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.
Hum Resour Health. 2017 Dec 29;15(1):89. doi: 10.1186/s12960-017-0266-4.
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.
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.
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.
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.
在撒哈拉以南非洲，医疗工作者（HCW）能力的限制加剧了结核病和艾滋病毒双重流行的负担。为了弥补知识和技能方面的差距，需要有效的持续专业发展（CPD）计划来支持在职 HCW 达到高标准的护理水平。电子学习机会可以为实地 HCW 带来专业知识，并提供灵活的学习选择，以适应当地环境。很少有研究深入了解发展中国家背景下 HCW 对在线 CPD 的体验。
使用封闭式和开放式问题对完成华盛顿大学（UW）医学院在线研究生课程“HIV 临床管理”的撒哈拉以南非洲 HCW 进行在线调查。使用卡方检验分析与学习者特征（年龄、性别、城乡、职称）和学习偏好、课程障碍以及强调在线课程的促进因素之间的关系。p<0.05 时采用多变量逻辑回归分析有意义的协变量。使用简化的扎根理论分析开放式评论的回复。
在 2299 名前学生中，有 464 名（20%）HCW 来自 13 个国家的完成了调查：其中约一半是女性。医生（33%）、护士（27%）和临床医生（30%）主要来自城市地区（67%）和公共机构（69%）。62%的人从工作中访问在线课程，他们指出网速慢（55%）或有限（41%）以及缺乏时间（53%）是完成课程的障碍。与男性或年龄较大的 HCW 相比，女性（p<0.001）和年龄在 40 岁以下的 HCW（p=0.007）更倾向于通过指导学习。在被要求选择 3 种首选学习模式时，受访者更喜欢小组讨论（46%）、案例研究（42%）、自我指导的互联网/计算机为基础的学习（39%）和临床指导（37%）。自由回复评论进一步对在线课程的吸引力提出了积极的看法，指出了知识的收获、格式的灵活性、对课程完成的认可愿望以及对更多在线课程的要求。
来自撒哈拉以南非洲的多元化 HCW 群体接受了在线 CPD 机会，应该扩大这些机会，为自主学习提供更灵活的机会；但是，这些机会需要针对那些寻求这些课程的人的有限资源做出响应。
