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J Med Internet Res. 2019 Jan 9;21(1):e12449. doi: 10.2196/12449.

E-Learning for Medical Education in Sub-Saharan Africa and Low-Resource Settings: Viewpoint.

Author information

1
Heidelberg Institute of Global Health, Heidelberg, Germany.
2
Ministry of Health, Lusaka, Zambia.
3
Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, United States.
4
Africa Health Research Institute (AHRI), KwaZulu-Natal, South Africa.
5
Chainama College of Health Sciences, Lusaka, Zambia.
6
SolidarMed, Lusaka, Zambia.

Abstract

E-learning has been heralded as a revolutionary force for medical education, especially for low-resource countries still suffering from a dire lack of health care workers. However, despite over two decades of e-learning endeavors and interventions across sub-Saharan Africa and other low- and middle-income countries, e-learning for medical education has not gained momentum and continues to fall short of the anticipated revolution. Many e-learning interventions have been cul-de-sac pilots that have not been scaled up but rather terminated after the pilot phase. This is usually a result of not adopting a system-wide approach, which leads to insufficient scope of training, insufficient technological maintenance and user support, unattainably high expectations, and unrealistic financial planning. Thus, a multitude of e-learning evaluations have failed to provide scientifically sound evidence of the effectiveness of e-learning for medical education in low-resource countries. Instead, it appears that technological development has overwhelmed rather than revolutionized medical education. The question of how to push e-learning into a higher gear in low-resource countries persists. Provision of e-learning as a technology is insufficient. E-learning needs to be vigorously and sustainably integrated into the local educational setting and aligned with national strategies and other national endeavors and interventions. Adhering to a standardized framework for the implementation and evaluation of e-learning endeavors is key, especially to bridge the gap in robust evidence that should also guide e-learning implementations. The primary objective of e-learning for medical education is to strengthen the health system in order to serve the population's health care needs and expectations. Currently, medical e-learning does not measure up to its potential or do justice to medical students in low-resource countries. Technology may help unfold the potential of e-learning, but an all-encompassing change is needed. This can only be achieved through a joint effort that follows a systematic and standardized framework, especially for implementation and evaluation.

KEYWORDS:

blended learning; developing countries; eHealth; health system strengthening; health workers; low-resource countries; mHealth; medical e-learning; medical education; sub-Saharan Africa; technology-enhanced learning; universal health coverage

PMID:
30626565
DOI:
10.2196/12449
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