E-learning in medical education in resource constrained low- and middle-income countries

Abstract

BackgroundIn the face of severe faculty shortages in resource-constrained countries, medical schools look to e-learning for improved access to medical education. This paper summarizes the literature on e-learning in low- and middle-income countries (LMIC), and presents the spectrum of tools and strategies used.MethodsResearchers reviewed literature using terms related to e-learning and pre-service education of health professionals in LMIC. Search terms were connected using the Boolean Operators “AND” and “OR” to capture all relevant article suggestions. Using standard decision criteria, reviewers narrowed the article suggestions to a final 124 relevant articles.ResultsOf the relevant articles found, most referred to e-learning in Brazil (14 articles), India (14), Egypt (10) and South Africa (10). While e-learning has been used by a variety of health workers in LMICs, the majority (58%) reported on physician training, while 24% focused on nursing, pharmacy and dentistry training. Although reasons for investing in e-learning varied, expanded access to education was at the core of e-learning implementation which included providing supplementary tools to support faculty in their teaching, expanding the pool of faculty by connecting to partner and/or community teaching sites, and sharing of digital resources for use by students. E-learning in medical education takes many forms. Blended learning approaches were the most common methodology presented (49 articles) of which computer-assisted learning (CAL) comprised the majority (45 articles). Other approaches included simulations and the use of multimedia software (20 articles), web-based learning (14 articles), and eTutor/eMentor programs (3 articles). Of the 69 articles that evaluated the effectiveness of e-learning tools, 35 studies compared outcomes between e-learning and other approaches, while 34 studies qualitatively analyzed student and faculty attitudes toward e-learning modalities.ConclusionsE-learning in medical education is a means to an end, rather than the end in itself. Utilizing e-learning can result in greater educational opportunities for students while simultaneously enhancing faculty effectiveness and efficiency. However, this potential of e-learning assumes a certain level of institutional readiness in human and infrastructural resources that is not always present in LMICs. Institutional readiness for e-learning adoption ensures the alignment of new tools to the educational and economic context.

Review of e-learning Practice at the Tertiary Education level in Malaysia

“…12 William stated that paramedical students also found computer-based learning to be useful for their learning; however, not all the students can accept the application of computer-based learning in the online environment as some of them are facing difficulties in accessing the internet other than in their university. 17 In Malaysia, there are also studies of e-learning intervention done on health science faculties including the biomedical science, optometry, and nutrition and dietetics department.…”

“…Although a number of studies have been done in tertiary education related to e-learning, not many studies focus on specific departments such as health science department. 2,3,[9][10][11][12][13][14][15][16][17] By doing the microscopic study of e-learning in specific departments such as in pharmacy education, generalizing the findings from the study is not allowed as it is only the fraction of the interested population. However, by understanding the students' perception on e-learning in a small scale, earlier modification can be made by the lecturers and academic staff as to motivate and overcome any problems faced by the students.…”

A Multilevel Systematic Approach for Identification of Mobile Learning Multimedia in Low Bandwidth Environment

“…Boolean Operators "AND" and "OR" were used to connect search terms aimed to study all relevant article suggestions [12].…”

“…Frehywot et al [12] carried out the research on e-learning in medical education in resource constrained countries and found that low quality of videos or visual outputs was one of the major challenge users were facing, due to bandwidth limitations that often contributed to low speed network. Therefore, designers of learning content must follow good learning theories and appropriate instructional design for the learning to be effective.…”

Radiation Oncology Quality and Safety Considerations in Low-Resource Settings: A Medical Physics Perspective

“…Potential tools, techniques and procedures that can aid education and training in resource limited environments include: (1) e-learning [68][69][70][71] , (2) e-mentoring/e-rounds 72 (e.g., http://chartrounds.com/), (3) collaborative course development/education/training 39,73 , and (4) courses provided by national/international organizations 74 .…”