mobile malaria training africa.ppt [read-only]elearningsymposium.gmu.edu/2010/presentations...
TRANSCRIPT
MOBILE MALARIA TRAINING FOR HEALTHCARE WORKERS IN AFRICA
Presenters: Katrina Allangba and Judith Stevenson
M-LEARNING TEAM
Katrina Allangba Jeff Seeley Judith StevensonShannon Strassner Edith Kuklish Jesse Highsmith
mLearning Team
Team comprised of graduate students enrolled in the part-time Instructional Design and Development Masters program at GMU
All team members also pursuing eLearning graduate certificates
mLearning Team cont.
Professional experience includes: Instructional design, computer information management
and interoperability, audio production and editing, e-learning development, teaching in public and adult education environments
Project History: Analysis
Our Client Research Associate for the Institute of Simulation and
Training (IST) of the University of Central Florida Contact: David Rogers Website: http://www.ist.ucf.edu/
Requirements and Assessed Problem Mobile application for the Android operating system Audience: rural healthcare workers The problem: rural non-physician clinicians (NPCs) need
updated training in various medical arenas
Project History: Clients Goals
Client’s Goals Use open courseware and other respected sources as
learning content Develop a method of content delivery that maximizes the
growing telecommunication sector in Africa Address healthcare concerns of greatest importance in
Sub-Saharan Africa Create learning content practical and readily usable by
NPCsGather assessment and usage data from groups of
learners using the smart phone mobile training system for use by regional managers
Project History: Instructional Objectives Upon completion of our mobile training, NPCs
working in rural healthcare clinics in sub-Saharan Africa will be able to use available resources to effectively prevent, diagnose, and treat malaria within the local communities they serve. Use smart phone as a learning device Prevent, identify and treat mild to severe forms of
malaria Educate patients about malaria prevention, treatment
and control Demonstrate mastery of course content, > 80%
Target Audience
Few qualified health care providers in Sub-Saharan Africa
Health-care providers not trained as physicians Non-physician clinicians (NPCs)
Target Audience Circumstances
Shortage of health care workers/NPCs NPCs provide wide range of medical procedures NPCs burn out
Working Environment
Extremely challenging work
Medical clinics provided with inadequate supplies, equipment, and resources
NPCs serve rural populations in deserts, mountains, jungles, and islands
Job and Learning Environment
For NPCs, location means more opportunity for further education Greater opportunities in urban areas Fewer opportunities in rural areas
Financial and Other Motivators
NPCs paid a small amount and salaries in arrears
Must pay NPCs to attend training
NPCs’ intrinsic motivation
Content Knowledge and Training Gap
Must know malaria prevention, detection and treatment procedures
Must accurately diagnose malaria
Need to know about new drugs
Dacia Nkoana-Mashabane (meaning: purple flower)
Age: 56MidwifeMotivation for
using a high-tech product is to help those in her village
Chantal Mistique(meaning: singer and mystery)
Age: 32 Works as a nurse in a
clinic that serves over 12,000 people
Motivated to use any training tool she can get, if it will help her to treat her patients more effectively
Kamuzu Balogun (meaning: medicinal warrior)
Age: 25 Nurse Medical clinic has couple
of rooms in which they store everything and see patients
Motivation for using high-tech products financial as well as educational
Themba Laila (meaning: hope and reliability)
Age: 18 Nurse Assistant Austere medical clinic Eager to learn and
practice medicine Motivated to use smart-
phone as an up-to-date medical information resource and to further her medical education
Nathan Copeland
Age: 28 Volunteer Bill Selke Memorial Clinic
with three examination rooms, a nurses' station, a laboratory, a small pharmacy, a HIV/AIDS Education Office, a medical records office, an administrative office and a waiting room
Dependent upon having modern medicine and equipment at his disposal
Findings, Drivers, and Barriers
NPCs need access to up-to-date medical information/education
Regional health departments need information Open source curricula gaining popularity Online courseware is US-centric Use of mobile phones in Africa Workshops for NPCs
Technology Skills and Gap Assessment
Limited experience with computers and Internet Reliance on cell phones for basic communication Recommend smart phone training for
Android OS and features
The Problem: Technological
Limited infrastructure in remote parts of Africa
Need to preload smart phones with courseware Limited Internet access OS, Android apps and LMS updates?
Design Goals
Make the training interesting and interactive
Find middle ground between objectivist and constructivist approach
Convey essential medical knowledge
Engaging and User-Centered
Use of multiple options for viewing Audio, video and textual presentation Colorful styling Job-aid and readily-available search function
Content
Detailed instruction for Rapid Diagnostic Test (RDT) procedure
More hands-on and practical approach Expressed in simpler language
Present ideas in visual, non-verbal ways
Solid Instructional Design
Supports many different learning styles
Gives the user more control over learning
Increases learner’s sense of participation
Mobile Interface
Best practice for small screen
Uncluttered Short label for every
graphic Provides options and
presentation styles
1. IntroductionObjectives:
You will develop the skills to safely and effectively perform an RDT in your clinic.
WatchVideo
Read Steps
RDT Training
33 44
Introduction
Perform RDT
Read Results
Prepare for RDT
Record Results
Collect Blood
Home Favourites Resources Search
Final AssessmentFinal Assessment
6655
11 22
3. Collect Blood
2) What is the first step for collecting a blood sample from a patient’s finger?
Prick the patient’s finger.
Clean the syringe.
Clean the finger with alcohol.
Collect cotton balls.
3. Collect Blood
The first step for collecting a blood sample from a patient’s finger is to clean the finger with alcohol.
Answer
3. Collect Blood
3) Select the tube that contains the correct amount of blood to collect from a patient’s finger.
3. Collect Blood
End of Section 3 Review
You have completed the Review for Section 3: Collect Blood. You may return to the Home Menu or continue to the next section, Section 4: Perform RDT.
Congratulations!
Home Favourites Resources Search
Research Goals
Assess Usability Ease of Use,
effectiveness Organization/layout
of content User experience,
improvement suggestions
Assess Content: Simplicity, clearness,
and appropriateness Logicality and
practicality Level of detail Alignment of content
with assessments Suggestions for
additional content
Round 1 Round 2
Participants
7of 8 participants (87.5%)
Medical experience in similar environment
Intrinsic motivation; no incentives
4 of 5 participants (80%)
3 repeat participants 1 new contact
Intrinsic motivation; no incentives
Round 1 Round 2
Research Method
Full RDT Prototype Online Survey –
Zoomerang 17 questions (closed &
open-ended and Likert) Demographics Navigation, interface,
usability experience
Section 5: Read Results and the Final Assessment
Online Survey -SurveyGizmo
13 questions (closed & open-ended and Likert) Demographics Experience performing
malaria testing in a rural health care clinic
Evaluation of prototype content
Round 1 Round 2
Research Findings – Round 1 (Usability)
Navigation Graphics Overall Layout Icons Usability for Limited
Technical Knowledge Users
BEFORE AFTER
5. Read Results
Prototype Changes – Round 1
5. Read Results
DO NOT read results before 15 minutes!
1) Read results EXACTLY 15 minutes after adding buffer.
DO NOT read results before 15 minutes!
1) Read results EXACTLY 15 minutes after adding buffer.
Prototype Changes – Round 1 (cont.)
Removed Form 038 (WHO –N/A for field use)
Clarified Reading RDT Results
6. Record Results1) Enter results into master record sheet (Form 038) OR enter electronically.
2) Mail results to WHO every 3 months using the provided format.
5. Read Results
2) How to read:
POSITIVE : faint test line
POSITIVE : two lines
NEGATIVE : one control line
1) Enter test results onto patient’s record OR enter electronically.
2) Mail results to WHO every 3 months using the provided format.
Research Findings – Round 2 (Content)
Simplicity Appropriateness Clarity Logic Detail Assessments Missing Information
Future Recommendations
Changes to content Date format changes requested Include information on symptomatic diagnosis of
malaria Add question found in final assessment to section
assessment
Future Recommendations
Changes to the interface Add how to use the mobile device section Image colors to reflect local culture Incorporate French and other African languages Native African voice for narration Break up monotony once familiar with the application Incorporate game to increase interactivity May cause confusion Recommend careful usability testing
QUESTIONS?
Presenter Contact Information:
Katrina AllangbaNEW Customer Service Companies, [email protected]
Judith StevensonWestwood [email protected]
Resources
Advisory Board Company. (2009). iHealthBeat. http://www.benton.org/ outgoingframe/27058.
Africa cannot stop poverty without more health workers. (2005). Retrieved October 11, 2009, from http://physiciansforhumanrights.org/library/news-2005-06-17.html.
Android 1.6 Release (n.d.). Retrieved October 15, 2009 from Official Android website. http://www.android.com/.
Android Market (n.d.). Retrieved October 15, 2009 from http://www.android.com/market/.
Android Wiki (n.d.). Retrieved October 15, 2009 from http://en.androidwiki.com/wiki/Main_Page.
Bancroft, E. (n.d.). Uganda health workforce retention study manual. Retrieved October 7, 2009, from http://courses.washington.edu/thesis/Manual%202/OPEN_FIRST_Study_Manual.pdf.
Bristol, N. (2009). Global Health. Are Cell Phones Leading the mHealth Revolution? http://www.globalhealthmagazine.com/top_stories/are_ cell_phones_leading_the_mhealth_revolution/.
Buckley, S. (1997, October 7). Lives and Deaths of an Ethiopian Midwife. Washington Post. Retrieved from http://www.washingtonpost.com/wp-srv/inatl/longterm/africanlives/ethiopia/ethiopia.htm.
Bushara, I., & Badr, E.S. (2005). Mapping of human resources for health Sudan. Retrieved October 10, 2009, from http://www.emro.who.int/sudan/pdf/Mapping%20of%20HRH%20Sudan.pdf.
Centers for Disease Control and Prevention (n.d.). Retrieved October 22, 2009 from http://www.cdc.gov/Malaria/faq.htm.
Chandler, C.I.R., Chony, S., Mtei, F., Reyburn H., & Whitty, C.J.M. (2009). Motivation, money and respect: A mixed-method study of Tanzanian non-physician clinicians. Social Science & Medicine, Vol 68:11. doi:10.1016/j.
Clinical officers. (2009). African Medical and Research Foundation. Retrieved October 9, 2009, from AMREF: http://www.amref.org/what-we-do/train-health-workers/clinical-officers.Mullan, F., & Frehywot, S. (Dec, 2007). Non-physician clinicians in 47 sub-Saharan African Countries. The Lancet, vol 370. DOI:10.1016/S0140-6736(07)60785-5.
Core Health Indicators from World Health Organization (WHO). Retrieved October 28, 2009 from http://www.who.int/countries/sdn/en/.
Dolan. B. (Mar, 2009). The real top ten iPhone medical apps. Mobile Health News. http://mobihealthnews.com/850/the-real-top-ten-iphone-medical-apps/.
Drona Mobile Assessment (2008-2009) Retrieved November 16, 2009 from http://www.deltecs.com/WhymobileLMS.html.
Explaining adherence success in sub-Saharan Africa: An ethnographic study. (2009). Retrieved October 11, 2009, from http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1000011.
Facts and Figures from the United Nations Mission in the Sudan (UNMIS). Retrieved October 27, 2009 from http://www.un.org/Depts/dpko/missions/unmis/.
Goodwin, Kim (2009). Designing for the Digital Age: How to Create Human-Centered Products and Services.San Francisco: Wiley Publishing.
Hall, S. (2007). People first: African solutions to the health worker crisis. African Medical and Research Foundation, Retrieved October 10, 2009, from http://www.hrhresourcecenter.org/node/1530.
Hamilton, K. & Yau, J., (2001). The global tug-of-war for health care workers. Migration Policy Institute, Washington, DC. Available at: http://www.migrationinformation.org/Feature/print.cfm?ID=271.
Health Global Access Project. (2005). Factsheet: Health worker crisis in Africa. New York: Health GAP.
The health of the people: The African regional health report. (2006). Brazzaville: World Health Organization - Regional Office for Africa.
HIV/AIDS information systems taps cell phone texting capabilities. (2007). External Research Digital Inclusion Program. Retrieved October 16, 2009, from http://research.microsoft.com/en-us/collaboration/papers/botswana.pdf.
Hodgkinson-Williams, C., & Ng’ambi, D. (Feb 2009) Case Study 5: Mobile Learning. Centre of Educational Technology. University of Cape Town.
Icon Pot (2009). Retrieved November 16, 2009 from http://www.iconpot.com.
Increasing access to health workers in remote and rural areas through improved retention. (2009). Retrieved October 7, 2009, from www.who.int/hrh/migration/background_paper.pdf.
Johns Hopkins Bloomberg School of Public Health (n.d.). Retrieved September 20, 2009 from http://ocw.jhsph.edu/courses/malariology/lectureNotes.cfm.
Khan, R. (2006). Why I Became a Doctor. Retrieved October 30, 2009 from http://www.taim.org/i4a/pages/index.cfm?pageid=784.
Kruse, G.R., Chapula, B.T., Ikeda, S., Nkhoma, M., Quiterio, N., Pankratz, D., Mataka, K., Chi, B.H., Bond, V., & Reid, S.E. (2009). Burnout and use of HIV services among health care workers in Lusaka District, Zambia: a cross-sectional study. Human Resources for Health, 7:55. doi: 10.1186/1478-4491-7-55.
Kuniavksy, M. (2003). Observing the User Experience: A Practitioner's Guide to User Research. San Francisco: Morgan Kaufmann Publishers. http://mlearning.edublogs.org/2009/05/19/the-mobile-learning-engine-mle-for-moodle/ .
Mali: Fatoumata Dio, “I have delivered more than 500 babies.” (2009, May 6). IRIN Humanitarian News and Analysis. Retrieved from http://www.irinnews.org/Report.aspx?ReportId=84243.
Media Convergence Laboratory. (n.d.). About. http://www.mcl.ucf.edu/about.html.
Medical Teams International – Cameroon: Situation Report. Retrieved October 29, 2009 from http://www.medicalteams.org/sf/our_work/where_we_work/africa/cameroon.aspx#report.
Meeting of the Africa health workforce observatory. (2006). Retrieved October 7, 2009, from http://www.afro.who.int/hrh-observatory/documentcentre/meetingreports/arusha_meeting_report_09_07.pdf.
Midwife gives hope to new mums in Africa. (2009, October 4). Craven Herald and Pioneer. Retrieved from http://www.cravenherald.co.uk/news/4661360.Midwife_gives_hope_to_new_mums_in_Africa/.
Minges, M. (2004). African telecommunications indicators 2004, International Telecommunications Union.
MIT OpenCourseWare. (Fall, 2009) MAS.965 / 6.976 / SP.716 NextLab I: Designing Mobile Technologies for the Next Billion Users. http://ocw.mit.edu/OcwWeb/Media-Arts-and-Sciences/MAS-965Fall-2008/CourseHome/index.htm.
Mobile Learning. (May, 2009). The Mobile Learning Engine (MLE) for Moodle.
Mullan, F., & Frehywot, S. (2007). Non-physician clinicians in 47 sub-Saharan African Countries. The Lancet, vol 370. DOI:10.1016/S0140-6736(07)60785-5.
Pakenham-Walsh, N., & Bukachi, F. (2009). Information needs of health care workers in developing countries: A literature review with a focus on Africa. Human Resources for Health, 7:30. doi:10.1186/1478-4491-7-30. Retrieved from http://www.human-resources-health.com/content/pdf/1478-4491-7-30.pdf.
Piskurich, George (2006). Rapid Instructional Design. San Francisco: Pfeiffer.
Prerez, S. (Feb 20, 2009). Read Write Web. Mobile Phones to Serve as Doctors in Developing Countries. http://www.readwriteweb.com/archives/mobile_phones_to_serve_as_doctors_in_developing_countries.php
The President's malaria initiative: Saving the lives of mothers and children in Africa. (2007). Washington, D.C.: USAID.
Rogers, David. Personal Interview. 28 September 2009.
Rossett, A. (2009). First Things Fast: A Handbook for Performance Analysis. (2nd ed). San Francisco: Pfeiffer.
Rural clinics. (2008). Amsale Gessesse Memorial Foundation. Retrieved October 16, 2009, from http://www.amsalefoundation.org/rural-clinic.html.
SourceForge. (2009). MLE-Moddle. http://mle.sourceforge.net/mlemoodle/ index.php?lang=en
Studio 7.5 (2006). Designing for Small Screens. Lausanne: AVA Publishing.
Skye, K. (2008). Midwifery in Senegal. Retrieved from http://www.africanbirthcollective.org/html/InSenegal.html.
Top Ten iPhone Medical Apps (2009) Retrieved November 16, 2009 from http://mobihealthnews.com/850/the-real-top-ten-iphone-medical-apps/.
Tulles, T. and Albert, B. (2008). Measuring the User Experience: Collecting, Analyzing and Presenting Usability Metrics. San Francisco: Morgan Kaufmann Publishers.
United Nations Foundation. 2009. MHealth Alliance. http://www.unfoundation .org/global-issues/technology/mhealth-alliance.html.
United Nations Map of Cameroon. Retrieved October 30, 2009 from http://www.un.org/Depts/Cartographic/map/profile/cameroon.pdf.
United Nations Profile of Cameroon. Retrieved October 29, 2009 from http://www.un.org/esa/agenda21/natlinfo/wssd/cameroon.pdf.
University of Central Florida. (2009). Institute for Simulation and Training: About Us. http://www.ist.ucf.edu/overview.htm.
Voice Assessment (2009) Retrieved November 16, 2009 from http://www.youtube.com/watch?v=F3PkIdF1R04.
Volunteer Kenya (2006). Fighting HIV/AIDS and Poverty, Improving Education and Healthcare. Retrieved October 30, 2009 from http://www.volunteerkenya.org/index.html.
Walter, N.D., Lyimo, T., Skarbinski, J., Metta, E., Kahigwa, E., Flannery, B., Dowell, S.F., Abdulla, S., & Kachur, S.P. (2008). Why first-level health workers fail to follow guidelines for managing severe disease in children in the Coast Region, the United Republic of Tanzania. Bulletin World Health Organization, 87(2): 99-107. doi: 10.2471/BLT.08.050740.
Wikipedia. (2009). Retrieved from Wikipedia, MHealth: http://en.wikipedia.org/wiki/MHealth.
WHO RDT Instructions and Training (2005). Retrieved November 6, 2009 from http://www.wpro.who.int/sites/rdt/using_rdts/training/.
Zurn P., et al. (2004). Imbalance in the health workforce. Human Resources for Health, 2:13.
101 Best Android Apps (2009). Retrieved November 01, 2009 from http://101bestandroidapps.com/.