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Jensen LX, Buhl A, Hussain S, Karan A, Konradsen F, Bearman M. Digital education for health professionals in India: a scoping review of the research. BMC Med Educ 2023; 23:561. [PMID: 37559028 PMCID: PMC10410828 DOI: 10.1186/s12909-023-04552-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 07/30/2023] [Indexed: 08/11/2023]
Abstract
BACKGROUND The World Health Organization (WHO) predicts a global shortfall of 18 million health workers by 2030, particularly in low- and middle-income countries like India. The country faces challenges such as inadequate numbers of health professionals, poor quality of personnel, and outdated teaching styles. Digital education may address some of these issues, but there is limited research on what approaches work best in the Indian context. This paper conducts a scoping review of published empirical research related to digital health professions education in India to understand strengths, weaknesses, gaps, and future research opportunities. METHODS We searched four databases using a three-element search string with terms related to digital education, health professions, and India. Data was extracted from 36 included studies that reported on empirical research into digital educational innovations in the formal health professions education system of India. Data were analysed thematically. RESULTS Most study rationales related to challenges facing the Indian health care system, rather than a wish to better understand phenomena related to teaching and learning. Similarly, most studies can be described as general evaluations of digital educational innovations, rather than educational research per se. They mostly explored questions related to student perception and intervention effectiveness, typically in the form of quantitative analysis of survey data or pre- and post-test results. CONCLUSIONS The analysis revealed valuable insights into India-specific needs and challenges. The Indian health professions education system's size and unique challenges present opportunities for more nuanced, context-specific investigations and contributions to the wider digital education field. This, however, would require a broadening of methodological approaches, in particular rigorous qualitative designs, and a focus on addressing research-worthy educational phenomena.
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Affiliation(s)
- Lasse X Jensen
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, Bdg. 9, Copenhagen K, 1353, Denmark.
| | - Alexandra Buhl
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, Bdg. 9, Copenhagen K, 1353, Denmark
| | | | - Anup Karan
- Public Health Foundation of India, New Delhi, India
| | - Flemming Konradsen
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, Bdg. 9, Copenhagen K, 1353, Denmark
- Novo Nordisk Foundation, Copenhagen, Denmark
| | - Margaret Bearman
- Centre for Research in Assessment and Digital Learning, Deakin University, Melbourne, Australia
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2
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Romli MH, Wan Yunus F, Cheema MS, Abdul Hamid H, Mehat MZ, Md Hashim NF, Foong CC, Hong WH, Jaafar MH. A Meta-synthesis on Technology-Based Learning Among Healthcare Students in Southeast Asia. Med Sci Educ 2022; 32:657-677. [PMID: 35573465 PMCID: PMC9077634 DOI: 10.1007/s40670-022-01564-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/27/2022] [Indexed: 05/11/2023]
Abstract
Healthcare education providers are eager to apply technologies in teaching and learning activities; however, students are the consumers in higher education, and their opinion and experience should be considered. We performed a meta-synthesis of qualitative studies to help inform our understanding of Southeast Asian healthcare students' perceptions and experience of technology-based teaching and learning in their education. Our search strategy located 1599 articles from a dozen electronic research databases. Articles were analyzed for quality using the Hawker's Evidence Appraisal Tool, and 23 qualitative studies were included in the final meta-synthesis. Technologies investigated largely involved online or blended learning, with fewer exploring virtual reality, simulations, telehealth, game-based learning, and videos. Three overarching themes were synthesized: (i) culture does matter in the implementation of technology-based learning; (ii) the values and limitations of technology used for learning; and (iii) technology is part of daily life and creates new challenges in education. Technology is an asset to enhance the learning experience, but educators must be aware of its limitations. Pre-coronavirus disease 2019 (COVID-19) studies were more focused on technology and product, and were optimistically reported, whereas COVID-19-spanning studies focused on life experience and paid more attention to reporting on the inherent challenges. The educational approaches, theories, cultural aspects, and availability of facilities all play a vital role in steering successful technology use in learning.
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Affiliation(s)
- Muhammad Hibatullah Romli
- Department of Rehabilitation Medicine, UPM Teaching Hospital, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor Malaysia
- Malaysian Research Institute on Ageing (MyAgeing), Universiti Putra Malaysia, 43400 Serdang, Selangor Malaysia
| | - Farahiyah Wan Yunus
- Centre for Rehabilitation and Special Needs Studies, Occupational Therapy Programme, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300 Kuala Lumpur, Malaysia
| | - Manraj Singh Cheema
- Department of Biomedical Science, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor Malaysia
| | - Hafizah Abdul Hamid
- Department of Human Anatomy, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor Malaysia
| | - Muhammad Zulfadli Mehat
- Department of Human Anatomy, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor Malaysia
| | - Nur Fariesha Md Hashim
- Department of Biomedical Science, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor Malaysia
| | - Chan Choong Foong
- Medical Education & Research Development Unit (MERDU), Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Wei-Han Hong
- Medical Education & Research Development Unit (MERDU), Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Mohamad Hasif Jaafar
- Academy Contemporary of Islamic Studies (ACIS), Universiti Teknologi MARA, 72000 Kuala Pilah, Negeri Sembilan Malaysia
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Bezerra de Lima AC, Moura dos Santos DC, Lima de Almeida S, da Silva EL, Batista Ferreira e Pereira E. Ensino híbrido na formação em saúde: uma revisão sistemática. Rev Cuid 2022. [DOI: 10.15649/cuidarte.2051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introdução: A partir da necessidade de reestruturação das instituições de ensino em saúde devido à pandemia da COVID-19, o ensino híbrido vem se destacando como possibilidade de reorganização das atividades educativas. O objetivo deste estudo foi escrever o desenvolvimento do ensino híbrido na formação de profissionais da área da saúde. Materiais e Métodos: Revisão sistemática da literatura, baseada nas recomendações da Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A pesquisa foi desenvolvida em pares, entre julho a setembro de 2020, em quatro bases de dados eletrônicas. Os descritores foram os termos “Educação a Distância”, “Educação Superior”, “Aprendizagem”, “Saúde”, “Enfermagem”, “Medicina”, “Odontologia” e “Fisioterapia” e “Ensino híbrido”. Os artigos foram classificados conforme seu Nível de Evidência. Resultados: 49 artigos foram selecionados, entre estudos quantitativos, qualitativos e de método misto. Foram encontradas experiências do desenvolvimento do ensino híbrido nos diferentes cursos de formação na área da saúde. Observou-se aplicação do ensino híbrido segundo o modelo de Rotação, modelo à la carte e o modelo Flex. Discussão: o ensino híbrido vem ganhando destaque cada vez maior no cenário da educação acadêmica em saúde. Foi visto que, a partir dele, o aluno destaca-se em sua aprendizagem, pois é o principal gerenciador deste processo, aprendendo ativamente por diversos instrumentos educativos a partir da condução do professor. Conclusões: O êxito do ensino híbrido pode estar relacionado ao seu caráter inovador, flexível, com boa relação custo-benefício e capaz de tornar os alunos protagonistas do seu processo de ensino-aprendizagem, influenciando no desempenho acadêmico dos alunos.
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Nathaniel TI, Goodwin RL., Fowler L, McPhail B, Black AC. An Adaptive Blended Learning Model for the Implementation of an Integrated Medical Neuroscience Course During the Covid-19 Pandemic. Anat Sci Educ 2021; 14:699-710. [PMID: 33915035 PMCID: PMC8239699 DOI: 10.1002/ase.2097] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 03/31/2021] [Accepted: 04/24/2021] [Indexed: 05/07/2023]
Abstract
The implementation of an integrated medical neuroscience course by technologically pivoting an in-person neuroscience course to online using an adaptive blended method may provide a unique approach for teaching a medical neuroscience course during the Covid-19 pandemic. An adaptive blended learning method was developed in response to the requirements necessitated by the Covid-19 pandemic. This model combined pedagogical needs with digital technology using online learning activities to implement student learning in a medical neuroscience course for year one medical students. This approach provided medical students with an individually customized learning opportunity in medical neuroscience. The students had the complete choice to engage the learning system synchronously or asynchronously and learn neuroscience materials at different locations and times in response to the demands required to deal with the pandemic. Students' performance in summative and formative examinations of the adaptive blended learning activities were compared with the previous performance obtained the previous year when the contents of the medical neuroscience course were implemented using the conventional "face-to-face" learning approach. While the cohort of our students in 2019 and 2020 changed, the contents, sessions, volume of material, and assessment were constant. This enabled us to compare the results of the 2019 and 2020 classes. Overall, students' performance was not significantly different between the adaptive blended learning and the in-person approach. More students scored between 70% and 79% during the adaptive blended learning compared with in-class teaching, while more students scored between 80% and 89% during the in-person learning than during the adaptive blended learning. Finally, the percentage of students that scored >90% was not significantly different for both Years 2019 and 2020. The adaptive blended learning approach was effective in enhancing academic performance for high-performing medical students. It also permitted the early identification of underachieving students, thereby serving as an early warning sign to permit timely intervention.
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Affiliation(s)
- Thomas I. Nathaniel
- Department of Biomedical SciencesSchool of Medicine GreenvilleUniversity of South CarolinaGreenvilleSouth Carolina
| | - Richard L . Goodwin
- Department of Biomedical SciencesSchool of Medicine GreenvilleUniversity of South CarolinaGreenvilleSouth Carolina
| | - Lauren Fowler
- Department of Biomedical SciencesSchool of Medicine GreenvilleUniversity of South CarolinaGreenvilleSouth Carolina
| | - Brooks McPhail
- Department of Biomedical SciencesSchool of Medicine GreenvilleUniversity of South CarolinaGreenvilleSouth Carolina
| | - Asa C. Black
- Department of Biomedical SciencesSchool of Medicine GreenvilleUniversity of South CarolinaGreenvilleSouth Carolina
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Vides-Porras A, Cáceres P, Company A, Guillen O, Arrien MA, Castellano Y, Margalef M, Yantuche W, Fernández E, Martínez C. Gaining insight into the implementation of an e-learning smoking cessation course in Latin American countries. Health Promot Int 2021; 36:349-362. [PMID: 32594125 DOI: 10.1093/heapro/daaa054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Continuous medical education focused on health problems emerging in low- and middle-income countries (LMICs) is scarce. Although tobacco consumption is increasing in LMICs, there is a lack of tobacco cessation training programs in these countries. To promote smoking cessation interventions in Bolivia, Guatemala and Paraguay, we adapted an e-learning program developed in Catalonia (Spain). This process evaluation study reports on reach, dose and satisfaction of participants with the course, as well as the contextual factors of its application. We conducted a multiple method evaluation, which included a survey and several focus groups, each one specific to the same type of healthcare professional (nurses, doctors, other professionals). Two hundred and ninety-two participants registered into the online course. The motivation for undertaking the course was different between doctors and nurses. The main sources of difficulty in enrolling and finishing the course were the technical problems experienced when accessing the platform, and lack of acquaintance with computers and the Internet in general. Our results show that implementing e-learning education in hospitals from LMICs is feasible, especially when there are similarities between participating countries and the country in which the original program was developed. However, several elements such as strong organizational commitment, technical support and resources and adequate communication channels should be provided to facilitate enrollment and training completion. Efforts to improve Internet access should be made to avoid jeopardizing students' motivation to enroll and complete online training.
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Affiliation(s)
- Ana Vides-Porras
- School of Social Sciences, Universidad del Valle de Guatemala, 18 Av. 11-95 zona 15 Vista Hermosa III, Guatemala 01015, Guatemala
| | - Paula Cáceres
- Radiation Oncology Department, Instituto de Cancerología y Hospital Dr. Bernardo del Valle S., 6 Av 6-58 Z-11, Guatemala
| | - Assumpta Company
- E-oncologia Unit, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain
| | - Olga Guillen
- E-oncologia Unit, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain
| | - Martha Alicia Arrien
- Instituto Oncologico del Oriente Boliviano de Santa Cruz de la Sierra Av. Marcelo Terceros Bánzer, Santa Cruz de la Sierra, Bolivia
| | - Yolanda Castellano
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO 08907.,Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain
| | - Mercè Margalef
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO 08907.,Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain
| | - Wendy Yantuche
- Oncologic Surgery, Instituto de Cancerología y Hospital Dr. Bernardo del Valle S, Guatemala
| | - Esteve Fernández
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO 08907.,Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain.,Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, C. Feixa llarga s/n, 08907.,Consortium for Biomedical Research in Respirarory Diseases (CIBER en Enfermedades Respiratorias, CIBERES), Madrid, Spain
| | - Cristina Martínez
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO 08907.,Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain.,Consortium for Biomedical Research in Respirarory Diseases (CIBER en Enfermedades Respiratorias, CIBERES), Madrid, Spain.,Department of Nursing: Public Health, Mental Health and Maternal and Child Health, Faculty of Medicine and Health Sciences, Universitat de Barcelona, L'Hospitalet del Llobregat, Barcelona, Spain.,Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, 3333 California St., Ste. 265, San Francisco, CA 94118, USA
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Nathaniel TI, Black AC. An Adaptive Blended Learning Approach in the Implementation of a Medical Neuroscience Laboratory Activities. Med Sci Educ 2021; 31:733-743. [PMID: 33850633 PMCID: PMC8032318 DOI: 10.1007/s40670-021-01263-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/01/2021] [Indexed: 05/06/2023]
Abstract
Background The COVID-19 pandemic revealed existing gaps in the medical educational system that is heavily dependent on the presence of medical students and teachers in laboratory and class for instruction. This affects continuity in the implementation of the neuroanatomy component of the medical neuroscience laboratory activities during COVID-19. We hypothesized that pivoting wet laboratory neuroanatomy activities to online using an adaptive flexible blended method might represent an effective approach in the implementation of laboratory neuroanatomy activities during a pandemic. Methods The current study describes an adaptive flexible blended learning approach that systematically mixes virtual face-to-face interaction activities with the online learning of brain structures, and the discussion of clinical cases. Learning materials are delivered through both synchronous and asynchronous modes, and Year 1 medical students learn neuroanatomy laboratory activities at different locations and different times. Student performances in the adaptive flexible blended learning approach were compared with the learning of similar activities during an in-person implementation of neuroscience laboratory activities. Results The results of using this adaptive flexible blended learning approach provided an autonomous independent learning, self-study approach that broadened student performance such that we have more students scoring between 80 and 89%, whereas the in-person learning resulted in most of the students scoring > 90% in the medical neuroscience laboratory activities. Conclusion An adaptive flexible blended learning approach that combined virtual face-to-face instruction using digital technology with online learning of neuroscience laboratory activities provided a unique educational experience for Year 1 medical students to learn neuroscience laboratory activities during the COVID-19 pandemic.
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Affiliation(s)
- Thomas I. Nathaniel
- University of South Carolina School of Medicine-Greenville, Greenville, SC 29605 USA
| | - Asa C Black
- University of South Carolina School of Medicine-Greenville, Greenville, SC 29605 USA
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Abstract
Universities must transform to fulfil expectations of the knowledge society. At the same time academics are required to respond to the dynamic environment that information and communications technologies (ICT) bring to effective and efficient teaching methods. Utilizing a qualitative case study approach, this study set out to explore experiences of academics' as they made a pedagogic turn towards using social media technology for teaching in a resource-constrained context. The Technology Acceptance Model served as the theoretical mooring of this study. Data capture included a mix of semi-structured interviews, classroom observations, document analysis and field notes. Findings are presented as three academic turns. First, a turn away from the institutions' LMS due to contextual exigencies. Second, a pedagogical turn towards Web 2.0 technologies using social media tools to enhance their pedagogy. Third, a beliefs and attitude turn about the affordances of social media; augmenting academics' resilience to persevere with this technology of choice. This study recommends that the use of social media networking in higher education creates a viable form of technology enhanced teaching, particularly in resource-constrained contexts. Further studies should explore academics emerging pedagogical practices in their use of social media, and students' perceptions and engagement in social media learning communities.
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Affiliation(s)
- Thirusellvan Vandeyar
- Department of Science, Mathematics and Technology Education, Faculty of Education, University of Pretoria, Leyds Street, Pretoria, 0002 South Africa
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Bowsher G, Papamichail A, El Achi N, Ekzayez A, Roberts B, Sullivan R, Patel P. A narrative review of health research capacity strengthening in low and middle-income countries: lessons for conflict-affected areas. Global Health 2019; 15:23. [PMID: 30914049 PMCID: PMC6434620 DOI: 10.1186/s12992-019-0465-y] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 03/07/2019] [Indexed: 11/10/2022] Open
Abstract
Conducting health research in conflict-affected areas and other complex environments is difficult, yet vital. However, the capacity to undertake such research is often limited and with little translation into practice, particularly in poorer countries. There is therefore a need to strengthen health research capacity in conflict-affected countries and regions.In this narrative review, we draw together evidence from low and middle-income countries to highlight challenges to research capacity strengthening in conflict, as well as examples of good practice. We find that authorship trends in health research indicate global imbalances in research capacity, with implications for the type and priorities of research produced, equity within epistemic communities and the development of sustainable research capacity in low and middle-income countries. Yet, there is little evidence on what constitutes effective health research capacity strengthening in conflict-affected areas. There is more evidence on health research capacity strengthening in general, from which several key enablers emerge: adequate and sustained financing; effective stewardship and equitable research partnerships; mentorship of researchers of all levels; and effective linkages of research to policy and practice.Strengthening health research capacity in conflict-affected areas needs to occur at multiple levels to ensure sustainability and equity. Capacity strengthening interventions need to take into consideration the dynamics of conflict, power dynamics within research collaborations, the potential impact of technology, and the wider political environment in which they take place.
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Affiliation(s)
- Gemma Bowsher
- Conflict and Health Research Group, Department of War Studies, King’s College London, London, UK
| | | | - Nassim El Achi
- R4HC-MENA, Global Health Institute, American University of Beirut, Beirut, Lebanon
| | | | - Bayard Roberts
- RECAP, Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Richard Sullivan
- R4HC-MENA, Institute of Cancer Policy, Conflict and Health Research Group, King’s College London, London, UK
| | - Preeti Patel
- R4HC-MENA, Department of War Studies, King’s College London, London, UK
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Burrola-Mendez Y, Goldberg M, Gartz R, Pearlman J. Development of a Hybrid Course on Wheelchair Service Provision for clinicians in international contexts. PLoS One 2018; 13:e0199251. [PMID: 29906794 PMCID: PMC6003808 DOI: 10.1371/journal.pone.0199251] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 06/04/2018] [Indexed: 01/30/2023] Open
Abstract
Introduction Wheelchair users worldwide are at high risk of developing secondary health conditions and premature death due to inappropriate wheelchair provision by untrained providers. The International Society of Wheelchair Professionals (ISWP) has developed a Hybrid Course based on the World Health Organization’s Wheelchair Service Training Package—Basic Level. The Hybrid Course leverages online modules designed for low-bandwidth internet access that reduces the in-person training exposure from five to three and a half days, making it less expensive and more convenient for both trainees and trainers. Methods The Hybrid Course was designed using a systematic approach guided by an international group of stakeholders. The development followed the Quality Matters Higher Educational Rubric, web design guidelines for low bandwidth, experts’ opinions, and the best practices for blended course design. A quasi-experimental approach was used to evaluate the effectiveness of the Hybrid Course taken by six graduate students in Rehabilitation Sciences at the University of Pittsburgh by measuring pre- and post knowledge using the validated ISWP Wheelchair Service Provision—Basic Test. The outcome measure was assessed using a paired sample t-test between pretest and posttest scores. The quality of the Hybrid Course was evaluated by three external reviewers using the Quality Matters Higher Educational Rubric who were blind to each others’ evaluation and the results of the training intervention. Results Hybrid Course participants reported significant increases in scores on the ISWP Wheelchair Service Provision—Basic Test after participating in the training, with an average increase of 10.84±5.42, p = 0.004, Cohen’s d = 1.99. In addition, the Hybrid Course met the Quality Matters Standards in two out of three evaluations and reported a percentage of agreement between evaluators of 84%. Conclusions The Hybrid Course met quality standards and proved to be effective in increasing basic level wheelchair knowledge in a group of Rehabilitation Science graduate students.
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Affiliation(s)
- Yohali Burrola-Mendez
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- International Society of Wheelchair Professionals (ISWP), University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Mary Goldberg
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- International Society of Wheelchair Professionals (ISWP), University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- * E-mail:
| | - Rachel Gartz
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- International Society of Wheelchair Professionals (ISWP), University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Jon Pearlman
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- International Society of Wheelchair Professionals (ISWP), University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
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Kumpu M, Atkins S, Zwarenstein M, Nkonki L. A partial economic evaluation of blended learning in teaching health research methods: a three-university collaboration in South Africa, Sweden, and Uganda. Glob Health Action 2016; 9:28058. [PMID: 27725076 PMCID: PMC5056980 DOI: 10.3402/gha.v9.28058] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Revised: 11/27/2015] [Accepted: 12/10/2015] [Indexed: 11/23/2022] Open
Abstract
Background Novel research training approaches are needed in global health, particularly in sub-Saharan African universities, to support strengthening of health systems and services. Blended learning (BL), combining face-to-face teaching with computer-based technologies, is also an accessible and flexible education method for teaching global health and related topics. When organised as inter-institutional collaboration, BL also has potential for sharing teaching resources. However, there is insufficient data on the costs of BL in higher education. Objective Our goal was to evaluate the total provider costs of BL in teaching health research methods in a three-university collaboration. Design A retrospective evaluation was performed on a BL course on randomised controlled trials, which was led by Stellenbosch University (SU) in South Africa and joined by Swedish and Ugandan universities. For all three universities, the costs of the BL course were evaluated using activity-based costing with an ingredients approach. For SU, the costs of the same course delivered with a classroom learning (CL) approach were also estimated. The learning outcomes of both approaches were explored using course grades as an intermediate outcome measure. Results In this contextually bound pilot evaluation, BL had substantially higher costs than the traditional CL approach in South Africa, even when average per-site or per-student costs were considered. Staff costs were the major cost driver in both approaches, but total staff costs were three times higher for the BL course at SU. This implies that inter-institutional BL can be more time consuming, for example, due to use of new technologies. Explorative findings indicated that there was little difference in students’ learning outcomes. Conclusions The total provider costs of the inter-institutional BL course were higher than the CL course at SU. Long-term economic evaluations of BL with societal perspective are warranted before conclusions on full costs and consequences of BL in teaching global health topics can be made.
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Affiliation(s)
- Minna Kumpu
- 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
| | - Merrick Zwarenstein
- Centre for Studies in Family Medicine, Department of Family Medicine, Western University, London, Ontario, Canada
| | - Lungiswa Nkonki
- Centre for Health Systems and Services Research, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa;
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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: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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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Affiliation(s)
- Henry Lucas
- Health and Nutrition, Institute of Development Studies, University of Sussex, Brighton BN1 9RE, UK
| | - John Kinsman
- Division of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, 901 87 Umeå, Sweden
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Atkins S, Yan W, Meragia E, Mahomed H, Rosales-Klintz S, Skinner D, Zwarenstein M. Student experiences of participating in five collaborative blended learning courses in Africa and Asia: a survey. Glob Health Action 2016; 9:28145. [PMID: 27725077 PMCID: PMC5056983 DOI: 10.3402/gha.v9.28145] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Revised: 12/03/2015] [Accepted: 01/08/2016] [Indexed: 02/06/2023] Open
Abstract
Background As blended learning (BL; a combination of face-to-face and e-learning methods) becomes more commonplace, it is important to assess whether students find it useful for their studies. ARCADE HSSR and ARCADE RSDH (African Regional Capacity Development for Health Systems and Services Research; Asian Regional Capacity Development for Research on Social Determinants of Health) were unique capacity-building projects, focusing on developing BL in Africa and Asia on issues related to global health. Objective We aimed to evaluate the student experience of participating in any of five ARCADE BL courses implemented collaboratively at institutions from Africa, Asia, and Europe. Design A post-course student survey with 118 students was conducted. The data were collected using email or through an e-learning platform. Data were analysed with SAS, using bivariate and multiple logistic regression. We focused on the associations between various demographic and experience variables and student-reported overall perceptions of the courses. Results In total, 82 students responded to the survey. In bivariate logistic regression, the course a student took [p=0.0067, odds ratio (OR)=0.192; 95% confidence interval (CI): 0.058–0.633], male gender of student (p=0.0474, OR=0.255; 95% CI: 0.066–0.985), not experiencing technical problems (p<0.001, OR=17.286; 95% CI: 4.629–64.554), and reporting the discussion forum as adequate for student needs (p=0.0036, OR=0.165; 95% CI: 0.049–0.555) were found to be associated with a more positive perception of BL, as measured by student rating of the overall helpfulness of the e-learning component to their studies. In contrast, perceiving the assessment as adequate was associated with a worse perception of overall usefulness. In a multiple regression, the course, experiencing no technical problems, and perceiving the discussion as adequate remained significantly associated with a more positively rated perception of the usefulness of the online component of the blended courses. Discussion The results suggest that lack of technical problems and functioning discussion forums are of importance during BL courses focusing on global health-related topics. Through paying attention to these aspects, global health education could be provided using BL approaches to student satisfaction.
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Affiliation(s)
- Salla Atkins
- Department of Public Health Sciences (Global Health/IHCAR), Karolinska Institutet, Stockholm, Sweden;
| | - Weirong Yan
- Department of Public Health Sciences (Global Health/IHCAR), Karolinska Institutet, Stockholm, Sweden.,Tongji Medical College, Huazhong, University of Science and Technology, Wuhan, China
| | - Elnta Meragia
- Department of Public Health Sciences (Global Health/IHCAR), Karolinska Institutet, Stockholm, Sweden
| | - Hassan Mahomed
- Division of Community Health, Department of Interdisciplinary Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa.,Metro District Health Services, Western Cape Government, Cape Town, South Africa
| | - Senia Rosales-Klintz
- Department of Public Health Sciences (Global Health/IHCAR), Karolinska Institutet, Stockholm, Sweden
| | - Donald Skinner
- Research on Health and Society, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - 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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Färnman R, Diwan V, Zwarenstein M, Atkins S. Successes and challenges of north-south partnerships - key lessons from the African/Asian Regional Capacity Development projects. Glob Health Action 2016; 9:30522. [PMID: 27725080 PMCID: PMC5056985 DOI: 10.3402/gha.v9.30522] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Revised: 05/12/2016] [Accepted: 06/01/2016] [Indexed: 12/03/2022] Open
Abstract
Introduction Increasing efforts are being made globally on capacity building. North–south research partnerships have contributed significantly to enhancing the research capacity in low- and middle-income countries (LMICs) over the past few decades; however, a lack of skilled researchers to inform health policy development persists, particularly in LMICs. The EU FP7 funded African/Asian Regional Capacity Development (ARCADE) projects were multi-partner consortia aimed to develop a new generation of highly trained researchers from universities across the globe, focusing on global health-related subjects: health systems and services research and research on social determinants of health. This article aims to outline the successes, challenges and lessons learned from the life course of the projects, focusing on the key outputs and experiences of developing and implementing these two projects together with sub-Saharan African, Asian and European institution partners. Design Sixteen participants from 12 partner institutions were interviewed. The data were analysed using thematic content analysis, which resulted in four themes and three sub-categories. These data were complemented by a review of project reports. Results The results indicated that the ARCADE projects have been successful in developing and delivering courses, and have reached over 920 postgraduate students. Some partners thought the north–south and south–south partnerships that evolved during the project were the main achievement. However, others found there to be a ‘north–south divide’ in certain aspects. Challenges included technical constraints and quality assurance. Additionally, adapting new teaching and learning methods into current university systems was challenging, combined with not being able to award students with credits for their degrees. Conclusion The ARCADE projects were introduced as an innovative and ambitious project idea, although not designed appropriately for all partner institutions. Some challenges were underestimated from the beginning, and for such future projects, a more structured approach needs to be adopted. ARCADE partners learned that integrating courses into current university systems and awarding students credits are essential.
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Affiliation(s)
- Rosanna Färnman
- 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
| | - Merrick Zwarenstein
- Centre for Studies in Family Medicine, Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Salla Atkins
- Department of Public Health Sciences (Global Health/IHCAR), Karolinska Institutet, Stockholm, Sweden;
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Protsiv M, Rosales-Klintz S, Bwanga F, Zwarenstein M, Atkins S. Blended learning across universities in a South-North-South collaboration: a case study. Health Res Policy Syst 2016; 14:67. [PMID: 27589996 PMCID: PMC5010676 DOI: 10.1186/s12961-016-0136-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 08/09/2016] [Indexed: 11/10/2022] Open
Abstract
Background Increased health research capacity is needed in low- and middle-income countries to respond to local health challenges. Technology-aided teaching approaches, such as blended learning (BL), can stimulate international education collaborations and connect skilled scientists who can jointly contribute to the efforts to address local shortages of high-level research capacity. The African Regional Capacity Development for Health Systems and Services Research (ARCADE HSSR) was a European Union-funded project implemented from 2011 to 2015. The project consortium partners worked together to expand access to research training and to build the research capacity of post-graduate students. This paper presents a case study of the first course in the project, which focused on a meta-analysis of diagnostic accuracy studies and was delivered in 2013 through collaboration by universities in Uganda, Sweden and South Africa. Methods We conducted a mixed-methods case study involving student course evaluations, participant observation, interviews with teaching faculty and student feedback collected through group discussion. Quantitative data were analysed using frequencies, and qualitative data using thematic analysis. Results A traditional face-to-face course was adapted for BL using a mixture of online resources and materials, synchronous online interaction between students and teachers across different countries complemented by face-to-face meetings, and in-class interaction between students and tutors. Synchronous online discussions led by Makerere University were the central learning technique in the course. The learners appreciated the BL design and reported that they were highly motivated and actively engaged throughout the course. The teams implementing the course were small, with individual faculty members and staff members carrying out many extra responsibilities; yet, some necessary competencies for course design were not available. Conclusions BL is a feasible approach to simultaneously draw globally available skills into cross-national, high-level skills training in multiple countries. This method can overcome access barriers to research methods courses and can offer engaging formats and personalised learning experiences. BL enables teaching and learning from experts and peers across the globe with minimal disruption to students’ daily schedules. Transforming a face-to-face course into a blended course that fulfils its full potential requires concerted effort and dedicated technological and pedagogical support.
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Affiliation(s)
- Myroslava Protsiv
- Department of Public Health Sciences (Global Health/IHCAR), Karolinska Institutet, Tomtebodavägen 18A, 171 77, Stockholm, Sweden.
| | - Senia Rosales-Klintz
- Department of Public Health Sciences (Global Health/IHCAR), Karolinska Institutet, Tomtebodavägen 18A, 171 77, Stockholm, Sweden
| | - Freddie Bwanga
- College of Health Sciences, Makerere University, Kampala, Uganda
| | - Merrick Zwarenstein
- Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, 1151 Richmond St, N6A 3K7, London, Ontario, Canada.,Faculty of health sciences, Stellenbosch University, Francie Van Zijl Dr, Tygerberg Hospital, Cape Town, 7505, South Africa
| | - Salla Atkins
- Department of Public Health Sciences (Global Health/IHCAR), Karolinska Institutet, Tomtebodavägen 18A, 171 77, Stockholm, Sweden
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