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J Med Educ Curric Dev. 2018 Apr 26;5:2382120518771913. doi: 10.1177/2382120518771913. eCollection 2018 Jan-Dec.

Evaluation of an E-Learning Course for Clubfoot Treatment in Tanzania: A Multicenter Study.

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Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA.
Division of Trauma and Orthopedic Surgery, Department of Surgery, Bugando Medical Centre, Mwanza, Tanzania.
Department of Physiotherapy, Mbeya Zonal Referral Hospital, Mbeya, Tanzania.


In total, 80% of clubfoot cases occur in low- and middle-income countries, where lack of clinical knowledge of the Ponseti method of treatment presents as a major barrier to treatment. This study aims to determine the effectiveness of an electronic learning course to teach clinicians in Tanzania Ponseti method theory. A total of 30 clinicians were recruited from clinics with high referral rates for clubfoot patients and invited to 1 of 3 training sites: Mbeya (n = 15), Zanzibar (n = 10), and Mwanza (n = 5). Baseline knowledge, measured through a pretest, was compared to performance on a posttest after e-learning course completion. Scores for Mbeya and Zanzibar participants improved from 44 ± 12.5 to 69.8 ± 16.5 (P < .0001) and 44.3 ± 14.0 to 67.9 ± 21.4 (P = .01), respectively. Our results suggest that an e-learning course may be an effective method of disseminating Ponseti method theory in Tanzania. Successful implementation requires an understanding of the device availability and technology literacy of the users.


Electronic learning; Ponseti method; clubfoot; global health; low- and middle-income countries; medical education

Conflict of interest statement

Declaration of conflicting interests:The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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