Kilimanjaro Christian Medical University College Research Articles

Engagement of stakeholders in the development of generic medical and nursing curricula in Tanzania through media outlets and social media

Background. The Catholic University of Health and Allied Health Sciences, Kilimanjaro Christian Medical University College and Muhimbili University of Health and Allied Sciences teamed up to address gaps in the training curricula for medical doctors and nurses with the aim of developing harmonised curricular templates that would be comprehensive and suit national objectives. Objectives. To share experiences and lessons learned in engaging stakeholders using social media as an additional method to collect information on curricular gaps and ideas to develop harmonised medical and nursing curricula. Methods. Pictures, newsprint extracts, and videos of face-to-face events in the curriculum development process and project and a curriculum advert were posted on Facebook, Twitter and YouTube and used to engage stakeholders, including regulatory bodies, health professional councils, graduates, students, practitioners, health training institutions, private and public employers, internship supervisors, faculty and the public. Reactions, comments and post insights from stakeholder postings, in both Swahili and English, were analysed manually and categorised into four types of messages: congratulatory, comments on the process and expected outcomes, curricular gaps, and faculty development needs to implement new curricula. Results. A total of 69 290 stakeholders were engaged via Facebook and 229 via Twitter. A total of 13 553 (19.6%) Facebook and 179 (78.2%) Twitter comments were directly related to gaps in current curricula and graduate competencies. Other inputs received through social media were on faculty development needs to implement harmonised curricula and the project in general. Conclusion. This was the first attempt to engage curriculum stakeholders using social media for the development of harmonised curricula in Tanzania. The impact of social media in providing relevant inputs for curriculum development was significant. Use of social media, with multiple language options, is an economical and efficient way to reach a large number of stakeholders for curriculum quality improvement.

'Pamoja Tunaweza': A Collaborative Program Model for Global Health Training & Education.

The past two decades have seen unprecedented student demand for global health education through experiential and engaged learning within institutions of higher education in the United States. This demand created a need for innovative institutional partnerships. Since 2007, faculty from Cornell University's Global Health Program and Kilimanjaro Christian Medical University College (KCMUCo) have worked together to design, implement, and evaluate an innovative experiential learning program in global health and development policy. Since its inception, 176 Cornell undergraduates and 188 KCMUCo medical students have successfully engaged in the policy case study collaborative program and course, leading to the development of 75 policy case studies. This long-term partnership between Cornell and KCMUCo has led to an innovative cross-cultural teaching model, funding support, professional presentations for students and faculty, a visiting scholars program at Cornell, and new avenues for research and collaboration. Fifteen years of sustained partnership has required the navigation of several unique and complex challenges, providing the opportunity to reimagine and strengthen this program and partnership. The objective of this article is to share a powerful program model for global health training and education, and discuss the challenges, successes, and lessons learned through this continued collaboration.

Practice and Prevalence of Antibiotic Self-Medication among Undergraduate Students at Kilimanjaro Christian Medical University College, Tanzania

Background: Antibiotic self-medication has been on the rise in different parts of the world. Antibiotic self-medication causes excessive antibiotic exposure to humans which is associated with many health risks including antibiotic resistance. The objective of this study was to assess practice and determine the prevalence of antibiotic self-medication among undergraduate students. Methodology: This was a descriptive cross-sectional study conducted at Kilimanjaro Christian Medical University College. A self-administered questionnaire was used to assess the practice and knowledge of antibiotic self-medication among undergraduate students. A total of 300 undergraduate students were purposively sampled. The association between categorical predictors and antibiotic self-medication waspresented as Odds Ratios (OR) with 95% Confidence Intervals (95% CIs) using logistic regression. Result: The prevalence of antibiotic self-medication among undergraduate students is 191(63.7%) with amoxicillin 103(53.9%) being the most used antibiotic for treatment of respiratory disorders 109(57.1%) and gastrointestinal disorders 50(26.2%). Pharmacy is the major source of antibiotics used for self-medication 165(86.4%). Delayed/queue in seeking hospitals services was the main reason for practicing antibiotic self-medication 74(38.7%). Conclusion: The study observed a high prevalence of antibiotic self-medication among undergraduate students. This calls for immediate implementation of public health programs aimed at increasing awareness of consequences that may results from antibiotic self-medication. At the policy-making level, there is an urgent need to legislate and enforce laws restricting access to antibiotics in Tanzania.

Online Assignments at Kilimanjaro Christian Medical University College during the COVID-19 Pandemic

Online Assignments at Kilimanjaro Christian Medical University College during the COVID-19 Pandemic

How Public Health Crises Expose Systemic, Day-to-Day Health Inequalities in Low- and-Middle Income Countries - An Example From East Africa

Background: The Coronavirus disease pandemic reveals political and structural inequities of the world’s poorest people who have little or no access to health care and with the largest burdens of poor health. This is in parallel to a more persistent but global health crisis, antimicrobial resistance (AMR). We explore the fundamental challenges of health care in humans and animals in relation to AMR in Tanzania. Methods: We conducted 57 individual interviews and focus groups with providers and patients in high, middle and lower tier health care facilities and communities across three regions of Tanzania between April 2019 and February 2020. We covered topics from health infrastructure and prescribing practices to health communication and patient experiences. Findings: Three interconnected themes emerged about systemic issues impacting health. First, there are challenges around infrastructure and availability of vital resources such as healthcare staff and supplies. Second, health outcomes are predicated on patient and provider access to services as well as social determinants of health. Third, health communication is critical in defining trusted sources of information, and narratives of blame emerge around health outcomes with the onus of responsibility for action falling on individuals. Interpretation: Entanglements between infrastructure, access and communication exist while constraints in the health system lead to poor health outcomes even in ‘normal’ circumstances. These are likely to be relevant across the globe and highly topical for addressing pressing global health challenges. Redressing structural health inequities can better equip countries and their citizens to not only face pandemics but also day-to-day health challenges. Funding Statement: This research was funded by the Antimicrobial Resistance Cross-Council Initiative through a grant from the Medical Research Council, a Council of UK Research and Innovation and the National Institute for Health Research (MRC/AMR/ MR/S004815/1). Hilton’s time was also funded by a core grant for the Medical Research Council/Chief Scientist Office (MRC/CSO) Social and Public Health Sciences Unit (MC_UU_12017/14; SPHSU14; MC_UU_12017/15; SPHSU15). This publication was supported by the University of Edinburgh and the University of Glasgow Jointly Funded PhD studentships (Loosli).Declaration of Interests: There are no conflicts of interests between the authors and/or institutions.Ethics Approval Statement: The study received approval from the Kilimanjaro Christian Medical University College Ethics Review committee with certificate n. 2408 and the Catholic University Health and Allied Sciences committee with certificate n. CREC/318/2018; National Institute for Medical Research (NIMR), Tanzania, with Reference Number NIMR/HQ/R.8a/Vol. IX/3017; Tanzanian Commission for Science and Technology (Davis, permit n. 2020-335-NA-2019-205; Lembo, permit n. 2020-333-NA-2019-205; Laurie, permit n. 2020-332-NA-2019-205; Mutua, permit n. 2020-334-NA-2019-205; Nthambi, permit n. 2020-336-NA-2019-205; Matthews, permit n. 2019-482-NA-2019-205; and Hilton, permit n.2019-476-NA-2019-205); and College of Medical Veterinary and Life Sciences ethics committee at the University of Glasgow (project application number 200180046). Permission for research in communities was obtained from relevant local and district authorities. All participants were explained study objectives and written and/or verbal informed consent was obtained. Verbal consent was utilised instead of written consent with participants who were unable to write. Informed consent forms and participant information sheets were approved by all ethics panels.

Teaching and Learning Experiences in Medical Education During the COVID-19 Pandemic: The Case of Kilimanjaro Christian Medical University College (KCMUCo), Tanzania

Objective
 The purpose of this paper was to share teaching and learning experiences during the COVID-19 pandemic and mandated university closure.
 Methods
 A cross-sectional study was conducted among all eligible students and faculty members using voluntary anonymous questionnaires. To capture the attitudes and perceptions of respondents, five-point Likert scale questions were used.
 Results
 A total of 865 (58%) students and 57 (51%) faculty members participated in the survey. Uptake of e-learning platforms increased by 15.4% for students, 43.0% for faculty and by 22.3% in courses. The overall students’ strength of consensus measure of perception on accessibility of platforms was 65% and support entities 79%. About 70% of students owned a smartphone as a learning device. More than 67% of the students highlighted the cost of Internet bundles as a major challenge.
 Conclusion
 Shifting from blended learning to online learning during the lockdown was feasible given the pre-planned e-learning practices.

Using discrete choice experiments to design interventions for heterogeneous preferences: protocol for a pragmatic randomised controlled trial of a preference-informed, heterogeneity-focused, HIV testing offer for high-risk populations

IntroductionApproximately one million undiagnosed persons living with HIV in Southern and Eastern Africa need to test for HIV. Novel approaches are necessary to identify HIV testing options that match the...

Community engagement in COVID-19 prevention: experiences from Kilimanjaro region, Northern Tanzania.

Prevention of exposure to the COVID-19 virus in the general population is an essential strategy to slow community transmission. This paper shares the experiences and challenges of community engagement in COVID-19 prevention in the Kilimanjaro region, Northern Tanzania implemented by our team from the Institute of Public Health (IPH), Kilimanjaro Christian Medical University College (KCMUCo) in collaboration with the COVID-19 response team in the Moshi Municipality. We conducted an education session with the COVID-19 response team and together brainstormed transmission hotspots and which interventions would be most feasible in their settings. The first hotspot identified was crowded local market spaces. Suggested interventions included targeted and mass public health education through the engagement of market opinion leaders, public announcements, and radio shows. We conducted participatory rural appraisal techniques to enable market vendors and clients to visualize two-meter distances and provided a prototype hand-washing facility that was foot operated. We found mass public health educational campaigns essential to inform and update the public about COVID-19 pandemic and to address rumors and misinformation, which hampers compliance with public health interventions. Coordinated efforts among stakeholders in the country are necessary to develop context-specific prevention and case management strategies following the national and international guidelines. Local ownership of recommended interventions is necessary to ensure compliance.

Internet addiction and associated factors among medical and allied health sciences students in northern Tanzania: a cross-sectional study

BackgroundInternet addiction is one of the fast-growing addictive behaviors and is a significant public health problem affecting a large number of people worldwide. Excessive use of the internet among university students increases their risk of internet addiction and related negative consequences. This study aimed to determine the prevalence and factors associated with internet addiction among medical and allied health sciences students in northern Tanzania.MethodsThis cross-sectional study was conducted at Kilimanjaro Christian Medical University College (KCMUCo) from May to June 2018. A total of 500 consenting undergraduate students were sampled using the Simple Random Sampling technique proportional to the size of each class and a self-administered questionnaire used to collect data. Internet addiction was measured using a 20-item internet addiction test (IAT-20). Generalized linear model with Poisson family and log link function was used to estimate prevalence ratio (PR) and the corresponding 95% confidence intervals for factors associated with internet addiction.ResultsThe prevalence of internet addiction was 31%. Undergraduate students using the internet at the college were less likely to be addicted to internet (PR = 0.45, 95%CI 0.23, 0.86, p = 0.02) compared to those using both at the hostel/home and college. Higher prevalence of internet addiction was among those who used internet for a long time, i.e., 5 h or more per day (PR = 1.84, 95%CI 1.30, 2.63, p = 0.001) and for social networking (PR = 1.64, 95%CI 1.17, 2.31, p = 0.004) compared to those who used for less than 5 h per day and academic purposes, respectively.ConclusionsThirty-one percent of undergraduate students in northern Tanzania were addicted to the internet. Internet addiction was associated with using the internet at the college, a long time using the internet per day, and social networking. The college administration should put effort into improving the accessibility, reliability, and regulation of college internet services to promote learning and academic productivity. We also recommend awareness creation intervention about the harmful consequences of excessive internet use in this population. More studies are needed to determine the burden of mental, psychological, and social problems associated with internet addiction in high-risk populations, and associated consequences.

Factors associated with mental distress among undergraduate students in northern Tanzania

BackgroundMental distress is a major public health problem which includes anxiety, depression and somatic symptoms such as sleeping problems, fatigue and headache. University students are consistently reported to have higher levels of mental distress compared to the general population. Although university students with mental distress have significantly impaired cognitive functioning, learning disabilities and poor academic performance, the burden of this problem in Tanzania is unknown. This study aimed to determine prevalence and factors associated with mental distress among undergraduate students in northern Tanzania.MethodsA cross-sectional study was conducted among undergraduate students at Kilimanjaro Christian Medical University College from April–July 2018. Simple random sampling technique using probability proportional to size was used to sample students from their respective classes. Mental distress was screened using the self-reporting questionnaire (SRQ-20). Data was analyzed using Stata version 15.1. Frequencies and percentages were used to summarize categorical variables while mean and standard deviation for numeric variables. Multivariable logistic regression was used to determine factors associated with mental distress adjusted for potential confounders.ResultsA total of 402 undergraduate students participated in this study, 14% screened positive for mental distress. Residing off-campus (OR = 0.44, 95%CI 0.20–0.96) and perceived availability of social support (OR = 0.22, 95%CI 0.11–0.45) reduced the odds of mental distress while students with family history of mental distress (OR = 2.60, 95%CI 1.04–6.57) and those with decreased grades than anticipated (OR = 3.61, 95%CI 1.91–6.83) had higher likelihood of mental distress.ConclusionOne in every ten students screened was positive for mental distress. Those who reported a family history of mental illness and lower grades than anticipated had higher response of mental distress. To relieve students from stress and frustrations related to studies and their lives in general, this study recommends awareness creation, counselling to help those with mental health issues, establishment of student drop-in centers for such services and promotion of social and recreational activities at the college.

Community engagement in COVID-19 prevention: experiences from Kilimanjaro region, Northern Tanzania

Prevention of exposure to the COVID-19 virus in the general population is an essential strategy to slow community transmission. This paper shares the experiences and challenges of community engagement in COVID-19 prevention in the Kilimanjaro region, Northern Tanzania implemented by our team from the Institute of Public Health (IPH), Kilimanjaro Christian Medical University College (KCMUCo) in collaboration with the COVID-19 response team in the Moshi Municipality. We conducted an education session with the COVID-19 response team and together brainstormed transmission hotspots and which interventions would be most feasible in their settings. The first hotspot identified was crowded local market spaces. Suggested interventions included targeted and mass public health education through the engagement of market opinion leaders, public announcements, and radio shows. We conducted participatory rural appraisal techniques to enable market vendors and clients to visualize two-meter distances and provided a prototype hand-washing facility that was foot operated. We found mass public health educational campaigns essential to inform and update the public about COVID-19 pandemic and to address rumors and misinformation, which hampers compliance with public health interventions. Coordinated efforts among stakeholders in the country are necessary to develop context-specific prevention and case management strategies following the national and international guidelines. Local ownership of recommended interventions is necessary to ensure compliance.

Association Between E-learning System Usage and Medical Student Academic Performance at the Kilimanjaro Christian Medical University College in Moshi, Tanzania

Association Between E-learning System Usage and Medical Student Academic Performance at the Kilimanjaro Christian Medical University College in Moshi, Tanzania

Building Clinical Clerkships Capacity in a Resource-limited Setting: The Case of the Kilimanjaro Christian Medical University College in Tanzania

Background:The shortage of medical doctors in sub-Saharan Africa (SSA) has resulted in increased enrolment in medical schools, which has not been matched with increased faculty size or physical infrastructure. This process has led to overcrowding and possibly reduced quality of training. To reduce overcrowding at its teaching hospital, the Kilimanjaro Christian Medical University College introduced eight-week peripheral clerkship rotations in 2012. We explore students’ perceptions and attitudes towards peripheral hospital placements.Method:The clerkship rotations were conducted in eight hospitals operating in the northern Tanzania, after evaluating each hospitals’ capabilities and establishing the optimum number of students per hospital. Paper-based surveys were conducted after student rotations from 2014 to 2016.Results:Overall student satisfaction was moderate (strength of consensus measure (sCns), 77%). The three cohorts exhibited improving trends over three years with respect to satisfaction with clinical skills and attitude towards placements. student-preceptor interaction was rated highly (sCns 81–84%). The first cohort students expressed concerns about limited laboratory support, and poor access to Internet and learning resources. Specific interventions were undertaken to address these concerns.Conclusions:Student experiences in peripheral rotations were positive with adequate satisfaction levels. Opportunities exist for medical schools in SSA to enhance clinical training and relieve overcrowding through peripheral clerkship rotations.

Implementation of a Learning Management System for Medical Students: A Case Study of Kilimanjaro Christian Medical University College.

This article was migrated. The article was marked as recommended. Learning Management Systems (LMS) are powerful tools for the organization and presentation of curricular learning materials, for monitoring of student and faculty members performance, and for overall quality control. However, there is limited evidence regarding the acceptance and performance of LMS in Africa. This manuscript describes the implementation, the outcomes, and the challenges of the first five years of a LMS at the Kilimanjaro Christian Medical University College (KCMUCo). The LMS has been fully adopted into KCMUCo curriculum and deployed to 1356 students. It has been demonstrated to enhance learning with strength of consensus measure of 84% for basic sciences and 78% for clinical classes. 80% of faculty members have been satisfied with the use of LMS. Electronic assessment has become an obligatory platform for theory examinations. LMS adoption may improve education outcomes at other medical schools in Tanzania and sub-Saharan Africa.

Descriptive study of nursing scope of practice in rural medically underserved areas of Africa, South of the Sahara

AimsThe aims of this study are to describe the scope of “non-nursing duties” carried out by nurses, in rural low-resource regions of Tanzania, and describe how the role of nurses is viewed in their communities. BackgroundMore than 70% of Tanzanians live in rural areas. Nurses are more likely than physicians to practice in these communities. As a result nurses are frequently forced to function beyond their educational preparation and expand their practice to meet the health needs of the community. DesignThis exploratory study sampled two randomly selected district hospitals, with associated health centers and dispensaries (small village clinics), in each of the four target-regions (Tanga, Mtwara, Singida, and Shinyanga). MethodsIn November 2014, members of the Faculty of Nursing at Kilimanjaro Christian Medical University–College (KCMUCo) in Moshi, Tanzania interviewed nurses, health facility managers, non-nurse health professionals, and health service consumers. Results/findingsNurses at all levels of education, with or without additional training, are prescribing for patients and performing minor surgical procedures, well beyond their educational preparation. The consensus by all participants is that nurses should receive training in skills to provide primary care as a solution to the lack of providers. ConclusionStrengthening health services by advancing the nurses’ role is an innovative way to improve health care outcomes in Tanzania.

Enhancing future acceptance of rural placement in Tanzania through peripheral hospital rotations for medical students.

BackgroundMal-distribution of health care workers is a global health challenge that exacerbates health disparities, especially in resource-limited settings. Interventions to mitigate the problem have targeted qualified personnel with little focus on medical students. However, studies have demonstrated that rural rotations positively influence students to practice in rural settings upon graduation. To evaluate the influence of peripheral rotations in a resource-limited setting, the Kilimanjaro Christian Medical University College introduced a 12-week clerkship rotation in peripheral hospitals for third-year medical (MD3) students in 2012. We administered an end-of-rotation survey to assess student perceptions, and attitudes toward rural practice after graduation.MethodsQuestionnaires were voluntarily and anonymously administered to MD3 students in April 2014. The questions assessed perceptions of the experience, and attitudes towards rural practice upon graduation. The perceptions were assessed using strength of consensus measures (sCns). The effect of the experience on likelihood for rural practice was assessed using Crude Odds Ratio (COR), and predictors using Adjusted Odds Ratio (AOR) with 95 % Confidence Intervals (CI) tested at a 5 % level of significance. Variation was assessed using Hosmer and Lemeshow test Chi-square.Results111 out of 148 MD3 students participated; 62 % were male; 62 % <25 years old; and 72 % matriculated directly from secondary school. Overall, 81 % of MD3 students were satisfied with rural rotations (sCns = 83 %). The likelihood of accepting rural practice deployment after graduation was predicted by satisfaction with the peripheral hospital rotation program (AOR, 4.32; 95 % CI, 1.44–12.96; p, 0.009) and being male (AOR, 2.73; 95 % CI, 1.09–6.84; p, 0.032). Students admitted in medical school after health-related practice trended toward a higher likelihood of accepting rural practice after graduation compared to those enrolled directly from secondary school, although the difference was not significant (AOR, 4.99; 95 % CI, 0.88–28.41; p, 0.070). The Hosmer and Lemeshow test p-value was 0.686, indicating a good fit of the model. No significant differences in satisfaction between these two groups were observed, and also no significant differences between students born in rural areas compared to those born in urban areas existed.ConclusionResults indicate that satisfaction with rural rotations is associated with increased likelihood of rural practice after graduation. We conclude that opportunities may exist to reduce mal-distribution of healthcare workers through interventions that target medical students.

Oral health in nursing students at Kilimanjaro Christian Medical Centre teaching hospital in Moshi, Tanzania.

BackgroundThis study aimed to determine the prevalence and severity of dental caries, oral hygiene levels and assessment of the oral health knowledge and practices of nursing students at Kilimanjaro Christian Medical Centre teaching hospital in Moshi, Tanzania.MethodsA cross-sectional survey was done on 217 student nurse population at Kilimanjaro Christian Medical Centre Teaching Hospital in Moshi, Tanzania in 2014. Ethical approval was obtained from the Kilimanjaro Christian Medical University College Ethical Committee. A questionnaire probing on socio-demographic characteristics, knowledge and practices on selected oral health issues was administered to the students. Students were also examined for oral hygiene and dental caries using Simplified Oral Hygiene Index (OHI-S) and WHO 1997 recommended method respectively.ResultsThere were 214 (98.6%) respondents aged between 18 and 53 years (mean age was 27.2 SD ± 7.35 years). About 72% of the respondents were in the young age group (below 31 years), 63.1% were pursuing Diploma in Nursing while the rest were pursuing Bachelor of Science in Nursing. Although oral health knowledge of the respondents was generally poor, more students pursuing Bachelor of Science in Nursing had significant adequate oral health knowledge than those who were pursuing Diploma in Nursing (p = 0.05). Population Oral Hygiene Index- Simplified was 0.41 meaning good oral hygiene in the current population. Overall, caries prevalence was 40.2%. The mean population DMFT was 1.34 (SD ± 2.44). The decay component was 0.53 (SD ± 1.29), whereas the missing component was 0.67 (SD ±1.34) and filled component was 0.14 (SD ± 0.69). Significantly more students in the older age group had more missing and filled teeth than their counterparts in the young age group (p ≤0.05).ConclusionMajority of the students in this population had good oral hygiene and a very low DMFT. There was poor basic oral health knowledge and poor recall visit to dental personnel. Curriculum development in these school programmes should strengthen or encompass comprehensive oral health education components. This will empower nursing professional with basic oral health knowledge and promotive oral health behaviors and hence to disseminate to the clients.

Modernizing and transforming medical education at the Kilimanjaro Christian Medical University College.

The Kilimanjaro Christian Medical University (KCMU) College and the Medical Education Partnership Initiative (MEPI) are addressing the crisis in Tanzanian health care manpower by modernizing the college's medical education with new tools and techniques. With a $10 million MEPI grant and the participation of its partner, Duke University, KCMU is harnessing the power of information technology (IT) to upgrade tools for students and faculty. Initiatives in eLearning have included bringing fiber-optic connectivity to the campus, offering campus-wide wireless access, opening student and faculty computer laboratories, and providing computer tablets to all incoming medical students. Beyond IT, the college is also offering wet laboratory instruction for hands-on diagnostic skills, team-based learning, and clinical skills workshops. In addition, modern teaching tools and techniques address the challenges posed by increasing numbers of students. To provide incentives for instructors, a performance-based compensation plan and teaching awards have been established. Also for faculty, IT tools and training have been made available, and a medical education course management system is now being widely employed. Student and faculty responses have been favorable, and the rapid uptake of these interventions by students, faculty, and the college's administration suggests that the KCMU College MEPI approach has addressed unmet needs. This enabling environment has transformed the culture of learning and teaching at KCMU College, where a path to sustainability is now being pursued.

Introduction of a learning management system at the Kilimanjaro Christian Medical University College

Background . Medical schools in Africa face daunting challenges including faculty shortages, growing class sizes, and inadequate resources. Learning management systems (LMS) may be powerful tools for organising and presenting curricular learning materials, with the potential for monitoring and evaluation functions. Objective . To introduce a LMS for the first-year medical student curriculum at the Kilimanjaro Christian Medical University College (KCMU Co) in Moshi, Tanzania, in partnership with the Duke University School of Medicine (Durham, North Carolina, USA). Methods . Observations were made on the requisite information technology (IT) infrastructure and human resource needs, and participation in training exercises. LMS utilisation was recorded, and two (student and faculty) surveys were done. Results . The KCMU Co IT infrastructure was upgraded, and an expert team trained for LMS implementation. An introductory LMS workshop for faculty had 7 out of 25 invitees, but attendance improved to more than 50% in subsequent workshops. Student attendance at workshops was mandatory. Use of the LMS by students rapidly expanded, and growing faculty utilisation followed later. By the end of the second semester, online examinations were offered, resulting in greater student and faculty satisfaction owing to rapid availability of results. A year after LMS introduction, 90% of students were accessing the LMS at least 4 days/week. A student survey identified high levels of satisfaction with the LMS software, quality of content, and learning enhancement. Conclusion . LMS can be a useful and efficient tool for curriculum organisation, administration of online examinations, and continuous monitoring. The lessons learned from KCMU Co may be useful for similar academic settings.

Introduction of team-based learning (TBL) at Kilimanjaro Christian Medical University College: Experience with the ectoparasites module

Background: Contemporary teaching in sub-Saharan African medical schools is largely through didactic and problem-based approaches. These schools face challenges from burgeoning student numbers, severe faculty shortages, faculty without instruction in teaching methods and severe infrastructure inadequacies. Team-based learning (TBL) is a pedagogy which may be attractive because it spares faculty time. TBL was piloted in a module on ectoparasites at the Kilimanjaro Christian Medical University College (KCMU Co.).Methods: TBL orientation began six weeks before starting the module. Students were issued background readings and individual and group readiness assessment tests, followed by module application, discussion and evaluation. At completion, student perceptions of TBL were assessed using a 5-point Likert scale evaluating six domains, with a score of 5 being most favourable. Strength of consensus measures (sCns) was applied. Final examination scores were compiled for 2011 (didactic) and 2012 (TBL).Results: About 158 students participated in the module. The mean student scores across the six domains ranged from 4.2 to 4.5, with a high degree of consensus (range 85–90%). The final examination scores improved between 2011 and 2012.Conclusions: KCMU Co. student perceptions of TBL were very positive, and final exam grades improved. These observations suggest future promise for TBL applications at KCMU Co. and potentially other schools.