Mobile-Social Learning for Continuing Professional Development in Low- and Middle-Income Countries: Integrative Review (Preprint)

Abstract

BACKGROUND Access to continuing professional development (CPD) for health care workers in low-and-middle- income countries (LMICs) is severely limited. Digital technology serves as a promising platform in supporting CPD for health care workers through providing educational content virtually, along with enabling virtual peer-to-peer and mentor interaction for enhanced learning. Digital strategies for CPD that foster virtual interaction can increase workforce retention and bolster the health workforce in LMICs. OBJECTIVE The objective of this integrative review was to evaluate evidence in which digital platforms were utilized to provide CPD to health care workers and clinical students in LMICs which was complemented with virtual peer-to-peer and/or mentor interaction. We have phrased this intersection of virtual learning and virtual interaction as mobile-social learning. METHODS A comprehensive database and grey literature search was conducted to identify qualitative, quantitative, and mixed-methods studies, along with empirical evidence employing digital technology to provide CPD and virtual interaction with peers and/or mentors. PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed. Eligible articles were written in English, took place in a low-and-middle-income country, and utilized a mobile device to provide CPD and facilitated virtual peer-to-peer and/or mentor interaction. Titles, abstracts, and full texts were screened, followed by assessment of the quality of evidence and appraisal of articles. Content analysis was then used to deductively code data into emerging themes. RESULTS A total of 750 articles were identified, and 31 articles were included in the review. Text messaging, mobile instant messaging (MIM), and short-message services (SMS) was the most common method used to provide continuing education and virtual interaction between peers and mentors (n=25). Across included articles, participants had high acceptability of using digital platforms for learning and interaction. Virtual peer interaction and mentorship was found to contribute to positive learning outcomes across the majority of studies (n=27) through increased knowledge sharing, knowledge gains, improved clinical skills, and improved service delivery. Peer-to-peer and mentor interaction was found to improve social support and reduce feelings of isolation (n=9). Several challenges existed in the implementation and utilization of digital technology for mobile-social learning which included limited access to resources (e.g. internet coverage and stable electricity), flexibility in scheduling to participate in CPD, and sociobehavioral challenges among students. CONCLUSIONS This integrative review demonstrates that digital platforms that foster mobile-social learning can serve as an innovative method in providing health care providers and clinical students in LMICs with CPD while simultaneously enabling supportive interaction among peers and mentors. This evidence synthesis demonstrates the added value of social learning networks in enhancing the utility and effectiveness of digital learning platforms, whether as independent dissemination strategies, or as part of blended-learning approach. CLINICALTRIAL N/A