A scoping review of the use of e-learning and e-consultation for healthcare workers in low- and middle-income countries and their potential complementarity

Abstract

Objective Although the provision of e-learning (EL) training for healthcare workers (HCWs) and provider-to-HCW e-consultation (EC) is considered useful for health outcomes, research on their joint use is limited. This scoping review aimed to create an overview of what is currently known in the literature about the use and implementation of EC and EL by HCWs in LMICs and to answer the question of whether there is evidence of complementarity. Materials and Methods Scientific databases were searched and peer-reviewed papers were reviewed systematically according to predefined inclusion/exclusion criteria. Data were extracted including the study focus (EC/EL), year of publication, geographical location, target population, target disease(s) under study, type(s) of study outcomes, and article type. Results A total of 3051 articles were retrieved and screened for eligibility, of which 96 were kept for analysis. Of these, only 3 addressed both EL and EC; 54 studies addressed EL; and 39 addressed EC. Most studies looked at gain in knowledge/skills usability, efficiency, competence, and satisfaction of HCW, or barriers/challenges to implementation. Descriptive studies focused on the application of EL or EC for targeting specific health conditions. Factors contributing to the success of EC or EL networks were institutional anchoring, multiple partnership, and capacity building of local experts. Conclusions Our review found an important gap in the literature in relation to the complementary role of EL and EC for HCWs in LMICs evidenced by outcome measures. There is an important role for national and international academic institutions, learned medical societies, and networks to support regional experts in providing EL and EC for added value that will help the clinical performance of HCWs and improve health outcomes.

Barriers and facilitators to utilizing digital health technologies by healthcare professionals

“…Most studies did not precisely consider one medical specialty, disease, or condition. However, some reviews focused on diseases of the respiratory system (e.g., tuberculosis, asthma, and chronic pulmonary obstructive disease) 19 , 22 , 31 , 32 , 46 , 93 , 101 , 123 , pregnancy, childbirth, or puerperium (e.g., maternal health, postpartum hemorrhage, and reproductive health) 19 , 22 , 23 , 26 , 31 , 35 , 46 , 56 , 61 , 77 , 94 , certain infectious or parasitic diseases (e.g., malaria, human immunodeficiency virus infection, and influenza) 19 , 22 , 23 , 28 , 31 , 46 , 50 , 61 , endocrine, nutritional, or metabolic diseases (e.g., diabetes mellitus) 57 , 64 , 76 , 93 , 123 , mental and behavioral disorders (e.g., post-traumatic disorder syndrome, stress, depression, and burnout) 23 , 41 , 44 , 64 , 70 , 76 , 94 , 125 , neoplasms 50 , 67 , 85 , 123 , diseases of the circulatory system (e.g., hypertension) 19 , 25 , 48 , 50 , 57 , 67 , 93 , 123 , diseases of the blood or blood-forming organs (e.g., anemia) 22 , and diseases or disorders of orofacial complex (e.g., oral lesions) 28 , 42 . Identified reviews mostly included quantita...…”

Learning Design Strategies in MOOCs for Physicians’ Training: A Scoping Review

“…In recent years, a large number of reviews have been conducted by considering studies on MOOCs related to healthcare workers in general [ 52 , 53 , 54 ], whereas, to the best of our knowledge, few studies have focused on physicians by paying attention solely to the outcomes of such courses. More precisely, Zhao et al [ 24 ] performed a meta-analysis based on the examination of four articles reporting no significant differences between the efficacy of the MOOC teaching model and that of the traditional one.…”

Ten-Year Experience of a Global and Freely Accessible e-Learning Website for Pediatric Endocrinology and Diabetes

“…The future of education delivery may include hybrid learning strategies, which include in-person and e-learning platforms and are likely to become the universal mode of delivering health education [30]. Combined e-learning and e-consultation webinars illustrate how international academic institutions, learned medical specialty societies, and networks are uniquely placed to deliver balanced, disease-oriented, and patient-centered e-learning education and at the same time provide expert consultation, as illustrated in Figure 5 [7]. Moreover, they are well equipped to maintain professional standards and to offer appropriate accreditation [10, 11].…”

“…It is important to note that explicitly offering e-learning in combination with e-consultation will enhance the usability of e-consultation. As illustrated in Figure 5, e-learning provides background and in-depth DOI: 10.1159/000527984 understanding of underlying pathophysiology and evidence-based management, which will improve effectiveness, efficiency as well as satisfaction and empowerment within the community [7].…”

“…Finally, given that recent literature has indicated complementary roles for e-learning and e-consultation [7], we describe pilot studies aimed at establishing joint e-learning/e-consultation webinars. We conclude by briefly reviewing some proposals to help develop further e-learning strategies in the future.…”