Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.
Center for Innovation in Medical Education, Leiden University Medical Center, Leiden, The Netherlands.
J Am Med Inform Assoc. 2022 Mar 15;29(4):713-722. doi: 10.1093/jamia/ocab271.
Although the provision of e-learning (EL) training for healthcare workers (HCWs) and provider-to-HCW e-consultation (EC) is considered useful for health outcomes, research on their joint use is limited. This scoping review aimed to create an overview of what is currently known in the literature about the use and implementation of EC and EL by HCWs in LMICs and to answer the question of whether there is evidence of complementarity.
Scientific databases were searched and peer-reviewed papers were reviewed systematically according to predefined inclusion/exclusion criteria. Data were extracted including the study focus (EC/EL), year of publication, geographical location, target population, target disease(s) under study, type(s) of study outcomes, and article type.
A total of 3051 articles were retrieved and screened for eligibility, of which 96 were kept for analysis. Of these, only 3 addressed both EL and EC; 54 studies addressed EL; and 39 addressed EC. Most studies looked at gain in knowledge/skills usability, efficiency, competence, and satisfaction of HCW, or barriers/challenges to implementation. Descriptive studies focused on the application of EL or EC for targeting specific health conditions. Factors contributing to the success of EC or EL networks were institutional anchoring, multiple partnership, and capacity building of local experts.
Our review found an important gap in the literature in relation to the complementary role of EL and EC for HCWs in LMICs evidenced by outcome measures. There is an important role for national and international academic institutions, learned medical societies, and networks to support regional experts in providing EL and EC for added value that will help the clinical performance of HCWs and improve health outcomes.
尽管为医疗保健工作者(HCWs)提供电子学习(EL)培训和提供者与 HCW 之间的电子咨询(EC)被认为对健康结果有益,但关于它们联合使用的研究有限。本范围综述旨在概述文献中关于中低收入国家 HCWs 使用和实施 EC 和 EL 的情况,并回答是否存在互补证据的问题。
搜索了科学数据库,并根据预先确定的纳入/排除标准系统地审查了同行评审论文。提取的数据包括研究重点(EC/EL)、发表年份、地理位置、目标人群、研究中的目标疾病、研究结果的类型和文章类型。
共检索到 3051 篇文章并进行了资格筛选,其中有 96 篇被保留用于分析。其中,只有 3 篇文章同时涉及 EL 和 EC;54 项研究涉及 EL;39 项研究涉及 EC。大多数研究着眼于 HCW 的知识/技能可用性、效率、能力和满意度的提高,或实施的障碍/挑战。描述性研究侧重于 EL 或 EC 在针对特定健康状况的应用。EC 或 EL 网络成功的因素包括机构锚定、多方合作和当地专家的能力建设。
我们的综述发现,文献中存在一个重要的空白,即中低收入国家 HCWs 的 EL 和 EC 的互补作用在结果衡量方面证据不足。国家和国际学术机构、专业医学协会和网络在为 HCWs 提供 EL 和 EC 以增加价值方面发挥着重要作用,这将有助于提高 HCWs 的临床绩效并改善健康结果。