A
Global Model for Effective Use and Evaluation of e-Learning in Health
By
Kai Ruggeri, PhD, Conor Farrington, PhD, and
Carol Brayne, MD
(Institute of Public Health, University of
Cambridge, United Kingdom)
Healthcare
systems worldwide face a range of challenges in the 21st Century due
to global health trends changes, healthcare delivery costs have risen steeply
in recent years and in 2008 it was estimated that none of the health-related
Millennium Development Goals would be met by 2015 in sub-Saharan Africa. In
response to all these challenges, many healthcare systems across the world have
initiated policy reforms aimed at reducing inefficiencies and health
inequalities. The range and severity of global healthcare challenges combined
with healthcare reforms generate considerable difficulties for medical
education and continued professional development (CPD). A recent study outlines
these difficulties which arise against a changing educational background.
These
challenges have been particularly severe in developing world contexts and
consequently, renewed efforts to reform medical education and CPD to be
necessary in a wide range of contexts and for a wide range of workforce
sectors.
E-learning
in health is defined as the delivery of training or CPD material via electronic
media. The e-learning programs can be classified as eight dimensions with
different advantages and disadvantages. They are:
Synchronicity
·
Asynchronous means content delivery occurs at
different time than receipt by student;
·
Synchronous means content delivery occurs at the
same time as receipt by student;
Location
·
Same
place means students
use an application at the same physical location as other students and/or the instructor
·
Distributed means students use an application at
various physical locations, separate from other students and the instructor
Independence
·
Individual means students work independently from
one another to complete learning tasks
·
Collaborative means students work collaboratively
with one another to complete learning tasks
Mode
·
Electronic-only means all content is delivered via
technology. There is no face-to-face component
·
Blended means E-learning is used to supplement
traditional classroom learning (and vice versa)
Out
of all eight dimensions, the blended learning (ie learning used to supplement
traditional classroom learning) is considered to have more positive and
interactive learning experience.
Numerous
studies have done about e-learning and they concluded that most e-learning
programs are far more effective than no training intervention and are as
effective as traditional small. There is no report of cost effectiveness in any
of the study. There are no security and no reliability against misuse due to
the nature of the Internet. Many public information outlets are without review,
therefore accuracy should never be assumed from unknown sources.
According
to the evidence, critical success factors (CSF) for e-learning include: institutional
characteristics, instructor characteristics, learner characteristics, and
e-learning program characteristics. Additional CSFs for a healthcare context
are: constant updating of course content, monitoring of workforce learning to
ensure the latest clinical guidance, adoption of new technologies to ensure
alignment of training with delivery models.
Unfortunately,
there is no standardized model (universally applied but locally adapted) to
evaluate the effectiveness and safety of e-learning programs in healthcare.
This
article discussed the importance facts about developing the evaluation model
and described the proposed model in schematic form as in figure 1, as well as,
illustrated form. The model provides a minimum standard but it can be a
starting point for discussion and dialogue. The model also has limitations.
Fig. 1. A model for evaluation of e-learning programs in
health and care. KPIs, key performance
indicators.
Limitations
of the model include language barrier, no accreditation standard for online
training, it does not describe how to structure the content or facilitation or
presenting information within the program and it applies to a direct training
program. Interested organizations should work toward establishing a standard
model for evaluating programs in a wide range of contexts. Therefore, a
standard model should aim to provide a practical and adaptable framework to
support the systematic development of high-quality evaluations to elicit
valuable and important information for decision makers.
Application
of this model in my context (Medical University training programs)
As
the contexts are differ between medical training for undergraduate programs and
healthcare program training, this model cannot apply in my context. I agree
that training in healthcare program could benefit to use this model for evaluate
their e-learning programs but due to its detailed structure, and extra
components than simple medical training, it is not applicable to my context.
For
medical training context, I would prefer using the Kirkpatrick model for outcome
evaluation of e-learning which focuses more on the learner. It is quite simple
model which evaluates four levels. They are: (level 1) Reaction, which measures
both students and facilitators’ feelings to the course; (level 2) Learning, which
measures what students learned; (level 3) Learned behavior, which measures
behavior changes of students after the course; and (level 4) Results, which
measures the outcomes of the course.
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