Increasing health worker capacity through distance learning: a comprehensive review of programmes in Tanzania

<p>Abstract</p> <p>Background</p> <p>Tanzania, like many developing countries, faces a crisis in human resources for health. The government has looked for ways to increase the number and skills of health workers, including using distance learning in their training. In 2008, the authors reviewed and assessed the country's current distance learning programmes for health care workers, as well as those in countries with similar human resource challenges, to determine the feasibility of distance learning to meet the need of an increased and more skilled health workforce.</p> <p>Methods</p> <p>Data were collected from 25 distance learning programmes at health training institutions, universities, and non-governmental organizations throughout the country from May to August 2008. Methods included internet research; desk review; telephone, email and mail-in surveys; on-site observations; interviews with programme managers, instructors, students, information technology specialists, preceptors, health care workers and Ministry of Health and Social Welfare representatives; and a focus group with national HIV/AIDS care and treatment organizations.</p> <p>Results</p> <p>Challenges include lack of guidelines for administrators, instructors and preceptors of distance learning programmes regarding roles and responsibilities; absence of competencies for clinical components of curricula; and technological constraints such as lack of access to computers and to the internet. Insufficient funding resulted in personnel shortages, lack of appropriate training for personnel, and lack of materials for students.</p> <p>Nonetheless, current and prospective students expressed overwhelming enthusiasm for scale-up of distance learning because of the unique financial and social benefits offered by these programs. Participants were retained as employees in their health care facilities, and remained in their communities and supported their families while advancing their careers. Space in health training institutions was freed up for new students entering in-residence pre-service training.</p> <p>Conclusions</p> <p>A blended print-based distance learning model is most feasible at the national level due to current resource and infrastructure constraints. With an increase in staffing; improvement of infrastructure, coordination and curricula; and decentralization to the zonal or district level, distance learning can be an effective method to increase both the skills and the numbers of qualified health care workers capable of meeting the health care needs of the Tanzanian population.</p

Development and Validation of an Instrument for Assessing Distance Education Learning Environments in Higher Education: The Distance Education Learning Environments Survey (DELES)

The purpose of this study was to develop and validate a new learning environments instrument designed to aid investigators and practitioners in measuring and researching the psychosocial learning environment in post-secondary distance education. Using a three-stage approach, the Distance Education Learning Environments Survey (DELES) was developed, field-tested with 680 distance education students, and then validated. The DELES has 34 items allocated to six scales: (1) Instructor Support; (2) Student Interaction and Collaboration; (3) Personal Relevance; (4) Authentic Learning; (5) Active Learning; and (6) Student Autonomy. An additional scale of Enjoyment was included in this study to explore associations between the psychosocial learning environment and student affective traits. Each learning environment item had a factor loading of at least 0.50 with its own scale, and less than 0.50 with all other scales. The alpha reliability coefficient for each scale ranged from 0.75 to 0.94. Simple correlations between Enjoyment and the DELES scales ranged from 0.12 to 0.31, with the scale of Personal Relevance having the strongest correlation with Enjoyment when all other scales were mutually controlled. The DELES, an online instrument that can be utilized by students at any location, eliminates data transfer errors and does not allow for non-responses, adding to the overall validity of the instrument. The development of DELES relied extensively on literature pertaining to high-quality distance education and expert content validation techniques. It treats distance learning as having a distinct social-psychological climate unlike those found in other post-secondary classroom environments