Effects of improving primary health care workers' knowledge about public health services in rural China: A comparative study of blended learning and pure E-Learning

Journal of Medical Internet Research

Volumn 19, Issue 5, 2017, Pages

  Zhan, Xingxin ^a   Zhang, Zhixia ^a   Sun, Fang ^a   Liu, Qian ^a   Peng, Weijun ^a   Zhang, Heng ^a   Yan, Weirong ^a  

^a HUAZHONG UNIVERSITY OF SCIENCE AND TECHNOLOGY   (China)

Author keywords

Blended learning; E learning; Primary health care workers; Public health services

Indexed keywords

ACHIEVEMENT; CASE REPORT; CHINA; COMPARATIVE STUDY; CONTROL GROUP; CONTROLLED CLINICAL TRIAL; CONTROLLED STUDY; EXPERIMENTAL MODEL; FEMALE; HUMAN; LEARNING; LIKERT SCALE; MALE; NORMAL HUMAN; PRIMARY HEALTH CARE; PUBLIC HEALTH SERVICE; RANDOMIZED CONTROLLED TRIAL; SATISFACTION; WORKER; ADULT; EDUCATION; HEALTH CARE PERSONNEL; INTERNET; MANPOWER; MIDDLE AGED; PROCEDURES; PUBLIC HEALTH; RURAL HEALTH; RURAL HEALTH CARE; RURAL POPULATION;

ADULT; CHINA; EDUCATION, DISTANCE; EDUCATIONAL MEASUREMENT; FEMALE; HEALTH PERSONNEL; HUMANS; INTERNET; LEARNING; MALE; MIDDLE AGED; PRIMARY HEALTH CARE; PUBLIC HEALTH; RURAL HEALTH; RURAL HEALTH SERVICES; RURAL POPULATION;

EID: 85019832148     PISSN: None     EISSN: 14388871     Source Type: Journal    
DOI: 10.2196/jmir.6453     Document Type: Article

References (47)

1. Meng Q, Yuan J, Jing L, Zhang J. Mobility of primary health care workers in China. Hum Resour Health 2009;7:24 [FREE Full text] [doi:10.1186/1478-4491-7-24] [Medline: 19292911].
2. NHFPC. 2016. Illustration: Understanding national basic public health services URL: http://www.nhfpc.gov.cn/jws/s3578/201504/49bf80b308fb47dbb138f86b1a49a2fc.shtml [accessed 2016-08-01] [WebCite Cache ID 6jQraoP6I].
3. Hongoro C, McPake B. How to bridge the gap in human resources for health. Lancet 2004;364(9443):1451-1456. [doi:10.1016/S0140-6736(04)17229-2] [Medline: 15488222].
4. Zhao Y, Cui S, Yang J, Wang W, Guo A, Liu Y, et al. Basic public health services delivered in an urban community: A qualitative study. Public Health 2011 Jan;125(1):37-45. [doi:10.1016/j.puhe.2010.09.003] [Medline: 21145087].
5. Yip WC, Hsiao WC, Chen W, Hu S, Ma J, Maynard A. Early appraisal of China's huge and complex health-care reforms. Lancet 2012 Mar 3;379(9818):833-842. [doi:10.1016/S0140-6736(11)61880-1] [Medline: 22386036].
6. Strasser R, Kam SM, Regalado SM. Rural health care access and policy in developing countries. Annu Rev Public Health 2016;37:395-412. [doi:10.1146/annurev-publhealth-032315-021507] [Medline: 26735432].
7. Li X, Liu J, Huang J, Qian Y, Che L. An analysis of the current educational status and future training needs of China's rural doctors in 2011. Postgrad Med J 2013 Apr;89(1050):202-208. [doi:10.1136/postgradmedj-2012-131094] [Medline: 23389284].
8. Khatony A, Nayery ND, Ahmadi F, Haghani H, Vehvilainen-Julkunen K. The effectiveness of web-based and face-To-face continuing education methods on nurses' knowledge about AIDS: A comparative study. BMC Med Educ 2009;9:41 [FREE Full text] [doi:10.1186/1472-6920-9-41] [Medline: 19591678].
9. Zhang Z, Zhan X, Li Y, Hu R, Yan W. Web-based training for primary healthcare workers in rural China: A qualitative exploration of stakeholders' perceptions. PLoS One 2015;10(5):e0125975 [FREE Full text] [doi:10.1371/journal.pone.0125975] [Medline: 25961727].
10. Bollinger R, Chang L, Jafari R, O'Callaghan T, Ngatia P, Settle D, et al. Leveraging information technology to bridge the health workforce gap. Bull World Health Organ 2013 Nov 1;91(11):890-892 [FREE Full text] [doi:10.2471/BLT.13.118737] [Medline: 24347719].
11. Kulier R, Gülmezoglu AM, Zamora J, Plana MN, Carroli G, Cecatti JG, et al. Effectiveness of a clinically integrated e-learning course in evidence-based medicine for reproductive health training: A randomized trial. JAMA 2012 Dec 5;308(21):2218-2225. [doi:10.1001/jama.2012.33640] [Medline: 23212499].
12. Wallen GR, Cusack G, Parada S, Miller-Davis C, Cartledge T, Yates J. Evaluating a hybrid web-based basic genetics course for health professionals. Nurse Educ Today 2011 Aug;31(6):638-642 [FREE Full text] [doi:10.1016/j.nedt.2010.11.001] [Medline: 21106279].
13. Hauge LS, Frischknecht AC, Gauger PG, Hirshfield LE, Harkins D, Butz DA, et al. Web-based curriculum improves residents' knowledge of health care business. J Am Coll Surg 2010 Dec;211(6):777-783. [doi:10.1016/j.jamcollsurg.2010.07.011] [Medline: 20851642].
14. Gaikwad N, Tankhiwale S. Interactive E-learning module in pharmacology: A pilot project at a rural medical college in India. Perspect Med Educ 2014 Jan;3(1):15-30 [FREE Full text] [doi:10.1007/s40037-013-0081-0] [Medline: 24072666].
15. Cook DA, Levinson AJ, Garside S, Dupras DM, Erwin PJ, Montori VM. Internet-based learning in the health professions: A meta-Analysis. JAMA 2008 Sep 10;300(10):1181-1196. [doi:10.1001/jama.300.10.1181] [Medline: 18780847].
16. Rouse DP. The effectiveness of computer-Assisted instruction in teaching nursing students about congenital heart disease. Comput Nurs 2000;18(6):282-287. [Medline: 11105402].
17. Howerton WB, Enrique PR, Ludlow JB, Tyndall DA. Interactive computer-Assisted instruction vs. lecture format in dental education. J Dent Hyg 2004;78(4):10. [Medline: 16197750].
18. Shomaker TS, Ricks DJ, Hale DC. A prospective, randomized controlled study of computer-Assisted learning in parasitology. Acad Med 2002 May;77(5):446-449. [Medline: 12010707].
19. Llambí L, Esteves E, Martinez E, Forster T, García S, Miranda N, et al. Teaching tobacco cessation skills to Uruguayan physicians using information and communication technologies. J Contin Educ Health Prof 2011;31(1):43-48. [doi:10.1002/chp.20100] [Medline: 21425359].
20. Liu Q, Peng W, Zhang F, Hu R, Li Y, Yan W. The effectiveness of blended learning in health professions: Systematic review and meta-Analysis. J Med Internet Res 2016;18(1):e2 [FREE Full text] [doi:10.2196/jmir.4807] [Medline: 26729058].
21. NHFPC. Notification on National Basic Public Health Service (2011 edition) URL: http://www.nhfpc.gov.cn/zhuzhan/wsbmgz/201304/cb5978bb42814451a26e5c97dd855254.shtml [WebCite Cache ID 6jQspPXUJ].
22. TJMU. The public health services online training platform based on Moodle URL: http://elearning.tjmu.edu.cn/gwfw/[accessed 2016-10-02] [WebCite Cache ID 6kwmFAlPs].
23. Moodle. Using forum URL: https://docs.moodle.org/29/en/Using-Forum [accessed 2016-10-01] [WebCite Cache ID 6kvxljtVc].
24. Cohen J. Statistical Power Analysis for the Behavioral Sciences. Hillsdale, NJ: L. Erlbaum Associates; 1988.
25. Wang T, Zeng R. Addressing inequalities in China's health service. Lancet 2015 Oct 10;386(10002):1441. [doi:10.1016/S0140-6736(15)00402-X] [Medline: 26466037].
26. Zhou K, Zhang X, Ding Y, Wang D, Lu Z, Yu M. Inequality trends of health workforce in different stages of medical system reform (1985-2011) in China. Hum Resour Health 2015;13:94 [FREE Full text] [doi:10.1186/s12960-015-0089-0] [Medline: 26645960].
27. Anand S, Fan VY, Zhang J, Zhang L, Ke Y, Dong Z, et al. China's human resources for health: quantity, quality, and distribution. Lancet 2008 Nov 15;372(9651):1774-1781. [doi:10.1016/S0140-6736(08)61363-X] [Medline: 18930528].
28. Kerres M, Witt CD. A didactical framework for the design of blended learning arrangements. Journal of Educational Media 2003 Oct;28(2-3):101-113. [doi:10.1080/1358165032000165653].
29. Edginton A, Holbrook J. A blended learning approach to teaching basic pharmacokinetics and the significance of face-To-face interaction. Am J Pharm Educ 2010 Jun 15;74(5):88 [FREE Full text] [Medline: 20798797].
30. Frehywot S, Vovides Y, Talib Z, Mikhail N, Ross H, Wohltjen H, et al. E-learning in medical education in resource constrained low-And middle-income countries. Hum Resour Health 2013;11:4 [FREE Full text] [doi:10.1186/1478-4491-11-4] [Medline: 23379467].
31. Ballew P, Castro S, Claus J, Kittur N, Brennan L, Brownson RC. Developing web-based training for public health practitioners: What can we learn from a review of five disciplines? Health Educ Res 2013 Apr;28(2):276-287 [FREE Full text] [doi:10.1093/her/cys098] [Medline: 22987862].
32. Halstead JA, Coudret NA. Implementing Web-based instruction in a school of nursing: implications for faculty and students. J Prof Nurs 2000;16(5):273-281. [doi:10.1053/jpnu.2000.9459] [Medline: 11033937].
33. Kheng S. The challenges of upgrading from ISPO Category II level to Bachelor Degree level by distance education. Prosthet Orthot Int 2008 Sep;32(3):299-312. [doi:10.1080/03093640802109764] [Medline: 18720252].
34. Hein G. Constructivist learning theory. 1991 Presented at: International Committee of Museum Educators Conference. Proceedings of Developing Museum Exhibitions for Lifelong Learning Conference, ICOM/CECA; October 15-22, 1991; Jerusalem, Israel URL: http://beta.edtechpolicy.org/AAASGW/Session2/const-inquiry-paper.pdf.
35. Wu J, Tennyson RD, Hsia T. A study of student satisfaction in a blended e-learning system environment. Comput Educ 2010 Aug;55(1):155-164. [doi:10.1016/j.compedu.2009.12.012].
36. Wu J, Tennyson RD, Hsia T, Liao Y. Analysis of E-learning innovation and core capability using a hypercube model. Comput Human Behav 2008 Sep;24(5):1851-1866. [doi:10.1016/j.chb.2008.02.008].
37. Maki RH, Maki WS, Patterson M, Whittaker PD. Evaluation of a Web-based introductory psychology course: I. Learning and satisfaction in on-line versus lecture courses. Behav Res Methods Instrum Comput 2000 May;32(2):230-239. [Medline: 10875167].
38. So H, Brush TA. Student perceptions of collaborative learning, social presence and satisfaction in a blended learning environment: Relationships and critical factors. Comput Educ 2008 Aug;51(1):318-336. [doi:10.1016/j.compedu.2007.05.009].
39. Lim D, Morris M, Kupritz V. Online vs. blended learning: differences in instructional outcomes and learner satisfaction. JALN 2007;11(2):27-42 [FREE Full text].
40. Thorne K. Blended Learning: How to Integrate Online & Traditional Learning. London: Kogan Page; 2003.
41. Walsh K, Reeves S, Maloney S. Exploring issues of cost and value in professional and interprofessional education. J Interprof Care 2014 Nov;28(6):493-494. [doi:10.3109/13561820.2014.941212] [Medline: 25051088].
42. Battaglino T, Haldeman M, Laurans E. Eric. 2012. Creating sound policy for digital learning: A working paper series from the Thomas B. Fordham Institute URL: http://files.eric.ed.gov/fulltext/ED528948.pdf [accessed 2016-10-01] [WebCite Cache ID 6kvjPZzvN].
43. Singh H. Building effective blended learning programs. Educational Technology 2003;43(6):51-54 [FREE Full text].
44. Halan D. Blended learning. J Educ Technol 2005;2(1):20-24 [FREE Full text].
45. Maloney S, Nicklen P, Rivers G, Foo J, Ooi YY, Reeves S, et al. A cost-effectiveness analysis of blended versus face-To-face delivery of evidence-based medicine to medical students. J Med Internet Res 2015;17(7):e182 [FREE Full text] [doi:10.2196/jmir.4346] [Medline: 26197801].
46. Flys T, González R, Sued O, Suarez CJ, Kestler E, Sosa N, et al. A novel educational strategy targeting health care workers in underserved communities in Central America to integrate HIV into primary medical care. PLoS One 2012;7(10):e46426 [FREE Full text] [doi:10.1371/journal.pone.0046426] [Medline: 23115628].
47. Maarop AH, Embi MA. Implementation of blended learning in higher learning institutions: A review of literature. IES 2016 Feb;9(3):41. [doi:10.5539/ies.v9n3p41].