Background Before the Coronavirus COVID-19, universities offered blended learning as a mode of study. However, with the closure of all educational institutions, after the pandemic, most of these institutions were required to transition to e-learning to support continuous student learning. This transition was challenging to most institutions, as there were no standards to ensure the quality of e-learning. During this literature review, the researcher aimed to explore relevant literature and provide insight into the standards for undergraduate e-learning programmes in the health professions. Design An integrative review of literature. Data sources Online databases MEDLINE, CINAHL with full text, Academic search ultimate, APA PsycInfo, ERIC, Health Source: Nursing/academic edition, CAB abstracts, Africa-wide information, Sociology source ultimate, and Communication and Mass media complete were searched. Materials and methods Studies pertaining to low- and middle-income countries (LMICs) on standards in evaluating undergraduate e-learning programmes in health professions, published between January 2010 to June 2022, were considered. A two-step process was followed involving three reviewers and guided by an inclusion criteria focused on the evaluation of undergraduate e-learning programmes in the health professions. The initial hit produced 610 articles altogether, and eight articles that met the inclusion criteria were included in the study. Data was then extracted and analysed, and key themes were identified. Results Eight Key themes related to LMIC standards emerged from the eight selected articles: curriculum planning, proficiency of educators, learner proficiency and attitude, infrastructure for learning, support and evaluation. Conclusion In this review, we synthesised standards that have been used for evaluating undergraduate e-learning programmes in health professions in LMICs. A gap in standards related to clinical teaching and learning in undergraduate e-learning programmes in the health professions was evident from all the included articles. The identification of the eight unique LMIC standards in this review could contribute to guiding towards contextually appropriate quality e-learning programmes in the health professions.
Background The lack of standards hampers the evaluation of e-learning programmes in low- and middle-income countries. Fragmented approaches to evaluation coupled with a lack of uniform criteria have been a major deterrent to the growth of e-learning. Adopting standards from high-income countries has contextual challenges in low- and middle-income countries. Holistic approaches coupled with uniform standards provide holistic information to stakeholders hence the quality of the programmes is measurable. The e-learning situation in low-and middle-income countries provided an impetus to develop and validate these standards. Design A modified Delphi technique. Review methods Fourteen experts with experience and expertise in e-learning and regulation of undergraduate nursing from fourteen countries in low-and middle-income countries participated in three rounds of the modified Delphi process. A pre-described set of standards was shared electronically for independent and blinded ratings. An 80% agreement influenced consensus decisions. The standards were modified based on experts’ comments, and two subsequent rounds were used to refine the standards and criteria. Results At the end of round one, the expert consensus was to keep 67, modify 29 and remove three criteria. At the end of the second round, the consensus was to modify 28 and remove four criteria. In the third round, experts agreed that the standards were feasible, usable, and practical in LMICs. A total of six broad standards with 105 criteria were developed. Conclusion The Technological bloom permeating all spheres of society, including education is an essential component in the development of e-learning programmes. The standards are quintessential to evaluating the quality of undergraduate nursing programmes. E-learning in nursing education requires critical evaluation to ensure quality in undergraduate nursing programmes. The intricacies of the Low and middle-income context were taken into consideration in developing the standards to offer sustainable evaluation of the quality of e-learning in LMICs, and local solutions to local problems.
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