Delivering Modern Global Health Learning Requires New Obligations and Approaches

WHO public health laboratories webinar series - an online platform to disseminate testing recommendations and best practices during health emergencies

Laboratories play a central role in managing public health emergencies. The COVID-19 pandemic imposed unique challenges on global laboratory systems, including testing protocol uncertainties, supply shortages, rapid need for information dissemination, and disruptions to traditional training methods. In response, the WHO established the Public Health Laboratories (PHL) knowledge sharing webinar series whose goals were to respond to the increased demand in up-to-date and reliable information, which WHO is in a unique position to provide. It also aimed to enhance peer-to-peer exchanges across laboratories. This article outlines the PHL webinar series delivery format and presents how the webinar series was received and perceived by participants and how it evolved to support the response to other health emergencies. Contents of the knowledge sharing sessions, as well as attendance, participants' satisfaction and application of learning were monitored over time using registration forms, satisfaction polls, an annual survey and focus group discussions. From May 2020 to December 2023, 48 sessions attracted 58,688 registrations from 204 countries and territories. Thirty-five sessions featured presentations of WHO guidance, tools or documents and 39 sessions featured country experience sharing. Initially focused on COVID-19, the series became a tool to rapidly disseminate guidance and best practices during new health emergencies and to address cross-cutting topics relevant to the laboratory workforce. Feedback data shows participants found the webinars very useful (86% respondents), reporting knowledge gains in biosafety, quality management, and laboratory practices. The series facilitated knowledge application, with foreseen changes in workplace procedures and training activities (43% respondents). Barriers such as resource limitations, additional training needs, and connectivity issues were frequently identified. Evidence that this knowledge was subsequently applied by participants, such as through changes in workflow, onwards training events and procedural changes further reinforces the efficacy with which the series was able support the laboratory workforce globally in addressing challenges of the COVID-19 pandemic and other health emergencies. The series utilized sessions on cross-cutting topics to run routinely and to keep a high level of engagement with laboratory professionals globally. This enabled it to act as an adaptable tool that was leveraged effectively and quickly during health emergencies for just-in-time learning.

Assessing trainee critical thinking skills using a novel interactive online learning tool

BACKGROUND

Critical thinking is essential for the accurate diagnosis and management of patients. It is correlated with academic success.

OBJECTIVE

Our objective was to design a novel tool for interactive online learning to improve knowledge and to assess trainees' critical thinking skills using the framework of the American Philosophical Association (APA).

METHODS

Residents, fellows and students participated in an online, self-directed case-based vignette activity to learn malaria diagnosis and management. Pre and post-tests with multiple choice and open-ended case-based questions assessed knowledge and critical thinking. Comparison between pre and post-test scores across subgroups were performed using paired t-tests or one-way ANOVA.

RESULTS

Between 4 April 2017 to 14 July 2019, 62 of 75 (82%) eligible subjects completed both the pre and the post-test. Improved post-test scores occurred in 90% of medical students, p=0.001, 77% of residents, p<0.001, 60% of fellows, p=0.72 and 75% of trainees overall, p=<0.001. Fellows had higher pre-test scores than students or residents but there was no difference by level of training on the post-test.

CONCLUSIONS

This interactive online learning activity effectively imparted medical knowledge and improved trainee responses to questions requiring critical thinking. To our knowledge, this is the first time the APA's critical thinking framework has been incorporated into interactive online learning and assessment of critical thinking skills in medical trainees. We applied this innovation specifically in global health education, but there is obvious potential to expand it to a wide variety of areas of clinical training.

Implementation and evaluation of crowdsourcing in global health education

BACKGROUND

Current global health course is most set as elective course taught in traditional teacher-taught model with low credit and short term. Innovate teaching models are required. Crowdsourcing characterized by high flexibility and strong application-orientation holds its potential to enhance global health education. We applied crowdsourcing to global health teaching for undergraduates, aiming to develop and evaluate a new teaching model for global health education.

METHODS

Crowdsourcing was implemented into traditional course-based teaching via introducing five COVID-19 related global health debates. Undergraduate students majoring in preventative medicine and nursing grouped in teams of 5-8, were asked to resolve these debates in reference to main content of the course and with manner they thought most effective to deliver the messages. Students' experience and teaching effect, were evaluated by questionnaires and teachers' ratings, respectively. McNemar's test was used to compare the difference in students' experience before and after the course, and regression models were used to explore the influencing factors of the teaching effect.

RESULTS

A total of 172 undergraduates were included, of which 122 (71%) were females. Students' evaluation of the new teaching model improved after the course, but were polarized. Students' self-reported teaching effect averaged 67.53 ± 16.8 and the teachers' rating score averaged 90.84 ± 4.9. Students majoring in preventive medicine, participated in student union, spent more time on revision, and had positive feedback on the new teaching model tended to perform better.

CONCLUSION

We innovatively implemented crowdsourcing into global health teaching, and found this new teaching model was positively received by undergraduate students with improved teaching effects. More studies are needed to optimize the implementation of crowdsourcing alike new methods into global health education, to enrich global health teaching models.

Evaluation of the COVID-19 Lockdown-Adapted Online Methodology for the Cytology and Histology Course as Part of the Degree in Veterinary Medicine

The COVID-19 pandemic and lockdown brought numerous teaching challenges requiring innovative approaches to teaching and learning, including novel modes of content delivery, virtual classrooms, and online assessment schemes. The aim of this study is to describe and assess the efficacy of the methods implemented at the University of León (Spain) to adapt to lockdowns in the context of the Cytology and Histology (CH) course for veterinary medicine undergraduate students. To evaluate the success of lockdown-adapted methodologies, we used inferential statistical analysis to compare the academic outcomes of two cohorts: 2018–2019 (traditional face-to-face—presential—learning and evaluation) and 2019–2020 (some face-to-face and some online lockdown-adapted learning and online lockdown-adapted evaluation). This analysis considered scores in both theoretical and practical exams and students’ final subject score. We also evaluated the number of logs onto the Moodle platform throughout the 2019–2020 period, as well as performing a student satisfaction survey in both courses. The use of explanatory pre-recorded lectures, continuous online self-assessment tests, and virtual microscopy (VM) may have produced significant improvements in the acquisition of histology competencies among students in the lockdown cohort. However, we need to implement further strategies to improve the assessment of students’ true level of knowledge acquisition. According to the student feedback, VM is a well-accepted resource that is perceived as a flexible and enjoyable tool to use. However, while students found that the resource enhances their ability to learn about microscopic structures, they felt that it should not completely replace optical microscopy.