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. 2022 Mar 21;22(1):551.
doi: 10.1186/s12889-022-12943-1.

Development of a simple and effective online training for health workers: results from a pilot in Nigeria

Marshall P Thomas  1 , Samantha Kozikott  2 , Moreen Kamateeka  3 , Ramatu Abdu-Aguye  3 , Emmanuel Agogo  2 , Bakunawa Garba Bello  4 , Karen Brudney  2 , Olivier Manzi  2 , Leena N Patel  2 , Amy Elizabeth Barrera-Cancedda  2 , Jobin Abraham #  2 , Christopher T Lee #  2
Affiliations

Development of a simple and effective online training for health workers: results from a pilot in Nigeria

Marshall P Thomas et al. BMC Public Health. .

Abstract

Background: Health workers (HWs) in Africa face challenges accessing and learning from existing online training opportunities. To address these challenges, we developed a modular, self-paced, mobile-ready and work-relevant online course covering foundational infection prevention and control (IPC) concepts. Here, we evaluate the first pilot of this course, conducted with HWs in Nigeria.

Methods: We used a learner-centered design and prototyping process to create a new approach to delivering online training for HWs. The resulting course comprised 10 self-paced modules optimized for use on mobile devices. Modules presented IPC vignettes in which learning was driven by short assessment questions with feedback. Learners were recruited by distributing a link to the training through Nigeria-based email lists, WhatsApp groups and similar networks of HWs, managers and allied professionals. The course was open to learners for 8 weeks. We tracked question responses and time on task with platform analytics and assessed learning gains with pre- and post-testing. Significance was evaluated with the Wilcoxon signed-rank test, and effect size was calculated using Cohen's d.

Results: Three hundred seventy-two learners, with roles across the health system, enrolled in the training; 59% completed all 10 modules and earned a certificate. Baseline knowledge of foundational IPC concepts was low, as measured by pre-test scores (29%). Post-test scores were significantly higher at 54% (effect size 1.22, 95% confidence interval 1.00-1.44). Learning gains were significant both among learners with low pre-test scores and among those who scored higher on the pre-test. We used the Net Promoter Score (NPS), a common user experience metric, to evaluate the training. The NPS was + 62, which is slightly higher than published scores of other self-paced online learning experiences.

Conclusions: High completion rates, significant learning gains and positive feedback indicate that self-paced, mobile-ready training that emphasizes short, low-stakes assessment questions can be an effective, scalable way to train HWs who choose to enroll. Low pre-test scores suggest that there are gaps in IPC knowledge among this learner population.

Keywords: Africa; Design thinking; Health workers; Infection prevention and control; Learning science; Mobile health; Nigeria; Online learning; Primary health care.

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Conflict of interest statement

MPT is lead consultant at Enact Academy, which designs and develops online trainings. All other authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Course structure and screenshots of the prototype. Learners could access the modules in any order, though linear progression was encouraged. Screenshots are shown in mobile view, but all modules were also compatible with computers and tablets
Fig. 2
Fig. 2
Pre-/post-test performance. Learners who completed both the pre- and post-test were grouped by pre-test score. Learners who scored below the median and at or above the median both had significant learning gains
See this image and copyright information in PMC

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