Using a Canadian Online Public Health Professional Development program in the Caribbean. Hilary Robinson, Public Health Agency of Canada Annella Auer, Pan American Health Organisation

What is Skills Online? Highly successful Online continuing professional development program for front line public health professionals Series of online facilitated modules in English and French Offered free of charge in Canada to public health professionals since Spring 2002 Up to Autumn 2007, 4195 modules have been completed in English and French Previous international collaboration with Latrobe University, Melbourne, Australia

Need for Skills Online in the Caribbean Increasing demands on Public health workers – non-communicable disease and HIV/AIDs Lack of professional development opportunities Shrinking workforce due to migration (esp. nurses) means individuals may have to take on PH work in addition to work they are already doing.

Skills Online PAHO collaboration Discussions beginning 2007 to use the first three foundation modules of Skills online; First module for Caribbean learners was offered in Spring 2007 To date there have been 40 Caribbean participants-demand for participation is high reflecting a perceived need.

Participant Selection Participants for the modules are selected by the Ministries of Health within the Caribbean countries in consultation with the local PAHO office Some countries are using the opportunity to enhance the skills of a particular profession or work group – e.g. Trinidad and Tobago are trying to upgrade the skills of the health policy and planning unit of the Ministry of Health.

Participation of Caribbean learners So far 40 learners from the Caribbean have participated in Skills Online modules EPI1 – 41 (one learner participated twice) EPI EPI3 - 1

Module completion ModuleEnrolledCompletedPercentage EPI % EPI % EPI311100% Total574375% EPI1 - Basic epidemiologic concepts EPI2 - Measurement of Health Status EPI3 – Epidemiologic Methods

8 CountryParticipants Bahamas 3 Belize 3 Guyana 4 Jamaica 3 Trinidad and Tobago 12 St Lucia 3 St Kitts and Nevis 3 Grenada 2 Anguilla 1 St Vincent and Grenadine 3 Antigua and Barbuda 3 Participation by Country

Participation By Professional Background Professional BackgroundCompleted Module Nurse7 Public health inspector1 Nutritionist4 Doctor8 Program officer11 PH Manager7 Pharmacist1 Health Educator1

Place of work: Work place Ministry of Health26 Regional Health Authority7 Hospital2 PAHO Regional office1

Post Module survey response 53 learners completed the specific PAHO survey – (out of 57 – 93%) 41 completed the evaluation survey in the module – (out of 55* - 75%) Learners were encouraged to complete the post module evaluation at the end of the session. In addition learners were asked to complete and additional ed survey which was specific to the PAHO Caribbean project. * learners who failed to complete the module did not complete the post module evaluation included in the module but some did complete the specific PAHO survey

Demographics 45% of participants were 39 years or younger and 55% aged years 66% female 66% of participants had been working in their current capacity for 10 years or less

Connections 68% of learners accessed the internet from home 75% of learners visited the module 3 or more times per week Based on s and the evaluation replies, 53% of learners experienced technical challenges; most were related to their internet access

Connections “…my internet service interruptions were frequent and disruptive.” “I had great difficulty accessing the site, at first I could not get in and when I did manage to log in I would loose connection within less than five minutes.”

Support 53% of participants were given sufficient or some time during work hours to work on the module, 32% said that they preferred to work from home 37% of participants said that their supervisor did not support their learning “My workplace suggested me as a representative to complete the module but I had to find the time”

Experience with the module 93% felt that they had developed confidence to learn difficult subject matter 93% enjoyed the ability to work at their own pace The barriers to completion most commonly cited were:- work and family commitments and technical problems with internet connections

Future Participation All responders would recommend the module to others 96% would like to take other skills modules in the future

Applicability and relevance 95% reported that they could apply what they learned to their routine work “This first experience has really developed me professionally. The structure of the modules and the constant reminders to relate the content presented to your work experience or that of your colleagues, really make it hands on.”

Facilitation So far all modules have been facilitated by Canadian facilitators One Caribbean facilitator assisted in facilitating the Winter EPI1 module.

Facilitator’s notes Slow starts - The discussions took a long time to get going – by the end of the module learners were really starting to respond to each other. This occurred in the second module too but the facilitator was prepared and intervened early to stimulate discussion. Learners struggled to keep to the time line – many were slow getting started. Problems with learning styles – difficulty with the idea of facilitation vs. teaching Lack of conference calls maybe an issue. It was felt that this would have been helpful early in the module There were some content issues related to Canadian data and content.

Conclusions Skills Online appears to be a useful continuing professional development tool for the Caribbean Technical access, workplace support and time management are the main issues for learners Adaption of the program and adoption by a local organization are future considerations.

Conclusions - additional considerations A large group of people can access the online training – more than if it was in person (costs of travel etc). Countries can target specific professional or work groups in accordance with their own HRH strategy Improved communication within and between countries as contacts are established.

Next steps? May 08 – Epi1, EPI2 and EPI3 Caribbean modules will be offered PAHO and Skills Online will continue to work together to explore adaption and adoption of the program in the Caribbean Adaption of content and context Adoption by local agencies Incorporation into PAHO Virtual Campus of Public Health

“I liked it. Will do it again.” For more information contact: