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April 10, 2015

CME: Online Medical Education Could Revolutionize Training in Emerging Markets

CME E-Learn

A recent article published in Forbes argues that online medical education has the opportunity to revolutionize training for doctors and nurses in emerging markets. Internet-based learning tools “will increase the number of health workers globally and train them to provide high-quality care in places that desperately need it,” writes Will Greene, who runs TigerMine Ventures, an advisory firm that helps companies and organizations in Southeast Asia.

Greene argues that medical education in emerging markets “typically suffers from two problems.” He writes:

First, medical universities and residency programs rarely have enough qualified instructors, and sometimes lack access to modern curricula and equipment. Second, weak or nonexistent continuing medical education (CME) programs prevent health workers from later keeping their skills sharp.

The World Health Organization (WHO) estimates that more than 7 million additional skilled health professionals are needed globally, “with shortages at crisis proportions in many parts of South Asia, Southeast Asia, and Africa.” According to the WHO, the shortage will only worsen in coming years, but Greene believes many “underestimate the potential impact of new e-learning technologies to enable low-cost medical training at scale.”

Indeed, many universities, government health agencies, NGOs, private companies, and doctors around the world are already embracing e-learning. “Medical education typically begins with university coursework, and many medical schools now use e-learning tools like webcasts and online study aids to broaden enrollment and improve educational outcomes, Greene writes. “Some are working to adopt and apply these tools in emerging markets, though often-onerous data charges, patchy connections, lack of technological competency, and other challenges can limit their efficacy.”

Improving Medical Education

As an example of e-learning done well, Greene writes that the University of Washington’s Department of Global Health “is a leader in the use of distance learning technologies for low-resource settings.” The UW Department of Global Health E-Learning offers online courses in more than 30 countries. “Since 2007, when it opened two small program sites in Kenya and Haiti, it’s delivered classes to students in many of the world’s poorest places,” writes Greene. “Its flagship course on Clinical Management of HIV now reaches over 1,000 students globally each year.” UW e-learning programs use “blended learning,” which includes watching some online lectures and submitting homework virtually, but also mixing in local class discussions with classmates and professors.

Greene listed a number of real-life examples of companies and doctors embracing virtual medical education:

E-learning technologies can also streamline and scale up residency programs. In radiology, for instance, a growing number of hospitals around the world now use software by Lifetrack Medical Systems, a digital healthcare startup that Techonomy profiled in November 2014. The software enables radiology residents to receive virtual training from qualified practitioners anywhere in the world—a boon for places like Indonesia and Myanmar with acute radiologist shortages.

Even surgery can now be taught remotely with technologies that combine virtual reality with AI techniques to train both real time decision-making and psychomotor skills. Dr. Peter Haddawy, a Bangkok-based computer scientist who’s developing these technologies, says they’re actively being used for surgery students in Thailand. He believes they will be particularly valuable in emerging markets facing shortages of expert surgeons....

Some such platforms help by promoting professional mentoring. In Vietnam, for instance, a Harvard Medical School-affiliated NGO called HAIVN runs a video conferencing platform that connects HIV specialists in top Vietnamese hospitals with frontline community health workers. Inspired by Project ECHO, a University of New Mexico program that pioneered the use of video conferencing for remote training in healthcare, HAIVN now operates in more than 20 provinces in Vietnam.

FHI360 is another NGO using innovative online platforms to provide continuing medical education in emerging markets. Its USAID-funded Control and Prevention of Tuberculosis Project, which Techonomy highlighted in January, does this for health workers in Thailand and China with Qstream, a web and mobile application that supports workforce skill building. The app delivers informational content to distributed teams, drawing on principles from neuroscience and game mechanics to maximize uptake and retention.

Greene concludes: 

To be sure, improving healthcare in emerging markets is about much more than just expanding the health workforce. Countries need tools to ensure that health workers, once trained, end up where they are most needed. Interventions for behavior change at the community level, such as campaigns to promote hand washing and basic hygiene, will also be indispensable. So will massive investments in public health infrastructure, stronger regulatory regimes, and R&D for new and improved treatments.

Yet health workers remain the frontline stewards of public health, and healthcare systems cannot function without them. New e-learning tools will increase the number of health workers globally and train them to provide high-quality care in places that desperately need it. Most likely, these same health workers will also advocate for many other necessary improvements in global health.

The full Forbes article, entitled "Emerging Market Medical Education Goes Digital," is available here

 

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