Perspectives of Nonphysician Clinical Students and Medical Lecturers on Tablet-Based Health Care Practice Support for Medical Education in Zambia, Africa: Qualitative Study
Perspectives of Nonphysician Clinical Students and Medical Lecturers on Tablet-Based Health Care Practice Support for Medical Education in Zambia, Africa: Qualitative Study
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DOI：
10.2196/12637
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发表时间：
2019-01-15
影响因子：
5
通讯作者：
Jahn, Albrecht
中科院分区：
文献类型：
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作者：
Barteit, Sandra;Neuhann, Florian;Jahn, Albrecht
背景：赞比亚面临着卫生工作者严重短缺和国家卫生筹资方面的挑战。由于培训地点缺乏合格的医学讲师和学习资源，这给赞比亚培训非医生临床学生的执业医师（MLP）方案带来了负担。为了解决这一问题并加强MLP计划，引入了一个自我指导的电子健康（eHealth）平台，包括用于医学教育的技术支持学习（e-learning）和对医疗保健实践的支持。MLP学生提供了平板电脑，预装了离线访问的内容。Objective：本研究旨在探讨MLP学生和医学讲师对自我指导的电子健康平台的看法，在全面实施的第一年，离线平板电脑作为培训和医疗保健实践支持工具。我们对8名MLP学生和5名讲师进行了深入的定性访谈，并与16名学生进行了2次焦点小组讨论，以了解他们对有用性，易用性，以及通过离线平板电脑获得的自我指导电子学习和医疗保健实践支持的充分性。参与者被有目的地抽样。逐字记录进行了分析以下hypothesis coding.Results：电子健康平台（电子平台），包括电子学习的医学教育和医疗实践的支持，积极接受学生和医学讲师，被视为朝着现代化的MLP程序的一步。平板电脑使人们能够平等地获得离线学习内容，从而弥补了互联网连接缓慢或没有互联网连接的差距。研究结果表明，电子平台似乎足以在这种低资源环境中加强医学教育。然而，学生自我报告的使用率很低，医学讲师的使用率更低。一个原因是缺乏平板电脑使用方面的培训，另一个原因是平板电脑的质量。大多数电子学习内容的质量和数量一般，被认为是一个主要关切，因为据报告，材料已经过时，缺少多媒体功能，而且只涉及部分课程。医学讲师被指出很少更新或创建新的学习材料。提出了改进电子平台的建议。为了应对已确定的主要挑战，我们计划（1）在每个研究年度开始时引入半天的培训课程，以更好地为用户使用平板电脑做好准备，（2）通过促进与MLP计划利益相关者的合作并提名电子平台协调员，进一步更新和扩展电子学习内容，（3）设立一个包括医学讲师在内的电子平台指导委员会，（4）在整个课程中纳入电子学习和基于电子的医疗保健实践支持，以及（5）实施促进用户生成内容的程序。通过这些措施，我们的目标是通过实施基于平板电脑的电子平台作为医学教育和医疗保健实践支持的重要学习技术，可持续地加强MLP计划。
Background: Zambia is faced with a severe shortage of health workers and challenges in national health financing. This burdens the medical licentiate practitioner (MLP) program for training nonphysician clinical students in Zambia because of the shortage of qualified medical lecturers and learning resources at training sites. To address this shortage and strengthen the MLP program, a self-directed electronic health (eHealth) platform was introduced, comprising technology-supported learning (e-learning) for medical education and support for health care practice. MLP students were provided with tablets that were preloaded with content for offline access.Objective: This study aimed to explore MLP students' and medical lecturers' perceptions of the self-directed eHealth platform with an offline-based tablet as a training and health care practice support tool during the first year of full implementation.Methods: We conducted in-depth qualitative interviews with 8 MLP students and 5 lecturers and 2 focus group discussions with 16 students to gain insights on perceptions of the usefulness, ease of use, and adequacy of self-directed e-learning and health care practice support accessible through the offline-based tablet. Participants were purposively sampled. Verbatim transcripts were analyzed following hypothesis coding.Results: The eHealth platform (e-platform), comprising e-learning for medical education and health care practice support, was positively received by students and medical lecturers and was seen as a step toward modernizing the MLP program. Tablets enabled equal access to offline learning contents, thus bridging the gap of slow or no internet connections. The study results indicated that the e-platform appears adequate to strengthen medical education within this low-resource setting. However, student self-reported usage was low, and medical lecturer usage was even lower. One stated reason was the lack of training in tablet usage and another was the quality of the tablets. The mediocre quality and quantity of most e-learning contents were perceived as a primary concern as materials were reported to be outdated, missing multimedia features, and addressing only part of the curriculum. Medical lecturers were noted to have little commitment to updating or creating new learning materials. Suggestions for improving the e-platform were given.Conclusions: To address identified major challenges, we plan to (1) introduce half-day training sessions at the beginning of each study year to better prepare users for tablet usage, (2) further update and expand e-learning content by fostering collaborations with MLP program stakeholders and nominating an e-platform coordinator, (3) set up an e-platform steering committee including medical lecturers, (4) incorporate e-learning and e-based health care practice support across the curriculum, as well as (5) implement processes to promote user-generated content. With these measures, we aim to sustainably strengthen the MLP program by implementing the tablet-based e-platform as a serious learning technology for medical education and health care practice support.