The effectiveness of E-learning in continuing medical education for tuberculosis health workers: a quasi-experiment from China

Abstract

Background Given the context of rapid technological change and COIVD-19 pandemics, E-learning may provide a unique opportunity for addressing the challenges in traditional face-to-face continuing medical education (CME). However, the effectiveness of E-learning in CME interventions remains unclear. This study aims to evaluate whether E-learning training program can improve TB health personnel’s knowledge and behaviour in China. Methods This study used a convergent mixed method research design to evaluate the impact of E-learning programs for tuberculosis (TB) health workers in terms of knowledge improvement and behaviour change during the China-Gates TB Project (add the time span). Quantitative data was collected by staff surveys (baseline n = 555; final n = 757) and management information systems to measure the demographic characteristics, training participation, and TB knowledge. Difference-in-difference (DID) and multiple linear regression models were employed to capture the effectiveness of knowledge improvement. Qualitative data was collected by interviews (n = 30) and focus group discussions (n = 44) with managers, teachers, and learners to explore their learning experience. Results Synchronous E-learning improved the knowledge of TB clinicians (average treatment effect, ATE: 7.3 scores/100, P = 0.026). Asynchronous E-learning has a significant impact on knowledge among primary care workers (ATE: 10.9/100, P < 0.001), but not in clinicians or public health physicians. Traditional face-to-face training has no significant impact on all medical staff. Most of the learners (57.3%) agreed that they could apply what they learned to their practice. Qualitative data revealed that high quality content is the key facilitator of the behaviour change, while of learning content difficulty, relevancy, and hardware constraints are key barriers. Conclusions The effectiveness of E-learning in CME varies across different types of training formats, organizational environment, and target audience. Although clinicians and primary care workers improved their knowledge by E-learning activities, public health physicians didn’t benefit from the interventions.

E-Learning Success Model in the Context of COVID-19 Pandemic in Higher Educational Institutions

“…Finally, the scale validation to e-learning effectiveness constructs verified that user satisfaction had a powerful influence in developing e-learning effectiveness, with 0.95, whereas net benefits ranked second with 0.92. This result confirmed the research results of [ 4 , 26 ].…”

“…Despite this, many studies have attempted to examine the antecedents of ELE [ 22 , 23 , 24 ]; they did not introduce a comprehensive model for the antecedents of ELE. However, the results of these studies have not always been consistent [ 25 , 26 ] and, therefore, ELE antecedents remain unidentified. Thus, our research helped in filling this gap by introducing a comprehensive framework for the antecedents of ELE in higher education institutions during the COVID-19 pandemic in the KSA context.…”

“…As above, and with reference to the aforementioned literature review, in order to apprehend the reality of the developing ELE in HEI, precisely in the context of the COVID-19 pandemic, a conceptual model was proposed. This model focused on the assessment of ELE by considering four factors affecting ELE in terms of direct and indirect relationships: ELS [ 4 , 26 , 32 , 34 , 37 , 39 ], ELR [ 30 , 34 , 35 ], INTRVAY, [ 38 , 42 , 46 , 73 , 75 , 78 , 80 , 81 ] and RTC [ 32 , 34 , 45 , 88 ]. Integrating those factors resulted in the model depicted in Figure 1 .…”

The Impact of Leadership on Digital Learning in Health

“…Different studies show different results, but they often conclude that digital learning programs are far more effective than no training and as effective as traditional teaching (Ruggeri et al 2013;George et al 2014). Wang et al (2021) point out that few studies have explored the effectiveness of e-learning tools for health care providers. They conclude that both clinicians and primary health care professionals improved their knowledge with e-learning activity in continuing medical education.…”

Trends and insights in e‐learning in medical education: A bibliometric analysis

“…The rapid global adoption of e‐learning in medical education has led to a simultaneous increase in research in this domain. The literature on e‐LMED varies in perspectives on the program, process and outcome evaluation (Barteit et al., 2020; Sawarkar & Sawarkar, 2020; Wang, Zhang, Liu, Jiang, Jia, et al., 2021; Wang, Zhang, Liu, Jiang, Tang, & Liu, 2021) to the evaluation of the cost‐effectiveness of e‐learning in medical education (Bista et al., 2021; Finucane & McCrorie, 2021; Sandars, 2021; Walsh, 2021), to the challenges and opportunities of e‐learning in medical education (Cosnita et al., 2020; Förster et al., 2020; Gray et al., 2021; Hayat et al., 2021) and comparison between e‐learning, blended learning and traditional classroom teaching (AlQhtani et al., 2021; Amir et al., 2020; Fitzgerald et al., 2021; Vallée et al., 2020; Venkatesh et al., 2020) to mention just a few. Publications in digital medical education are diverse, and there seems to be no agreement between the methods, tools and techniques used by authors in solving the same problem.…”