Curriculum growth
To outline probably the most related matters in pediatric cardiology in Rwanda, we reviewed the competencies in Pediatric Cardiology of the College of Rwanda Residency Program and the Accreditation Council for Graduate Medical Schooling in the US. The Rwandan pediatric residency competencies had been developed by pediatric workers in collaboration with companions and authorised by the Faculty of Medication, the Faculty of Medication and Well being Sciences, the Tutorial Senate and eventually the Rwanda Excessive Schooling Council. We recruited pediatric college on the College of Rwanda and pediatric cardiologists with world well being expertise from Boston Youngsters’s Hospital to take part in a survey to determine core curriculum matters utilizing a modified Delphi method. Following the primary spherical of rating 23 matters comprised of cardiac diagnostic expertise and pediatric cardiac diagnoses, 12 college contributors participated in a second Delphi rating spherical. Following this complete overview, we devised a proposed curriculum with ten core matters that the authors agreed that every one pediatricians in Rwanda ought to have competency in.
We recruited lead authors from the pediatric cardiology college on the CHUK and Boston Youngsters’s Hospital to create this curriculum, in collaboration with basic pediatricians with world well being expertise in creating studying supplies for low useful resource settings, in addition to pediatric clinician-educators from OPENPediatrics™ who’ve experience within the curation and greatest practices for supply of on-line academic supplies.
5 studying modules had been created using the ten matters. Every studying module included two to 5 classes per module (extra file 1: Appendix 1). A lesson was outlined as a single subject and consisted of an interactive video related to content-related pre- and post-test questions in a number of selection format. For every of the ten matters, studying goals and a storyboard had been created by the lead authors, video instruction with participating visible reinforcements was recorded by the OPENPediatrics™ manufacturing workforce, the content material and language had been reviewed by basic pediatric world well being college in addition to by lead investigators to make sure appropriateness for the learners. Lastly every video was peer reviewed by a pediatric heart specialist. Pre- and post-test a number of selection evaluations had been developed and peer-reviewed for every subject.
Implementation
The OPENPediatrics™ Pediatric Cardiology Curriculum was trialed within the College of Rwanda Pediatric Postgraduate Residency Coaching Program between August 2016 and January 2017. Residents got entry to the curriculum by way of a number of modalities together with offline entry by way of a USB flash-drive and on-line entry with obtainable downloading characteristic to view offline on learner’s private digital units. Contributors might watch the modules within the order of their desire. Moreover, every digital lesson was obtainable for classroom viewings throughout 4 scheduled academic convention periods that consisted of a pediatric cardiology college member offering additional clarification, answering questions from residents and offering related scientific instructing on the bedside on the pediatric ward. Using a flipped classroom method, following completion of the e-learning module, learners participated in an in-person interactive case dialogue lead by Rwandan pediatric college to consolidate and apply the data gained.
The curriculum stays obtainable to most people from any nation on-line by way of the OPENPediatrics™ on-line open entry platform [16], underneath the “Introduction to Cardiac Illness” course and could be accessed by any system related to the web along with being obtainable for obtain for offline viewing. Ongoing IT help might be offered to Rwandan residents by way of the Rwandan Telemedicine Committee. The course goals are applicable for all pediatric medical trainees.
Analysis
Analysis of the influence, satisfaction, utilization, and limitations of the OPENPediatrics™ Pediatric Cardiology Curriculum had been evaluated utilizing a combined strategies method. Impression on information gained was evaluated with pre- and post-test a number of selection assessments. Qualitative and quantitative evaluation of the curriculum was accomplished by on-line survey and structured interviews.
Quantitative analysis
In April 2017, previous to accessing the e-learning curriculum, residents within the College of Rwanda Pediatric Postgraduate Residency Coaching Program accomplished a web-based survey assessing perceptions of e-learning in addition to a 50-question pre-test information evaluation. Two months later, following completion of the OPENPediatrics™ Cardiology Curriculum and the 4 in-person overview periods, residents had been invited to finish each a post-test information evaluation and a survey on self-reported competency, utilization, and satisfaction with using the digital coaching materials. Survey questions used a five-point Likert response scale to evaluate learner views. Survey responses had been obtained utilizing a web-based survey and downloaded as de-identified spreadsheet. Pre- and post-tests outcomes had been anonymized utilizing distinctive examine IDs that would not be linked to participation within the in-person overview periods.
Quantitative information evaluation, energy calculation and pattern dimension willpower
Modifications between pre- and post-test scores in information had been analyzed individually and collectively utilizing paired pattern t-tests and F-test, respectively. Wilcoxon signal rank take a look at was used to research modifications in learner response to survey questions using five-point Likert scale. Learner responses to questions on utilization and satisfaction had been analyzed utilizing descriptive statistics, mirrored as percentages.
Energy was estimated for a paired pattern t-test utilizing a medium impact dimension of 0.5 customary deviation primarily based on Cohen, with an alpha degree of 5% for a two-tailed take a look at. For energy ranges equal to 80%, the required pattern dimension is 34 contributors having full information. Out of the 50 trainees within the residency program, we selected to enroll 45 contributors on this examine, anticipating a lower than 100% survey completion compliance fee.
Qualitative analysis
Qualitative analysis included each free response questions within the post-curriculum survey and post-curriculum in-depth interviews (IDIs). We performed 12 IDIs of pediatric residents who had been rotating by means of CHUK throughout a two-week qualitative information assortment interval and had accomplished the curriculum to discover their satisfaction and acquire perception into their perceptions of strengths, weaknesses, and limitations related to this particular pediatric cardiology e-learning curriculum in addition to e-learning basically. IDIs befell in March of 2017 at CHUK. IDIs had been led by writer SV. The interviews had been performed on website inside a personal designated house as to encourage openness and cut back reporting bias. For all IDIs, solely the participant and interviewer had been current.
All IDIs utilized a semi-structured information, which requested preliminary questions and offered probe questions if wanted. The interviews had been performed in English, as all pediatric residents have to be proficient in English as a requirement for his or her coaching. With permission from the contributors, the interviews had been audio-recorded for reflection and evaluation by the analysis workforce. Full nameless transcripts for every recording which had been uploaded into NVivo software program model 11 [17]. Transcripts had been numbered, coded and sorted randomly, permitting for double coding of every transcript. Key themes had been recognized by every coder and discrepancies had been resolved throughout overview. Utilizing a deductive method, present themes of digital studying in resource-limited settings had been explored and rising themes had been recognized utilizing thematic evaluation.
Analysis ethics
Ethics approval for this examine was obtained from College of Rwanda and Boston Youngsters’s Hospital. Knowledgeable consent for participation within the analysis of the OPENPediatrics™ curriculum was obtained on the initiation of the web survey. Research contributors had been assigned a examine ID quantity for matching pre- and post-test response and information was collected anonymously for the only goal of evaluating the effectiveness of OPENPediatrics™. Combination information with out distinctive identifiers was saved digitally and mixture outcomes had been shared with College of Rwanda pediatric college.