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Benomar A, Cherif Chefchaouni A, Rahali Y, El Alaoui Y. Perception and expectation of Moroccan pharmacy students regarding e-learning in the context of COVID-19 pandemic lockdown. ANNALES PHARMACEUTIQUES FRANÇAISES 2024; 82:698-705. [PMID: 38447876 DOI: 10.1016/j.pharma.2024.02.014] [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: 01/11/2024] [Revised: 02/26/2024] [Accepted: 02/29/2024] [Indexed: 03/08/2024]
Abstract
PURPOSE Online learning, or e-learning, has grown exponentially in recent years, not least because the COVID-19 pandemic has forced many educational establishments to adopt distance learning modalities. In the field of pharmacy, where the acquisition of theoretical and practical knowledge is essential, the adoption of e-learning has attracted particular interest. The aim of this study is to analyze the feedback received by pharmacy students from different faculties in the country following the introduction of new learning methods during the Covid pandemic. METHODS The study was carried out using a "Google forms" questionnaire, which was sent to students at the country's faculties of pharmacy. The questionnaire included various points, such as a description of the population, preferred mode of distance learning of lectures among students and satisfaction with e-learning. RESULTS The study involved 176 respondents, 65.9% of whom were women. Around 50% of respondents use e-learning tools more than 6 times a week for educational purposes. Seventy per cent of respondents are satisfied with their e-learning experience, but only 43.2 believe that e-learning has a positive effect on their academic results. Forty-seven per cent of respondents considered the quality of teaching to be the major shortcoming of e-learning, followed by distraction (32%) and the questionable credibility of the diploma (20%). CONCLUSION E-learning has significant potential to transform teaching and learning in pharmacy, and its thoughtful integration can bring lasting benefits to students.
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Affiliation(s)
- Abdelhafid Benomar
- Laboratoire de chimie analytique, faculté de médecine et de pharmacie de Tanger, université Abdelmalek-Essaâdi, Tanger, Morocco; Centre hospitalier universitaire Mohammed VI de Tanger, Tanger, Morocco
| | - Ali Cherif Chefchaouni
- Équipe de formulation et de contrôle qualité des produits de santé, laboratoire de pharmaceutique, faculté de médecine et de pharmacie, université Mohammed V de Rabat, Rabat, Morocco; Centre hospitalier universitaire Ibn Sina, Rabat, Morocco.
| | - Younes Rahali
- Équipe de formulation et de contrôle qualité des produits de santé, laboratoire de pharmaceutique, faculté de médecine et de pharmacie, université Mohammed V de Rabat, Rabat, Morocco; Centre hospitalier universitaire Ibn Sina, Rabat, Morocco
| | - Yassir El Alaoui
- Équipe de formulation et de contrôle qualité des produits de santé, laboratoire de pharmaceutique, faculté de médecine et de pharmacie, université Mohammed V de Rabat, Rabat, Morocco; Centre hospitalier universitaire Ibn Sina, Rabat, Morocco
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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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Isangula K, Ngadaya E, Manu A, Mmweteni M, Philbert D, Burengelo D, Kagaruki G, Senkoro M, Kimaro G, Kahwa A, Mazige F, Bundala F, Iriya N, Donard F, Kitinya C, Minja V, Nyakairo F, Gupta G, Pearson L, Kim M, Mfinanga S, Baker U, Hailegebriel TD. Implementation of distance learning IMCI training in rural districts of Tanzania. BMC Health Serv Res 2023; 23:56. [PMID: 36658537 PMCID: PMC9854197 DOI: 10.1186/s12913-023-09061-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 01/11/2023] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND The standard face-to-face training for the integrated management of childhood illness (IMCI) continues to be plagued by concerns of low coverage of trainees, the prolonged absence of trainees from the health facility to attend training and the high cost of training. Consequently, the distance learning IMCI training model is increasingly being promoted to address some of these challenges in resource-limited settings. This paper examines participants' accounts of the paper-based IMCI distance learning training programme in three district councils in Mbeya region, Tanzania. METHODS A cross-sectional qualitative descriptive design was employed as part of an endline evaluation study of the management of possible serious bacterial infection in Busokelo, Kyela and Mbarali district councils of Mbeya Region in Tanzania. Key informant interviews were conducted with purposefully selected policymakers, partners, programme managers and healthcare workers, including beneficiaries and training facilitators. RESULTS About 60 key informant interviews were conducted, of which 53% of participants were healthcare workers, including nurses, clinicians and pharmacists, and 22% were healthcare administrators, including district medical officers, reproductive and child health coordinators and programme officers. The findings indicate that the distance learning IMCI training model (DIMCI) was designed to address concerns about the standard IMCI model by enhancing efficiency, increasing outputs and reducing training costs. DIMCI included a mix of brief face-to-face orientation sessions, several weeks of self-directed learning, group discussions and brief face-to-face review sessions with facilitators. The DIMCI course covered topics related to management of sick newborns, referral decisions and reporting with nurses and clinicians as the main beneficiaries of the training. The problems with DIMCI included technological challenges related to limited access to proper learning technology (e.g., computers) and unfriendly learning materials. Personal challenges included work-study-family demands, and design and coordination challenges, including low financial incentives, which contributed to participants defaulting, and limited mentorship and follow-up due to limited funding and transport. CONCLUSION DIMCI was implemented successfully in rural Tanzania. It facilitated the training of many healthcare workers at low cost and resulted in improved knowledge, competence and confidence among healthcare workers in managing sick newborns. However, technological, personal, and design and coordination challenges continue to face learners in rural areas; these will need to be addressed to maximize the success of DIMCI.
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Affiliation(s)
- Kahabi Isangula
- National Institute for Medical Research-Muhimbili Centre, Dar es Salaam, Tanzania. .,Aga Khan University, Dar Es Salaam, Tanzania.
| | - Esther Ngadaya
- National Institute for Medical Research-Muhimbili Centre, Dar es Salaam, Tanzania.
| | - Alexander Manu
- grid.8652.90000 0004 1937 1485University of Ghana School of Public Health, Accra, Ghana ,grid.8991.90000 0004 0425 469XLondon School of Hygiene and Tropical Medicine, Keppel Street, London, UK
| | | | - Doreen Philbert
- grid.416716.30000 0004 0367 5636National Institute for Medical Research-Muhimbili Centre, Dar es Salaam, Tanzania
| | - Dorica Burengelo
- grid.416716.30000 0004 0367 5636National Institute for Medical Research-Muhimbili Centre, Dar es Salaam, Tanzania
| | - Gibson Kagaruki
- grid.416716.30000 0004 0367 5636National Institute for Medical Research-Muhimbili Centre, Dar es Salaam, Tanzania
| | - Mbazi Senkoro
- grid.416716.30000 0004 0367 5636National Institute for Medical Research-Muhimbili Centre, Dar es Salaam, Tanzania
| | - Godfather Kimaro
- grid.416716.30000 0004 0367 5636National Institute for Medical Research-Muhimbili Centre, Dar es Salaam, Tanzania
| | - Amos Kahwa
- grid.416716.30000 0004 0367 5636National Institute for Medical Research-Muhimbili Centre, Dar es Salaam, Tanzania
| | | | - Felix Bundala
- grid.415734.00000 0001 2185 2147Ministry of Health, Dodoma, Tanzania
| | - Nemes Iriya
- World Health Organization, Dar Es Salaam, Tanzania
| | - Francis Donard
- grid.416716.30000 0004 0367 5636National Institute for Medical Research-Muhimbili Centre, Dar es Salaam, Tanzania
| | - Caritas Kitinya
- grid.416716.30000 0004 0367 5636National Institute for Medical Research-Muhimbili Centre, Dar es Salaam, Tanzania
| | - Victor Minja
- grid.416716.30000 0004 0367 5636National Institute for Medical Research-Muhimbili Centre, Dar es Salaam, Tanzania
| | - Festo Nyakairo
- grid.416716.30000 0004 0367 5636National Institute for Medical Research-Muhimbili Centre, Dar es Salaam, Tanzania
| | - Gagan Gupta
- grid.420318.c0000 0004 0402 478XUNICEF Headquarters, New York, USA
| | - Luwei Pearson
- grid.420318.c0000 0004 0402 478XUNICEF Headquarters, New York, USA
| | - Minjoon Kim
- grid.420318.c0000 0004 0402 478XUNICEF Headquarters, New York, USA
| | - Sayoki Mfinanga
- grid.416716.30000 0004 0367 5636National Institute for Medical Research-Muhimbili Centre, Dar es Salaam, Tanzania
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Sharma G, Molla YB, Budhathoki SS, Shibeshi M, Tariku A, Dhungana A, Bajracharya B, Mebrahtu GG, Adhikari S, Jha D, Mussema Y, Bekele A, Khadka N. Analysis of maternal and newborn training curricula and approaches to inform future trainings for routine care, basic and comprehensive emergency obstetric and newborn care in the low- and middle-income countries: Lessons from Ethiopia and Nepal. PLoS One 2021; 16:e0258624. [PMID: 34710115 PMCID: PMC8553030 DOI: 10.1371/journal.pone.0258624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 10/04/2021] [Indexed: 11/23/2022] Open
Abstract
Program managers routinely design and implement specialised maternal and newborn health trainings for health workers in low- and middle-income countries to provide better-coordinated care across the continuum of care. However, in these countries details on the availability of different training packages, skills covered in those training packages and the gaps in their implementation are patchy. This paper presents an assessment of maternal and newborn health training packages to describe differences in training contents and implementation approaches used for a range of training packages in Ethiopia and Nepal. We conducted a mixed-methods study. The quantitative assessment was conducted using a comprehensive assessment questionnaire based on validated WHO guidelines and developed jointly with global maternal and newborn health experts. The qualitative assessment was conducted through key informant interviews with national stakeholders involved in implementing these training packages and working with the Ministries of Health in both countries. Our quantitative analysis revealed several key gaps in the technical content of maternal and newborn health training packages in both countries. Our qualitative results from key informant interviews provided additional insights by highlighting several issues with trainings related to quality, skill retention, logistics, and management. Taken together, our findings suggest four key areas of improvement: first, training materials should be updated based on the content gaps identified and should be aligned with each other. Second, trainings should address actual health worker performance gaps using a variety of innovative approaches such as blended and self-directed learning. Third, post-training supervision and ongoing mentoring need to be strengthened. Lastly, functional training information systems are required to support planning efforts in both countries.
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Affiliation(s)
- Gaurav Sharma
- Society of Public Health Physicians, Kathmandu, Nepal
- * E-mail:
| | - Yordanos B. Molla
- USAID’s Maternal and Child Survival Program/Save the Children, Washington, DC, United States of America
| | | | | | | | - Adhish Dhungana
- USAID’s Maternal and Child Survival Program/Save The Children, Kathmandu, Nepal
| | | | | | | | - Deepak Jha
- Child Health Division, Ministry of Health and Population, Kathmandu, Nepal
| | | | - Abeba Bekele
- USAID’s Maternal and Child Survival Program/Save The Children, Addis Ababa, Ethiopia
| | - Neena Khadka
- USAID’s Maternal and Child Survival Program/Save the Children, Washington, DC, United States of America
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Jones SE, Campbell PK, Kimp AJ, Bennell K, Foster NE, Russell T, Hinman RS. Evaluation of a Novel e-Learning Program for Physiotherapists to Manage Knee Osteoarthritis via Telehealth: Qualitative Study Nested in the PEAK (Physiotherapy Exercise and Physical Activity for Knee Osteoarthritis) Randomized Controlled Trial. J Med Internet Res 2021; 23:e25872. [PMID: 33929326 PMCID: PMC8122295 DOI: 10.2196/25872] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 01/14/2021] [Accepted: 03/18/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The delivery of physiotherapy via telehealth could provide more equitable access to services for patients. Videoconference-based telehealth has been shown to be an effective and acceptable mode of service delivery for exercise-based interventions for chronic knee pain; however, specific training in telehealth is required for physiotherapists to effectively and consistently deliver care using telehealth. The development and evaluation of training programs to upskill health care professionals in the management of osteoarthritis (OA) has also been identified as an important priority to improve OA care delivery. OBJECTIVE This study aims to explore physiotherapists' experiences with and perceptions of an e-learning program about best practice knee OA management (focused on a structured program of education, exercise, and physical activity) that includes telehealth delivery via videoconferencing. METHODS We conducted a qualitative study using individual semistructured telephone interviews, nested within the Physiotherapy Exercise and Physical Activity for Knee Osteoarthritis randomized controlled trial, referred to as the PEAK trial. A total of 15 Australian physiotherapists from metropolitan and regional private practices were interviewed following the completion of an e-learning program. The PEAK trial e-learning program involved self-directed learning modules, a mock video consultation with a researcher (simulated patient), and 4 audited practice video consultations with pilot patients with chronic knee pain. Interviews were audio recorded and transcribed verbatim. Data were thematically analyzed. RESULTS A total of five themes (with associated subthemes) were identified: the experience of self-directed e-learning (physiotherapists were more familiar with in-person learning; however, they valued the comprehensive, self-paced web-based modules. Unwieldy technological features could be frustrating); practice makes perfect (physiotherapists benefited from the mock consultation with the researcher and practice sessions with pilot patients alongside individualized performance feedback, resulting in confidence and preparedness to implement new skills); the telehealth journey (although inexperienced with telehealth before training, physiotherapists were confident and able to deliver remote care following training; however, they still experienced some technological challenges); the whole package (the combination of self-directed learning modules, mock consultation, and practice consultations with pilot patients was felt to be an effective learning approach, and patient information booklets supported the training package); and impact on broader clinical practice (training consolidated and refined existing OA management skills and enabled a switch to telehealth when the COVID-19 pandemic affected in-person clinical care). CONCLUSIONS Findings provide evidence for the perceived effectiveness and acceptability of an e-learning program to train physiotherapists (in the context of a clinical trial) on best practice knee OA management, including telehealth delivery via videoconferencing. The implementation of e-learning programs to upskill physiotherapists in telehealth appears to be warranted, given the increasing adoption of telehealth service models for the delivery of clinical care.
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Affiliation(s)
- Sarah E Jones
- Department of Physiotherapy, School of Health Sciences, Centre for Health, Exercise and Sports Medicine, The University of Melbourne, Melbourne, Australia
| | - Penny K Campbell
- Department of Physiotherapy, School of Health Sciences, Centre for Health, Exercise and Sports Medicine, The University of Melbourne, Melbourne, Australia
| | - Alexander J Kimp
- Department of Physiotherapy, School of Health Sciences, Centre for Health, Exercise and Sports Medicine, The University of Melbourne, Melbourne, Australia
| | - Kim Bennell
- Department of Physiotherapy, School of Health Sciences, Centre for Health, Exercise and Sports Medicine, The University of Melbourne, Melbourne, Australia
| | - Nadine E Foster
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, United Kingdom.,STARS Education and Research Alliance, School of Health and Behavioural Sciences, The University of Queensland, Brisbane, Australia
| | - Trevor Russell
- RECOVER Injury Research Centre, The University of Queensland, Brisbane, Australia
| | - Rana S Hinman
- Department of Physiotherapy, School of Health Sciences, Centre for Health, Exercise and Sports Medicine, The University of Melbourne, Melbourne, Australia
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Pollack TM, Nhung VTT, Vinh DTN, Hao DT, Trang LTT, Duc PA, Kinh NV, Dung NTH, Dung DL, Ninh NT, Huyen HTT, Huy VX, Hai DM, Khanh TH, Hien NTT, Khuong PTA, Trong NT, Lam NV, Phinh VN, Phuong DT, Duat ND, Liem NT, Binh NT, Chi NK, Yen LN, Cosimi L. Building HIV healthcare worker capacity through telehealth in Vietnam. BMJ Glob Health 2020; 5:e002166. [PMID: 32337087 PMCID: PMC7170421 DOI: 10.1136/bmjgh-2019-002166] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 03/12/2020] [Accepted: 03/15/2020] [Indexed: 11/30/2022] Open
Abstract
Development of a robust technical assistance system is an essential component of a sustainable HIV response. Vietnam’s National HIV Program is transitioning from a largely donor-funded programme to one primarily supported by domestic resources. Telehealth interventions are increasingly being used for training, mentoring and expert consultation in high-resource settings and hold significant potential for use as a tool to build HIV health worker capacity in low and middle-income countries. We designed, implemented and scaled up a novel HIV telehealth programme for Vietnam, with the goal of building a sustainable training model to support the country’s HIV workforce needs. Over a 4-year period, HIV telehealth programmes were initiated in 17 public institutions with participation of nearly 700 clinical sites across 62 of the 63 provinces in the country. The telehealth programme was used to deliver certificate training courses, provide clinical mentoring and case-based learning, support programme implementation, provide coaching in quality improvement and disseminate new guidelines and policies. Programme evaluation demonstrated improved health worker self-reported competence in HIV care and treatment and high satisfaction among the programme participants. Lessons learnt from Vietnam’s experience with telehealth can inform country programmes looking to develop a sustainable approach to HIV technical assistance and health worker capacity building.
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Affiliation(s)
- Todd M Pollack
- The Partnership for Health Advancement in Vietnam, Beth Israel Deaconess Medical Center, Hanoi, Vietnam.,Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Vo Thi Tuyet Nhung
- The Partnership for Health Advancement in Vietnam, Beth Israel Deaconess Medical Center, Ho Chi Minh City, Vietnam
| | - Dang Thi Nhat Vinh
- The Partnership for Health Advancement in Vietnam, Beth Israel Deaconess Medical Center, Ho Chi Minh City, Vietnam
| | - Duong Thi Hao
- The Partnership for Health Advancement in Vietnam, Beth Israel Deaconess Medical Center, Ho Chi Minh City, Vietnam
| | - Le Thi Thu Trang
- The Partnership for Health Advancement in Vietnam, Beth Israel Deaconess Medical Center, Hanoi, Vietnam
| | - Pham Anh Duc
- The Partnership for Health Advancement in Vietnam, Beth Israel Deaconess Medical Center, Hanoi, Vietnam
| | | | | | - Duong Lan Dung
- National Hospital of Obstetrics and Gynaecology, Hanoi, Vietnam
| | | | | | - Vo Xuan Huy
- Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Duong Minh Hai
- Provincial AIDS Committee of HCMC, Ho Chi Minh City, Vietnam
| | - Truong Huu Khanh
- Department of Infectious Diseases, Pediatric Hospital No 1, Ho Chi Minh City, Vietnam
| | | | | | | | | | - Vu Ngoc Phinh
- The Partnership for Health Advancement in Vietnam, Beth Israel Deaconess Medical Center, Hanoi, Vietnam
| | - Do Thi Phuong
- The Partnership for Health Advancement in Vietnam, Beth Israel Deaconess Medical Center, Hanoi, Vietnam
| | - Nguyen Duc Duat
- The Partnership for Health Advancement in Vietnam, Beth Israel Deaconess Medical Center, Hanoi, Vietnam
| | - Nguyen Thanh Liem
- The Partnership for Health Advancement in Vietnam, Beth Israel Deaconess Medical Center, Ho Chi Minh City, Vietnam
| | - Nguyen Thanh Binh
- The Partnership for Health Advancement in Vietnam, Beth Israel Deaconess Medical Center, Hanoi, Vietnam
| | - Nguyen K Chi
- Centers for Disease Control and Prevention, Ho Chi Minh City, Vietnam
| | - Le Ngoc Yen
- Centers for Disease Control and Prevention, Hanoi, Vietnam
| | - Lisa Cosimi
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
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Wei MH, Chen XZ, Zhan XX, Zhang ZX, Yu SJ, Yan WR. The effect of a web-based training for improving primary health care providers' knowledge about diabetes mellitus management in rural China: A pre-post intervention study. PLoS One 2019; 14:e0222930. [PMID: 31550282 PMCID: PMC6759173 DOI: 10.1371/journal.pone.0222930] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 09/10/2019] [Indexed: 11/30/2022] Open
Abstract
Background The performance of primary health care providers regarding DM management is poor in rural China, and effective training methods for providers are urgently needed. This study aimed to evaluate the effect of web-based training for improving knowledge about DM management among primary health care providers in rural China and to further compare the effects of the training effect between primary health care providers with different backgrounds. Methods A pre-post intervention study was conducted from April to August 2014. In this study, a total of 901 primary health care workers were recruited from six counties in Hubei province. To evaluate the effect of the web-based training, the knowledge achievement of participants was measured with multiple choice questions (MCQ) at baseline, at the end of two weeks of training and at three months after training. A mixed linear model (MLM) was used to measure group differences in the mean scores at baseline and follow-up. Results After the web-based training, the knowledge scores of the village doctors increased from 73.58 at baseline to 89.98 at posttest and to 84.57 three months after the training. For township health workers, we observed an upward trend in scores from 78.87 at the pre-test to 91.72 at the second test, and at the three months after the training, the scores increased to 94.91. For village doctors, greater knowledge achievement was observed between the scores at baseline and after two weeks of training(adjusted difference: 3.55, P = 0.03) compared to that observed for the township health workers, while decreased their knowledge achievement between baseline and the third-test compared with that of township health workers (adjusted difference: 5.05, P = 0.01). Conclusions This study suggested that web-based training was an effective method for improving the knowledge of primary health care providers about management of DM in remote areas. Compared with the effect of the training on village doctors, the training had a poor short-term effect on township health workers but a better long-term effect.
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Affiliation(s)
- Mu-Hong Wei
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, China
| | - Xian-Zhen Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, China
| | - Xing-Xin Zhan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, China
- School of Nursing and Rehabilitation, Xinyu University, Xinyu, China
| | - Zhi-Xia Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, China
- Wuchang University of Technology, Wuhan, China
| | - Shao-Jing Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, China
| | - Wei-Rong Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, China
- * E-mail:
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Bertman V, Petracca F, Makunike-Chikwinya B, Jonga A, Dupwa B, Jenami N, Nartker A, Wall L, Reason L, Kundhlande P, Downer A. Health worker text messaging for blended learning, peer support, and mentoring in pediatric and adolescent HIV/AIDS care: a case study in Zimbabwe. HUMAN RESOURCES FOR HEALTH 2019; 17:41. [PMID: 31174543 PMCID: PMC6555929 DOI: 10.1186/s12960-019-0364-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 04/11/2019] [Indexed: 05/03/2023]
Abstract
BACKGROUND In sub-Saharan Africa, shortages of trained healthcare workers and limited resources necessitate innovative and cost-effective approaches for training, supervising, and mentoring. This qualitative case study describes participants' and trainers' perspectives and experiences with a text messaging component of a blended training course in HIV counseling and testing in Zimbabwe, using minimal resources in terms of staff time and equipment requirements. This component included a whole-group discussion forum as well as two-person partner discussions designed to promote reflection and analysis, teamwork, and active learning. CASE PRESENTATION The Ministry of Health and Child Care (MoHCC) of Zimbabwe collaborated with the International Training and Education Center for Health (I-TECH) on adaptation of a 5-day in-service training in HIV Testing Services for Children and Adolescents. The new 7-week blended format included in-person sessions, tablet-based self-study, and discussions using the text messaging application, WhatsApp. Between August 2016 and January 2017, 11 cohorts (293 participants in total) were trained with this new curriculum, incorporating text messaging to support peer-to-peer and work-based education. Data collected included training participants' feedback, key informant interviews with the training team, and thematic analysis of WhatsApp messages from full-cohort discussions and a sampling of one-to-one partner discussions. A total of 293 healthcare workers from 233 health facilities across all provinces in Zimbabwe completed the blended learning course. Participants strongly endorsed using WhatsApp groups as part of the training. In the whole-group discussions, the combined cohorts generated over 6300 text messages. Several categories of communication emerged in analysis of group discussions: (1) participants' case experiences and questions; (2) feedback and recommendations for work issues raised; (3) inquiries, comments, and responses about course assignments and specific course content; (4) encouragement; and (5) technical challenges encountered using the blended learning methodology. Case discussions were complex, including patient history, symptoms, medications, and psychosocial issues-child abuse, adherence, and disclosure. CONCLUSIONS Using text messaging in a communication platform that is an ongoing part of healthcare workers' daily lives can be an effective adjunct to in-service training, minimizing isolation and providing interactivity, supporting students' ability to fully integrate content into new skill attainment.
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Affiliation(s)
- V. Bertman
- International Training and Education Center for Health (I-TECH), Department of Global Health, University of Washington, Seattle, WA USA
| | - F. Petracca
- International Training and Education Center for Health (I-TECH), Department of Global Health, University of Washington, Seattle, WA USA
| | - B. Makunike-Chikwinya
- International Training and Education Center for Health (I-TECH), Department of Global Health, University of Washington, Seattle, WA USA
| | - A. Jonga
- International Training and Education Center for Health (I-TECH), Department of Global Health, University of Washington, Seattle, WA USA
| | - B. Dupwa
- Zimbabwe Ministry of Health and Child Care, Harare, Zimbabwe
| | - N. Jenami
- International Training and Education Center for Health (I-TECH), Department of Global Health, University of Washington, Seattle, WA USA
| | - A. Nartker
- Department of Global Health E-learning Program, University of Washington, Seattle, WA USA
| | - L. Wall
- Department of Global Health E-learning Program, University of Washington, Seattle, WA USA
| | - L. Reason
- International Training and Education Center for Health (I-TECH), Department of Global Health, University of Washington, Seattle, WA USA
| | - P. Kundhlande
- International Training and Education Center for Health (I-TECH), Department of Global Health, University of Washington, Seattle, WA USA
| | - A. Downer
- International Training and Education Center for Health (I-TECH), Department of Global Health, University of Washington, Seattle, WA USA
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Hatakka M, Osman F, Erlandsson K, Byrskog U, Egal J, Klingberg-Allvin M. "Change-makers in midwifery care": Exploring the differences between expectations and outcomes-A qualitative study of a midwifery net-based education programme in the Somali region. Midwifery 2018; 69:135-142. [PMID: 30503998 DOI: 10.1016/j.midw.2018.11.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 10/30/2018] [Accepted: 11/17/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The aim of this study is to explore midwifery educators' expected outcomes in the net-based master's programme, the programmes' realised outcomes and the reported difference regarding the increased choices for the graduates and the effect on their agency. DESIGN In this case study, we focused on a net-based master's programme in sexual and reproductive health in Somalia. Somalia suffers from a shortage of skilled birth attendants and there is a need for building up the capacity of midwifery educators. SETTING AND PARTICIPANTS Data was collected in focus group discussions at the start of the programme and eight months after the students graduated. The data were analysed through the lens of the choice framework, which is based on the capability approach. FINDINGS Findings show that many of the graduates' expectations were met, while some were more difficult to fulfil. While the midwives' choices and resource portfolios had improved because of their role as educators, the social structure prevented them from acting on their agency, specifically in regards to making changes at the social level. Several of the positive developments can be attributed to the pedagogy and structure of the programme. CONCLUSION The flexibility of net-based education gave the midwifery educators a new educational opportunity that they previously did not have. Students gained increased power and influence on some levels. However, they still lack power in government organisations where, in addition to their role as educators, they could use their skills and knowledge to change policies at the social level.
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Affiliation(s)
- Mathias Hatakka
- School of Technology and Business Studies, Dalarna University, 791 88 Falun, Sweden
| | - Fatumo Osman
- School of Education, Health and Social Studies, Dalarna University, 791 88 Falun, Sweden
| | - Kerstin Erlandsson
- School of Education, Health and Social Studies, Dalarna University, 791 88 Falun, Sweden
| | - Ulrika Byrskog
- School of Education, Health and Social Studies, Dalarna University, 791 88 Falun, Sweden
| | - Jama Egal
- School of Health Science, Hargeisa University, Hargesia, Somaliland
| | - Marie Klingberg-Allvin
- School of Education, Health and Social Studies, Dalarna University, 791 88 Falun, Sweden.
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Muhe LM, Iriya N, Bundala F, Azayo M, Bakari MJ, Hussein A, John T. Evaluation of distance learning IMCI training program: the case of Tanzania. BMC Health Serv Res 2018; 18:547. [PMID: 30001709 PMCID: PMC6044076 DOI: 10.1186/s12913-018-3336-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 06/27/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The standard 11-days IMCI (Integrated Management of Childhood Illness) training course (standard IMCI) has faced barriers such as high cost to scale up. Distance learning IMCI training program was developed as an alternative to the standard IMCI course. This article presents the evaluation results of the implementation of distance learning IMCI training program in Tanzania. METHODS From December 2012 to end of June 2015, a total of 4806 health care providers (HCP) were trained on distance learning IMCI from 1427 health facilities {HF) in 68 districts in Tanzania. Clinical assessments were done at the end of each course and on follow up visits of health facilities 4 to 6 weeks after training. The results of those assessments are used to compare performance of health care providers trained in distance learning IMCI with those trained in the standard IMCI course. Statistical analysis is done by comparing proportions of those with appropriate performances using four WHO priority performance indicators as well as cost of conducting the courses. In addition, the perspectives of health care providers, IMCI course facilitators, policy makers and partners were gathered using either focussed group discussions or structured questionnaires. RESULTS Distance learning IMCI allowed clusters of training courses to take place in parallel, allowing rapid expansion of IMCI coverage. Health care providers trained in distance learning IMCI performed equally well as those trained in the standard IMCI course in assessing Main Symptoms, treating sick children and counselling caretakers appropriately. They performed better in assessing Danger Signs. Distance learning IMCI gave a 70% reduction in cost of conducting the training courses. CONCLUSION Distance learning IMCI is an alternative to scaling up IMCI as it provides an effective option with significant cost reduction in conducting training courses.
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Affiliation(s)
- Lulu M Muhe
- Department of Pediatrics and Child Health, Addis Ababa University, P.O.Box 1768, Addis Ababa, Ethiopia.
| | - Nemes Iriya
- Child and Adolescent Health, World Health Organization Country Office, Dar Es Salaam, Tanzania
| | | | - Mary Azayo
- UNICEF Country Office, Dar Es Salaam, Tanzania
| | | | | | - Theopista John
- Child and Adolescent Health, World Health Organization Country Office, Dar Es Salaam, Tanzania
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Feldacker C, Jacob S, Chung MH, Nartker A, Kim HN. Experiences and perceptions of online continuing professional development among clinicians in sub-Saharan Africa. HUMAN RESOURCES FOR HEALTH 2017; 15:89. [PMID: 29284492 PMCID: PMC5747038 DOI: 10.1186/s12960-017-0266-4] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 12/20/2017] [Indexed: 05/15/2023]
Abstract
BACKGROUND Limitations in healthcare worker (HCW) capacity compound the burden of dual TB and HIV epidemics in sub-Saharan Africa. To fill gaps in knowledge and skills, effective continuing profession development (CPD) initiatives are needed to support practicing HCWs reach high standards of care. e-learning opportunities can bring expert knowledge to HCWs in the field and provide a flexible learning option adaptable to local settings. Few studies provide insight into HCW experiences with online CPD in the developing country context. METHODS An online survey using both close-ended and free response was conducted to HCWs in sub-Saharan Africa who completed the University of Washington (UW) School of Medicine online graduate course, "Clinical Management of HIV." Associations between respondent characteristics (age, gender, rural/urban, job title) and learning preferences, course barriers, and facilitators with an emphasis on online courses were examined using chi-square. Covariates significant at the p < 0.05 were analyzed using multivariable logistic regression. Responses to open-ended comments were analyzed using simplified grounded theory. RESULTS Of 2,299 former students, 464 (20%) HCWs completed surveys from 13 countries: about half were women. Physicians (33%), nurses (27%), and clinical officers (30%) responded mostly from urban areas (67%) and public institutions (69%). Sixty-two percent accessed the online course from work, noting that slow (55%) or limited (41%) internet as well as lack of time (53%) were barriers to course completion. Women (p < 0.001) and HCWs under age 40 (p = 0.007) were more likely to prefer learning through mentorship than men or older HCWs. Respondents favored group discussion (46%), case studies (42%), and self-paced Internet/computer-based learning (39%) and clinical mentorship (37%) when asked to choose 3 preferred learning modalities. Free-response comments offered additional positive insights into the appeal of online courses by noting the knowledge gains, the flexibility of format, a desire for recognition of course completion, and a request for additional online coursework. CONCLUSIONS Online CPD opportunities were accepted across a diverse group of HCWs from sub-Saharan Africa and should be expanded to provide more flexible opportunities for self-initiated learning; however, these need to be responsive to the limited resources of those who seek these courses.
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Affiliation(s)
- Caryl Feldacker
- International Training and Education Center for Health (I-TECH), 325 Ninth Avenue, Box 359932, Seattle, WA United States of America
- Department of Global Health, University of Washington, 325 Ninth Avenue, Box 357965, Seattle, WA United States of America
| | - Sheena Jacob
- International Training and Education Center for Health (I-TECH), 325 Ninth Avenue, Box 359932, Seattle, WA United States of America
- Department of Global Health, University of Washington, 325 Ninth Avenue, Box 357965, Seattle, WA United States of America
| | - Michael H. Chung
- Department of Global Health, University of Washington, 325 Ninth Avenue, Box 357965, Seattle, WA United States of America
- Department of Medicine, University of Washington, 325 Ninth Avenue, Box 359930, Seattle, WA United States of America
- Department of Epidemiology, University of Washington, 325 Ninth Avenue, Box 359909, Seattle, WA United States of America
| | - Anya Nartker
- Department of Global Health, University of Washington, 325 Ninth Avenue, Box 357965, Seattle, WA United States of America
| | - H. Nina Kim
- Department of Global Health, University of Washington, 325 Ninth Avenue, Box 357965, Seattle, WA United States of America
- Department of Medicine, University of Washington, 325 Ninth Avenue, Box 359930, Seattle, WA United States of America
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Rabbani F, Hashmani FN, Mukhi AAA, Gul X, Pradhan N, Hatcher P, Farag M, Abbas F. Hospital management training for the Eastern Mediterranean Region: time for a change? J Health Organ Manag 2017; 29:965-72. [PMID: 26556162 DOI: 10.1108/jhom-11-2014-0197] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE The WHO Eastern Mediterranean Regional Office has emphasized health system strengthening among the top five strategic priorities. One of the integral elements of health systems are the hospitals. The purpose of this paper is to review the need for formalized training in hospital management to improve the quality of care. DESIGN/METHODOLOGY/APPROACH Literature review and hands on experience of conducting a regional training in hospital management for Eastern Mediterranean Region (EMR) countries. FINDINGS Majority of patients in EMR bypass Primary Health Care facilities due to inadequate quality of services and prefer seeking specialized care at a tertiary level. There is mounting evidence of mediocre to poor patient satisfaction due to inefficient health care practices in hospitals of EMR. Strengthening the management capacity of the hospitals through a formal training programme is therefore necessary for improving the performance of health care delivery and the overall health system. Hospital management encompasses hospital planning and operational activities including development and implementation of organizational strategies to ensure adequate numbers and quality of trained human resources and effective financial management, disaster management, health management information system utilization, support services, biomedical engineering, transport and waste management. Such training will prepare health care professionals with leadership skills to deliver quality hospital services. ORIGINALITY/VALUE This is one of the first papers emphasizing the need for a formal structured regional training in hospital management for the countries of EMR. A modular incremental training approach developing an EMR Credit Transfer and Accumulation system is proposed.
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Affiliation(s)
- Fauziah Rabbani
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
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Atkins S, Marsden S, Diwan V, Zwarenstein M. North-south collaboration and capacity development in global health research in low- and middle-income countries - the ARCADE projects. Glob Health Action 2016; 9:30524. [PMID: 27725081 PMCID: PMC5057000 DOI: 10.3402/gha.v9.30524] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Revised: 05/09/2016] [Accepted: 06/01/2016] [Indexed: 12/04/2022] Open
Abstract
Background Research capacity enhancement is needed in low- and middle-income countries (LMICs) for improved health, wellbeing, and health systems’ development. In this article, we discuss two capacity-building projects, the African/Asian Regional Capacity Development (ARCADE) in Health Systems and Services Research (HSSR) and Research on Social Determinants of Health (RSDH), implemented from 2011 to 2015. The two projects focussed on providing courses in HSSR and social determinants of health research, and on developing collaborations between universities, along with capacity in LMIC universities to manage research grant submissions, financing, and reporting. Both face-to-face and sustainable online teaching and learning resources were used in training at higher postgraduate levels (Masters and Doctoral level). Design We collated project meeting and discussion minutes along with project periodic reports and deliverables. We extracted key outcomes from these, reflected on these in discussions, and summarised them for this paper. Results Nearly 55 courses and modules were developed that were delivered to over 920 postgraduate students in Africa, Asia, and Europe. Junior researchers were mentored in presenting, developing, and delivering courses, and in preparing research proposals. In total, 60 collaborative funding proposals were prepared. The consortia also developed institutional capacity in research dissemination and grants management through webinars and workshops. Discussion ARCADE HSSR and ARCADE RSDH were comprehensive programmes, focussing on developing the research skills, knowledge, and capabilities of junior researchers. One of the main strengths of these programmes was the focus on network building amongst the partner institutions, where each partner brought skills, expertise, and diverse work cultures into the consortium. Through these efforts, the projects improved both the capacity of junior researchers and the research environment in Africa, Asia, and Europe.
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Affiliation(s)
- Salla Atkins
- Department of Public Health Sciences (Global Health/IHCAR), Karolinska Institutet, Stockholm, Sweden
| | | | - Vishal Diwan
- Department of Public Health Sciences (Global Health/IHCAR), Karolinska Institutet, Stockholm, Sweden.,Department of Public Health and Environment, R.D. Gardi Medical College, Ujjain, India.,International Centre for Health Research, Ujjain Charitable Trust Hospital and Research Centre, Ujjain, India
| | - Merrick Zwarenstein
- Department of Family Medicine, Centre for Studies in Family Medicine, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
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Protsiv M, Atkins S. The experiences of lecturers in African, Asian and European universities in preparing and delivering blended health research methods courses: a qualitative study. Glob Health Action 2016; 9:28149. [PMID: 27725078 PMCID: PMC5056979 DOI: 10.3402/gha.v9.28149] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Revised: 09/23/2015] [Accepted: 09/24/2015] [Indexed: 02/06/2023] Open
Abstract
Background Growing demand for Global Health (GH) training and the internationalisation of education requires innovative approaches to training. Blended learning (BL, a form of e-learning combining face-to-face or real-time interaction with computer-assisted learning) is a promising approach for increasing GH research capacity in low- to middle-income countries. Implementing BL, however, requires additional skills and efforts from lecturers. This paper explores lecturers’ views and experiences of delivering BL courses within the context of two north–south collaborative research capacity building projects, ARCADE HSSR and ARCADE RSDH. Design We used a qualitative approach to explore the experiences and perceptions of 11 lecturers involved in designing and delivering BL courses collaboratively across university campuses in four countries (South Africa, Uganda, India and Sweden). Data were collected using interviews in person or via Skype. Inductive qualitative content analysis was used. Results Participants reported that they felt BL increased access to learning opportunities and made training more flexible and convenient for adult learners, which were major motivations to engage in BL. However, despite eagerness to implement and experiment with BL courses, they lacked capacity and support, and found the task time consuming. They needed to make compromises between course objectives and available technological tools, in the context of poor Internet infrastructure. Conclusions BL courses have the potential to build bridges between low- and middle-income contexts and between lecturers and students to meet the demand for GH training. Lecturers were very motivated to try these approaches but encountered obstacles in implementing BL courses. Considerable investments are needed to implement BL and support lecturers in delivering courses.
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Affiliation(s)
- Myroslava Protsiv
- Department of Public Health Sciences, Global Health (IHCAR), Karolinska Institutet, Stockholm, Sweden;
| | - Salla Atkins
- Department of Public Health Sciences, Global Health (IHCAR), Karolinska Institutet, Stockholm, Sweden
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Zhang Z, Zhan X, Li Y, Hu R, Yan W. Web-based training for primary healthcare workers in rural China: a qualitative exploration of stakeholders' perceptions. PLoS One 2015; 10:e0125975. [PMID: 25961727 PMCID: PMC4427271 DOI: 10.1371/journal.pone.0125975] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Accepted: 03/27/2015] [Indexed: 11/29/2022] Open
Abstract
Background Equitable access to basic public health services is a priority in China. However, primary healthcare workers’ competence to deliver public health services is relatively poor because they lack professional training. Since the availability of web-based training has increased in China, the current study explored stakeholders’ perceptions of a web-based training program on basic public health services to understand their thoughts, experiences, and attitudes about it. Methods Six focus group discussions with primary healthcare workers and three with directors of township hospitals, county-level Health Bureaus, and county-level Centers for Disease Control and Prevention were conducted in Yichang City during 2013. Semi-structured topic guides were used to facilitate qualitative data collection. Audio recordings of the sessions were transcribed verbatim and theme analysis was performed. Results Most of the study’s participants, especially the village doctors, had insufficient knowledge of basic public health services. The existing training program for primary healthcare workers consisted of ineffective traditional face-to-face sessions and often posed accessibility problems for the trainees. Most of the study’s participants had a positive attitude about web-based learning and expressed a strong desire to receive this novel training approach because of its flexibility and convenience. The perceived barriers to utilizing the web-based training method included poor computer literacy, lack of personal interaction, inadequate infrastructure, and lack of time and motivation. The facilitators of this approach included the training content applicability, the user-friendly and interactive learning format, and policy support. Conclusions Web-based training on basic public health services is a promising option in rural China. The findings of the study will contribute knowledge to implementation of web-based training in similar settings.
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Affiliation(s)
- Zhixia Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, P.R. China
| | - Xingxin Zhan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, P.R. China
| | - Yingxue Li
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, P.R. China
| | - Rong Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, P.R. China
| | - Weirong Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, P.R. China
- * E-mail:
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Tanaka N, Horiuchi S, Shimpuku Y, Leshabari S. Career development expectations and challenges of midwives in Urban Tanzania: a preliminary study. BMC Nurs 2015; 14:27. [PMID: 25977640 PMCID: PMC4431371 DOI: 10.1186/s12912-015-0081-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Accepted: 04/30/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Approaches to addressing the shortage of midwives are a great need especially in Sub-Saharan Africa including Tanzania. The midwifery shortage in Tanzania consists of two major causes; the first is the shortage of pre-service nursing training and the second is the low rate of retention as it is difficult to sustain midwives' career motivations. Lack of opportunities for career development, is one of the most related problems to keep midwives motivated. Continuing education as an approach to career development can heighten midwives' motivation and cultivate more skilled midwives who can educate other midwives or students and who could raise the status of midwives. Effective continuing education is ongoing, interactive, contextually relevant and based on needs assessment, however there is very limited research that describes Tanzanian midwives perspective of expectations for career development; hence this research is significant for revealing important and meaningful professional desires of midwives in Tanzania. METHODS This was a preliminary qualitative study, using snowball sampling to recruit 16 midwives in Tanzania. The researchers used a semi-structured interview including probing questions with both a focus group and several individuals. The data were collected from July to December 2013 and coded into categories and sub-categories. RESULTS There were 14 midwives in the focus group interview and two midwives in the individual interviews. Through data analysis, four major categories (with subcategories) emerged: (1) motivation for learning (to achieve the MDGs, and to raise reproductive health), (2) knowledge is power (to provide good practice based on knowledge, to be a role model, knowledge gives higher position and courage, and knowledge enables one to approach to the government), (3) there is no end to learning (hunger for learning, and ripple effect). CONCLUSIONS From findings, four major categories plainly showed midwives' desire for learning, however they experienced a number of barriers to access further education. Continuing education is one of the most important and effective ways to cultivate and retain midwives. In order to respond to the midwives expectations and challenges to overcome the barriers inherent in providing more continuing education, it will be necessary to increase accessible opportunities for career development in Tanzania.
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Affiliation(s)
- Nao Tanaka
- St. Luke's International University, Tokyo, Japan
| | | | | | - Sebalda Leshabari
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
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Emmerick ICM, Chaves LA, Marin N, Luiza VL. Strengthening the capacity of managers in pharmaceutical services based on Primary Health Care (PHC) at different levels of the health system. HUMAN RESOURCES FOR HEALTH 2014; 12:34. [PMID: 24927816 PMCID: PMC4091956 DOI: 10.1186/1478-4491-12-34] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2013] [Accepted: 05/21/2014] [Indexed: 05/30/2023]
Abstract
INTRODUCTION Distance learning methods have been widely used because of their advantages to continuing professional development processes. The Primary Health Care (PHC) is a strategy which has been implemented in order to improve the efficiency of health systems. Due to the need for access to medicines and technologies regardless of the strengthening of health systems, a new approach that better integrates both pharmaceutical services and health systems has been implemented. CASE DESCRIPTION This is a case study which consists of describing the process of restructuring, developing and implementing the second version of the Virtual Course on Primary Health Care-based Pharmaceutical Services for managers (CVSERVFAPS-12). The main objective is to strengthen the capacity of managers in pharmaceutical services, based on PHC at different levels of the health system, in order to support the restructuring and empowering of these services and, consequently, the health systems in the American region. DISCUSSION AND EVALUATION Many evaluation tools were applied to identify the achievement/improvement of planned competencies. The intervention proposals were collectively built and intended to be more than an academic exercise, looking forward to being implemented as a strategic intervention to promote changes in the pharmaceutical services of the American region. The main strengths identified for the second version of the course were related to the quality of the didactic material and content. Additionally, the tutors' support was commented upon as a positive aspect. The main challenges faced in this rebuilding process related to the due dates of the activities and lectures as well as the time to capture and assimilate the content. CONCLUSIONS The CVSERVFAPS-Pilot was reformulated and CVSERVFAPS-12 is consistent with the issues raised in the pilot course's evaluation in 2011, which were successfully implemented. The use of the distance learning strategy, through a virtual environment, for the application of the Virtual Course on PHC- based pharmaceutical services for managers, is appropriate and confirmed its role in public policy promotion through effective retention and distribution of health workers.
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Affiliation(s)
- Isabel Cristina Martins Emmerick
- Department of Population Medicine, Harvard Medical School, Harvard University (DPM/HU), Boston, MA, USA
- Center for Pharmaceutical Policies, Sergio Arouca National School of Public Health, Oswaldo Cruz Foundation, 1480, Rua Leopoldo Bulhões, #624, Manguinhos, Rio de Janeiro 21041-210, Brazil
| | - Luisa Arueira Chaves
- Center for Pharmaceutical Policies, Sergio Arouca National School of Public Health, Oswaldo Cruz Foundation, 1480, Rua Leopoldo Bulhões, #624, Manguinhos, Rio de Janeiro 21041-210, Brazil
| | - Nelly Marin
- Center for Pharmaceutical Policies, Sergio Arouca National School of Public Health, Oswaldo Cruz Foundation, 1480, Rua Leopoldo Bulhões, #624, Manguinhos, Rio de Janeiro 21041-210, Brazil
| | - Vera Lucia Luiza
- Center for Pharmaceutical Policies, Sergio Arouca National School of Public Health, Oswaldo Cruz Foundation, 1480, Rua Leopoldo Bulhões, #624, Manguinhos, Rio de Janeiro 21041-210, Brazil
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Rasmussen K, Belisario JM, Wark PA, Molina JA, Loong SL, Cotic Z, Papachristou N, Riboli-Sasco E, Tudor Car L, Musulanov EM, Kunz H, Zhang Y, George PP, Heng BH, Wheeler EL, Al Shorbaji N, Svab I, Atun R, Majeed A, Car J. Offline eLearning for undergraduates in health professions: A systematic review of the impact on knowledge, skills, attitudes and satisfaction. J Glob Health 2014; 4:010405. [PMID: 24976964 PMCID: PMC4073241 DOI: 10.7189/jogh.04.010405] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The world is short of 7.2 million health-care workers and this figure is growing. The shortage of teachers is even greater, which limits traditional education modes. eLearning may help overcome this training need. Offline eLearning is useful in remote and resource-limited settings with poor internet access. To inform investments in offline eLearning, we need to establish its effectiveness in terms of gaining knowledge and skills, students' satisfaction and attitudes towards eLearning. METHODS We conducted a systematic review of offline eLearning for students enrolled in undergraduate, health-related university degrees. We included randomised controlled trials that compared offline eLearning to traditional learning or an alternative eLearning method. We searched the major bibliographic databases in August 2013 to identify articles that focused primarily on students' knowledge, skills, satisfaction and attitudes toward eLearning, and health economic information and adverse effects as secondary outcomes. We also searched reference lists of relevant studies. Two reviewers independently extracted data from the included studies. We synthesized the findings using a thematic summary approach. FINDINGS Forty-nine studies, including 4955 students enrolled in undergraduate medical, dentistry, nursing, psychology, or physical therapy studies, met the inclusion criteria. Eleven of the 33 studies testing knowledge gains found significantly higher gains in the eLearning intervention groups compared to traditional learning, whereas 21 did not detect significant differences or found mixed results. One study did not test for differences. Eight studies detected significantly higher skill gains in the eLearning intervention groups, whilst the other 5 testing skill gains did not detect differences between groups. No study found offline eLearning as inferior. Generally no differences in attitudes or preference of eLearning over traditional learning were observed. No clear trends were found in the comparison of different modes of eLearning. Most of the studies were small and subject to several biases. CONCLUSIONS Our results suggest that offline eLearning is equivalent and possibly superior to traditional learning regarding knowledge, skills, attitudes and satisfaction. Although a robust conclusion cannot be drawn due to variable quality of the evidence, these results justify further investment into offline eLearning to address the global health care workforce shortage.
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Affiliation(s)
- Kristine Rasmussen
- Global eHealth Unit, School of Public Health, Imperial College London, London, UK
| | | | - Petra A Wark
- Global eHealth Unit, School of Public Health, Imperial College London, London, UK
| | | | - Stewart Lee Loong
- Global eHealth Unit, School of Public Health, Imperial College London, London, UK
| | - Ziva Cotic
- Global eHealth Unit, School of Public Health, Imperial College London, London, UK
| | - Nikos Papachristou
- Global eHealth Unit, School of Public Health, Imperial College London, London, UK
| | - Eva Riboli-Sasco
- Global eHealth Unit, School of Public Health, Imperial College London, London, UK
| | - Lorainne Tudor Car
- Global eHealth Unit, School of Public Health, Imperial College London, London, UK
| | - Eve Marie Musulanov
- Global eHealth Unit, School of Public Health, Imperial College London, London, UK
| | - Holger Kunz
- Global eHealth Unit, School of Public Health, Imperial College London, London, UK
| | - Yanfeng Zhang
- Department of Integrated Early Childhood Development, Capital Institute of Pediatrics, Chaoyang District Beijing, 100020, P.R. China
| | | | | | | | - Najeeb Al Shorbaji
- Knowledge, Ethics and Research, World Health Organization, Geneva, Switzerland
| | - Igor Svab
- Department of Family Medicine, Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Rifat Atun
- Department of Global Health and Population, Harvard School of Public Health, Harvard, MA, USA
| | - Azeem Majeed
- Global eHealth Unit, School of Public Health, Imperial College London, London, UK
| | - Josip Car
- Global eHealth Unit, School of Public Health, Imperial College London, London, UK ; Health Services and Outcomes Research Programme, Lee Kong Chian School of Medicine, Imperial College & Nanyang Technological University, Singapore
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George PP, Papachristou N, Belisario JM, Wang W, Wark PA, Cotic Z, Rasmussen K, Sluiter R, Riboli-Sasco E, Tudor Car L, Musulanov EM, Molina JA, Heng BH, Zhang Y, Wheeler EL, Al Shorbaji N, Majeed A, Car J. Online eLearning for undergraduates in health professions: A systematic review of the impact on knowledge, skills, attitudes and satisfaction. J Glob Health 2014; 4:010406. [PMID: 24976965 PMCID: PMC4073252 DOI: 10.7189/jogh.04.010406] [Citation(s) in RCA: 213] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Health systems worldwide are facing shortages in health professional workforce. Several studies have demonstrated the direct correlation between the availability of health workers, coverage of health services, and population health outcomes. To address this shortage, online eLearning is increasingly being adopted in health professionals' education. To inform policy-making, in online eLearning, we need to determine its effectiveness. METHODS We performed a systematic review of the effectiveness of online eLearning through a comprehensive search of the major databases for randomised controlled trials that compared online eLearning to traditional learning or alternative learning methods. The search period was from January 2000 to August 2013. We included articles which primarily focused on students' knowledge, skills, satisfaction and attitudes toward eLearning and cost-effectiveness and adverse effects as secondary outcomes. Two reviewers independently extracted data from the included studies. Due to significant heterogeneity among the included studies, we presented our results as a narrative synthesis. FINDINGS Fifty-nine studies, including 6750 students enrolled in medicine, dentistry, nursing, physical therapy and pharmacy studies, met the inclusion criteria. Twelve of the 50 studies testing knowledge gains found significantly higher gains in the online eLearning intervention groups compared to traditional learning, whereas 27 did not detect significant differences or found mixed results. Eleven studies did not test for differences. Six studies detected significantly higher skill gains in the online eLearning intervention groups, whilst 3 other studies testing skill gains did not detect differences between groups and 1 study showed mixed results. Twelve studies tested students' attitudes, of which 8 studies showed no differences in attitudes or preferences for online eLearning. Students' satisfaction was measured in 29 studies, 4 studies showed higher satisfaction for online eLearning and 20 studies showed no difference in satisfaction between online eLearning and traditional learning. Risk of bias was high for several of the included studies. CONCLUSION The current evidence base suggests that online eLearning is equivalent, possibly superior to traditional learning. These findings present a potential incentive for policy makers to cautiously encourage its adoption, while respecting the heterogeneity among the studies.
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Affiliation(s)
- Pradeep Paul George
- Health Services and Outcomes Research, National Healthcare Group, Singapore ; Joint first authors
| | - Nikos Papachristou
- Global eHealth Unit, Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK ; Joint first authors
| | | | - Wei Wang
- Department of Integrated Early Childhood Development, Capital Institute of Pediatrics, Chaoyang District Beijing, P.R. China
| | - Petra A Wark
- Global eHealth Unit, Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
| | - Ziva Cotic
- Global eHealth Unit, Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
| | - Kristine Rasmussen
- Global eHealth Unit, Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
| | - René Sluiter
- Department of Health Evidence, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Eva Riboli-Sasco
- Global eHealth Unit, Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
| | - Lorainne Tudor Car
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
| | - Eve Marie Musulanov
- Global eHealth Unit, Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
| | | | - Bee Hoon Heng
- Health Services and Outcomes Research, National Healthcare Group, Singapore
| | - Yanfeng Zhang
- Department of Integrated Early Childhood Development, Capital Institute of Pediatrics, Chaoyang District Beijing, P.R. China
| | | | - Najeeb Al Shorbaji
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
| | - Azeem Majeed
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
| | - Josip Car
- Health Services and Outcomes Research, National Healthcare Group, Singapore ; Health Services and Outcomes Research Programme, Lee Kong Chian School of Medicine, Imperial College & Nanyang Technological University, Singapore
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Frehywot S, Vovides Y, Talib Z, Mikhail N, Ross H, Wohltjen H, Bedada S, Korhumel K, Koumare AK, Scott J. E-learning in medical education in resource constrained low- and middle-income countries. HUMAN RESOURCES FOR HEALTH 2013; 11:4. [PMID: 23379467 PMCID: PMC3584907 DOI: 10.1186/1478-4491-11-4] [Citation(s) in RCA: 238] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2012] [Accepted: 01/23/2013] [Indexed: 05/06/2023]
Abstract
BACKGROUND In the face of severe faculty shortages in resource-constrained countries, medical schools look to e-learning for improved access to medical education. This paper summarizes the literature on e-learning in low- and middle-income countries (LMIC), and presents the spectrum of tools and strategies used. METHODS Researchers reviewed literature using terms related to e-learning and pre-service education of health professionals in LMIC. Search terms were connected using the Boolean Operators "AND" and "OR" to capture all relevant article suggestions. Using standard decision criteria, reviewers narrowed the article suggestions to a final 124 relevant articles. RESULTS Of the relevant articles found, most referred to e-learning in Brazil (14 articles), India (14), Egypt (10) and South Africa (10). While e-learning has been used by a variety of health workers in LMICs, the majority (58%) reported on physician training, while 24% focused on nursing, pharmacy and dentistry training. Although reasons for investing in e-learning varied, expanded access to education was at the core of e-learning implementation which included providing supplementary tools to support faculty in their teaching, expanding the pool of faculty by connecting to partner and/or community teaching sites, and sharing of digital resources for use by students. E-learning in medical education takes many forms. Blended learning approaches were the most common methodology presented (49 articles) of which computer-assisted learning (CAL) comprised the majority (45 articles). Other approaches included simulations and the use of multimedia software (20 articles), web-based learning (14 articles), and eTutor/eMentor programs (3 articles). Of the 69 articles that evaluated the effectiveness of e-learning tools, 35 studies compared outcomes between e-learning and other approaches, while 34 studies qualitatively analyzed student and faculty attitudes toward e-learning modalities. CONCLUSIONS E-learning in medical education is a means to an end, rather than the end in itself. Utilizing e-learning can result in greater educational opportunities for students while simultaneously enhancing faculty effectiveness and efficiency. However, this potential of e-learning assumes a certain level of institutional readiness in human and infrastructural resources that is not always present in LMICs. Institutional readiness for e-learning adoption ensures the alignment of new tools to the educational and economic context.
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Affiliation(s)
- Seble Frehywot
- The George Washington University, 2121 K St NW, Washington, DC, 20037, USA
| | - Yianna Vovides
- Georgetown University, 3700 O St NW, Washington, DC, 20057, USA
| | - Zohray Talib
- The George Washington University, 2121 K St NW, Washington, DC, 20037, USA
| | - Nadia Mikhail
- The George Washington University, 2121 K St NW, Washington, DC, 20037, USA
| | - Heather Ross
- The George Washington University, 2121 K St NW, Washington, DC, 20037, USA
| | - Hannah Wohltjen
- The George Washington University, 2121 K St NW, Washington, DC, 20037, USA
| | - Selam Bedada
- The George Washington University, 2121 K St NW, Washington, DC, 20037, USA
| | - Kristine Korhumel
- The George Washington University, 2121 K St NW, Washington, DC, 20037, USA
| | - Abdel Karim Koumare
- Université de Bamako - Colline de Badalabougou, BP E2528, Bamako, Mali, West Africa
| | - James Scott
- The George Washington University, 2121 K St NW, Washington, DC, 20037, USA
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Chang LW, Kadam DB, Sangle S, Narayanan S, Borse RT, McKenzie-White J, Bowen CW, Sisson SD, Bollinger RC. Evaluation of a multimodal, distance learning HIV management course for clinical care providers in India. ACTA ACUST UNITED AC 2012; 11:277-82. [PMID: 22802357 DOI: 10.1177/1545109712451330] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Distance learning is an important tool for training HIV health workers. However, there is limited evidence on design and evaluation of distance learning HIV curricula and tools. We therefore designed, implemented, and evaluated a distance learning course on HIV management for clinical care providers in India. After course completion, participant scores rose significantly from a pretest (78.4% mean correct) compared with the posttest (87.5%, P < .001). After course completion, participants were more likely to be confident in starting an initial antiretroviral (ARV) regimen, understanding ARV toxicities, encouraging patient adherence, diagnosing immune reconstitution syndrome, and monitoring patients on ARV medications (P ≤ .05). All participants (100%) strongly agreed/agreed that they would recommend this course to others, and most of them (96%) strongly agreed/agreed that they would take a course in this format again. A pragmatic approach to HIV curriculum development and evaluation resulted in reliable learning outcomes, as well as learner satisfaction and improvement in knowledge.
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Affiliation(s)
- Larry William Chang
- 1Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
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Khandelwal S, Huffman MD, Shah S, Kishore S, Siegel K. Non-Communicable, Chronic Disease Training and Education Needs in
India. Glob Heart 2011; 6:195-9. [DOI: 10.1016/j.gheart.2011.07.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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