1. implementation of telemedicine in resource-limited settings
Blended learning: a capacity building method of healthcare professionals for the
implementation of telemedicine in resource-limited settings
Georges Bediang1, Yannick Kamga2, Jean Roger Moulion3, Cleia Etoa Bekono1, Cheick Oumar
Bagayoko4, Samuel Nko'o Amvene1,3, Antoine Geissbuhler5
1 Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Cameroon
2 Department for the Control of Disease, Epidemics and Pandemics, Ministry of Public Health, Cameroon
3 Yaoundé University Hospital, Cameroon
4 Faculté de Médecine et d'Odontostomatologie, Université des Sciences, des techniques et des technologies de Bamako
5 Faculty of Medicine, University of Geneva, Switzerland
Figure 1. District Hospital of Sa'a (Cameroon)
Figure 2. Dudal Software (screenshot) used for e-learning
Objective:
To explore the potential of blended learning (BL) in capacity building of healthcare professionals (HPs) working in remote areas in order to implement an emergency tele-ultrasound (tele-eFAST*) unit.
Methods:
Design :
Two groups of HPs were involved: in intervention group, HPs received BL-based training on practice of eFAST whereas in control group they received no training.
Participants and Settings:
Four HPs (3 doctors and 1 nurse) were included in intervention group (District Hospital of Sa’a [figure 1] located at 72 km from Yaoundé, the capital) and four (3 doctors and 1 nurse) in control group (District Hospital of Akonolinga located at 116 km from Yaoundé).
Intervention: Blended learning
E-learning: 4 hours of live video-lectures of approximately 1 hour each using the Dudal system (distant education software developed by the RAFT network) were delivered (figure 2). They were burned also on CD-ROM media and handed to the participants in order to follow them asynchronously regardless of the internet connection. These video-lectures covered various subjects such as: generalities of thoracic and abdominal trauma, basics of ultrasound, human echo-anatomy and practice of eFAST.
Face-to-face teaching: 8 hours of hands-on classroom training one week after e-learning was provided by a radiologist (figure 3). It consisted of two half-days of activities on practice of eFAST. Participants practiced on selected clinical cases of their own hospital.
Assessed Outcomes:
Knowledge assessment: pre-test (before blended learning) and post-test (after) scores as well as progression of the scores (difference between pre- and post-test scores) in both groups.
Skills assessment: quality of image cuts (during the first 2 months of tele-eFAST practice after Blended leaning) in intervention group.
Figure 3. Face-to-face training about the eFAST practice at HDS
Results:
Progression of the scores (table 1) in both groups between pre-test and post-test was 35.58% for intervention group versus 8.65% for control group (p = 0.20).
Two months after implementation of tele-eFAST unit, 22 exams were performed autonomously by participants who benefited from BL. The radiologist estimated that quality of image cuts was good in 54.5% (n = 12) of the cases.
Table 1. Progression (difference between pre- and post-test scores) of both groups
DHS (Intervention)
DHA (Control) p
Mean
(±SD)
Progression
(SD)
Pre-test Scores (%)
48,08
(±18,97)
35,58
(±25,59)
40,38
(±17,90)
8,65
(±6,56)
0,20
Post-test Scores (%)
83,65
(±10,11)
49,03
(±19,20)
Conclusion:
BL has potential benefits for the capacity building of HPs in resource-limited settings. It can be considered as an alternative training method.
Acknowledgments:
This work was supported by a grant from the Geneva University Hospitals
Contact: Dr Georges Bediang
Web:
* Extended Focused Assessment with Sonography for Trauma