03721nas a2200385   4500000000100000008004100001653001200042653002100054653003300075653002500108653004700133653002500180653001200205653001400217653001100231653001100242100001600253700001100269700001600280700001200296700001000308700001300318700001700331700001500348700001000363700001200373700001600385700001800401245018800419856007700607300000700684490000700691520262300698022001403321       2018                            d10aMhealth10aBlended learning10aCommunity healthcare workers10aDeveloping countries10aInformation and communication technologies10aTraditional learning10aeHealth10amLearning10aMalawi10aAfrica1 aMastellos N1 aTran T1 aDharmayat K1 aCecil E1 aLee H1 aWong CPC1 aMkandawire W1 aNgalande E1 aWu JT1 aHardy V1 aChirambo BG1 aO'Donoghue JM00aTraining community healthcare workers on the use of information and communication technologies: a randomised controlled trial of traditional versus blended learning in Malawi, Africa.  uhttps://bmcmededuc.biomedcentral.com/track/pdf/10.1186/s12909-018-1175-5  a610 v183 a<p><strong>BACKGROUND: </strong>Despite the increasing uptake of information and communication technologies (ICT) within healthcare services across developing countries, community healthcare workers (CHWs) have limited knowledge to fully utilise computerised clinical systems and mobile apps. The 'Introduction to Information and Communication Technology and eHealth' course was developed with the aim to provide CHWs in Malawi, Africa, with basic knowledge and computer skills to use digital solutions in healthcare delivery. The course was delivered using a traditional and a blended learning approach.</p>

<p><strong>METHODS: </strong>Two questionnaires were developed and tested for face validity and reliability in a pilot course with 20 CHWs. Those were designed to measure CHWs' knowledge of and attitudes towards the use of ICT, before and after each course, as well as their satisfaction with each learning approach. Following validation, a randomised controlled trial was conducted to assess the effectiveness of the two learning approaches. A total of 40 CHWs were recruited, stratified by position, gender and computer experience, and allocated to the traditional or blended learning group using block randomisation. Participants completed the baseline and follow-up questionnaires before and after each course to assess the impact of each learning approach on their knowledge, attitudes, and satisfaction. Per-item, pre-post and between-group, mean differences for each approach were calculated using paired and unpaired t-tests, respectively. Per-item, between-group, satisfaction scores were compared using unpaired t-tests.</p>

<p><strong>RESULTS: </strong>Scores across all scales improved after attending the traditional and blended learning courses. Self-rated ICT knowledge was significantly improved in both groups with significant differences between groups in seven domains. However, actual ICT knowledge scores were similar across groups. There were no significant differences between groups in attitudinal gains. Satisfaction with the course was generally high in both groups. However, participants in the blended learning group found it more difficult to follow the content of the course.</p>

<p><strong>CONCLUSIONS: </strong>This study shows that there is no difference between blended and traditional learning in the acquisition of actual ICT knowledge among community healthcare workers in developing countries. Given the human resource constraints in remote resource-poor areas, the blended learning approach may present an advantageous alternative to traditional learning.</p>
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