Bonawitz Rachael, Bird Liat, Le Ngoc Bao, Nguyen Viet Ha, Halim Nafisa, Williams Anna Larson, Sabin Lora, Gill Christopher J
Department of Global Health, Boston University School of Public Health, Boston, USA.
Department of Pediatrics, Boston University School of Medicine, Boston, USA.
Mhealth. 2019 Feb 25;5:7. doi: 10.21037/mhealth.2019.02.01. eCollection 2019.
Mobile technology is a novel approach for delivering continuing medical education (CME), with numerous advantages including lower costs and the ability to reach larger numbers than traditional in-person CME workshops.
From May 2015 to May 2017, we conducted two randomized controlled trials in a phased approach to evaluate the effectiveness of a mobile CME (mCME) approach for two cadres of health professionals in Vietnam. The first randomized controlled trial (RCT) tested the use of an SMS-based educational intervention among Community-Based Physician's Assistants; while feasible and acceptable, this intervention failed to improve medical knowledge among participants. Given the failure of the first RCT, and drawing on qualitative work conducted with participants at the conclusion of the trial, various modifications were employed in the second RCT conducted among HIV specialist physicians in Vietnam. Version 2.0 of the mCME intervention did lead to significant improvement in medical knowledge among intervention participants. Here, we discuss in detail the development of an mCME platform and the experiential "lessons learned" during two phases of implementation.
Numerous lessons were learned during implementation, including the importance of: (I) mixed methods approaches; (II) an underlying theoretical framework for behavior change projects; (III) expertise in software programming; (IV) aligning educational content to a well-defined participant population; and (V) engaging and motivating adult learners. We also discuss the critical importance of projects with local ownership and investment that are relevant to local problems.
mHealth approaches for continued healthcare training and education is increasingly relevant in many low-resource settings, the lessons learned here will be valuable to other organizations looking to scale-up similar mHealth-type educational programmes.
移动技术是提供继续医学教育(CME)的一种新方法,具有许多优点,包括成本较低以及比传统的面对面CME研讨会能够覆盖更多人群。
2015年5月至2017年5月,我们分阶段进行了两项随机对照试验,以评估移动CME(mCME)方法对越南两类卫生专业人员的有效性。第一项随机对照试验(RCT)测试了基于短信的教育干预措施在社区医师助理中的应用;虽然该干预措施可行且可接受,但未能提高参与者的医学知识。鉴于第一项RCT的失败,并借鉴试验结束时与参与者进行的定性研究结果,在越南针对HIV专科医生开展的第二项RCT中采用了各种改进措施。mCME干预措施的2.0版本确实使干预参与者的医学知识有了显著提高。在此,我们详细讨论了mCME平台的开发以及在两个实施阶段中获得的经验教训。
在实施过程中吸取了许多经验教训,包括以下方面的重要性:(I)混合方法;(II)行为改变项目的基础理论框架;(III)软件编程专业知识;(IV)使教育内容与明确界定的参与者群体相匹配;以及(V)吸引和激励成年学习者。我们还讨论了具有地方自主权和投资且与当地问题相关的项目的至关重要性。
移动健康方法在持续的医疗保健培训和教育中在许多资源匮乏地区越来越重要,这里吸取的经验教训将对其他希望扩大类似移动健康型教育项目规模的组织有价值。