Barriers and facilitators to online medical and nursing education during the COVID-19 pandemic: perspectives from international students from low- and middle-income countries and their teaching staff

Abstract Background The COVID-19 pandemic posed a huge challenge to the education systems worldwide, forcing many countries to provisionally close educational institutions and deliver courses fully online. The aim of this study was to explore the quality of the online education in China for international medical and nursing students from low- and middle-income countries (LMICs) as well as the factors that influenced their satisfaction with online education during the COVID-19 pandemic. Methods Questionnaires were developed and administered to 316 international medical and nursing students and 120 teachers at a university in China. The Chi-square test was used to detect the influence of participants’ personal characteristics on their satisfaction with online education. The Kruskal–Wallis rank-sum test was employed to identify the negative and positive factors influencing the online education satisfaction. A binary logistic regression model was performed for multiple-factor analysis to determine the association of the different categories of influential factors—crisis-, learner-, instructor-, and course-related categories, with the online education satisfaction. Results Overall, 230 students (response rate 72.8%) and 95 teachers (response rate 79.2%) completed the survey. It was found that 36.5% of students and 61.1% of teachers were satisfied with the online education. Teachers’ professional title, students’ year of study, continent of origin and location of current residence significantly influenced the online education satisfaction. The most influential barrier for students was the severity of the COVID-19 situation and for teachers it was the sense of distance. The most influential facilitating factor for students was a well-accomplished course assignment and for teachers it was the successful administration of the online courses. Conclusions Several key factors have been identified that affected the attitudes of international health science students from LMICs and their teachers towards online education in China during the COVID-19 pandemic. To improve the online education outcome, medical schools are advised to promote the facilitating factors and cope with the barriers, by providing support for students and teaching faculties to deal with the anxiety caused by the pandemic, caring for the state of mind of in-China students away from home, maintaining the engagement of out-China students studying from afar and enhancing collaborations with overseas institutions to create practice opportunities at students’ local places.

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Impact of Merit-Based Immigration Policies on Brain Drain From Low- and Middle-Income Countries

JCO Global Oncology ◽

10.1200/jgo.19.00266 ◽

2020 ◽

pp. 185-189 ◽

Cited By ~ 3

Author(s):

Nagi S. El Saghir ◽

Benjamin O. Anderson ◽

Julie Gralow ◽

Gilberto Lopes ◽

Lawrence N. Shulman ◽

...

Keyword(s):

Brain Drain ◽

Care Delivery ◽

International Medical ◽

Immigration Policies ◽

International Medical Graduates ◽

Middle Income ◽

Middle Income Countries ◽

Medical Graduates ◽

Trump Administration ◽

Low And Middle Income

PURPOSE Brain drain is the migration of educated and skilled individuals from a less developed region or country to a more economically established one. The Trump administration proposed a merit-based immigration plan. This article addresses its potential impact on health care delivery in low- and middle-income countries (LMICs) and their preparedness to deal with it. MATERIALS AND METHODS Data on immigration policies, numbers of international medical graduates practicing in high-income countries (HICs), various scientific exchange methods, and efforts for capacity building in LMICs. RESULTS Talented individuals seek to advance their knowledge and skills, and may stay in HICs because of greater rewards and opportunities. HICs also rely on immigrant international medical graduates to supplement their physician workforces. CONCLUSION Ambitious individuals from LMICs need and should have opportunities to advance their education and training in more advanced countries. LMICs should increase their educational efforts, research capabilities, infrastructures, and living conditions to better serve their own populations and reduce their brain drain phenomenon.

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192 Assessment of Local Health Worker Attitudes Toward International Medical Volunteers in Low- and Middle-Income Countries: A Global Survey

Annals of Emergency Medicine ◽

10.1016/j.annemergmed.2019.08.198 ◽

2019 ◽

Vol 74 (4) ◽

pp. S76

Author(s):

N.S. Naik ◽

C. Bae ◽

M. Misak ◽

S. Barnes ◽

A. Papali ◽

...

Keyword(s):

Health Worker ◽

International Medical ◽

Local Health ◽

Middle Income ◽

Global Survey ◽

Worker Attitudes ◽

Middle Income Countries ◽

Local Health Worker ◽

Medical Volunteers ◽

Low And Middle Income

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Facilitation of nursing students' competency acquisition for paediatric pain management in low- and middle-income countries: a scoping review

Research Journal of Health Sciences ◽

10.4314/rejhs.v9i1.10 ◽

2021 ◽

Vol 9 (1) ◽

pp. 82-99

Author(s):

P. Uwimana ◽

D. Mukamana ◽

O. Adejumo ◽

Y. Babenko-Mould ◽

B. Umubyeyi

Keyword(s):

Pain Management ◽

Nursing Students ◽

Scoping Review ◽

Nurse Educators ◽

Middle Income ◽

Middle Income Countries ◽

Service Training ◽

Keywords Pain Management ◽

Ebsco Host ◽

Low And Middle Income

Objective: To elucidate evidence regarding nurse educators' and preceptors' capacity to facilitate students' learning about paediatric pain management (PPM) in low- and middle-income countries(LMICs).Methods: The five-stage framework by Arksey and O'Malley guided this review. Studies published in English between January 2010 and April 2020 were searched using EBSCO Host/ ScienceDirect, CINAHL, MEDLINE, PUBMED and Scopus. Of 300 papers identified through the search strategy 27 primary research articles were retained: quantitative (n=18), qualitative (n=8) and mixed-methods (n=1).Results: Knowledge deficiency and inappropriate attitudes toward PPM, lack of autonomy in decisionmaking, scarcity of resources and cultural misconception regarding pain in children were hindering the effective PPM in LMICs. Strategies including nursing curricula review, continuous in-service training, access to resources and the leadership support are required to optimise effective PPM and improve students' facilitation for learning about PPM.Conclusion: Further research is required as a body of evidence to support the development of a framework for capacity enhancement of nurse educators and nurse preceptors who facilitate nursing students acquiring competency for PPM in LMICs. Keywords: Pain management education, Children, Scoping review, Low- and middle- income countries

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Gynecologic pathology services in low- and middle-income countries

International Journal of Gynecological Cancer ◽

10.1136/ijgc-2021-003103 ◽

2021 ◽

pp. ijgc-2021-003103

Author(s):

Ekaternia Olkhov-Mitsel ◽

Fang-I Lu ◽

Anna Gagliardi ◽

Anna Plotkin

Keyword(s):

Online Education ◽

Central America ◽

Gynecologic Cancer ◽

Molecular Testing ◽

Subspecialty Training ◽

Middle Income ◽

Middle Income Countries ◽

Tumor Boards ◽

The Caribbean ◽

Low And Middle Income

ObjectiveThe International Gynecologic Cancer Society (IGCS) offers multidisciplinary conferences to underserved communities. Mentor pathologists have become an integral part of these tumor boards, as pathology services in low-to-middle-income countries are often inadequate and disjointed. The IGCS Pathology Working Group conducted a survey to assess barriers to quality pathology services in low-to-middle-income countries and identified potential solutions.MethodsA 69-question cross-sectional survey assessing different aspects of pathology services was sent to 15 IGCS Extension for Community Healthcare Outcomes (ECHO) training sites in Africa, Asia, Central America, and the Caribbean. Local gynecologic oncologists distributed the survey to their pathology departments for review. The responses were tabulated in Microsoft Excel.ResultsResponses were received from nine training sites: five sites in Africa, two in Asia, one in Central America, and one in the Caribbean. There were no pathologists with subspecialty training in gynecologic pathology. Most (7/9, 78%) surveyed sites indicated that they have limited access to online education and knowledge transfer resources. Of the eight sites that responded to the questions, 50% had an electronic medical system and 75% had a cancer registry. Synoptic reporting was used in 75% of the sites and paper-based reporting was predominant (75%). Most (6/7, 86%) laboratories performed limited immunohistochemical stains on site. None of the sites had access to molecular testing.ConclusionsInitial goals for collaboration with local pathologists to improve diagnostic pathology in low- and middle-income countries could be defining minimal gross, microscopic, and reporting pathology requirements, as well as wisely designed educational programs intended to mentor local leaders in pathology. Larger studies are warranted to confirm these observations.

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