Global eHealth Unit, Department of Primary Care and Public Health, School of Public Health, Imperial College London, Reynolds Building, London, W6 8RP, UK.
Dr Foster Unit, Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK.
BMC Med Educ. 2018 Apr 2;18(1):61. doi: 10.1186/s12909-018-1175-5.
Despite the increasing uptake of information and communication technologies (ICT) within healthcare services across developing countries, community healthcare workers (CHWs) have limited knowledge to fully utilise computerised clinical systems and mobile apps. The 'Introduction to Information and Communication Technology and eHealth' course was developed with the aim to provide CHWs in Malawi, Africa, with basic knowledge and computer skills to use digital solutions in healthcare delivery. The course was delivered using a traditional and a blended learning approach.
Two questionnaires were developed and tested for face validity and reliability in a pilot course with 20 CHWs. Those were designed to measure CHWs' knowledge of and attitudes towards the use of ICT, before and after each course, as well as their satisfaction with each learning approach. Following validation, a randomised controlled trial was conducted to assess the effectiveness of the two learning approaches. A total of 40 CHWs were recruited, stratified by position, gender and computer experience, and allocated to the traditional or blended learning group using block randomisation. Participants completed the baseline and follow-up questionnaires before and after each course to assess the impact of each learning approach on their knowledge, attitudes, and satisfaction. Per-item, pre-post and between-group, mean differences for each approach were calculated using paired and unpaired t-tests, respectively. Per-item, between-group, satisfaction scores were compared using unpaired t-tests.
Scores across all scales improved after attending the traditional and blended learning courses. Self-rated ICT knowledge was significantly improved in both groups with significant differences between groups in seven domains. However, actual ICT knowledge scores were similar across groups. There were no significant differences between groups in attitudinal gains. Satisfaction with the course was generally high in both groups. However, participants in the blended learning group found it more difficult to follow the content of the course.
This study shows that there is no difference between blended and traditional learning in the acquisition of actual ICT knowledge among community healthcare workers in developing countries. Given the human resource constraints in remote resource-poor areas, the blended learning approach may present an advantageous alternative to traditional learning.
尽管发展中国家的医疗服务部门越来越多地采用信息和通信技术（ICT），但社区卫生工作者（CHW）对充分利用计算机临床系统和移动应用程序的知识有限。“信息和通信技术与电子卫生简介”课程的开发旨在为非洲马拉维的 CHW 提供基本的知识和计算机技能，以在医疗保健服务中使用数字解决方案。该课程采用传统和混合学习方法进行教学。
开发了两份问卷，并在有 20 名 CHW 参与的试点课程中进行了有效性和可靠性检验。这些问卷旨在衡量 CHW 在参加课程前后对 ICT 的使用的知识和态度，以及他们对每种学习方法的满意度。在验证后，进行了一项随机对照试验，以评估两种学习方法的有效性。共招募了 40 名 CHW，按职位、性别和计算机经验进行分层，并使用分组随机化将其分配到传统或混合学习组。参与者在每次课程前后完成基线和随访问卷，以评估每种学习方法对其知识、态度和满意度的影响。使用配对和非配对 t 检验分别计算了每种方法的每个问题的前后和组间的平均差异。使用非配对 t 检验比较了每个问题的组间满意度评分。
参加传统和混合学习课程后，所有量表的分数都有所提高。两组的自我评估 ICT 知识都有显著提高，其中七个领域的组间差异具有统计学意义。然而，实际的 ICT 知识得分在两组之间相似。组间的态度增益没有显著差异。两组的课程满意度普遍较高。然而，混合学习组的参与者发现更难跟上课程的内容。
本研究表明，在发展中国家的社区卫生工作者中，混合学习和传统学习在获取实际 ICT 知识方面没有差异。鉴于偏远资源匮乏地区的人力资源限制，混合学习方法可能是传统学习的一个有利替代方案。
