Abstract
BackgroundClinicians in developing countries have had limited access to continuing education (CE) outside major cities, and CE strategies have had limited impact on sustainable change in performance. New educational tools could improve CE accessibility and effectiveness.Methodology/Principal FindingsThe objective of this study was to evaluate an interactive Internet-based CE course on Sexually Transmitted Diseases (STDs) management for clinicians in Peru. Participants included physicians and midwives in private practice drawn from a census of 10 Peruvian cities. The CE included a three-hour workshop for improving Internet skills, followed by a 22-hour online course on STD-syndrome-management, with subsequent educational support. The course used case-based clinical vignettes tailored to local STD problems. Knowledge and reported practices on STD management were assessed before, immediately after and at four months after completion of the course. Statistical analysis included parametric tests-linear regression multivariate analysis, paired t-test and repeated measures ANOVA using SPSS 14.0. Of 1,071 eligible clinicians, 510 agreed to participate, as did an additional 132 public sector clinicians. Of these 642 participants, 619 (96.4%) completed the course, and 596 (96.3%) took the four-month follow-up evaluation. Physician and midwife scores improved from 64.2% correct answers on the pre-test to 77.9% correct on the four-month follow-up test (p<0.001). Most participants (95%) found the online course useful for their work needs. Self reported STD management practices did not change.Conclusions/SignificanceAmong physicians and midwives in Peru, an Internet-based CE course was feasible, acceptable with high participation rates, and led to sustained improvement in knowledge at four months. Further studies are needed to test it as a model for improving the training of physicians, midwives, and other health care providers.
Highlights
Continuing education (CE) for health care workers is required by professional credentialing, governmental and licensing agencies and is available in many developed countries, but in developing countries, accessibility to those programs is limited, especially outside major urban settings
The I-continuing education (CE) course was developed as a training component for the Urban Community-Randomized Trial of Sexually Transmitted Diseases (STDs) Prevention in Peru (The PREVEN study)[16]
Of online-CE courses identified by systematic reviews[21,22], not many in Latin America and Africa have provided comprehensive Internet-based CE (I-CE) and to our knowledge, few were developed as casebased training within in a developing country[23,24]
Summary
Continuing education (CE) for health care workers is required by professional credentialing, governmental and licensing agencies and is available in many developed countries, but in developing countries, accessibility to those programs is limited, especially outside major urban settings. Traditional, didactic CE programs for health professionals have shown modest impact on sustained improvement in knowledge, health provider practices or patient outcomes[1,2]. Effectiveness of I-CE has improved by designing courses based upon educational theory and by including new educational tools such as case scenarios or clinical vignettes[4,7,8,9].
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