Effectiveness, relevance, and feasibility of an online neurocritical care course for African healthcare workers

Abstract

The majority of neurological disorders exist in low- and middle-income countries, but these nations have the fewest neurologists and neurological training opportunities worldwide. The objective of this study was to assess the effectiveness, relevance, and feasibility of a five-day neurocritical care course delivered online to African healthcare workers and to understand participants' prior neurological and neurocritical care training experiences. We offered the Neurocritical Care Society's Emergency Neurological Life Support (ENLS) course covering 14 neurocritical conditions via Zoom to 403 African healthcare workers over a 4-day period. An additional day was devoted to management of neurological emergencies in resource-limited settings. Participants completed pre- and post-course surveys to assess the effectiveness, relevance, and feasibility of the overall course to their settings. 318 participants (46% female; 56% residents; 24% neurologists; 9.0 ± 6.7 years practicing medicine) from 11 African countries completed the pre-course self-assessment, and 232 completed the post-course self-assessment. 97% reported prior experience caring for patients with neurological emergencies but only 35% reported prior neurology training and 9% prior neurocritical care training. Pre-course and post-course comfort levels showed statistically significant improvements (p < 0.001) across all fourteen neurocritical topics. 95% of participants found the course relevant to their current practice setting, 94% agreed the Zoom online platform was easy to use, and 93% reported it facilitated their learning. Suggestions for course improvement included addition of non-critical neurological conditions and inclusion of locally available diagnostics and treatment modalities. Study results suggest virtual platforms may offer a way to improve neurology training in areas with reduced neurological workforce.