The rapid scale up of medical education in Ethiopia: Medical student experiences and the role of e-learning at Addis Ababa University

Abstract

Background In response to a physician shortage in Ethiopia, the number of medical students admitted to public universities was rapidly increased through a “flooding” policy. Objectives To assess medical student perceptions on the impact of the “flooding” policy on medical education and e-learning initiatives, as well as plans for future emigration. Design A cross-sectional survey of medical students at AAU was implemented in 2014. Attitude and practice items were assessed using a Likert scale. Logistic regression analysis was performed to identify characteristics associated with an interest in future emigration. Results 673 (99.6%) of 676 students approached completed the survey, representing 39.5% of all 1705 medical students enrolled at AAU in 2014. Most students felt the “flooding” policy had a negative impact on their medical education and >90% felt there was not adequate infrastructure to support the increased student body. E-learning activities to accommodate increased class size included distribution of electronic tablets, but at the time of the survey only 34.8% of students still had a working tablet and 82.3% reported problems with internet connectivity. Most preclinical students (85.1%) who had attended live-streamed lectures preferred traditional classroom lectures. Half of the students (49.5%) intended to practice medicine in Ethiopia. Independent risk factors for planning to emigrate included age <21 years (aOR = 1.30, 95% CI 1.04, 1.97); having applied to medical school for reasons other than “wanting to be a physician” (aOR = 1.55, 95% CI 1.14, 2.20), and not believing that “flooding” policy would increase the number of physicians working in Ethiopia (aOR = 1.87, 95% CI 1.33, 2.58). Conclusions The “flooding” policy lead to significant educational challenges that were not fully alleviated by e-learning initiatives. Concomitant increases in resources for infrastructure development and faculty expansion are needed to maintain quality medical education. Additional research is needed on factors that influence medical graduates decision to emigrate.

Training pediatric hematologist/oncologists for capacity building in Ethiopia

“…However, each of these approaches has significant limitations. Fellowship training abroad presents potential negative consequences as these efforts remove talented physicians for multiple years and can increase the permanent emigration from LMIC 23–26 . Additionally, many of the skills learned in HIC may not be immediately applicable to LMIC settings.…”

“…Fellowship training abroad presents potential negative consequences as these efforts remove talented physicians for multiple years and can increase the permanent emigration from LMIC. [23][24][25][26] Additionally, many of the skills learned in HIC may not be immediately applicable to LMIC settings. Short-term skillset-based observerships or brief coursework can be beneficial for procedural services and increasing funds of knowledge, but these approaches do not pro- ilar to ours in Ethiopia.…”

Exploring the perspectives of medical students on application of e-learning in medical education during the COVID-19 pandemic

“…The literature shows that there are barriers to the implementation of e-learning; these include obstacles related to technology, resources, skills, institutional strategies, and support [32]. Both students and faculty face poor internet connectivity and a lack of hardware as the primary technical barriers to e-learning [20,33]. Other barriers related to technology include other hardware equipment, learning management systems, and digital library, among others [4].…”

Assessing Predictors of Academic Performance for NMEI Curriculum-Based Medical Students Found in the Southern Ethiopia

“…Applicants with a first degree in health science, computational science, and agriculture educational background were considered for admission to NMEI schools. e main feature of the NMEI program is integrating basic sciences to clinical skills complemented by early clinical and frequent community exposure, PBL, and PCD where all need the active engagement of the students [5,7].…”

“…Studies elsewhere reported that students were passively engaged in the educational process and courses are discrete and discipline-based [6]. Since 2012, the Ethiopian Federal Ministry of Health and Education implemented a new medical education initiative (NMEI) in 13 institutions [5,7]. NMEI utilizes modern educational principles like self-directed learning, problem-based learning (PBL), and professional competency development (PCD) [8,9].…”