Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany.
Nursing and Midwifery, Faculty of Medicine, Nursing and Health Science, Monash University, Clayton, VIC, Australia.
Front Public Health. 2022 Jul 12;10:891987. doi: 10.3389/fpubh.2022.891987. eCollection 2022.
Massive Open Online Courses (MOOCs) have the potential to improve access to quality education for health care workers (HCWs) globally. Although studies have reported on the use of MOOCs in low- and middle-income countries (LMICs), our understanding of the scope of their utilization or access barriers and facilitators for this cohort is limited. We conducted a scoping review to map published peer-reviewed literature on MOOCs for HCW education in LMICs. We systematically searched four academic databases (Scopus, Web of Science, PubMed, ERIC) and Google Scholar, and undertook a two-stage screening process. The analysis included studies that reported on MOOCs relevant to HCWs' education accessed by HCWs based in LMICs.
The search identified 1,317 studies with 39 studies included in the analysis, representing 40 MOOCs accessed in over 90 LMICs. We found that MOOCs covered a wide range of HCWs' including nurses, midwives, physicians, dentists, psychologists, and other workers from the broader health care sector, mainly at a post-graduate level. Dominant topics covered by the MOOCs included infectious diseases and epidemic response, treatment and prevention of non-communicable diseases, communication techniques and patient interaction, as well as research practice. Time contribution and internet connection were recognized barriers to MOOC completion, whilst deadlines, email reminders, graphical design of the MOOC, and blended learning modes facilitated uptake and completion. MOOCs were predominantly taught in English (20%), French (12.5%), Spanish (7.5%) and Portuguese (7.5%). Overall, evaluation outcomes were positive and focused on completion rate, learner gain, and student satisfaction.
We conclude that MOOCs can be an adequate tool to support HCWs' education in LMICs and may be particularly suited for supporting knowledge and understanding. Heterogeneous reporting of MOOC characteristics and lack of cohort-specific reporting limits our ability to evaluate MOOCs at a broader scale; we make suggestions on how standardized reporting may offset this problem. Further research should focus on the impact of learning through MOOCs, as well as on the work of HCWs and the apparent lack of courses covering the key causes of diseases in LMICs. This will result in increased understanding of the extent to which MOOCs can be utilized in this context.
大规模开放式在线课程（MOOCs）有可能改善全球医疗保健工作者（HCWs）获得高质量教育的机会。尽管已经有研究报告了 MOOCs 在低收入和中等收入国家（LMICs）的使用情况，但我们对其利用范围或该人群的访问障碍和促进因素的了解有限。我们进行了一项范围综述，以绘制发表的关于 LMICs 中 HCW 教育的 MOOC 同行评审文献。我们系统地搜索了四个学术数据库（Scopus、Web of Science、PubMed、ERIC）和谷歌学术，并进行了两阶段筛选过程。分析包括报告了 HCWs 在 LMICs 中接受的与 HCWs 教育相关的 MOOCs 的研究。
搜索共确定了 1317 项研究，其中 39 项研究纳入分析，代表了在 90 多个 LMICs 中使用的 40 个 MOOCs。我们发现，MOOCs 涵盖了广泛的 HCWs，包括护士、助产士、医生、牙医、心理学家和更广泛的医疗保健领域的其他工作人员，主要是研究生水平。MOOCs 涵盖的主要主题包括传染病和疫情应对、非传染性疾病的治疗和预防、沟通技巧和医患互动，以及研究实践。时间投入和互联网连接被认为是完成 MOOC 的障碍，而截止日期、电子邮件提醒、MOOC 的图形设计和混合学习模式则促进了参与和完成。MOOCs 主要以英语（20%）、法语（12.5%）、西班牙语（7.5%）和葡萄牙语（7.5%）授课。总的来说，评估结果是积极的，重点是完成率、学习者收益和学生满意度。
我们得出结论，MOOCs 可以成为支持 LMICs 中 HCWs 教育的合适工具，并且可能特别适合支持知识和理解。MOOC 特征的异质性报告和缺乏特定于队列的报告限制了我们在更广泛的范围内评估 MOOCs 的能力；我们就如何通过标准化报告来解决这个问题提出了建议。进一步的研究应侧重于通过 MOOCs 学习的影响，以及 HCWs 的工作和明显缺乏涵盖 LMICs 中疾病主要原因的课程。这将增加对 MOOCs 在这种情况下可以利用的程度的理解。
