JMIR Publications

ABSTRACT

Background:

Zambia is faced with a severe shortage of health workers and challenges in national health financing. This burdens the medical licentiate practitioner (MLP) program for training non-physician clinical students in Zambia, due to the shortage of qualified medical lecturers and learning resources at training locations. To address this shortage and strengthen the MLP program, a self-directed e-learning platform for medical education with an eHealth component was introduced. MLP students were provided with tablets that were pre-loaded with e-learning and eHealth content for offline access.

Objective:

To identify MLP students and medical lecturers’ perceptions of self-directed e-learning and eHealth with an offline-based tablet as a training and healthcare practice support tool during the first year of full implementation.

Methods:

We conducted in-depth qualitative interviews with eight MLP students and six lecturers and two focus group discussions with 16 students to gain insights on perceptions of the usefulness, ease of use, and adequacy of self-directed e-learning with its eHealth component accessible through the offline-based tablet. Participants were purposively sampled. Verbatim transcripts were analyzed following hypothesis coding.

Results:

E-learning and eHealth (e-platform) was positively received by students and medical lecturers, and was seen as a step towards modernizing the MLP program. Tablets enabled equal access to offline learning contents, thus bridging the gap of slow or no internet connections. The study results indicated that a self-directed learning with a healthcare practice support approach appears adequate to strengthen medical education within this low-resource setting. However, student self-reported usage was low and medical lecturer usage was even lower. The lack of training in tablet usage was stated as one reason, and another was the alleged low quality of the tablets. The mediocre quality and quantity of e-learning contents were perceived as a primary concern, since materials were reported to be outdated, missing multimedia features and addressing only part of the curriculum. Medical lecturers were noted to have little commitment for updating and creating new learning materials. Suggestions for improving the e-learning and eHealth platform were given.

Conclusions:

Identified challenges served as the base to formulate improvements for the MLP program’s e-learning and eHealth platform. To this end, we plan to provide comprehensive half-day training sessions at the beginning of each study year to enable productive tablet usage. To address the primary concern of outdated and insufficient e-learning content, we will focus on working with MLP program stakeholders to nominate an e-platform coordinator, setup an e-platform steering committee including medical lecturers and incorporate e-learning and eHealth across the curriculum. Furthermore, we plan to implement processes to foster user-generated content. With these measures we aim to strengthen the MLP program and sustainably implement the tablet-based e-platform as a serious learning technology for medical education and healthcare practice support.