How should eLearning be implemented in resource-constrained settings? The introduction of eLearning at four African medical schools and one school of pharmacy, all part of the Medical Education Partnership Initiative (MEPI) eLearning Technical Working Group, highlighted the need for five factors essential for successful and sustainable implementation: institutional support; faculty engagement; student engagement; technical expertise; and infrastructure and support systems. All five MEPI schools reported strengthening technical expertise, infrastructure, and support systems; four schools indicated that they were also successful in developing student engagement; and three reported making good progress in building institutional support. Faculty engagement was the one core component that all five schools needed to enhance.
Learning Management Systems (LMS) are powerful tools for the organization and presentation of curricular learning materials, for monitoring of student and faculty members performance, and for overall quality control. However, there is limited evidence regarding the acceptance and performance of LMS in Africa. This manuscript describes the implementation, the outcomes, and the challenges of the first five years of a LMS at the Kilimanjaro Christian Medical University College (KCMUCo). The LMS has been fully adopted into KCMUCo curriculum and deployed to 1356 students. It has been demonstrated to enhance learning with strength of consensus measure of 84% for basic sciences and 78% for clinical classes. 80% of faculty members have been satisfied with the use of LMS. Electronic assessment has become an obligatory platform for theory examinations. LMS adoption may improve education outcomes at other medical schools in Tanzania and sub-Saharan Africa.
The Kilimanjaro Christian Medical University (KCMU) College and the Medical Education Partnership Initiative (MEPI) are addressing the crisis in Tanzanian health care manpower by modernizing the college’s medical education with new tools and techniques. With a $10 million MEPI grant and the participation of its partner, Duke University, KCMU is harnessing the power of information technology (IT) to upgrade tools for students and faculty. Initiatives in eLearning have included bringing fiber-optic connectivity to the campus, offering campus-wide wireless access, opening student and faculty computer laboratories, and providing computer tablets to all incoming medical students. Beyond IT, the college is also offering wet laboratory instruction for hands-on diagnostic skills, team-based learning, and clinical skills workshops. In addition, modern teaching tools and techniques address the challenges posed by increasing numbers of students. To provide incentives for instructors, a performance-based compensation plan and teaching awards have been established. Also for faculty, IT tools and training have been made available, and a medical education course management system is now being widely employed. Student and faculty responses have been favorable, and the rapid uptake of these interventions by students, faculty, and the college’s administration suggests that the KCMU College MEPI approach has addressed unmet needs. This enabling environment has transformed the culture of learning and teaching at KCMU College, where a path to sustainability is now being pursued.
Background: Sub-Saharan Africa faces a health workforce crisis with only 3% of the world's health care workers for 24% of the global burden of disease and only 1% of the world health expenditure. Recent data indicate that nurses in select African countries were not able to perform critical health care delivery tasks, highlighting the need for relevant nursing and midwifery curricula. The PEPFARfunded Nurse Education Partnership Initiative (NEPI) aims to scale up nursing and midwifery preservice education programs to address essential health challenges through the introduction of competencybased curricula where students are taught, learn, and are evaluated based on how well they can put clinical skills into practice, and through clinical simulation where students gain patient care experience using lifelike models. Structure/Method/Design: NEPI is partnering with governments in five African countries and collecting best practices in nursing curriculum development and clinical teaching and learning methodologies. Baseline assessment of teaching programs and outputs, as well as a desk and data survey of best practices in curriculum development, clinical simulation and training evaluation, were conducted to inform innovation in nursing education across the continent. New topics that require training were also identified, particularly Option B+ for PMTCT. Results (Scientific Abstract)/Collaborative Partners (Programmatic Abstract): Intersectoral collaboration has produced four competency-based preservice curricula, expanding the availability of comprehensively trained nurses to address general health and maternal and child health challenges in Zambia, Lesotho, and Malawi. Simulation laboratories were installed at six nursing education institutions in Lesotho and one refurbished in Malawi; over 1500 nursing students have utilized these laboratories to enhance their skills. A curriculum for Option B+ is being developed to respond to the urgent need for its scale up. Summary/Conclusion: Nurse and midwives with the right knowledge, skills, and abilities are key to a country's mandate to deliver effective primary health care services and tackle priority health challenges. Competency-based curricula, including the Option B+ curriculum under development, and the expanded use of clinical simulation will facilitate increased learning and skill transfer when students care for patients in today's complex, health care environment. Various evaluation methods will assess the effectiveness of these interventions and inform scale up.
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