Effectiveness and uptake of WhatsApp-based HIV microlearning for healthcare workers in remote South African clinics: A pragmatic, mixed-methods, cluster-randomised trial.

IF 3.3 3区 医学 Q1 NURSING Nurse Education in Practice Pub Date : 2025-03-06 DOI:10.1016/j.nepr.2025.104326
Briony Sue Chisholm, Lovemore Mapahla, Carl Lombard, Marc Blockman, Catherine Orrell
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Abstract

Aim/objective: To design and test the usability of case-based HIV microlearning lessons using WhatsApp groups. This paper reports on effectiveness and uptake.

Background: South Africa has the largest antiretroviral treatment program globally. National guidelines are regularly updated. Ongoing training of healthcare workers is vital but complicated by infrastructural, financial and human resource shortages. Innovative solutions are needed.

Design: A pragmatic, mixed methods, parallel group, cluster randomised trial.

Methods: Nurses and community health workers (CHWs) at 50 clinics in the Eastern Cape were invited to participate. Online questionnaires tested knowledge and retention of knowledge; retrospective folder reviews measured changes in patient care. Patient folders were sampled purposively pre-/post-intervention for clinical points learned. Descriptive and inferential analyses were performed.

Results: Uptake and participation were good: 232 (79 %) nurses and 207 (76 %) CHWs participated. 96 % of nurses and 88 % of CHWs read the lessons within two weeks. There was a significant intervention effect on knowledge, based on the online questionnaires: nurses (0.5 units; 95 % CI 0.11-1.0; p = 0.0499) and CHWs (0.7 units; 95 % CI 0.2-1.3; p = 0.004). 1083 patient folders were reviewed to compare changes in patient care between the study arms. Adjusting for pre-care differences between the arms, the intervention increased correct patient care by 21 % ( 95 % CI 10 %-32 %; p < 0.001) in the year after the training.

Conclusions: WhatsApp-based microlearning improves knowledge and patient care. This, with the companion paper's data showing that it is well received and accepted, makes it a valuable option for simple, accessible, scalable continuing medical education for HCWs.

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目的/目标:利用 WhatsApp 群组设计并测试基于案例的艾滋病微课的可用性。背景:南非拥有全球最大的抗逆转录病毒治疗项目:背景:南非拥有全球最大的抗逆转录病毒治疗项目。国家指导方针定期更新。对医护人员的持续培训至关重要,但却因基础设施、资金和人力资源短缺而变得复杂。我们需要创新的解决方案:设计:务实、混合方法、平行小组、分组随机试验:方法:邀请东开普省 50 家诊所的护士和社区保健员 (CHW) 参与。在线问卷测试了知识和知识保留情况;回顾性文件夹审查衡量了病人护理的变化。在干预前/后,有目的性地抽查病人文件夹,以了解所学到的临床要点。对结果进行了描述性和推论性分析:接受和参与情况良好:232 名护士(79%)和 207 名社区保健工作者(76%)参加了干预。96% 的护士和 88% 的社区保健员在两周内阅读了课程。根据在线问卷调查结果,干预对知识的影响非常明显:护士(0.5 个单位;95 % CI 0.11-1.0;p = 0.0499)和社区保健工作者(0.7 个单位;95 % CI 0.2-1.3;p = 0.004)。对 1083 份患者文件夹进行了审查,以比较研究臂之间患者护理的变化。在调整了各研究臂之间的护理前差异后,干预措施使患者护理的正确率提高了 21 %(95 % CI 10 %-32 %;p 结论:基于 WhatsApp 的微学习提高了知识水平和患者护理水平。这一点以及配套论文中的数据表明,微学习深受欢迎和认可,使其成为为医护人员提供简单、方便、可扩展的继续医学教育的重要选择。
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来源期刊
CiteScore
5.40
自引率
9.40%
发文量
180
审稿时长
51 days
期刊介绍: Nurse Education in Practice enables lecturers and practitioners to both share and disseminate evidence that demonstrates the actual practice of education as it is experienced in the realities of their respective work environments. It is supportive of new authors and will be at the forefront in publishing individual and collaborative papers that demonstrate the link between education and practice.
期刊最新文献
Lights, camera, leadership: Teaching nursing students through film. Effective and ethical leadership in undergraduate nursing education: A future challenge. Effectiveness and uptake of WhatsApp-based HIV microlearning for healthcare workers in remote South African clinics: A pragmatic, mixed-methods, cluster-randomised trial. Students’ perspectives on the congruence and effectiveness of a problem-based learning approach to teach recovery-oriented practice: A mixed method study Application of the Rosenthal effect combined with the CDIO teaching model to enhance core competencies in nursing interns
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