Scott Kirstin Woody, Dushime Theophile, Rusanganwa Vincent, Woskie Liana, Attebery Clint, Binagwaho Agnes
Harvard Medical School, Boston, Massachusetts, USA.
Ministry of Health, Republic of Rwanda, Kigali, Rwanda.
BMJ Open Qual. 2019 Nov 6;8(4):e000532. doi: 10.1136/bmjoq-2018-000532. eCollection 2019.
Improving the quality of healthcare delivery is increasingly a global health priority. However, quality improvement training opportunities that provide theoretical foundations and basic skills for patient safety and other quality initiatives have been limited or historically out of reach, especially in low-and-middle income countries (LMICs). To address this gap, the Harvard Initiative on Global Health Quality (HIGHQ) created and launched a massive open online course (MOOC) in 2014 focused on patient safety and quality of care using the edX platform. More than 30 000 students from across 195 countries registered for the online course. This paper summarises an innovative educational partnership between the course team and one of these countries, Rwanda, to develop a blended-learning model to bolster participation in this new course among Rwandan healthcare professionals. Although a small country, Rwanda was among the top performing countries for attracting course registrants and was the leading country for the proportion of enrollees who ultimately completed the course. Further, half (21 of 42) of Rwanda's district hospitals opted to appoint a PH555x course facilitator at their site to help lead regular meetings and discussions about the course content at their facility. The majority of Rwandan enrollees were health professionals (63%) and 81% reported that PH555x was their first experience taking an online course. Among those participating in the 'flipped' component at hospital sites, 94% reported that the course helped them to think of specific ways to improve healthcare quality at their facility. In this paper, we describe this innovative public-private educational model, challenges to implementation and lessons learned that may be helpful for future MOOC developers who wish to augment learning opportunities among healthcare professionals in LMICs.
提高医疗服务质量日益成为全球卫生工作的重点。然而，为患者安全和其他质量改进举措提供理论基础和基本技能的质量改进培训机会一直有限，或者从历史上看难以获得，尤其是在中低收入国家。为了填补这一空白，哈佛全球卫生质量倡议（HIGHQ）于2014年在edX平台上创建并推出了一门大规模在线开放课程（MOOC），重点关注患者安全和医疗质量。来自195个国家的30000多名学生注册了这门在线课程。本文总结了课程团队与其中一个国家卢旺达之间的创新教育合作关系，以开发一种混合学习模式，以促进卢旺达医疗专业人员对这门新课程的参与。卢旺达虽然是一个小国，但在吸引课程注册者方面是表现最佳的国家之一，并且在最终完成课程的注册者比例方面是领先国家。此外，卢旺达42家地区医院中有一半（21家）选择在其所在地指定一名PH555x课程协调员，以帮助领导关于其机构课程内容的定期会议和讨论。大多数卢旺达注册者是卫生专业人员（63%），81%的人报告说PH555x是他们第一次参加在线课程。在医院现场参与“翻转”部分的人中，94%的人报告说该课程帮助他们思考了改善其机构医疗质量的具体方法。在本文中，我们描述了这种创新的公私合营教育模式、实施过程中遇到的挑战以及吸取的经验教训，这些经验教训可能对未来希望增加中低收入国家医疗专业人员学习机会的MOOC开发者有所帮助。
