The effectiveness of E-learning in continuing medical education for tuberculosis health workers: a quasi-experiment from China

Enhancing knowledge of vascular pythiosis: Impact of a self-paced online course among Thai learners

BACKGROUND

Pythiosis caused by Pythium insidiosum, is a rare but deadly infectious disease that is often underrecognized. The disease has high morbidity and mortality rates, particularly in vascular forms where surgical resection is necessary. A previous study demonstrated low awareness and knowledge of vascular pythiosis among Thai medical personnel. There is an urgent need to improve disease recognition given that vascular pythiosis is very prevalent in Thailand.

METHODS

This study aimed to enhance knowledge and disease recognition about vascular pythiosis among Thai medical personnel and the public through a self-paced, asynchronous, open-access online course. The course included seven video lessons and was available from February to July 2023. Participants' knowledge was assessed using pretest and posttest analysis.

RESULTS

A total of 428 participants completed the course. Participants showed significant knowledge improvement, with mean posttest scores substantially higher than pretest scores, 6.77 vs. 3.46 (p-value < 0.01). Higher educational level had a positive impact with higher pretest and posttest scores, but the delta scores between the posttest and pretest of all groups were comparable. Moreover, 80% of participants demonstrated knowledge gain. However, participants of all groups scored the lowest on the posttest in diagnostic investigation field.

CONCLUSIONS

Very low pretest scores underline the neglected problem of vascular pythiosis. This asynchronous online course successfully enhanced participants' knowledge about vascular pythiosis. Future efforts should focus on collaborative initiatives at the government and university levels to emphasize disease recognition.

Evaluation and examination of factors influencing the continued effective use of E-learning among faculty members of medical sciences universities

INTRODUCTION

E-learning facilitates the learning process for medical students by allowing them to enhance their knowledge, skills, and professional experiences, thereby improving quality and standards in education. The objective is to investigate the continuity of use of e-learning systems among academic faculty members of medical sciences universities.

METHODS

A researcher-constructed questionnaire was distributed to collect data from approximately 300 faculty members of medical sciences universities who have used the e-learning system for at least one year. Out of these, 120 questionnaires contained valid responses. The data were processed using statistical software and the statistical analysis technique based on (SEM).

RESULTS

The results indicated that among the demographic factors of the members, age has a significant impact on the continued use of the electronic learning system. Among the two most influential factors on the continued use of the system, perceived usefulness and satisfaction, perceived usefulness was not influential in our study. This means that the members are aware of the benefits of face-to-face instruction compared to system use because the system is simple and basic without features.

CONCLUSION

In our study, the incentive factor was not influential, partly due to the alignment of objectives between university management and faculty members and the use of the electronic system. Presenting more complex systems incorporating decision support and virtual training could increase perceived usefulness somewhat. Additionally, providing blended systems, combining face-to-face and virtual modalities, could compensate for the perceived usefulness.

CLINICAL TRAIL NUMBER

Not applicable.

Identification of the contextual factors influencing the successful implementation of in-service training policies for the health workforce in Iran

BACKGROUND

In-service training is critical for achieving organizational goals and developing the health workforce. Therefore, this study aimed to identify contextual factors that significantly impact the implementation of in-service training policies for the health workers.

METHODS

This study employed an inductive qualitative approach, utilizing semi-structured interviews as the data collection method. The target group consisted of human resources managers and experts. Purposeful sampling was conducted using the snowball method. A total of 23 interviews were conducted, and data saturation was achieved. Framework analysis was performed using MAXQDA10 software to analyze the data. To enhance the credibility of the findings, interview transcripts, and the initially extracted codes were shared with participants for verification. Additionally, various methods were employed to ensure the accuracy and reliability of the data, including seeking input and additional comments from two colleagues and one expert familiar with qualitative research, as well as sending the interview transcripts and extracted codes to each participant for correction during the data collection phase.

RESULTS

The analysis of the data identified seven themes and 16 subthemes related to the implementation of in-service training for healthcare workers. These themes include social factors, personal characteristics, economic and political factors, crises and epidemics, organizational factors, and legal factors. Social factors, such as social crises and demographic characteristics, can affect the type of training provided. Personal characteristics, including motivation, age, job position, and gender, can influence the implementation of training. Political and economic factors, such as government policies and budget constraints, also play a role. Crises and epidemics present opportunities for relevant training. Organizational factors, such as top management commitment and organizational culture, determine the success of training. Legal factors, including restrictive laws and incentives, impact the implementation of training.

CONCLUSIONS

The implementation of policies cannot be considered in isolation from contextual factors. Therefore, decision-makers and policymakers should thoroughly identify and analyze the relevant contextual factors when formulating and implementing policies. This approach will enable them to make informed decisions based on the specific context.

Physician preferences for Online and In-person continuing medical education: a cross-sectional study

BACKGROUND

The worldwide market for continuing medical education (CME) was severely affected by the COVID-19 pandemic, which precipitated an increase in web-based CME course attendance. Virtual education methods may be effective for engaging learners and changing behaviors. However, more information is needed about physician preferences for in-person vs. livestreamed CME courses in the postpandemic era. Because of the paucity of data regarding this topic, the current study was designed to evaluate CME participant characteristics, preferences, engagement, and satisfaction with traditional in-person vs. virtual educational methods.

METHODS

A cross-sectional study was performed of attendees of two large internal medicine CME courses held in 2021. Both CME courses were offered via in-person and livestream options, and were taught by Mayo Clinic content experts. Participants, who consisted of practicing physicians seeking CME, completed a 41-question survey after CME course completion. Statistical comparisons were performed by using Fisher exact tests for all survey items, except for those with ordinal response sets, which were compared with Cochran-Armitage trend tests.

RESULTS

A total of 146 participants completed the survey (response rate, 30.2%). Among the 77 respondents who attended in-person courses, the most frequent reasons indicated were the opportunity to travel (66%) and collaboration/networking with others (25%). Among the 68 respondents who attended the livestream courses, the most frequent reasons indicated included COVID-19-related concerns (65%), convenience (46%), and travel costs (34%). The percentage of respondents who indicated that they would choose the same mode of attendance if given the option again was higher for those who attended in person than for those who attended via livestream (91% vs. 65%, P < .001).

CONCLUSIONS

These data suggest that in-person course offerings will continue to be a preferred learning method for some physicians. However, most respondents who attended virtually preferred that method. Therefore, hybrid CME models offering both in-person and virtual options may be most beneficial for meeting the needs of all CME learners.

Effectiveness of eLearning programme for capacity building of healthcare professionals: a systematic review

BACKGROUND

The effectiveness of eLearning in enhancing healthcare professionals' capacity has received substantial attention globally. This review sought to synthesis evidence on the effectiveness of various types of eLearning programmes, and the facilitators and barriers to its use.

METHODS

The review was guided by Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Four main databases (PubMed, Web of Science, JSTOR, and Scopus) in July 2023 and 44 articles met the eligibility criteria and were included in the review. The JBI critical appraisal checklist was used to appraise the methodological quality of the studies. The data were examined using narrative review to determine the effectiveness of the intervention as well as the barriers and facilitators to its use.

RESULTS

This review found that asynchronous, synchronous, blended, and self-learning methodologies are effective eLearning approaches for continuous professional development. Previous positive experiences, user-friendly interfaces and relevance of the eLearning content to daily practice are critical elements that facilitate eLearning usage. Poor computer competence and literacy, lack of personal computers and high family duties were the main personal factors that hindered eLearning use. Some systemic barriers included; heavy workloads, shortage of specialised eLearning facilitators poor management involvement, and technical inadequacies within the ICT departments. Environmental issues such as poor infrastructure, including limited internet and frequent power outages acted as barriers.

CONCLUSION

The review highlights the effectiveness of various eLearning approaches among health professionals and presents the disparities between developing and developed economies in relation to the facilitators and barriers.

Evaluating tuberculosis knowledge and awareness of effective control practices among health care workers in primary- and secondary-level medical institutions in Beijing, China

OBJECTIVE

Inadequate tuberculosis (TB) knowledge and awareness of proper TB control practices among health care workers (HCWs) may increase the risk of nosocomial TB transmission. This study aimed to assess HCWs' TB-related knowledge and control practices to guide the development of more effective targeted TB health education and training programs.

METHODS

In January 2023 a cross-sectional survey was administered to 323 HCWs employed by five primary health care centers and three secondary comprehensive medical institutions in Beijing, China. Survey data were collected using a standard questionnaire.

RESULTS

Analysis of survey responses revealed TB knowledge and practices awareness rates of 60.4% and 90.6%, respectively. The overall average awareness rate across all 19 TB knowledge- and practice-related questions was 70.0%. Intermediate- and senior-level HCW's average TB knowledge score was respectively 2.225 and 8.175 times higher than that of primary-level HCWs, while the average TB knowledge score of HCWs in secondary comprehensive medical institutions was 3.052 times higher than that of HCWs in primary health care centers. Higher average TB knowledge score correlated with higher-level professional titles and higher level work units, but higher average TB control practices score correlated with employment at primary health care center rather than secondary comprehensive medical institution. Notably, 13.6% of HCWs had not received TB training during the past three years, while 86.1% expressed willingness to undergo online TB training.

CONCLUSION

These findings highlight inadequate TB knowledge and awareness of proper TB control practices among HCWs in primary health care centers and secondary comprehensive medical institutions in Beijing, underscoring the urgent need for targeted educational and training initiatives to improve TB awareness and control efforts.

Learning interventions and training methods in health emergencies: A scoping review

BACKGROUND

Keeping the health workforce and the public informed about the latest evolving health information during a health emergency is critical to preventing, detecting and responding to infectious disease outbreaks or other health emergencies. Having a well-informed, ready, willing, and skilled workforce and an informed public can help save lives, reduce diseases and suffering, and minimize socio-economic loss in affected communities and countries. Providing "just in time" support and opportunities for learning in health emergencies is much needed for capacity building. In this paper, 'learning intervention' refers to the provision of ad-hoc, focused, or personalized training sessions with the goal of preparing the health workers for emergencies or filling specific knowledge or skill gaps. We refer to 'training methods' as instructional design strategies used to teach someone the necessary knowledge and skills to perform a task.

METHODS

We conducted a scoping review to map and better understand what learning interventions and training methods have been used in different types of health emergencies and by whom. Studies were identified using six databases (Pubmed/Medline, Embase, Hinari, WorldCat, CABI and Web of Science) and by consulting with experts. Characteristics of studies were mapped and displayed and major topic areas were identified.

RESULTS

Of the 319 records that were included, contexts most frequently covered were COVID-19, disasters in general, Ebola and wars. Four prominent topic areas were identified: 1) Knowledge acquisition, 2) Emergency plans, 3) Impact of the learning intervention, and 4) Training methods. Much of the evidence was based on observational methods with few trials, which likely reflects the unique context of each health emergency. Evolution of methods was apparent, particularly in virtual learning. Learning during health emergencies appeared to improve knowledge, general management of the situation, quality of life of both trainers and affected population, satisfaction and clinical outcomes.

CONCLUSION

This is the first scoping review to map the evidence, which serves as a first step in developing urgently needed global guidance to further improve the quality and reach of learning interventions and training methods in this context.

Using a participatory design to develop an implementation framework for integrating falls prevention for older people within the Chinese primary health care system

BACKGROUND

Chinese National Essential Public Health Service Package (NEPHSP) has mandated primary health care providers to provide falls prevention for community-dwelling older people. But no implementation framework is available to guide better integration of falls prevention for older people within the primary health care system.

METHODS

This is a two-stage online participatory design study consisting of eight workshops with stakeholders from three purposively selected cities. First, two workshops were organised at each study site to jointly develop the framework prototype. Second, to refine, optimise and finalise the prototype via two workshops with all study participants. Data analysis and synthesis occurred concurrently with data collection, supported by Tencent Cloud Meeting software.

RESULTS

All participants confirmed that the integration of falls prevention for older people within the NEPHSP was weak and reached a consensus on five opportunities to better integrate falls prevention, including workforce training, community health promotion, health check-ups, health education and scheduled follow-up, during the delivery of NEPHSP. Three regional-tailored prototypes were then jointly developed and further synthesised into a generic implementation framework by researchers and end-users. Guided by this framework, 11 implementation strategies were co-developed under five themes.

CONCLUSIONS

The current integration of falls prevention in the NEPHSP is weak. Five opportunities for integrating falls prevention in the NEPHSP and a five-themed implementation framework with strategies are co-identified and developed, using a participatory design approach. These findings may also provide other regions or countries, facing similar challenges, with insights for promoting falls prevention for older people.

Diversity competence training for health professionals in Europe: a modified delphi study investigating relevant content for short or online courses

BACKGROUND

Diversity is a reality in our societies, requiring health professionals to adapt to the unique needs of all patients, including migrants and ethnic minorities. In order to enable health professionals to meet related challenges and reduce health disparities, long and demanding training courses have been developed. But due to busy schedules of professionals and often scarce resources, a need for shorter training courses exists. This study aims to investigate which topics and methods should be prioritised in designing basic diversity training courses that provide health professionals the opportunity to foster this competence.

METHODS

The study provided an expert panel of 31 academic and clinical migrant health experts with the content and methods of an existing diversity training course. The panel was asked to prioritise training topics and teaching methods in a two-stage process, using an adapted Delphi method. In the first stage, experts rated 96 predefined items, commented on those items, provided answers to eight open-ended questions and suggested additional content for a short course. In the second stage, they commented on the ratings from Round 1, and rated new suggested content. Consensus for training topics was set to 80% and for teaching methods 70%.

RESULTS

The entire panel deemed 'health effects of migration (pre-, during- and post-migration risk factors)' to be important or very important to include in a short/online, basic diversity training (100% consensus). Other high-scoring items and therefore topics to be included in trainings were 'social determinants of health' (97%) and 'discrimination within the healthcare sector' (also 97%). A general trend was to focus on reflective practice since almost all items regarding reflection reached consensus. 'Reflection on own stereotypes and prejudices' (97%) was the highest-rated reflection item. 'Opportunities and best practices in working with interpreters' was the highest-scoring skills item, both on consensus (96%) and mean value (5.77).

CONCLUSIONS

Experts' prioritizations of teaching content and methods for diversity training can help the design of short (online) trainings for health professionals and reduce unnecessary course content, thereby fostering professional development and enabling diversity competence trainings to be implemented also when time and/or financial resources are limited.

Factors Influencing the Effectiveness of E-Learning in Healthcare: A Fuzzy ANP Study

E-learning has transformed the healthcare education system by providing healthcare professionals with training and development opportunities, regardless of their location. However, healthcare professionals in remote or rural areas face challenges such as limited access to educational resources, lack of reliable internet connectivity, geographical isolation, and limited availability of specialized training programs and instructors. These challenges hinder their access to e-learning opportunities and impede their professional development. To address this issue, a study was conducted to identify the factors that influence the effectiveness of e-learning in healthcare. A literature review was conducted, and two questionnaires were distributed to e-learning experts to assess primary variables and identify the most significant factor. The Fuzzy Analytic Network Process (Fuzzy ANP) was used to identify the importance of selected factors. The study found that success, satisfaction, availability, effectiveness, readability, and engagement are the main components ranked in order of importance. Success was identified as the most significant factor. The study results highlight the benefits of e-learning in healthcare, including increased accessibility, interactivity, flexibility, knowledge management, and cost efficiency. E-learning offers a solution to the challenges of professional development faced by healthcare professionals in remote or rural areas. The study provides insights into the factors that influence the effectiveness of e-learning in healthcare and can guide the development of future e-learning programs.

E-Learning Success Model in the Context of COVID-19 Pandemic in Higher Educational Institutions

Nowadays, the extensive use of e-learning in higher educational institutions in many countries leads us to apprehend the reality, precisely the key success/failure factors of the implementation, of e-learning systems in these institutions. This motivation becomes more and more important, inevitable, and urgent, especially for institutions that have heavily adopted e-learning systems under exceptional conditions without any prior planning, such as the COVID-19 pandemic. From this perspective, this research aimed to provide an e-learning success model in the context of the COVID-19 pandemic by assessing e-learning effectiveness and by investigating the key antecedents of e-learning effectiveness. The literature review led to the identification of four main factors influencing e-learning effectiveness: The e-learning system, e-learning readiness, interactivity, and resistance to change. These four variables constituted the antecedents of an effective e-learning system, which was tested in a KSA context. A structured survey, including a sample of 1202 students from Imam Mohammad Ibn Saud Islamic University was used to examine the linkages among our proposed model. The model, with a total of ten direct and six indirect relationships, was tested by using structural equation modeling. The research findings indicate that effective e-learning is supported by the interactions between four factors: the e-learning system, e-learning readiness, interactivity, and resistance to change.