s pe c i a l r e p o r t T h e ne w e ngl a nd jou r na l o f m e dicine n engl j med 369;21 nejm.org november 21, 2013

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BackgroundTo continue delivering the courses despite school closure during the covid-19 pandemic, the University of Rwanda abruptly shifted its teaching from traditional physical to online teaching. This was the compulsory medium of teaching during the lockdown period. This sudden change did not allow for adequate preparation for students. ObjectivesTo assess the preparation of learners to use the e-learning platform, and to explore the factors that enabled or inhibited learners’ use of the e-learning platform. MethodThis was a cross-sectional quantitative research design study done between June and July 2020. An online questionnaire was sent to all students registered in the College of Medicine and Health Sciences for the academic year 2019-2020. ResultsA total of 446 students completed the questionnaire. Students reported not being adequately oriented and unprepared to effectively use e-learning. Students were motivated to use e-learning when the learning objectives were clear, interactive, with engaging materials. Inadequate e-learning infrastructure, limited access to internet connectivity and inadequate devices were identified as the strongest barriers of using e-learning. ConclusionThe covid-19 pandemic has brought a transformational opportunity to embrace a blended learning approach. To sustain such a transformation, proper and timely planning and strategies need to be invested. Rwanda J Med Health Sci 2022;5(1):99-112

Background The department of Mental Health Nursing (MHN) at the University of Rwanda was founded in 1998.Until that time, Rwanda had faced a huge shortage of mental health professionals; specifically, there were 1 psychiatrist, 3 mental health nurses and very few clinical psychologists (less than 5) in the country. The purpose of creating the Mental Health Nursing program was to foster the mental well-being of Rwandans who survived the tragic events related to the 1994 genocide against the Tutsi.The aim of this study was to evaluate the MHN graduates' work place settings in relationship to mental health needs in Rwanda. This was a descriptive study. The respondents were graduates from 2000-2014 and the collection of data related to their workplace was made using phone calls to all former students. About 326 out of 348 (93.67%) were reached and for the 22 (6.32%) we did not manage to get information about them. Results Since its existence, the department has graduated 348 mental health nurses at the A1 level who are integrated in the national existing pyramidal structure of care. The employment rate was 90.79 % and most of them were working in hospitals: 26.43% in district hospitals and 24.13% in referral hospitals Conclusion The current professional placements of the mental health nursing workforce in Rwanda ascertain that these placements correlate with the National Mental Health Policy. All structures of the national health system are provided but they are far from reaching the grassroots level and mental health needs of the population, 26, 1% of which had PTSD. Further placement of MHN must reinforce the community level, including Health Centers.

Background In South Africa, seclusion is one of the practices used in the management of disruptive behaviors in psychiatric settings. Despite its continued use, seclusion is always subject to controversial debates, and patients who undergo it express a range of negative experiences. Objective To explore the experiences of patients regarding seclusion during their admission in a psychiatric hospital. Methods A qualitative descriptive design was used. In-depth interviews were conducted with ten patients attending a community psychiatric clinic in KwaZulu-Natal. Interviews were analyzed using content analysis. Results Two themes emerged from the findings: controversial views of seclusion and negative experiences of seclusion. Seclusion was considered more as a punishment measure which was often used abusively, than a therapeutic intervention. Participants expressed loneliness, humiliation, and powerlessness following their seclusion experience. Limited patient-staff interaction and communication worsened patients’ negativity towards seclusion. Conclusion Findings from this study underscore the need to review practices, policies and procedures regarding the use of seclusion. Seclusion should be only used when the need is absolute and as the last treatment option. Open communication between the care providers and the patients should be emphasized during the time of seclusion. Rwanda J Med Health Sci 2020;3(3):342-361

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BackgroundTowards the beginning of 2020, the COVID-19 pandemic spread worldwide and caused many schools to close. Many educational institutions transitioned from traditional face-to-face or blended to a total e-learning approach. The University of Rwanda rapidly shifted from a blended teaching and learning approach to a total e-learning approach. Thus,this study assessed the faculty preparedness and the factors influencing the use of e-learningplatforms at the College of Medicine and Health Sciences.MethodsThe study used a cross-sectional design. A web self-administered questionnaire was used to collect data from 450 CMHS faculty from June to July 2020, with a response rate of 34.4% (n=155). SPSS was used to describe nominal variables with frequencies and percentages. Similarly, continuous variables were analyzed by calculating median and interquartile ranges. The Chi-Square and Man-Whitney tests were also computed using SPSS.ResultsThe majority of participants (93.7%) started using the e-learning approach, and 92.4% attended e-learning training. The top motivator for e-learning use was a personal interest in technology use (93.3%) and the leading barrier to using e-learning was the concern about access to students (77.1%).ConclusionThis study found that faculty preparedness was significantly associated with e-learning use. The leading motivator and barriers were a personal interest in technology use and concern about access to students, respectively.Rwanda J Med Health Sci 2022;5(2):189-202

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