scholarly journals Development and Evaluation of an e-Learning Module for Low- and Middle-Income Countries on the Safe Handling of Chemotherapy Drugs

2021 ◽  
Author(s):  
Sandrine von Grünigen ◽  
Berangère Dessane ◽  
Pauline Le Pape ◽  
Ludivine Falaschi ◽  
Antoine Geissbühler ◽  
...  
Keyword(s):  
Training Module ◽  
Middle Income ◽  
Participant Satisfaction ◽  
Safe Handling ◽  
Chemotherapy Drugs ◽  
Middle Income Countries ◽  
Learning Module ◽  
E Learning ◽  
Training Opportunities ◽  
Low And Middle Income

Abstract Despite the growing use of chemotherapy drugs in resource-constrained settings, training opportunities on safe handling practices are lacking. This study’s objectives were to develop and evaluate an e-learning training module on the safe handling of chemotherapy drugs to strengthen knowledge and practices in low- and middle-income countries (LMICs). The module’s curriculum was developed using the Six-Step Approach for Curriculum Development for Medical Education. Asynchronous, self-paced, e-learning lessons within the module were created and uploaded onto a free online platform, Pharm-Ed. The study ran online from January to April 2021. Participant recruitment was done using convenience sampling through various channels (social media, communities of practice). Training module effectiveness was evaluated using knowledge assessments (a pre-test and post-test study design) and participant satisfaction. We developed a comprehensive e-learning module on the safe handling of chemotherapy drugs comprising 11 asynchronous, self-paced, e-learning lessons. Eighty-two participants (68% pharmacists and 17% pharmacy students) from 17 countries completed at least one lesson, with a total of 259 lessons completed. Evaluation of the different lessons showed significant improvements in theoretical knowledge (p < 0.01) in all except one lesson and a high degree of participant satisfaction. As the use of anti-cancer drugs in LMICs will continue to increase, this e-learning module is an effective means to address the lack of training opportunities on the safe handling of chemotherapies for healthcare workers in these countries. The module could be integrated into a multi-modal approach aimed at reducing occupational exposure and increasing patient safety in cancer care centers.

scholarly journals The safe handling of chemotherapy drugs in low- and middle-income countries: An overview of practices

2021 ◽  
pp. 107815522199553
Author(s):  
Sandrine von Grünigen ◽  
Antoine Geissbühler ◽  
Pascal Bonnabry
Keyword(s):  
Low Income ◽  
Incident Management ◽  
Middle Income ◽  
Healthcare Facilities ◽  
Safe Handling ◽  
Chemotherapy Drugs ◽  
Middle Income Countries ◽  
Improve Access ◽  
Low And Middle Income ◽  
Safe Practices

Introduction The rising burden of cancer in low- and middle-income countries (LMICs) has led to substantial efforts to improve access to chemotherapy. The present study’s objectives were to obtain an overview of the safe handling practices implemented in LMICs’ healthcare facilities when dealing with chemotherapy drugs and to prioritize opportunities for improving them. Methods We conducted an online survey, from June 2018 to April 2019, among LMIC healthcare facilities dealing with chemotherapy drugs. Facilities were asked to self-assess their chemotherapy handling processes using Cyto-SAT, a self-assessment tool incorporating 134 items organized into 10 domains (management, personnel, logistics, prescription, preparation, administration, incident management, waste management, cleaning, and patient counselling). Data were recorded on an online platform ( www.datapharma.ch/cyto-SAT ). Results The survey enrolled 53 healthcare facilities (15 from low-income, 26 from lower-middle-income, and 12 from upper-middle-income countries). The median level of implementation of safe practices was 63% (Q1:39%–Q3:77%). Facilities in low-income countries (LICs) reported lower median levels of safe practices than middle-income countries (MICs) [LICs: 32% (Q1:24%–Q3:62%), Lower-MICs: 63% (Q1:49%–Q3:70%), Upper-MICs: 85% (Q1:77%–Q3:93%)]. The biggest differences between country categories were observed in the domains related to personnel, preparation processes, and incident management. Conclusion This overview of practices highlighted a large variability and major gaps in the safe handling of chemotherapy drugs in LMICs. Improvement strategies are needed to increase patient and staff safety and limit environmental contamination, especially in LICs. Safe handling programs should be part of continuing efforts to improve access to quality cancer drugs and should be integrated into national cancer control programs.

A scoping review of oncology medical education interventions in low and middle income countries.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e23004-e23004
Author(s):  
Safiya Karim ◽  
Zahra Sunderji ◽  
Matthew Jalink ◽  
Sahar Mohamed ◽  
Nazik Hammad ◽  
...  
Keyword(s):  
Medical Education ◽  
Scoping Review ◽  
Middle Income ◽  
Middle Income Countries ◽  
Medical Education And Training ◽  
Incidence And Mortality ◽  
E Learning ◽  
Education Interventions ◽  
Low And Middle Income ◽  
Education Initiatives

e23004 Background: A large proportion of the global cancer burden occurs in low and middle income countries (LMICs). One of the significant barriers to adequate cancer control is the lack of an adequately trained oncology workforce. Medical education and training initiatives in oncology are necessary to tackle growing cancer incidence and mortality rates. We performed a scoping review of oncology medical education interventions in LMICs to understand the strategies used to train the global oncology workforce. Methods: We searched OVID MEDLINE and EMBASE databases between January 1, 1995 and March 4, 2020 using a standardized scoping review framework. Articles were eligible if they described an oncology medical education intervention within an LMIC with clear outcomes. Articles were classified based on the target population, the level of medical education, form of collaboration with another institution and if there was an e-learning component to the intervention. Results: Of the 806 articles screened, 25 met criteria and were eligible for analysis. The Middle East/Africa was the most common geographic area of the educational initiative (N=14/25). The majority of interventions were targeted towards physicians (n=15/25) and focused on continuing medical education (n=22/25). Twelve articles described the use of e-learning as part of the intervention. Twenty four articles described some form of collaboration, most commonly with an institution from a high-income country. Language barriers, technology, and lack of physical infrastructure and resources in the LMIC were the most common challenges described. The majority of the initiatives were funded through grants or charitable donations. Conclusions: There is a paucity of published interventions of oncology medical education initiatives in LMICs. Continued medical education initiatives and those targeted towards physicians are most common. There is a lack of collaboration between LMICs in these interventions. Further interventions are needed earlier during medical training and for non-physicians. In addition, increased use of e-learning interventions may overcome certain identified challenges. Encouragement of locally funded initiatives as well as scholarly evaluation and publication of these initiatives are important to improve cancer care in LMICs.

scholarly journals Development and Proof of Concept of an Audit Toolkit for the Safe Handling of Cytotoxic Drugs in Low- and Middle-Income Countries

2021 ◽  
pp. 1480-1489
Author(s):  
Sandrine von Grünigen ◽  
Ludivine Falaschi ◽  
Nicolas Guichard ◽  
Sandrine Fleury-Souverain ◽  
Antoine Geissbühler ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Facilities ◽  
Quality And Safety ◽  
Proof Of Concept ◽  
Middle Income ◽  
Safe Handling ◽  
Middle Income Countries ◽  
Care Facilities ◽  
Handling Practices ◽  
Low And Middle Income

PURPOSE Chemotherapies are considered high-risk drugs for patient and staff safety. Considering the rising burden of cancer and the increasing use of chemotherapy drugs in low- and middle-income countries (LMICs), promoting continuous improvements in the safety and quality of practices in these settings is essential. This paper describes the development and proof of concept of a toolkit to audit chemotherapy handling practices in the health care facilities of LMICs. METHODS A steering committee defined the audit method and the toolkit content. Several checklists were developed to facilitate the audit and data collection. Items included in checklists were derived from key reference works on safe handling. Different tools were validated using Delphi surveys and expert reviews. Audits of pilot sites were performed to test the toolkit's applicability and relevance. RESULTS The toolkit contains a 134-item global assessment tool for the different processes at each step of the medication pathway and three step-specific observation checklists to assess different health workers' practices during the prescription, preparation, and administration of chemotherapies. The toolkit also proposes using a surface-wipe sampling method to measure any cytotoxic contamination of the immediate environment. The toolkit was tested in three teaching hospitals in Africa. CONCLUSION The toolkit developed was successfully implemented in a variety of LMIC settings, providing a comprehensive evaluation of the quality and safety of the chemotherapy drug handling practices in participating health care facilities. This toolkit can help facilities in LMICs to implement a new approach to continuously improving the quality and safety of their practices and ultimately ensure patient and staff safety.

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

2013 ◽  
Vol 11 (1) ◽  
Author(s):  
Seble Frehywot ◽  
Yianna Vovides ◽  
Zohray Talib ◽  
Nadia Mikhail ◽  
Heather Ross ◽  
...  
Keyword(s):  
Medical Education ◽  
Resource Constrained ◽  
Middle Income ◽  
Middle Income Countries ◽  
E Learning ◽  
Low And Middle Income

scholarly journals Evaluation of e-learning for medical education in low- and middle-income countries: A systematic review

2020 ◽  
Vol 145 ◽  
pp. 103726 ◽  
Author(s):  
Sandra Barteit ◽  
Dorota Guzek ◽  
Albrecht Jahn ◽  
Till Bärnighausen ◽  
Margarida Mendes Jorge ◽  
...  
Keyword(s):  
Systematic Review ◽  
Medical Education ◽  
Middle Income ◽  
Middle Income Countries ◽  
E Learning ◽  
Low And Middle Income

scholarly journals A review of training opportunities for ultrasonography in low and middle income countries

2012 ◽  
Vol 17 (7) ◽  
pp. 808-819 ◽  
Author(s):  
Lacey N. LaGrone ◽  
Vijay Sadasivam ◽  
Adam L. Kushner ◽  
Reinou S. Groen
Keyword(s):  
Middle Income ◽  
Middle Income Countries ◽  
Training Opportunities ◽  
Low And Middle Income

scholarly journals Effects of information and communication technology use in nursing and obstetric learning in low- and middle-income countries: a systematic review

2021 ◽  
Author(s):  
Arzouma Hermann Pilabré ◽  
Patrice Ngangué ◽  
Nestor Bationo ◽  
Issouf Tassembédo ◽  
Doulaye Traoré ◽  
...  
Keyword(s):  
Systematic Review ◽  
Technology Use ◽  
Analysis Tool ◽  
Middle Income ◽  
Middle Income Countries ◽  
Positive Effects ◽  
Ict Use ◽  
Information And Communication ◽  
E Learning ◽  
Low And Middle Income

Abstract Background The use of ICT in learning has become commonplace in higher education and, consequently, in nurses, midwives, and other health professionals worldwide. This use has become widespread and intensified since the advent of the COVID-19 pandemic. Despite growing evidence that e-learning has positive effects, studies on the effects of ICT use in nursing and midwifery learning in low- and middle-income countries are limited. Objectives This systematic review aims to identify and synthesize the effects of information and communication technologies utilization in nursing and obstetric learning in low- and middle-income countries. Methods A search of articles published from 2016 to 2020 on the effects of ICT use in nursing and obstetric learning was conducted in PubMed, CINAHL, Epistemonikos and ERIC using free and controlled vocabularies. All original articles meeting the predefined criteria were included. Following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidelines, searches were performed among published and unpublished articles. Data were extracted and assessed for quality using the Mixed Methods Analysis Tool (MMAT). Results Of 483 articles identified, eleven were reviewed, and eight were found to be relevant. The included articles were synthesized into a narrative synthesis. The effects of using ICT in learning are related to student motivation, autonomy in learning, meaningful acquisition of knowledge and skills. Furthermore, students have a positive perception of the use of ICT in learning. Conclusion The results of this study on the use of ICTs in nursing and midwifery learning in low- and middle-income countries show that ICTs are used primarily as a medium for distance learning. In addition, it was found that e-learning has several advantages or positive effects. However, many students do not have a personal computer, and they have low or average skills in the use of computer tools, and access to the Internet is low. A limitation of this study is the lack of primary data on the effects of ICT use in midwifery learning in low- and middle-income countries.

Reply to letter “Leveraging e-learning for medical education in low- and middle-income countries”

2020 ◽  
Vol 30 (6) ◽  
pp. 905-906
Author(s):  
Justin T. Tretter ◽  
Preeti Ramachandran ◽  
Bistra Zheleva ◽  
Jackie Boucher ◽  
Sarah de Loizaga Carney ◽  
...  
Keyword(s):  
Medical Education ◽  
Middle Income ◽  
Middle Income Countries ◽  
E Learning ◽  
Low And Middle Income

Evaluation of E-Learning for Medical Education in Low- and Middle-Income Countries: A Systematic Review (Preprint)

2018 ◽  
Author(s):  
Sandra Barteit ◽  
Dorota Guzek ◽  
Albrecht Jahn ◽  
Till Bärnighausen ◽  
Margarida Mendes Jorge ◽  
...  
Keyword(s):  
Medical Education ◽  
Medical Students ◽  
Health Workers ◽  
Medical Doctors ◽  
Study Quality ◽  
Middle Income ◽  
Middle Income Countries ◽  
E Learning ◽  
Learning Interventions ◽  
Low And Middle Income

BACKGROUND E-learning in medical education can contribute to alleviating the severe shortages of health workers in many low- and middle-income countries. In the past few decades, the rapid development of technologies resulted in an abundance of new resources, including personal computers, smartphones, handheld devices, software and the Internet – at constantly decreasing costs. Consequently, educational interventions increasingly integrate e-learning to tackle the challenges of health workforce development and training. However, evaluations of e-learning interventions still lack clear methodology to assess the effectiveness and the success of e-learning for medical education, especially in those countries where they are most needed. OBJECTIVE Our specific research aim was to systematically describe currently used evaluation methods and definitions for the success of medical e-learning interventions for medical doctors and medical students in low- and middle-income countries. Our long-term objective is to contribute to generating effective and robust e-learning interventions to address critical health worker shortages in low- and middle-income countries. METHODS Seven databases were searched for e-learning interventions for medical education in low- and middle-income countries, covering publications ranging from January 2007 to June 2017. We derived search terms following a preliminary review of relevant literature and included studies published in English which implemented e-learning asynchronously for medical doctors and/or medical students in a low- or middle-income country. Three reviewers screened the references, assessed their study quality, and synthesized extracted information from the literature. RESULTS We included 52 studies representing a total of 12294 participants. Most of the e-learning evaluations were assessed summatively (83%) and within pilot studies (73%), relying mainly on quantitative evaluation methods using questionnaire (45%) and/or knowledge testing (36%). We identified a lack of evaluation standards for medical e-learning interventions, as methods varied considerably in the evaluation of their medical e-learning interventions with a high variation in study quality (general low study quality, based on study quality scales MERSQI, NOS and NOS-E), study period (ranging from 5 days up to 6 years), assessment methods (6 different main methods) and outcome measures (a total of 52 different outcomes), as well as in the interpretation of intervention success. The majority of studies relied on subjective measures and self-made evaluation frameworks, resulting in low comparability and validity of evidence. Most of the included studies reported success in their e-learning intervention. CONCLUSIONS The evaluation of e-learning interventions needs to produce meaningful and comparable results. Currently, a majority of evaluations of e-learning approaches to educate medical doctors and medical students is based on self-reported measures that lack adherence to a standard evaluation framework. While the majority of studies report success of e-learning interventions – suggesting the potential benefits of the e-learning – the overall low quality of the evidence makes it difficult to draw firm conclusions. Methods development, study design guidance, and standardization of evaluation outcomes and approaches for e-learning interventions will be important for this field of education research to prosper. Methodological strength and standardization are particularly important, because the majority of the existing studies evaluate pilot interventions. Rigorous evidence on pilot success can improve the chances of scaling and sustaining e-learning approaches for health workers.

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