The value of mobile tablet computers (iPads) in the undergraduate medical curriculum

The deployment of mobile tablet computers in medical teaching and learning is viewed with mounting interest. Medical educators are embracing insights from technological advancements to ensure that students are equipped with the necessary tools to flourish as physicians. Here we reflect on the benefits and challenges of the tablet learning experience within undergraduate medicine and how students may make the best use of it

A systematic review on mobile learning in higher education: The African perspective

The spread and popularity of mobile devices has led to their increased application in higher education. While studies have reviewed mobile learning initiatives in different contexts, none has explored this subject in Africa. This systematic review collates and compares studies published between 2010 and 2016 on mobile learning in higher education in the African context to explore the application, impact and challenges of mobile technology-supported learning. Findings show that mobile learning within higher education institutions in Africa increased student and lecturer collaboration and, provide dinstant communication, increased student participation and engagement, facilitating authentic learning and reflective practice, as well as fostering learning communities. A change in the lecturers’ approaches to teaching also occurred. The findings also indicate significant challenges in integrating mobile learning in higher education institutions within Africa: poor technological infrastructure, lack of access to modern mobile devices, lack of mobile learning pedagogical skills among lecturers, poor attitudes among students and lecturers, and incompatibility of mobile devices with the university online management systems. Policies to guide the implementation of mobile learning were also lacking. Large-scale studies assessing the effectiveness of mobile learning within African higher education institutions are lacking and existing studies lacked a theoretical framework. The review highlights enabling conditions for successful integration of mobile learning in African institutions addressing access, training, curriculum design, support and technical requirements. The absence of studies reporting on existing mobile learning projects reflects the limited penetration of this technology and associated pedagogies and a need to strengthen research in this emerging field

Levels of interest among prospective and enrolled undergraduate students in learning through online and blended modes

In many developing countries, at least in Africa, many colleges and universities continue to deliver undergraduate level education in the in-person, face-to-face, mode. Many of these institutions are slow in adopting and embracing the online learning mode. This study investigated levels of interest among prospective and enrolled undergraduates for the full-online or blended learning mode. The study also assessed the factors that stimulated the interest of these groups for the preferred delivery mode. Based on a sample of 414 prospective and enrolled undergraduates from private and public colleges and universities in the context of Botswana, and using a survey design that involved questionnaires, and regression analysis, the study found that majority (56%, n=414) of the sample was interested in and preferred some form of online or blended learning, compared to the face-to-face learning mode. The proportion of individuals with keen interest in the blended learning mode, at undergraduate level, is surprisingly high. The motivational drivers for the student choice are linked to greater flexibility and convenience, and perceived better opportunity for interactions with professors and classmates (OR=10.9; 95% CI: 5.4 – 22.1). The COVID-19 outbreak and the requirements for social distancing may have also accounted for the level of interest reported. The findings have major significance for curriculum design and development, instructional design in higher education, education technology infrastructure development, and long-term enrolment planning

Justice as fairness in preparing for emergency remote teaching: A case from Botswana

Background. The COVID-19 pandemic necessitated drastic changes to undergraduate medical training at the University of Botswana (UB). To save the academic year when campus was locked down, the Department of Medical Education conducted a needs assessment to determine the readiness for emergency remote teaching (ERT) of the Faculty of Medicine, UB. Objectives. To report on the findings of needs assessment surveys to assess learner and teaching staff preparedness for fair and just ERT, as defined by philosopher John Rawls. Methods. Needs assessment surveys were conducted using Office 365 Forms distributed via WhatsApp, targeting medical students and teaching staff during the 5 undergraduate years. Data were analysed quantitatively and qualitatively. Results. Ninety-two percent (266/289) of students and 73.5% (62/84) of teaching staff responded. Surveys revealed a high penetration of smartphones among students, but poor internet accessibility and affordability in homes. Some teaching staff also reported internet and device insufficiencies. Only WhatsApp was accessible to students and teaching staff. Conclusions. For equitable access to ERT in the future, the surveys revealed infrastructural improvement needs, including wider, stronger, affordable WiFi coverage within Botswana and enhanced digital infrastructures in educational institutions, with increased support for students

Using ODL and ICT to develop the skills of the unreached: a contribution to the ADEA triennial of the Working Group on Distance Education and Open Learning

Innovation in technology is occurring at rapid pace thus shrinking the distances and making information and knowledge more than ever accessible to everyone irrespective of where the person resides. This paper consists of four main articles. The first one deals with technological trends. The second one focuses on the deployment and use of open and distance education mode in rural areas by documenting initiatives that embrace information and communication technologies (ICTs). Due to challenges faced in rural areas only a few success stories/cases currently exist and some of these are cited in this article. The challenges faced in the deployment of ICT enhanced ODL have been highlighted as well as the potential of developing and delivering effective and relevant ODL programmes in rural areas in order to ensure that issues of educational equity and social exclusion rural communities are adequately addressed. ICTs in ODL are perhaps the greatest tool to date for self-education and value addition to any community’s development efforts, yet poor rural communities particularly in Africa do not have the necessary awareness, skills or facilities to enable themselves to develop using ICTs. Inadequate ICT infrastructures in rural areas remain a major source for the digital divide in Africa and for under-performance of distance learners. The third one analyses the support provided to ODL learners who often encounter difficulties in completing their studies through the distance education mode due to loneliness, uncertainties and de-motivation. ICT has not been able to sufficiently support distance learners in overcoming those obstacles efficiently. An investigation regarding those learning supports has been conducted in ten distance learning institutions, along with an intensive literature review with the aim of understanding the high percentage of dropout rates of distant learners. The learners’ interactions have been scrutinized through content analysis of their synchronous exchanges, during a completely online course. After taking into account the limited technical and human resources in Africa, a technological virtual environment along with a pedagogical framework has been proposed with the aim of giving adequate educational support to them. The fourth article has explored The Open University (UK) and its efforts to use new technologies to deliver online courses to difficult-to- reach learners in prison environments. The case study analysed here is an international course (called, B201- Business Organisations and their environments) which also touches an African cohort of learners. The implications for designing and delivering online ODL to the complex unreachable environments of prisons anywhere, and particularly in Africa, have been discussed

Investigating the Use of M-Health for Learning and Clinical Training by Medical Students in Ghana

There is a challenge with healthcare access in most developing countries. With the high rate of mobile technology penetration in these countries, there is a strong belief that mobile technology can help address this and other health system and education challenges. This study investigated how clinical year medical students in Ghana used m-health and with what outcomes. This was a mixed-methods study to assess what technologies students used, what the impact of use was, what enablers and barriers they encountered, what factors explained m-health adoption and what the attitudes of students, staff and faculty members were towards m-health use. The study was conducted in four out of five medical schools in Ghana with clinical year students, namely, Kwame Nkrumah University of Science and Technology School of Medical Sciences (KNUST-SMS), University of Cape Coast School of Medical Sciences (UCC-SMS), University of Development Studies School of Medicine and Health Sciences (UDS-SMHS) and University of Ghana School of Medicine and Dentistry (UG-SMD). Online and paper questionnaires were distributed to 828 students and 291 questionnaires were returned. Questionnaires from dental students at UG-SMD (n = 5) were excluded from the analysis.Two focus group discussions were held involving seven students while three students, seven faculty members and five staff were interviewed. Qualitative data were analyzed using thematic analysis. Only one student did not own a mobile device. About 78% of students reported using m-health at some point during their medical education. The most popular devices used by students were laptop computers (90.8%), smartphones (66.2%), cellular phones (46.6%) and tablets (44.1%). Over 84% of the students owned Android devices, while 21% owned iPhones and iPads. Majority of students owned three devices or less. Students used mobile technologies in ways that suited their learning needs and contexts. M-health helped students to participate better in lessons and improve their knowledge, skills and efficiency in various contexts. The main drawbacks of m-health use were distraction and time wasting, difficulty in determining credibility of some online information and the risk of using these technologies inappropriately around patients and during assessments. The main facilitating conditions for m-health use were availability, quality and reliability of technological services, technical support, security, price value, technology competence and training, portability, task and goal fit, social influence and organizational factors. Habit and Hedonic Motivation were the only significant factors that explained intention to use m-health and actual m-health use respectively in the UTAUT2 model, in the presence of age, gender and experience. Students, staff and faculty members were open to using m-health in teaching and learning, although they recommended regulation of use through policies and guidelines to ensure effective teaching and learning and ethical m-health use. Considering the benefits offered by m-health, the study encourages medical schools in Ghana to explore mobile learning with the possibility of incorporating it into their curricula. This should be accompanied by development of policies and guidelines to spell out how mobile technologies should be used in order to mitigate most of the drawbacks identified. This study contributed empirical evidence from the Ghanaian context regarding m-health adoption and use in medical education. This evidence will contribute to theory regarding benefits, drawbacks, facilitating conditions and factors that influence m-health adoption among medical students in a developing country context. Understanding how medical students use mobile technology in learning will be useful in planning how m-health can be incorporated into their curricula. It will also help in informing development and deployment of m-health in healthcare in contexts similar to Ghana

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A Best Evidence Medical Education (BEME) systematic review of: What works best for health professions students using mobile (hand-held) devices for educational support on clinical placements? BEME Guide No. 52

Background: Ingrained assumptions about clinical placements (clerkships) for health professions students pursuing primary basic qualifications might undermine best educational use of mobile devices. Question: What works best for health professions students using mobile (hand-held) devices for educational support on clinical placements? Methods: A Best Evidence Medical Education (BEME) effectiveness-review of ‘justification’ complemented by ‘clarification’ and ‘description’ research searched: MEDLINE, ERIC (Educational Resource Information Center), Web of Science, CINAHL (Cumulative Index to Nursing and Allied Health Literature), PsycInfo, Cochrane Central, Scopus (1988-2016). Reviewer-pairs screened titles/abstracts. One pair coded, extracted, and synthesized evidence, working within the pragmatism paradigm. Summary of results: From screening 2,279 abstracts, 49 articles met inclusion-criteria, counting four systematic reviews for context. The 45 articles of at least Kirkpatrick K2 primary research mostly contributed K3 (39/45, 86.7%), mixed methods (21/45, 46.7%), and S4-strength (about one-half) evidence. Mobile devices particularly supported student: assessment; communication; clinical decision-making; logbook/notetaking; and accessing information (in about two-thirds). Informal and hidden curricula included: ---concerns about: disapproval; confidentiality and privacy; security ---distraction by social connectivity and busy clinical settings; ---mixed messages about policy. Discussion & Conclusion: This idiosyncratic evidence-base of modest robustness suggested that mobile devices provide potentially powerful educational support on clinical placement, particularly with student transitions, metalearning, and care contribution. Explicit policy must tackle informal and hidden curricula though, addressing concerns about transgressions

E-learning in medical education in resource constrained low- and middle-income countries

Background In the face of severe faculty shortages in resource-constrained countries, medical schools look to e-learning for improved access to medical education. This paper summarizes the literature on e-learning in low- and middle-income countries (LMIC), and presents the spectrum of tools and strategies used. Methods Researchers reviewed literature using terms related to e-learning and pre-service education of health professionals in LMIC. Search terms were connected using the Boolean Operators “AND” and “OR” to capture all relevant article suggestions. Using standard decision criteria, reviewers narrowed the article suggestions to a final 124 relevant articles. Results Of the relevant articles found, most referred to e-learning in Brazil (14 articles), India (14), Egypt (10) and South Africa (10). While e-learning has been used by a variety of health workers in LMICs, the majority (58%) reported on physician training, while 24% focused on nursing, pharmacy and dentistry training. Although reasons for investing in e-learning varied, expanded access to education was at the core of e-learning implementation which included providing supplementary tools to support faculty in their teaching, expanding the pool of faculty by connecting to partner and/or community teaching sites, and sharing of digital resources for use by students. E-learning in medical education takes many forms. Blended learning approaches were the most common methodology presented (49 articles) of which computer-assisted learning (CAL) comprised the majority (45 articles). Other approaches included simulations and the use of multimedia software (20 articles), web-based learning (14 articles), and eTutor/eMentor programs (3 articles). Of the 69 articles that evaluated the effectiveness of e-learning tools, 35 studies compared outcomes between e-learning and other approaches, while 34 studies qualitatively analyzed student and faculty attitudes toward e-learning modalities. Conclusions E-learning in medical education is a means to an end, rather than the end in itself. Utilizing e-learning can result in greater educational opportunities for students while simultaneously enhancing faculty effectiveness and efficiency. However, this potential of e-learning assumes a certain level of institutional readiness in human and infrastructural resources that is not always present in LMICs. Institutional readiness for e-learning adoption ensures the alignment of new tools to the educational and economic context

eHealth for family planning in Botswana: acceptability and feasibility

BACKGROUND: As many as 50% of pregnancies in Botswana are unintended, but only half of women in the country are currently using contraception. This thesis explores the barriers and facilitators for provision, choice and use of contraception in Botswana, and the feasibility and potential for an eHealth intervention in the field of family planning to address them. METHODS: I conducted a narrative review of factors influencing contraceptive choice, uptake and use in Botswana, and qualitative, semi-structured interviews with Batswana women (n=22), healthcare providers and key policy stakeholders in family planning (n=14), and Botswanabased eHealth experts (n=11). FINDINGS: Many Batswana women lack accurate, in-depth family planning knowledge, and experience extreme clinical and social barriers in accessing contraception. Socio-cultural barriers are more influential than physical access or availability, with partner control and patriarchal attitudes towards sex and gender the most prominent reason for women’s non-use of contraception, exacerbated by urban-rural disparity and education level. Botswana’s HIV epidemic has heavily dominated sexual health services and policy, leading to conflict between national approaches towards HIV and family planning. Key challenges for eHealth innovation in Botswana are related to inconsistent Wi-Fi infrastructure, a lack of national policy, and a reliance on external partners leading to unsustainable design and implementation of interventions. Suggestions for an eHealth intervention in family planning include using a range of media platforms to address varied levels of technological knowledge and access, and ensuring content is culturally appropriate and useful to intended users. CONCLUSION: There is a need, and desire, for more detailed, balanced, up-to-date family planning information for women, their partners, and the providers who counsel them. An eHealth intervention that adheres to the realities of technology and infrastructure limitations, and is Botswana-led in terms of content, design, and implementation, could be highly effective in addressing this gap