertility and Infertility Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, 000000021965099x, Iran.
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Lynch-Godrei A, Sapkota S, Rowe J, Paudel BD, Aryal G, Doherty M. An Online Pediatric Palliative Care Education and Mentoring (Project ECHO) in Nepal: A Program Implementation Case Study and Assessment of Changes in Healthcare Providers' Knowledge, Confidence, and Attitudes. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2024; 11:23821205241234541. [PMID: 38405367 PMCID: PMC10894557 DOI: 10.1177/23821205241234541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 02/06/2024] [Indexed: 02/27/2024]
Abstract
OBJECTIVES The goal of this implementation study was to describe the implementation and evaluation of the impact of an online pediatric palliative care training program in Nepal, using the Project ECHO model. METHODS The study used mixed methods, including a program case study describing the online learning program and before-and-after surveys of program participants, assessing learning through changes in knowledge, comfort, and attitudes. An end-of-program survey was used to evaluate participants' overall experiences with the learning program and use of the learning resources. RESULTS A literature review, stakeholder surveys, and expert input informed the design of the intervention. The course used the Project ECHO model of online education, with modifications based on the leadership team's previous ECHO experiences and local stakeholder input. The intervention occurred over 9 months, with 22 online teaching sessions. Each session consisted of a didactic lecture, case presentation, and interactive discussion with expert clinical teachers. Fifty-five clinicians in Nepal participated, including physicians (47%), nurses (44%), and psychotherapists (5%). Clinicians reported improvements in knowledge, skills, and attitudes after program participation. Program acceptability scores were high, with 93% of participants reporting that the course provided effective learning. CONCLUSIONS Project ECHO can be successfully implemented to deliver continuing professional development in Nepal. Delivering palliative care education online using the Project ECHO model, leads to improved knowledge, skills, and attitudes for clinicians. Project ECHO suggests an innovative solution which can provide training and support to clinicians in settings where educational opportunities in palliative care are limited.
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Affiliation(s)
- Anisha Lynch-Godrei
- Roger Neilson House, Ottawa, Ontario, Canada
- Department of Medicine, University of Melbourne, Parkville, VIC, Australia
| | | | | | | | - Garima Aryal
- Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Megan Doherty
- Roger Neilson House, Ottawa, Ontario, Canada
- University of Ottawa, Ottawa, Ontario, Canada
- Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
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21
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Little KM, Nwala AA, Demise E, Archie S, Nwokoma EI, Onyezobi C, Anyasi H, Afolabi K, OlaOlorun FM, Rademacher KH, Danna K, Lorenzetti L, Anyanti J, Plotkin M. Use of a hybrid digital training approach for hormonal IUD providers in Nigeria: results from a mixed method study. BMC Health Serv Res 2023; 23:1316. [PMID: 38031098 PMCID: PMC10685471 DOI: 10.1186/s12913-023-10211-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 10/25/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND In Nigeria, in-service trainings for new family planning (FP) methods have typically been conducted using a combination of classroom-based learning, skills labs, and supervised practicums. This mixed-methods study evaluated the feasibility, acceptability, provider competency, and costs associated with a hybrid digital and in-person training model for the hormonal intrauterine device (IUD). METHODS The study was conducted in Enugu, Kano, and Oyo states, Nigeria, and enrolled FP providers previously trained on non-hormonal IUDs. Participants completed a digital didactic training, an in-person model-based practicum with an Objective Structured Clinical Examination (OSCE), followed by supervised provision of service to clients. Provider knowledge gains and clinical competency were assessed and described descriptively. Data on the feasibility, acceptability, and scalability of the approach were gathered from participating providers, clinical supervisors, and key stakeholders. Training costs were captured using an activity-based approach and used to calculate a cost per provider trained. All analyses were descriptive. RESULTS Sixty-two providers took the hybrid digital training, of whom 60 (91%) were included in the study (n = 36 from public sector, n = 15 from private sector, and n = 9 both public/private). The average knowledge score increased from 62 to 86% pre- and post-training. Clinical competency was overall very high (mean: 94%), and all providers achieved certification. Providers liked that the digital training could be done at the time/place of their choosing (84%), was self-paced (79%), and reduced risk of COVID-19 exposure (75%). Clinical supervisors and Ministry of Health stakeholders also had positive impressions of the training and its scalability. The hybrid training package cost $316 per provider trained. CONCLUSIONS We found that a hybrid digital training approach to hormonal IUD service provision in Nigeria was acceptable and feasible. Providers demonstrated increases in knowledge following the training and achieved high levels of clinical competency. Both providers and clinical supervisors felt that the digital training content was of high quality and an acceptable (sometimes preferable) alternative to classroom-based, in-person training. This study provided insights into a hybrid digital training model for a long-acting contraceptive, relevant to scale-up in Nigeria and similar settings.
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Affiliation(s)
- Kristen M Little
- Population Services International (PSI), Strategy and Insights Department, 1120 19th, Street NW, Suite 600, Washington, DC, 20020, USA.
| | - Anthony A Nwala
- Society for Family Health (SFH) Nigeria, RH/FP Division, Abuja, Nigeria
| | - Eden Demise
- Population Services International (PSI), Strategy and Insights Department, 1120 19th, Street NW, Suite 600, Washington, DC, 20020, USA
| | - Samantha Archie
- FHI 360, Health Services Research Department, Durham, NC, USA
| | | | - Chinedu Onyezobi
- Society for Family Health (SFH) Nigeria, RH/FP Division, Abuja, Nigeria
| | - Helen Anyasi
- FHI 360, Product Development and Introduction Department, Abuja, Nigeria
| | - Kayode Afolabi
- Nigeria Federal Ministry of Health, Reproductive Health Division, Abuja, Nigeria
| | - Funmilola M OlaOlorun
- Evidence for Sustainable Human Development Systems in Africa and the Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Kate H Rademacher
- FHI 360, Product Development and Introduction Department, Abuja, Nigeria
| | - Kendal Danna
- PSI, Sexual and Reproductive Health Department, Washington, DC, USA
| | - Lara Lorenzetti
- FHI 360, Behavioral, Epidemiological, and Clinical Sciences Division, Durham, NC, USA
| | - Jennifer Anyanti
- Society for Family Health (SFH) Nigeria, RH/FP Division, Abuja, Nigeria
| | - Marya Plotkin
- FHI 360, Reproductive, Maternal, Newborn, and Child Health Department, Durham, NC, USA
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Kejela E, Tesfaye G, Getachew A, Rose ES, Winful T, Eyayu Z, Martin MH, Sileshi B. Evaluation of Knowledge, Attitudes, and Practice in an Online Faculty Development Course for Anesthesia Educators in East Africa. THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS 2023; 43:274-278. [PMID: 37185663 DOI: 10.1097/ceh.0000000000000493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
INTRODUCTION Faculty in low-resourced communities often have limited training on teaching and learning. An innovative, online, 13-week course using a flipped classroom model was developed for junior faculty anesthesiologists at teaching hospitals in East Africa and piloted in Ethiopia and Tanzania. METHODS Quantitative and qualitative data were collected and analyzed to evaluate potential change in participants' knowledge, skills, and attitudes as well as the feasibility of e-learning in the region. RESULTS Analysis of data revealed that top areas of change in participants' knowledge were in the flipped classroom approach (increased by 79%), effective mentoring practices (67%), and elements of effective course goals and objectives (58%). Leading areas of change in skills were in developing goals and objectives (72%), using case-based learning (67%), and engaging learners through PowerPoint (64%). Change in attitudes was largest in the areas of effective mentoring and strong leadership (27%), using course and lecture learning objectives (26%), and student-centered learning theory (26%). Qualitative data revealed that participants were satisfied with the course; found the structure, presentations, and delivery methods to be effective; and appreciated the flexibility of being online but experienced challenges, particularly in connectivity. DISCUSSION This evaluation demonstrated the efficacy of using e-learning in East Africa and highlights the innovation of online faculty development in a region where it has not been done before. By using participants as future instructors, this course is scalable in the region and worldwide, and it can help address limited access to training by providing a critical mass of trainers competent in teaching, mentoring, and leading.
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Affiliation(s)
- Edosa Kejela
- Dr. Kejela: Assistant Professor, Department of Anesthesiology, Jimma University, Jimma, Ethiopia. Dr. Tesfaye: Assistant Professor, Department of Anesthesiology, Bahir Dar University, Bahir Dar, Ethiopia. Dr. Getachew: Assistant Professor, Department of Anesthesiology, Bahir Dar University, Bahir Dar, Ethiopia. Dr. Rose: Global Health Education Specialist, Vanderbilt University Medical Center, Institute for Global Health, Nashville, Tennessee. Winful: Graduate Student, Department of Anthropology, Vanderbilt University, Nashville, Tennessee. Dr. Eyayu: Assistant Professor, Department of Anesthesiology, Critical Care and Pain Medicine, Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia. Dr. Martin: Associate Professor, Institute for Global Health, Vanderbilt University Medical Center, Nashville, Tennessee. Dr. Sileshi: Associate Professor, Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee
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Mohammed MM, Rashid AA, Abbas AN. Perception and preference of pharmacy students toward e-learning during the COVID-19 pandemic. J Adv Pharm Technol Res 2023; 14:351-355. [PMID: 38107451 PMCID: PMC10723166 DOI: 10.4103/japtr.japtr_101_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 05/01/2023] [Accepted: 07/03/2023] [Indexed: 12/19/2023] Open
Abstract
This study is designed to evaluate students' knowledge and perceptions about the online learning of pharmacy curricula in Iraq during the COVID-19 quarantine. A descriptive, cross-sectional study involving 278 pharmacy students was done between October 2020 and June 2021. About 42.44% preferred face-face lecturers over other modes of delivery for lectures in the pharmacy curriculum. Most participants preferred both active learning and face-face lectures. The results show that 72.66% of responders chose to stay at home as one of the privileges of e-learning. However, the main barriers that associated with e-learning were lack of patient involvement and some technical issues regarding IT equipment, (74.82%) and (62.23%), respectively. E-learning is seen as a lack of social presence, less social contact, and synchronization of connections. However, e-learning undoubtedly benefits students in several ways. Online learning is an essential podium for students to achieve their studies in periods of crisis.
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Krishnan S V, Kunju SA, Nayak SS, Gopinathan V, Sirur FM, Kumara V, Balakrishnan JM. Evaluating the Use of E-Learning in Indian Emergency Medicine Residency Programs During the COVID-19 Pandemic: A National Cross-Sectional Survey. Disaster Med Public Health Prep 2023; 17:e491. [PMID: 37711031 DOI: 10.1017/dmp.2023.146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Abstract
OBJECTIVE The coronavirus disease (COVID-19) pandemic has necessitated e-learning strategies in academic emergency medicine (EM) programs. A study was conducted during the COVID-19 pandemic to understand e-learning in the Indian EM context. METHODS After IEC/IRB approval, we conducted a multicenter national survey validated by experts and underwent multiple reviews by the research team. The final survey was converted into Google Forms for dissemination via email to National Medical Commission (NMC) approved EM residency program as of 2020-2021. Data were exported into Excel format and analyzed. RESULTS Residents and faculty comprised 41.5% and 58.5% of 94 respondents. The COVID-19 pandemic's second wave in India significantly impacted response rates. Internet connectivity was cited as a significant barrier to e-learning, while flexible timings and better engagement were facilitators identified by the survey. The attitude among residents and faculty toward e-learning was also evaluated. CONCLUSION This survey reveals a significant positive shift in medical education from conventional teaching strategies toward e-learning, specifically during the pandemic. It also shows the need for all stakeholders (learners/educators) to better understand e-learning and adapt to its requirements. We need more data on the efficacy of e-learning compared to traditional methods. Until then, innovative hybrid/blended strategies would be the way forward.
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Affiliation(s)
- Vimal Krishnan S
- Department of Emergency Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
- Department of Medical Education, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Sanjan Asanaru Kunju
- Department of Emergency Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
- Department of Emergency Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Sachin Sujir Nayak
- Department of Emergency Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Vivek Gopinathan
- Department of Emergency Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
- Department of Emergency Medicine, Believers Church Medical College Hospital, Thiruvalla, Kerala, India
| | - Freston Marc Sirur
- Department of Emergency Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Vijaya Kumara
- Department of Emergency Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
- Department of Emergency Medicine, Kanachur Institute of Medical Science, Natekal, Mangaluru, Karnataka, India
| | - Jayaraj M Balakrishnan
- Department of Emergency Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
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Carrillo LA, Katyal T, Panchal NN, Sabharwal S. Pediatric Orthopaedic Observerships in North America for International Surgeons: A Qualitative Study Exploring Motivations, Relevance, and Alternate Learning Platforms. J Bone Joint Surg Am 2023; 105:1344-1353. [PMID: 37498985 DOI: 10.2106/jbjs.23.00321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
BACKGROUND Given the growing interest among international surgeons to participate in North American clinical observerships, it is essential to incorporate international surgeons' views to further enhance the program's applicability, value, and accessibility. In this qualitative follow-up study, we explored the motivations, relevance, and opinions about alternate learning platforms among the international surgeons who had participated in a pediatric orthopaedic clinical observership in North America. METHODS Using a semistructured interview guide, international surgeons who had participated in a North American pediatric orthopaedic observership during 2009 to 2019 were interviewed until data saturation and inductive thematic saturation were reached. Twenty-one international surgeons representing 15 different countries (1 from a low-income country, 10 from a lower middle-income country, 8 from an upper middle-income country, and 2 from a high-income country) were interviewed. RESULTS The most commonly cited motivations for doing a clinical observership were to advance clinical training and learn specific skills. The clinical and nonclinical skills gained during the observership, such as utilizing an integrated team approach and open communication style, were helpful to most interviewees; however, several respondents highlighted the critical need to adapt and modify surgical indications, techniques, and skills to suit their local environment and limited resource availability. Although respondents were interested in exploring virtual learning models to save time and expense, several preferred a hybrid model, including access to remote learning opportunities and sharing their own clinical experiences with the North American hosts. CONCLUSIONS Identifying the visiting surgeon's motivation for participation can allow North American hosts to align their clinical exposure more closely with the unique needs and aspirations of the international surgeons and enable a more relevant exchange of clinical and nonclinical skills. Use of a blended learning model, including in-person and virtual learning platforms, and the missed opportunity of having the international surgeons share their clinical experiences and skills with their North American counterparts should be explored further.
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Affiliation(s)
| | - Toshali Katyal
- University of California, San Francisco (UCSF), San Francisco, California
- UCSF Benioff Children's Hospital Oakland, Oakland, California
| | - Niel N Panchal
- University of California, San Francisco (UCSF), San Francisco, California
| | - Sanjeev Sabharwal
- University of California, San Francisco (UCSF), San Francisco, California
- UCSF Benioff Children's Hospital Oakland, Oakland, California
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Khan J, Baatjes KJ, Layman-Lemphane JI, Correia J. Online anatomy education during the Covid-19 pandemic: Opinions of medical, speech therapy, and BSc Anatomy students. ANATOMICAL SCIENCES EDUCATION 2023; 16:892-906. [PMID: 36924347 DOI: 10.1002/ase.2271] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 03/10/2023] [Accepted: 03/14/2023] [Indexed: 06/18/2023]
Abstract
With the emergence of the Covid-19 pandemic in 2020, it was difficult to predict if the "cadaveric-based (golden) standard" of teaching anatomy would be possible in the unforeseeable future. This forced traditional anatomical teaching and learning practices to be transitioned to remote online platforms. This study explored the opinions of anatomy students (n = 51), on their online learning experience of anatomy during the Covid-19 pandemic. A mixed methods approach using a descriptive, exploratory study design was conducted, by use of an online survey. The survey consisted of a six-point Likert scale and was assembled into four sub-categories. Likert scale options ranged from; strongly disagree, to strongly agree, and not applicable. Results obtained seem to tally with expectations, indicating an adequate theoretical course component with room to improve practical online teaching. Most participants had a positive perception of the theoretical course content, duration, and platforms of communication. Virtual classes were simple to navigate with few technical difficulties experienced by the participants. Students also noted having access to sufficient study material, videos, and additional online material. Overall, more than half of all participants reported adapting well to the remote learning environment, however, the greatest challenge experienced highlighted a sense of deprivation from the lack of cadaver exposure and hands-on instruction. This research highlighted the effects of the pandemic on the modality of anatomy education and how it affected students. Although anatomy is multi-modal, it can be concluded that it is possible to achieve academic success by using online learning methods.
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Affiliation(s)
- Johara Khan
- Division of Clinical Anatomy, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Karin J Baatjes
- Dean's Division, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Division of Surgery, Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Jodie I Layman-Lemphane
- Division of Clinical Anatomy, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Janine Correia
- Division of Clinical Anatomy, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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Sharifdini M, Evazalipour M, Hesari Z. Virtual spaced-learning method, during COVID-19 for Pharm D students. BMC MEDICAL EDUCATION 2023; 23:605. [PMID: 37620834 PMCID: PMC10463503 DOI: 10.1186/s12909-023-04595-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 08/16/2023] [Indexed: 08/26/2023]
Abstract
BACKGROUND The coronavirus (COVID-19) outbreak basically changed teaching methods across the world, and learning was almost replaced by virtual learning during the pandemic. Also, the spacing effect is one of the most well-established phenomena in the science of learning. Using temporal intervals for re-exposing learners to information over time (spaced learning) leads to more effective retention of knowledge compared to having information presented at a single time (massed learning). Hence, we designed a virtual spaced learning method to reap the benefits of virtual learning and spaced learning concomitantly. METHODS/APPROACH An interventional semi- experimental survey among 66 Pharm D students was designed and implemented. Students were divided into two groups (spaced vs mass learning) in the national integrated virtual education platform (NAVID) as the matrix for teaching as well as evaluation. Classes were conducted in the following sequence: 1- answering the pre-test, 2- watching and listening to the educational content (separately for each group), 3- answering the post-test (n = 1). The pre/post-test consisted of 10 four-choice questions based on the Kirkpatrick Model extracted from the educational content. RESULTS/OUTCOMES Findings revealed that the average score was not significantly different between the post-tests of the spaced learning and mass learning (7.26 ± 2.26 vs 6.5 ± 2.5) methods utilizing the independent t- test (p ≥ 0.05). CONCLUSIONS Since no statistically significant improvement was observed in the virtual spaced learning group compared to the control group, it seems that clarifying the significant influence of the spaced learning strategy in pharmacy education requires longer period of study, or study on less complex or skill-based topics for further evaluation.
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Affiliation(s)
- Meysam Sharifdini
- Department of Medical Parasitology and Mycology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Mehdi Evazalipour
- Department of Pharmaceutical Biotechnology, School of Pharmacy, Guilan University of Medical Sciences, Rasht, Iran
| | - Zahra Hesari
- Medical Education Research Center, Education Development Center, Guilan University of Medical Sciences, Rasht, Iran.
- Department of Pharmaceutics, School of Pharmacy, Guilan University of Medical Sciences, Rasht, Iran.
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Koto-Shimada K, Carandang RR, Shibanuma A, Kiriya J, Ong KIC, Touch S, Koy V, Jimba M. Understanding competency of nursing students in the course of case-based learning in Cambodia: a convergent mixed method study. BMC Nurs 2023; 22:265. [PMID: 37568231 PMCID: PMC10416455 DOI: 10.1186/s12912-023-01420-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 07/24/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND In the last decade, nursing education has begun to reform to competency-based education worldwide, including in low-and middle-income countries. Case-Based Learning (CBL), an approach to delivering competency-based education, contributes to acquiring critical thinking competency, problem-solving, higher knowledge, professional value and attitude. However, it needs to be taught in a culturally appropriate manner. In Cambodia, CBL was initiated in a classroom and clinical practicum by faculty and preceptors who graduated from the upgrading course. This study examined the factors associated with the competency level of nursing students, explored the practice and perceptions of teaching-learning activities among students, faculty members and preceptors and assessed the coherence of qualitative and quantitative findings. METHODS This was a convergent, mixed methods study. Data were collected from eight educational institutions for quantitative and qualitative studies and seven hospitals for qualitative studies. From June to September 2019, a cross-sectional survey of nursing students in the third year of the three-year programme (n = 719), eight focus group discussions (FGDs; n = 55) with 6-8 members and 15 FGDs with faculty (n = 38) and clinical preceptors (n = 37) with 4-7 members were conducted to elicit the teaching-learning experience and perceptions. Multiple linear regression was performed to investigate the factors associated with student competency. Moreover, the study conducted thematic content analysis on the qualitative data. The integrated analysis was presented as side-by-side joint displays. RESULTS First, the quantitative and qualitative findings confirmed each other 's CBL learning experiences. Students had higher levels of nursing competencies if they had CBL experiences, both in the classroom and clinical practicum, both in a group manner. Next, the quantitative and qualitative findings complemented students' academic satisfaction with the teaching by faculty members and preceptors. Finally, the quantitative and qualitative findings were expanded to explain students' academic satisfaction with the programme. CONCLUSIONS The finding of CBL experiences in a group and students' satisfaction with faculty members' and preceptors' teaching improved nursing students' competency development. Meanwhile, students' satisfaction with the design and delivery of the educational programme provides implications for policy level to narrow the theory and practice gaps in low- and middle-income countries.
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Affiliation(s)
- Kyoko Koto-Shimada
- Department of Community and Global Health, School of International Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyoku, Tokyo, 113-0033 Japan
| | - Rogie Royce Carandang
- Department of Public Health Sciences, University of Connecticut School of Medicine, 263 Farmington Avenue, Farmington, Storrs, Connecticut, 06030-6325 USA
| | - Akira Shibanuma
- Department of Community and Global Health, School of International Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyoku, Tokyo, 113-0033 Japan
| | - Junko Kiriya
- Department of Community and Global Health, School of International Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyoku, Tokyo, 113-0033 Japan
| | - Ken Ing Cherng Ong
- Department of Community and Global Health, School of International Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyoku, Tokyo, 113-0033 Japan
| | - Sokneang Touch
- Department of Human Resource Development, Ministry of Health Cambodia, No:80, Samdach Penh Nouth Blvd (289), Sankat Beoungkak 2, Tuol Kork District, Phnom Penh, Cambodia
| | - Virya Koy
- Department of Hospital Service, Ministry of Health Cambodia, No:80, Samdach Penh Nouth Blvd (289), Sankat Beoungkak 2, Tuol Kork District, Phnom Penh, Cambodia
| | - Masamine Jimba
- Department of Community and Global Health, School of International Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyoku, Tokyo, 113-0033 Japan
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Jensen LX, Buhl A, Hussain S, Karan A, Konradsen F, Bearman M. Digital education for health professionals in India: a scoping review of the research. BMC MEDICAL EDUCATION 2023; 23:561. [PMID: 37559028 PMCID: PMC10410828 DOI: 10.1186/s12909-023-04552-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 07/30/2023] [Indexed: 08/11/2023]
Abstract
BACKGROUND The World Health Organization (WHO) predicts a global shortfall of 18 million health workers by 2030, particularly in low- and middle-income countries like India. The country faces challenges such as inadequate numbers of health professionals, poor quality of personnel, and outdated teaching styles. Digital education may address some of these issues, but there is limited research on what approaches work best in the Indian context. This paper conducts a scoping review of published empirical research related to digital health professions education in India to understand strengths, weaknesses, gaps, and future research opportunities. METHODS We searched four databases using a three-element search string with terms related to digital education, health professions, and India. Data was extracted from 36 included studies that reported on empirical research into digital educational innovations in the formal health professions education system of India. Data were analysed thematically. RESULTS Most study rationales related to challenges facing the Indian health care system, rather than a wish to better understand phenomena related to teaching and learning. Similarly, most studies can be described as general evaluations of digital educational innovations, rather than educational research per se. They mostly explored questions related to student perception and intervention effectiveness, typically in the form of quantitative analysis of survey data or pre- and post-test results. CONCLUSIONS The analysis revealed valuable insights into India-specific needs and challenges. The Indian health professions education system's size and unique challenges present opportunities for more nuanced, context-specific investigations and contributions to the wider digital education field. This, however, would require a broadening of methodological approaches, in particular rigorous qualitative designs, and a focus on addressing research-worthy educational phenomena.
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Affiliation(s)
- Lasse X Jensen
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, Bdg. 9, Copenhagen K, 1353, Denmark.
| | - Alexandra Buhl
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, Bdg. 9, Copenhagen K, 1353, Denmark
| | | | - Anup Karan
- Public Health Foundation of India, New Delhi, India
| | - Flemming Konradsen
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, Bdg. 9, Copenhagen K, 1353, Denmark
- Novo Nordisk Foundation, Copenhagen, Denmark
| | - Margaret Bearman
- Centre for Research in Assessment and Digital Learning, Deakin University, Melbourne, Australia
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Bankar MN, Bankar NJ, Singh BR, Bandre GR, Shelke YP. The Role of E-Content Development in Medical Teaching: How Far Have We Come? Cureus 2023; 15:e43208. [PMID: 37692742 PMCID: PMC10488137 DOI: 10.7759/cureus.43208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 08/09/2023] [Indexed: 09/12/2023] Open
Abstract
With the advancements in technology, medical educators are now able to create and deliver content to students through digital platforms. Electronic content (e-content) development has allowed educators to incorporate multimedia, animations, simulations, and interactive elements which support verbal instruction, such as improved expression and comprehension, into their teaching materials. E-content development is a relatively new field, but it is growing very rapidly. Recent findings have indicated that the e-learning sector will likely experience a huge surge in the upcoming years. The Indian government has launched various initiatives for e-content development in medical education. E-content development has great potential and can be used in various learning scenarios. While it initially gained popularity in higher education, it has since been applied to many other sectors, including healthcare. It allows educators to create highly engaging learning experiences that are accessible by all students. Challenges in e-content development include availability of the internet, creating content that is engaging and relevant to a wide range of learners, and access. Still, it is expected that the use of e-content in medical teaching will continue to increase in the future. The future of e-content development in medical teaching is likely to see continued growth and innovation as technology advances and more educators and learners recognize the benefits of online and digital resources.
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Affiliation(s)
- Maithili N Bankar
- Anatomy, Datta Meghe Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Nandkishor J Bankar
- Microbiology, Jawarhal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Brij Raj Singh
- Anatomy, Datta Meghe Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Gulshan R Bandre
- Microbiology, Jawarhal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Yogendra P Shelke
- Microbiology, Bhaktshreshtha Kamalakarpant Laxman Walawalkar Rural Medical College, Ratnagiri, IND
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Meaney P, Hokororo A, Ndosi H, Dahlen A, Jacob T, Mwanga JR, Kalabamu FS, Joyce C, Mediratta R, Rozenfeld B, Berg M, Smith Z, Chami N, Mkopi NP, Mwanga C, Diocles E, Agweyu A. Feasibility of an Adaptive E-Learning Environment to Improve Provider Proficiency in Essential and Sick Newborn Care in Mwanza, Tanzania. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.07.11.23292406. [PMID: 37502852 PMCID: PMC10370233 DOI: 10.1101/2023.07.11.23292406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Introduction To improve healthcare provider knowledge of Tanzanian newborn care guidelines, we developed adaptive Essential and Sick Newborn Care (aESNC), an adaptive e-learning environment (AEE). The objectives of this study were to 1) assess implementation success with use of in-person support and nudging strategy and 2) describe baseline provider knowledge and metacognition. Methods 6-month observational study at 1 zonal hospital and 3 health centers in Mwanza, Tanzania. To assess implementation success, we used the RE-AIM framework and to describe baseline provider knowledge and metacognition we used Howell's conscious-competence model. Additionally, we explored provider characteristics associated with initial learning completion or persistent activity. Results aESNC reached 85% (195/231) of providers: 75 medical, 53 nursing, and 21 clinical officers; 110 (56%) were at the zonal hospital and 85 (44%) at health centers. Median clinical experience was 4 years [IQR 1,9] and 45 (23%) had previous in-service training for both newborn essential and sick newborn care. Efficacy was 42% (SD±17%). Providers averaged 78% (SD±31%) completion of initial learning and 7%(SD±11%) of refresher assignments. 130 (67%) providers had ≥1 episode of inactivity >30 day, no episodes were due to lack of internet access. Baseline conscious-competence was 53% [IQR:38-63%], unconscious-incompetence 32% [IQR:23-42%], conscious-incompetence 7% [IQR:2-15%], and unconscious-competence 2% [IQR:0-3%]. Higher baseline conscious-competence (OR 31.6 [95%CI:5.8, 183.5) and being a nursing officer (aOR: 5.6 [95%CI:1.8, 18.1]), compared to medical officer) were associated with initial learning completion or persistent activity. Conclusion aESNC reach was high in a population of frontline providers across diverse levels of care in Tanzania. Use of in-person support and nudging increased reach, initial learning, and refresher assignment completion, but refresher assignment completion remains low. Providers were often unaware of knowledge gaps, and lower baseline knowledge may decrease initial learning completion or activity. Further study to identify barriers to adaptive e-learning normalization is needed.
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Affiliation(s)
- Peter Meaney
- Stanford University School of Medicine, Palo Alto, CA
| | - Adolfine Hokororo
- Catholic University of Health and Allied Sciences, Mwanza, Tanzania
- Pediatric Association of Tanzania, Dar Es Salaam, Tanzania
| | - Hanston Ndosi
- Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Alex Dahlen
- Stanford University School of Medicine, Palo Alto, CA
| | | | - Joseph R Mwanga
- Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Florence S Kalabamu
- Pediatric Association of Tanzania, Dar Es Salaam, Tanzania
- Hubert Kairuki Memorial University, Dar es Salaam, Tanzania
| | - Christine Joyce
- Cornell University School of Medicine, New York, New York USA
| | | | | | - Marc Berg
- Stanford University School of Medicine, Palo Alto, CA
- Area9 Lyceum, Boston, Massachusetts, USA
| | - Zack Smith
- Stanford University School of Medicine, Palo Alto, CA
| | - Neema Chami
- Catholic University of Health and Allied Sciences, Mwanza, Tanzania
- Pediatric Association of Tanzania, Dar Es Salaam, Tanzania
| | - Namala P Mkopi
- Pediatric Association of Tanzania, Dar Es Salaam, Tanzania
- Muhimbili National Hospital, Dar es Salaam, Tanzania
| | - Castory Mwanga
- Pediatric Association of Tanzania, Dar Es Salaam, Tanzania
| | - Enock Diocles
- Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Ambrose Agweyu
- KEMRI-Wellcome Trust Research Programme, Kenya
- London School of Hygiene and Tropical Medicine, London, UK
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Brown KE, Flores MJ, MacKechnie MC, Rodarte P, O'Marr J, Shearer DW, Toogood P. Novel e-learning platform for orthopaedic training in LMICs: A descriptive review of the IGOT portal. Surg Open Sci 2023; 13:24-26. [PMID: 37351189 PMCID: PMC10282557 DOI: 10.1016/j.sopen.2023.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 04/08/2023] [Indexed: 06/24/2023] Open
Abstract
Background While e-learning has been written about extensively within the context of orthopaedics in the United States, there are few articles describing e-learning initiatives geared towards low-and middle-income countries (LMICs). The Institute for Global Orthopaedics and Traumatology (IGOT) at the University of California, San Francisco (UCSF) developed the IGOT Learning Portal to meet this need. Methods The IGOT Learning Portal was designed to address knowledge gaps in patient care by increasing access to high-quality orthopaedic education for surgeons and trainees worldwide. It offers 10 distinct, asynchronous courses, which are divided into a modular format. Course enrollment is free and accessible to any surgeon or trainee with a web-browsing capable device and internet connection. Results There are more than 2700 registered users and 300 active learners enrolled in IGOT Learning Portal courses. The Surgical Management and Reconstructive Training (SMART) program is the most commonly taken course. Learners represent 32 different countries across six continents. The IGOT portal also has surgical videos available on YouTube. The IGOT Portal YouTube channel has over 2000 subscribers and over 143,000 total views. Conclusions The IGOT Learning Portal is an innovative approach to address the global disparity in orthopaedic trauma care by improving access to high-quality surgical education for surgeons and trainees both in the US and internationally. The development of an interactive online forum may be a beneficial addition to the Portal. Future directions include assessing content retention, participant interaction, and expanding existing content to other orthopaedic subspecialties.
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Affiliation(s)
| | | | | | | | | | | | - Paul Toogood
- Corresponding author at: 2550 23rd Street, San Francisco, CA 94110, USA.
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Nguyen D, Tupas KD, Thammasitboon S. Evolution of a Continuing Professional Development Program Based on a Community of Practice Model for Health Care Professionals in Resource-Limited Settings. THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS 2023; 44:58-63. [PMID: 37141179 DOI: 10.1097/ceh.0000000000000505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
INTRODUCTION The Baylor International Pediatric AIDS Initiative (BIPAI) Network supports a network of independent nongovernmental organizations providing health care for children and families in low- and middle-income countries (LMIC). Using a community of practice (CoP) framework, a continuing professional development (CPD) program was created for health professionals to enhance knowledge and exchange best practices. METHODS An online learning platform (Moodle), videoconferencing (Zoom), instant messaging systems (Whatsapp), and email listserv facilitated learning and interaction between program participants. Target participants initially included pharmacy staff and expanded to include other health professionals. Learning modules included asynchronous assignments and review of materials, live discussion sessions, and module pretests and posttests. Evaluation included participants' activities, changes in knowledge, and assignment completion. Participants provided feedback on program quality via surveys and interviews. RESULTS Five of 11 participants in Year 1 earned a certificate of completion, and 17 of 45 participants earned a certificate in Year 2. Most modules showed an increase in module pretest and posttest scores. Ninety-seven percent of participants indicated that the relevance and usefulness of modules were good or outstanding. Ongoing evaluation indicated changes in Year 2 for program improvement, and notable outcomes indicated how CoP added value in developing a true community. DISCUSSION Using a CoP framework allowed participants to improve their personal knowledge and become part of a learning community and network of interdisciplinary health care professionals. Lessons learned included expanding program evaluation to capture potential value creation of the community of practice in addition to individual-level development; providing briefer, more focused programs to better serve busy working professionals; and optimizing use of technological platforms to improve participant engagement.
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Affiliation(s)
- Diane Nguyen
- Dr. Nguyen: Director of Global Programs, BIPAI Baylor College of Medicine International Pediatrics AIDS Initiative (BIPAI) at Texas Children's Hospital, and Assistant Professor, Department of Pediatrics Department of Education, Innovation and Technology, Baylor College of Medicine, TX. Dr. Tupas: Assistant Professor of Clinical Sciences, IL. Dr. Thammasitboon: Associate Professor of Pediatrics, Critical Care Medicine Division, Director, Center for Research, Innovation and Scholarship in Medical Education (CRIS), Texas Children's Hospital, Baylor College of Medicine, TX
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Mastour H, Emadzadeh A, Hamidi Haji Abadi O, Niroumand S. Are students performing the same in E-learning and In-person education? An introspective look at learning environments from an Iranian medical school standpoint. BMC MEDICAL EDUCATION 2023; 23:209. [PMID: 37016360 PMCID: PMC10072012 DOI: 10.1186/s12909-023-04159-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 03/14/2023] [Indexed: 06/19/2023]
Abstract
INTRODUCTION This study investigated medical students' intended learning outcomes based on e-learning and in-person education. METHODS In this cross-sectional comparative analytical study, a group of 126 undergraduate medical students' intended learning outcomes under two different teaching methods, including e-learning and in-person, were repeatedly measured based on the census sampling method. Participants were in the preclinical curriculum phase (physiopathology) at Mashhad University of Medical Sciences (MUMS), Iran. Due to expert panel opinion, the same medical teachers and similar difficulty of lessons were considered in two investigated academic semesters. In addition, difficulty and discrimination indexes of formative and summative assessments were controlled for two study groups. The students' learning outcome index was the knowledge test scores participants received in the relevant lessons of the General Medicine (GM) curriculum preclinical courses. RESULTS The findings indicated that students learning outcomes were significantly higher during e-learning than in in-person education for all examined variables (P < 0.05). Moreover, the difference between students' Grade Point Average (GPA) categories among the two groups was significant (P = 0.022). Students with a GPA of less than 14 experienced higher increments in their average scores after the e-learning compared to in-person education. Compared to face-to-face courses, improvements in pharmacology, theoretical semiology, and pathology scores after e-learning courses were statistically significant (P < 0.001). The differences in mean scores related to practical pathology and semiology in the two approaches were not statistically significant, P = 0.624 and P = 0.149, respectively. Furthermore, the overall students' average scores increased significantly during e-learning versus in-person education (P < 0.001). CONCLUSION We concluded that e-learning could be appreciated as a successful method of medical education and can be used as an alternative educational method. However, considering the importance of practical or clinical courses in medical education, further research about the efficacy of the e-learning approach is highly recommended.
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Affiliation(s)
- Haniye Mastour
- Department of Medical Education, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Emadzadeh
- Department of Medical Education, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Shabnam Niroumand
- Department of Community Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Mulu MM, Nyoni CN. Standards for evaluating the quality of undergraduate nursing e-learning programme in low- and middle-income countries: a modified Delphi study. BMC Nurs 2023; 22:73. [PMID: 36935508 PMCID: PMC10025059 DOI: 10.1186/s12912-023-01235-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 03/06/2023] [Indexed: 03/21/2023] Open
Abstract
BACKGROUND The lack of standards for evaluating the quality of undergraduate nursing programmes hampers the evaluation of e-learning programmes in low- and middle-income countries. Fragmented approaches to evaluation coupled with a lack of uniform criteria have been a major deterrent to the growth of e-learning. Adopting standards from high-income countries has contextual challenges in low- and middle-income countries (LMICs). Holistic approaches coupled with uniform standards provide information to stakeholders hence the quality of the programmes is measurable. The e-learning situation in low-and middle-income countries provided an impetus to develop and validate these standards. DESIGN A modified Delphi technique. REVIEW METHODS Fourteen experts with experience and expertise in e-learning and regulation of undergraduate nursing from fourteen countries from LMICs participated in three rounds of the modified Delphi process. A pre-described set of standards was shared electronically for independent and blinded ratings. An 80% threshold was set for consensus decisions. The standards were modified based on experts' comments, and two subsequent rounds were used to refine the standards and criteria. RESULTS At the end of round one, the expert consensus was to keep 67, modify 39 and remove three criteria. At the end of the second round, the consensus was to modify 38 and remove one criteria. In the third round, experts agreed that the standards were feasible, usable, and practical in LMICs. A total of six broad standards with 104 criteria were developed. CONCLUSION The Technological bloom permeating all spheres of society, including education is an essential component in the development of e-learning programmes. E-learning in nursing education requires critical evaluation to ensure quality in undergraduate nursing programmes. The intricacies of the Low and middle-income context were taken into consideration in developing the standards to offer sustainable evaluation of the quality of e-learning in LMICs, and local solutions to local problems.
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Affiliation(s)
- Moses Mutua Mulu
- School of Nursing, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa.
| | - Champion N Nyoni
- School of Nursing, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
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García-Serna J, Almeida-Huanca G, Huarcaya-Victoria J, Vilela-Estrada AL, Zafra-Tanaka JH, Villarreal-Zegarra D. Characteristics of undergraduate and second speciality mental health programmes in Peru: a cross-sectional study. HUMAN RESOURCES FOR HEALTH 2023; 21:16. [PMID: 36859351 PMCID: PMC9979569 DOI: 10.1186/s12960-023-00805-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 02/15/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND This study aims to describe the training offered and the availability of professionals required by the Ministry of Health for mental health problems management in the community. METHODS A cross-sectional study was carried out on the training offered in mental health in Peruvian universities. A search for programs was conducted using the University Information System database and universities' websites, as well as using the Ministry of Health's database on health personnel and data on the number of enrolled and current students provided by the University Information System database and the Transparency section of the universities. RESULTS There were 214 undergraduate, 55 specialty and 7 subspecialty programmes, of which 39%, 47% and 100%, respectively, were offered in the capital city. The duration ranged from 5 to 7 years for undergraduate programs and from 1 to 3 years for subspecialty and second specialty programs. The cost of undergraduate programs ranged from free of charge up to USD 6863.75 for the first semester of study. Second specialty programs ranged from 720 up to 11 986 USD and subspecialty programs ranged from 2267 up to 9138 USD, with medicine being the most expensive. On the other hand, there are a greater number of psychology students (n = 78 781) pursuing undergraduate studies than working professionals (n = 5368), while in the second specialty of psychiatry there are far fewer students pursuing the specialty (n = 67) than working professionals (n = 454). CONCLUSIONS The problem of professional training in mental health requires that the institutions involved in health and education develop policies to decentralize programs, communicate the demand for professionals in certain areas, make them accessible to the low-income population, respond to mental health problems and guarantee their quality. On the other hand, regarding the low number of mental health personnel working, it is suggested to increase the mental health budget to generate more mental health services and employment.
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Affiliation(s)
| | | | - Jeff Huarcaya-Victoria
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Filial Ica, Ica, Peru
- Unidad de Psiquiatría de Enlace, Departamento de Psiquiatría, Hospital Nacional Guillermo Almenara Irigoyen, EsSalud, Lima, Peru
| | | | | | - David Villarreal-Zegarra
- Instituto Peruano de Orientación Psicológica, Lima, Peru
- South American Center for Education and Research in Public Health, Universidad Privada Norbert Wiener, Lima, Peru
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Jaffry Z, Sabawo M, Harrison WJ, Schade AT. Using a consensus meeting to enhance fracture care education in low income countries. BMC MEDICAL EDUCATION 2023; 23:111. [PMID: 36793036 PMCID: PMC9930265 DOI: 10.1186/s12909-023-04077-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 02/01/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND A key strategy to building surgical capacity in low income countries involves training care providers, particularly in the interventions highlighted by the Lancet Commission for Global Surgery, including the management of open fractures. This is a common injury, especially in areas with a high incidence of road traffic incidents. The aim of this study was to use a nominal group consensus method to design a course on open fracture management for clinical officers in Malawi. METHODS The nominal group meeting was held over two days, including clinical officers and surgeons from Malawi and the UK with various levels of expertise in the fields of global surgery, orthopaedics and education. The group was posed with questions on course content, delivery and evaluation. Each participant was encouraged to suggest an answer and the advantages and disadvantages of each suggestion were discussed before voting through an anonymous online platform. Voting included use of a Likert scale or ranking available options. Ethical approval for this process was obtained from the College of Medicine Research and Ethics Committee Malawi and the Liverpool School of Tropical Medicine. RESULTS All suggested course topics received an average score of greater than 8 out of 10 on a Likert scale and were included in the final programme. Videos was the highest ranking option as a method for delivering pre-course material. The highest ranking methods for each course topic included lectures, videos and practicals. When asked what practical skill should be tested at the end of the course, the highest ranking option was "initial assessment". CONCLUSION This work outlines how a consensus meeting can be used to design an educational intervention to improve patient care and outcomes. Through combining the perspectives of both the trainer and trainee, the course aligns both agendas so that it is relevant and sustainable.
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Affiliation(s)
| | | | - William J Harrison
- Countess of Chester Hospital NHS Trust, London, UK
- AO Alliance Africa, Davos, Switzerland
| | - Alexander T Schade
- Malawi- Liverpool Wellcome Trust, Blantyre, Malawi.
- Liverpool School of Tropical Medicine, Liverpool, UK.
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Mutua MM, Nyoni CN. Undergraduate e-learning programmes in health professions: An integrative review of evaluation standards in low- and middle-income countries. PLoS One 2023; 18:e0281586. [PMID: 36780488 PMCID: PMC9925085 DOI: 10.1371/journal.pone.0281586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 01/26/2023] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND Before the Coronavirus COVID-19, universities offered blended learning as a mode of study. However, with the closure of all educational institutions, after the pandemic, most of these institutions were required to transition to e-learning to support continuous student learning. This transition was challenging to most institutions, as there were no standards to ensure the quality of e-learning. During this literature review, the researcher aimed to explore relevant literature and provide insight into the standards for undergraduate e-learning programmes in the health professions. DESIGN An integrative review of literature. DATA SOURCES Online databases MEDLINE, CINAHL with full text, Academic search ultimate, APA PsycInfo, ERIC, Health Source: Nursing/academic edition, CAB abstracts, Africa-wide information, Sociology source ultimate, and Communication and Mass media complete were searched. MATERIALS AND METHODS Studies pertaining to low- and middle-income countries (LMICs) on standards in evaluating undergraduate e-learning programmes in health professions, published between January 2010 to June 2022, were considered. A two-step process was followed involving three reviewers and guided by an inclusion criteria focused on the evaluation of undergraduate e-learning programmes in the health professions. The initial hit produced 610 articles altogether, and eight articles that met the inclusion criteria were included in the study. Data was then extracted and analysed, and key themes were identified. RESULTS Eight Key themes related to LMIC standards emerged from the eight selected articles: curriculum planning, proficiency of educators, learner proficiency and attitude, infrastructure for learning, support and evaluation. CONCLUSION In this review, we synthesised standards that have been used for evaluating undergraduate e-learning programmes in health professions in LMICs. A gap in standards related to clinical teaching and learning in undergraduate e-learning programmes in the health professions was evident from all the included articles. The identification of the eight unique LMIC standards in this review could contribute to guiding towards contextually appropriate quality e-learning programmes in the health professions.
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Affiliation(s)
- Moses M. Mutua
- Faculty of Health Sciences, School of Nursing, University of the Free State, Bloemfontein, South Africa
- * E-mail:
| | - Champion N. Nyoni
- Faculty of Health Sciences, School of Nursing, University of the Free State, Bloemfontein, South Africa
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Ayoubieh H, Alkhalili E, Nino D, Coue M, Herber-Valdez C, Pfarr CM. Analysis of Pre-clerkship Medical Students' Perceptions and Performance During the COVID-19 Pandemic. MEDICAL SCIENCE EDUCATOR 2023; 33:147-156. [PMID: 36688011 PMCID: PMC9838249 DOI: 10.1007/s40670-022-01723-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 12/16/2022] [Indexed: 06/17/2023]
Abstract
PURPOSE Virtual instruction became the primary educational delivery method for pre-clerkship medical students during the COVID-19 pandemic. The aims of this study were to evaluate the effectiveness of a virtual and blended pre-clerkship curriculum and to assess its impact on students. METHODS We surveyed 223 1st- and 2nd-year medical students (MS1s and MS2s) enrolled at the Paul L Foster School of Medicine. We analyzed student satisfaction with their courses, along with summative exam scores, compared to previous academic years. RESULTS The survey was completed by 125 of 223 students (56%). Most students changed their study methods (78%), experienced technical issues (85%), and had difficulty communicating with faculty (62%). MS1s were significantly more likely than MS2s to report difficulty in adjusting to virtual instruction (p = 0.037) and a negative impact on their learning skills (p = 0.005) and academic performance (p = 0.003). Students reported the virtual environment negatively affected their social skills (77%), connectedness to peers (89%), and professional development (62%). MS1s were more likely than MS2s to perceive a negative effect on their sense of wellness (p = 0.002). The overall satisfaction with the courses was similar to previous academic years. Student performance in the summative examination of the first virtually delivered unit was lower (p = 0.007) than the previous year's cohorts. CONCLUSION The difference in MS1s and MS2s perceptions of virtual and blended instruction highlights the importance of face-to-face learning during the first year. Benefits and drawbacks were identified which may help inform educators when designing future learning models. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s40670-022-01723-6.
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Affiliation(s)
- Houriya Ayoubieh
- Department of Medical Education, Paul L Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX USA
| | - Eyas Alkhalili
- Department of Surgery, Paul L Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX USA
| | - Diego Nino
- Department of Medical Education, Florida International University, Miami, FL USA
| | - Martine Coue
- Department of Medical Education, Paul L Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX USA
| | - Christiane Herber-Valdez
- Department of Medical Education, Paul L Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX USA
| | - Curt M. Pfarr
- Department of Medical Education, Paul L Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX USA
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von Grünigen S, Dessane B, Le Pape P, Falaschi L, Geissbühler A, Bonnabry P. Development and Evaluation of an e-Learning Module for Low- and Middle-Income Countries on the Safe Handling of Chemotherapy Drugs. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2023; 38:285-291. [PMID: 34791602 PMCID: PMC9852134 DOI: 10.1007/s13187-021-02113-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 10/28/2021] [Indexed: 06/13/2023]
Abstract
Despite the growing use of chemotherapy drugs in resource-constrained settings, training opportunities on safe handling practices are lacking. This study's objectives were to develop and evaluate an e-learning training module on the safe handling of chemotherapy drugs to strengthen knowledge and practices in low- and middle-income countries (LMICs). The module's curriculum was developed using the Six-Step Approach for Curriculum Development for Medical Education. Asynchronous, self-paced, e-learning lessons within the module were created and uploaded onto a free online platform, Pharm-Ed. The study ran online from January to April 2021. Participant recruitment was done using convenience sampling through various channels (social media, communities of practice). Training module effectiveness was evaluated using knowledge assessments (a pre-test and post-test study design) and participant satisfaction. We developed a comprehensive e-learning module on the safe handling of chemotherapy drugs comprising 11 asynchronous, self-paced, e-learning lessons. Eighty-two participants (68% pharmacists and 17% pharmacy students) from 17 countries completed at least one lesson, with a total of 259 lessons completed. Evaluation of the different lessons showed significant improvements in theoretical knowledge (p < 0.01) in all except one lesson and a high degree of participant satisfaction. As the use of anti-cancer drugs in LMICs will continue to increase, this e-learning module is an effective means to address the lack of training opportunities on the safe handling of chemotherapies for healthcare workers in these countries. The module could be integrated into a multi-modal approach aimed at reducing occupational exposure and increasing patient safety in cancer care centers.
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Affiliation(s)
- Sandrine von Grünigen
- Pharmacy, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland.
- Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
| | - Berangère Dessane
- Pharmacy, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland
| | - Pauline Le Pape
- Pharmacy, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland
| | - Ludivine Falaschi
- Pharmacy, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland
| | - Antoine Geissbühler
- HI5lab, Department of Radiology and Medical Informatics, University of Geneva, Geneva, Switzerland
- Division of eHealth and Telemedicine, Geneva University Hospitals, Geneva, Switzerland
| | - Pascal Bonnabry
- Pharmacy, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland
- Institute of Pharmaceutical Sciences of Western Switzerland, School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland
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Dawidziuk A, Miller G, Malawana J. Visualisation Approaches in Technology-Enhanced Medical Simulation Learning: Current Evidence and Future Directions. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1421:175-190. [PMID: 37524988 DOI: 10.1007/978-3-031-30379-1_8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/02/2023]
Abstract
Technology-enhanced learning (TEL) has been proposed as an approach to minimise the healthcare workforce shortage preventing universal healthcare coverage. Simulation-based medical education is a well-established teaching method. Little is known about effective strategies to translate in-person medical simulation teaching into a virtual world. This work aimed to review the literature on approaches to visualisation in technology-enhanced medical simulation. A systematic search strategy was optimised using three databases: Embase, MEDLINE, and APA PsycInfo. Additional papers were identified through cross-referencing. The last date of this search was 3 January 2022. The articles were analysed qualitatively. The risk of bias was assessed using ROBINS-I and RoB 2 tools. The search yielded 656 results with 9 additional papers identified through cross-referencing. Following deduplication and exclusions, 23 articles were included in a qualitative synthesis of evidence. Offline and online computer-based modules with virtual patient cases or practical skills simulations were identified as the most prevalent clinical simulation teaching modalities. Visualisation approaches included text, images, animations, videos, and 3D environments. Significant heterogeneity of study designs with a moderate risk of bias was established. Based on the current data, the virtual patient scenarios should use natural language input interfaces enriched with video and voice recordings, 3D animations, and short text descriptions to make the patient management experience more lifelike and increase knowledge retention. However, there is no agreed framework for assessing the pedagogical value of these innovations. High-quality randomised controlled trials of TEL-based clinical simulation are essential to advance the field.
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Affiliation(s)
- Aleksander Dawidziuk
- The Healthcare Leadership Academy Research Collaborative, London, UK
- Royal Free London NHS Foundation Trust, London, UK
| | - George Miller
- The Healthcare Leadership Academy Research Collaborative, London, UK
- University of Central Lancashire, Preston, UK
| | - Johann Malawana
- The Healthcare Leadership Academy Research Collaborative, London, UK.
- University of Central Lancashire, Preston, UK.
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Alayande BT, Hughes Z, Fitzgerald TN, Riviello R, Bekele A, Rice HE. With equity in mind: Evaluating an interactive hybrid global surgery course for cross-site interdisciplinary learners. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001778. [PMID: 37141197 PMCID: PMC10159197 DOI: 10.1371/journal.pgph.0001778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 04/12/2023] [Indexed: 05/05/2023]
Abstract
There is limited understanding of the role of transcultural, cross-site educational partnerships for global surgery training between high- and low- or middle-income country (LMIC) institutions. We describe the development, delivery, and appraisal of a hybrid, synchronous, semester-long Global Surgical Care course by global health collaborators from widely different contexts, and evaluate the equity of the collaboration. The course was collaboratively modified by surgical educators and public health professionals with emphasis on collaboration ethics. Faculty from high-income and LMICs were paired to deliver lectures. To collaborate internationally, students and faculty participated either onsite or online. Perceptions and knowledge gained were quantitatively evaluated through participant and faculty cross-sectional surveys, using Likert scales, prioritization rankings, and free text responses analysed qualitatively. Equity was assessed using the Fair Trade Learning rubric and additional probes. Thirty-five learners from six institutions participated. Teams produced mock National, Surgical, Obstetric, and Anaesthesia Plans (NSOAPs) for selected LMICs, and reported a 9% to 65% increase in self-reported global health competencies following the course. Online learners had favourable perceptions of learning, but experienced connectivity challenges. Barriers to effective group work included time differences and logistics of communication for dispersed team members. Individuals taking the course for academic credit scored significantly higher than other learners in peer assessments of participation (8.56±1.53 versus 5.03±3.14; p<0.001). Using the Fair Trade Rubric, 60% of equity indicators were ideal, and no respondents perceived neo-colonialism in the partnership. Blended, synchronous, interdisciplinary global surgery courses based on "North-South" partnerships with a focus on equity in design and delivery are feasible but require careful and deliberate planning to minimize epistemic injustice. Such programs should address surgical systems strengthening, and not create dependency. Equity in such engagements should be evaluated and monitored in an ongoing fashion to stimulate discussion and continuous improvement.
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Affiliation(s)
- Barnabas Tobi Alayande
- Center for Equity in Global Surgery, University of Global Health Equity, Kigali, Rwanda
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Zoe Hughes
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
| | - Tamara N Fitzgerald
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
- Duke University School of Medicine, Duke University, Durham, North Carolina, United States of America
| | - Robert Riviello
- Center for Equity in Global Surgery, University of Global Health Equity, Kigali, Rwanda
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts, United States of America
- Brigham and Women's Hospital, Boston, Massachusetts, United States of America
| | - Abebe Bekele
- Center for Equity in Global Surgery, University of Global Health Equity, Kigali, Rwanda
| | - Henry E Rice
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
- Duke University School of Medicine, Duke University, Durham, North Carolina, United States of America
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Hortsch M, Koney NKK, Oommen AM, Yohannan DG, Li Y, de Melo Leite ACR, Girão-Carmona VCC. Virtual Microscopy Goes Global: The Images Are Virtual and the Problems Are Real. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1421:79-124. [PMID: 37524985 DOI: 10.1007/978-3-031-30379-1_5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/02/2023]
Abstract
For the last two centuries, the scholarly education of histology and pathology has been based on technology, initially on the availability of low-cost, high-quality light microscopes, and more recently on the introduction of computers and e-learning approaches to biomedical education. Consequently, virtual microscopy (VM) is replacing glass slides and the traditional light microscope as the main instruments of instruction in histology and pathology laboratories. However, as with most educational changes, there are advantages and disadvantages associated with a new technology. The use of VM for the teaching of histology and pathology requires an extensive infrastructure and the availability of computing devices to all learners, both posing a considerable financial strain on schools and students. Furthermore, there may be valid reasons for practicing healthcare professionals to maintain competency in using light microscopes. In addition, some educators may be reluctant to embrace new technologies. These are some of the reasons why the introduction of VM as an integral part of histology and pathology instruction has been globally uneven. This paper compares the teaching of histology and pathology using traditional or VM in five different countries and their adjacent regions, representing developed, as well as developing areas of the globe. We identify general and local roadblocks to the introduction of this still-emerging didactic technology and outline solutions for overcoming these barriers.
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Affiliation(s)
- Michael Hortsch
- Departments of Cell and Developmental Biology and of Learning Health Sciences, University of Michigan, Ann Arbor, MI, USA.
| | - Nii Koney-Kwaku Koney
- Department of Anatomy, University of Ghana Medical School, University of Ghana, Korle Bu, Accra, Ghana
| | - Aswathy Maria Oommen
- Government Medical College Thiruvananthapuram, Thiruvananthapuram, Kerala, India
- Kerala University of Health Sciences, Thrissur, Kerala, India
| | - Doris George Yohannan
- Government Medical College Thiruvananthapuram, Thiruvananthapuram, Kerala, India
- Kerala University of Health Sciences, Thrissur, Kerala, India
| | - Yan Li
- Department of Anatomy, Histology and Embryology, Fudan University, Shanghai, China
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Bälter K, Javan Abraham F, Mutimukwe C, Mugisha R, Persson Osowski C, Bälter O. A Web-Based Program About Sustainable Development Goals Focusing on Digital Learning, Digital Health Literacy, and Nutrition for Professional Development in Ethiopia and Rwanda: Development of a Pedagogical Method. JMIR Form Res 2022; 6:e36585. [DOI: 10.2196/36585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 05/31/2022] [Accepted: 07/01/2022] [Indexed: 12/07/2022] Open
Abstract
Background
East African countries face significant societal challenges related to sustainable development goals but have limited resources to address these problems, including a shortage of nutrition experts and health care workers, limited access to physical and digital infrastructure, and a shortage of advanced educational programs and continuing professional development.
Objective
This study aimed to develop a web-based program for sustainable development with a focus on digital learning, digital health literacy, and child nutrition, targeting government officials and decision-makers at nongovernmental organizations (NGOs) in Ethiopia and Rwanda.
Methods
A web-based program—OneLearns (Online Education for Leaders in Nutrition and Sustainability)—uses a question-based learning methodology. This is a research-based pedagogical method developed within the open learning initiative at Carnegie Mellon University, United States. Participants were recruited during the fall of 2020 from ministries of health, education, and agriculture and NGOs that have public health, nutrition, and education in their missions. The program was conducted during the spring of 2021.
Results
Of the 70 applicants, 25 (36%) were selected and remained active throughout the entire program and filled out a pre- and postassessment questionnaire. After the program, of the 25 applicants, 20 (80%, 95% CI 64%-96%) participants reported that their capacity to drive change related to the sustainable development goals as well as child nutrition in their organizations had increased to large extent or to a very large extent. Furthermore, 17 (68%, 95% CI 50%-86%) and 18 (72%, 95% CI 54%-90%) participants reported that their capacity to drive change related to digital health literacy and digital learning had increased to a large extent and to a very large extent, respectively.
Conclusions
Digital learning based on a question-based learning methodology was perceived as a useful method for increasing the capacity to drive change regarding sustainable development among government officials and decision-makers at NGOs in Ethiopia and Rwanda.
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Negm AS, Elhatw A, Badawy M, Gioe ML, Khan S, Hammad MF, Shalaby N, Choucair F, Saad MA, Elfeel A, Elbatal M, Saenz F, Shehata MA, Patel P, Aly M, Khalifa I, Kamel S, ElHefnawi Y, Fahmy MI, Rohren S, Hussein MY, Elsaiey A, Zitoun O, Elsayes KM. Effectiveness of virtual teaching of diagnostic and interventional imaging fundamentals to Egyptian medical students: an analytical cross-sectional study. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2022. [PMCID: PMC8744395 DOI: 10.1186/s43055-021-00688-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
There is a worldwide deficit in teaching and training in the field of radiology for undergraduate medical students. This educational gap is prominent in many medical schools as most radiology curricula are a part of other specialty trainings, usually provided by non-radiologists. After COVID-19 pandemic, there was an increased trend in online education. However, questions have been raised about the efficacy and acceptance of online education. We developed a course on the principles of radiology and medical imaging basics to target Egyptian medical students. We then assessed the impact of these educational videos through several online surveys. Our "The Principles of Radiology Online Course" was delivered to students at various Egyptian medical schools; it was a prerecorded series composed of nine sessions, and each session followed the sequence of a pre-test, video, and post-test. There was a final survey to assess the overall feedback. Finally, we analyzed the results to give insight onto how teaching radiology through online lectures can help build better physicians.
Results
Among various medical schools around Egypt, 1396 Egyptian medical students joined this cohort. Cohort population percentage was 56% female and 44% male. Ninety-eight percent of the students agreed that this program increased their understanding of radiology. Eighty-four percent of the students found the platform friendly and easy to use. Seventy-nine percent found these webinars were more convenient compared to in-person education. Statistical significance (p-value < 0.05) was achieved in all sessions after comparing students’ pre and post-test scores, and in students’ confidence and knowledge level before and after the course.
Conclusions
Radiology is an underrepresented subject for a lot of medical students. Online radiology webinars have proven to be a promising method of teaching medical students key medical imaging concepts. An online course of radiology basics and principles can help improve a medical student’s knowledge and enhance overall future patient care.
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Do TX, Tran HTL, Le TT. Factors influencing the E-learning system usage during the COVID-19 pandemic in Vietnam. PLoS One 2022; 17:e0278109. [PMID: 36454966 PMCID: PMC9714881 DOI: 10.1371/journal.pone.0278109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 11/10/2022] [Indexed: 12/03/2022] Open
Abstract
The outbreak of the COVID-19 pandemic has brought forward an unprecedented situation, which has forced the educational institutes worldwide to use a propriety "online only" model for teaching and learning. Teachers have been compelled to deliver lectures online using some form of an online delivery platform. In this dilemma situation with the closure of the educational institutes, one of the very basic necessities is to ensure quality features of e-learning systems that are being used for the purpose of education delivery, particularly from the students' perspective. The objective of this study was to identify factors affecting pharmacy students' satisfaction in Vietnam during the COVID 19 pandemic. A cross-sectional survey of a consecutive sample of 1612 valid responses from students who have been in distance learning at Hanoi University of Pharmacy has been conducted. An integrated model with three main dimensions had been developed: learner's characteristics; instructor's characteristics; system, and technology. Data were collected in the field on both online and offline platforms using the questionnaire of 39 items to investigate the critical factors affecting learners' satisfaction in e-learning. The reliability of the questionnaire was measured using Cronbach's alpha on this data. Descriptive statistics, factor analysis, and multiple regression analysis were employed for data analysis. Out of 2491 questionnaires distributed, 1612 questionnaires were completed (respond rate 64.7%). The results revealed that perceived usefulness, perceived ease of use, system and technical dimension and instructors' characteristics are the critical factors affecting learners' perceived satisfaction. The perceived usefulness of the students was the most important factor affecting overall satisfaction (beta coefficient = 0.610). Multiple regression analysis yielded the four main factors explaining 59.9% of total satisfaction. The findings revealed how to improve learners' satisfaction and further strengthen their e-learning implementation. The interventional solutions on students' characteristics, instructors' characteristics and system & technical dimension should be considered and implemented to improve the quality of e-learning and students' satisfaction at Hanoi University of Pharmacy.
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Affiliation(s)
- Thang Xuân Do
- Department of Pharmacoeconomic and Administration, Hanoi University of Pharmacy, Hanoi, Vietnam
- * E-mail:
| | - Huong Thi Lan Tran
- Department of Pharmacoeconomic and Administration, Hanoi University of Pharmacy, Hanoi, Vietnam
| | - Thuy Thu Le
- Department of Pharmacoeconomic and Administration, Hanoi University of Pharmacy, Hanoi, Vietnam
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Hasan S, Zubaidi HA, Saidawi W. Assessing Pharmacy Student Performance and Perceptions on Counseling Skills Through a Simulated Telehealth Encounter. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2022; 86:8619. [PMID: 34507953 PMCID: PMC10159465 DOI: 10.5688/ajpe8619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 09/03/2021] [Indexed: 05/06/2023]
Abstract
Objective. To describe the implementation of a teleconferencing-based patient counseling role play assessment in a newly developed pharmacy communications course, assess student performance on the role play and compare it with other assessments, and measure student perceptions of and satisfaction with the experience.Methods. Eighteen cases were developed, each belonging to one of three interactions in community pharmacy: filling a new prescription, completing a refill, or handling a request for a nonprescription (ie, over-the-counter [OTC]) medication. A rubric was designed to evaluate each type of interaction. Student scores in various course assessments were tested and scores on the three cases were compared. Students also evaluated their experience and satisfaction of the assessment and effectiveness of the course.Results. Seventy-nine students completed the assessment, achieving a mean score of 17.4/20 (87%). Student scores in the counseling role play were similar among case types and positively correlated with other traditional assessments in the course. Despite internet connectivity issues and heightened student anxiety, 71% of students agreed that the assessment did not affect the quality of their counseling, and 74% agreed that the experience was comparable to traditional assessments. The telehealth activity led to enhanced perceived student knowledge and confidence in interviewing and counseling patients.Conclusion. Students attained high scores that were consistent with other assessments in the course. Students reported that the assessment did not affect the quality of their counseling and felt the setting and context were still authentic. The experience required dedicated preparation and organization but was successful in demonstrating overall student satisfaction and positive perceptions.
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Affiliation(s)
- Sanah Hasan
- Ajman University, Center of Medical and Bio-allied Health Sciences, College of Pharmacy and Health Sciences, Ajman, United Arab Emirates
| | - Hamzah Al Zubaidi
- University of Sharjah, College of Pharmacy, Sharjah, United Arab Emirates
| | - Ward Saidawi
- University of Sharjah, College of Pharmacy, Sharjah, United Arab Emirates
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Uchitel J, Alden E, Bhutta ZA, Cavallera V, Lucas J, Oberklaid F, Patterson J, Raghavan C, Richter L, Rikard B, Russell RR, Mikati MA. Role of Pediatricians, Pediatric Associations, and Academic Departments in Ensuring Optimal Early Childhood Development Globally: Position Paper of the International Pediatric Association. J Dev Behav Pediatr 2022; 43:e546-e558. [PMID: 35980036 DOI: 10.1097/dbp.0000000000001112] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 04/15/2022] [Indexed: 02/04/2023]
Abstract
ABSTRACT Early childhood (birth-8 years), particularly the first 3 years, is the most critical time in development because of the highly sensitive developing brain. Providing appropriate developmental care (i.e., nurturing care, as defined by the World Health Organization [WHO]) during early childhood is key to ensuring a child's holistic development. Pediatricians are expected to play a critical role in supporting early childhood development (ECD) through providing developmental services such as developmental monitoring, anticipatory guidance, screening, and referral to medical and/or community-based services when delay is identified. Pediatricians are also expected to serve as advocates within their clinics and communities for improved delivery of ECD services, such as advocating for increasing funding for ECD initiatives, increasing insurance coverage of ECD services, and working to increase other pediatricians' awareness of the principles of ECD and how to deliver developmental services. However, this does not always occur. Typically, pediatricians' training and practice emphasizes treating disease rather than enhancing ECD. Pediatricians are further hindered by a lack of uniformity across nations in guidelines for developmental monitoring and screening. In this article, we present the vision of the International Pediatric Association (IPA) of the roles that pediatricians, academic departments, medical training programs, and pediatric associations should fulfill to help support ECD, including raising ECD to higher levels of priority in routine pediatric care. First, we present the challenges that face these goals in supporting ECD. We then propose, with supportive literature, strategies and resources to overcome these challenges in collaboration with local and international stakeholders, including the IPA, the WHO, UNICEF, and the World Bank.
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Affiliation(s)
- Julie Uchitel
- Department of Paediatrics, University of Cambridge, The Rosie Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
- Division of Pediatric Neurology and Developmental Medicine, Duke University Health System, Durham, NC
| | - Errol Alden
- International Pediatric Association, Uniformed Services of Health Sciences, Bethesda, MD
| | - Zulfiqar A Bhutta
- International Pediatric Association; Division of Women and Child Health, Aga Khan University, Karachi, Pakistan
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Canada
| | | | - Jane Lucas
- Consultant in International Health and Child Development to UNICEF and the World Health Organization, New York, NY
| | - Frank Oberklaid
- Centre for Community Child Health, The Royal Children's Hospital, Melbourne, Australia
| | - Janna Patterson
- Global Child Health and Life Support, American Academy of Pediatrics, Chicago, IL
| | - Chemba Raghavan
- Early Childhood Development Specialist/Acting Chief, UNICEF, New York, NY
| | - Linda Richter
- DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa
| | - Blaire Rikard
- Division of Pediatric Neurology and Developmental Medicine, Duke University Health System, Durham, NC
| | - Robert Ross Russell
- European Board of Paediatrics, European Academy of Paediatrics; Paediatric Respiratory Paediatrics, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - Mohamad A Mikati
- Early Childhood Development Standing Advisory Group, International Pediatrics Association; Department of Pediatrics, Division of Pediatric Neurology and Developmental Medicine Duke University Medical Center, Durham, NC
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Filipe HP, Golnik K, Geary AC, Kilangalanga J, Mack HG. Online Faculty Development on Curriculum Design in Simulation-based Education by International Collaboration - An Example from the Democratic Republic of the Congo. Middle East Afr J Ophthalmol 2022; 29:226-231. [PMID: 38162560 PMCID: PMC10754109 DOI: 10.4103/meajo.meajo_40_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 08/14/2023] [Accepted: 08/22/2023] [Indexed: 01/03/2024] Open
Abstract
PURPOSE Faculty development for procedural specialists is intended to improve clinical education and surgical/procedural skills. Despite challenging in under-resourced settings, this may be enhanced by developing international collaboration agreements and supported by online learning experiences. The Congolese Society of Ophthalmology and the International Council of Ophthalmology agreed to collaborate on implementing an online educational program to form a community of practice (CoP) of ophthalmologists educators and enhance competence in curriculum design and simulation-based education (SBE) on cataract surgery. METHODS Ten Congolese ophthalmologists, faculty for the "Centre de Formation Ophthalmologique pour l'Afrique Centrale" (CFOACF), participated in a group-mentored 12-webinar modular program on curriculum design, in 2019. Considering the geo-social-cultural learning environment, we developed a curriculum framework incorporating social constructivism and experiential learning principles to facilitate the implementation of learning. Educational strategies included flipped, practice-based and social learning, group mentoring, and individual and collective reflection opportunities. A CoP was virtually nurtured using WhatsApp. Program evaluation relied on (a) feedback survey per module and 3 months upon conclusion, (b) individual declarative knowledge assessment, and (c) group assignment to test competence improvement. RESULTS The CFOACF formed a virtual CoP, commented on an enjoyable opportunity to develop scholar teaching competence, expressed intention in systematically building educational curricula design that includes active learning strategies and effective feedback and showed individual learning and team-competence improvement. CONCLUSION This first iteration of our online faculty development program nurtured the formation of a CoP of ophthalmologists' educators and enabled to practice a scholar teaching approach, especially applied to SBE.
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Affiliation(s)
- Helena P. Filipe
- West Lisbon Hospitals Centre (CHLO), Service of Ophthalmology, Unit of Cornea and Ocular Surface, Hospital Egas Moniz, Lisbon, Portugal
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Almada, Portugal
| | - Karl Golnik
- Department of Ophthalmology, University of Cincinnati, Ohio, USA
| | | | - Janvier Kilangalanga
- Department of Ophthalmology, Saint Joseph Hospital, Kinshasa, Democratic Republic of the Congo, Melbourne, Australia
| | - Heather G. Mack
- Department of Surgery (Ophthalmology), University of Melbourne, Melbourne, Australia
- Centre for Eye Research, University of Melbourne, Melbourne, Australia
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Ezenwa BN, Umoren R, Fajolu IB, Hippe DS, Bucher S, Purkayastha S, Okwako F, Esamai F, Feltner JB, Olawuyi O, Mmboga A, Nafula MC, Paton C, Ezeaka VC. Using Mobile Virtual Reality Simulation to Prepare for In-Person Helping Babies Breathe Training: Secondary Analysis of a Randomized Controlled Trial (the eHBB/mHBS Trial). JMIR MEDICAL EDUCATION 2022; 8:e37297. [PMID: 36094807 PMCID: PMC9513689 DOI: 10.2196/37297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 07/14/2022] [Accepted: 07/31/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Neonatal mortality accounts for approximately 46% of global under-5 child mortality. The widespread access to mobile devices in low- and middle-income countries has enabled innovations, such as mobile virtual reality (VR), to be leveraged in simulation education for health care workers. OBJECTIVE This study explores the feasibility and educational efficacy of using mobile VR for the precourse preparation of health care professionals in neonatal resuscitation training. METHODS Health care professionals in obstetrics and newborn care units at 20 secondary and tertiary health care facilities in Lagos, Nigeria, and Busia, Western Kenya, who had not received training in Helping Babies Breathe (HBB) within the past 1 year were randomized to access the electronic HBB VR simulation and digitized HBB Provider's Guide (VR group) or the digitized HBB Provider's Guide only (control group). A sample size of 91 participants per group was calculated based on the main study protocol that was previously published. Participants were directed to use the electronic HBB VR simulation and digitized HBB Provider's Guide or the digitized HBB Provider's Guide alone for a minimum of 20 minutes. HBB knowledge and skills assessments were then conducted, which were immediately followed by a standard, in-person HBB training course that was led by study staff and used standard HBB evaluation tools and the Neonatalie Live manikin (Laerdal Medical). RESULTS A total of 179 nurses and midwives participated (VR group: n=91; control group: n=88). The overall performance scores on the knowledge check (P=.29), bag and mask ventilation skills check (P=.34), and Objective Structured Clinical Examination A checklist (P=.43) were similar between groups, with low overall pass rates (6/178, 3.4% of participants). During the Objective Structured Clinical Examination A test, participants in the VR group performed better on the critical step of positioning the head and clearing the airway (VR group: 77/90, 86%; control group: 57/88, 65%; P=.002). The median percentage of ventilations that were performed via head tilt, as recorded by the Neonatalie Live manikin, was also numerically higher in the VR group (75%, IQR 9%-98%) than in the control group (62%, IQR 13%-97%), though not statistically significantly different (P=.35). Participants in the control group performed better on the identifying a helper and reviewing the emergency plan step (VR group: 7/90, 8%; control group: 16/88, 18%; P=.045) and the washing hands step (VR group: 20/90, 22%; control group: 32/88, 36%; P=.048). CONCLUSIONS The use of digital interventions, such as mobile VR simulations, may be a viable approach to precourse preparation in neonatal resuscitation training for health care professionals in low- and middle-income countries.
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Affiliation(s)
| | - Rachel Umoren
- Department of Pediatrics, University of Washington, Washington, WA, United States
| | | | - Daniel S Hippe
- Clinical Research Division, Fred Hutchinson Cancer Center, Washington, WA, United States
| | - Sherri Bucher
- Department of Pediatrics, Indiana University School of Medicine, Indiana, IN, United States
| | - Saptarshi Purkayastha
- Department of BioHealth Informatics, Indiana University-Purdue University at Indianapolis, Indianapolis, IN, United States
| | - Felicitas Okwako
- Department of Paediatrics, Alupe University College, Busia, Kenya
| | - Fabian Esamai
- Department of Paediatrics, Alupe University College, Busia, Kenya
| | - John B Feltner
- Department of Pediatrics, University of Washington, Washington, WA, United States
| | - Olubukola Olawuyi
- Department of Paediatrics, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Annet Mmboga
- Department of Paediatrics, Alupe University College, Busia, Kenya
| | | | - Chris Paton
- Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford, United Kingdom
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