Mapping Evidence of Experiential learning for Primary Health Care Workers in Low-and-Middle-Income Countries: A Scoping Review

Abstract

Background: Improving equity of healthcare is one of the main global health priorities, particularly in low and medium-income-countries (LMICs). However, most LMICs still struggle to achieve equity in healthcare provision. One of the major contributing factors to achieving health equity in these settings include low levels of healthcare competency among primary healthcare workers. Experiential learning has been shown to contribute effectively to healthcare curriculum delivery. The purpose of this study was to systematically map evidence of experiential learning training programs for PHC workers with a focus on quality improvement in LMICs.
 
 Findings: Of the 240 022 articles retrieved from database search, 129 studies were found to be eligible for inclusion in abstract screening following title screening. Subsequent to abstract screening, 29 articles were eligible for inclusion in full article screening. Full article screening resulted in four articles found eligible for inclusion for data extraction and quality appraisal. Included studies were conducted in the following Countries: South Africa, China and Brazil. The following themes emerged: The utility, efficiency and acceptability of experiential learning approaches to PHC workers and Reflection. Experiential learning through various approaches was shown to have the potential to provide an important practical aspect on curriculum delivery not easily taught in lecture-based learning. Skills developed by PHC students in LMICs included communication, empathy, creativity and critical-reflexive skills. The reflection step of experiential learning was shown to be a useful tool to identify root causes of health systems inefficiencies and to inform policy making. The quality of included studies was found to range from above average to high quality.
 
 Conclusion: Limited research on the utility, efficiency and acceptability of experiential learning approaches to PHC-based professionals as well as on the impact of these approaches to the provision of quality services was found. Research focused on the development and piloting of experiential learning approaches to determine feasibility and to ensure effectiveness of interventions towards continuous professional development and life-long learning of PHC nurses in rural clinics is recommended.