Feasibility of an adaptive e-learning environment to improve provider proficiency in essential and sick newborn care in Mwanza, Tanzania

Kalabamu, Florence S.

Feasibility of an adaptive e-learning environment to improve provider proficiency in essential and sick newborn care in Mwanza, Tanzania

dc.contributor.author	Kalabamu, Florence S.
dc.date.accessioned	2023-10-06T12:59:13Z
dc.date.available	2023-10-06T12:59:13Z
dc.date.issued	2023-07-13
dc.description.abstract	Introduction. To improve healthcare provider knowledge of Tanzanian newborn care guidelines, we developed adaptive Essential and Sick Newborn Care (aESNC), an adaptive e-learning environment (AEE). The objectives of this study were to 1) assess implementation success with use of in-person support and nudging strategy and 2) describe baseline provider knowledge and metacognition. Methods. 6-month observational study at 1 zonal hospital and 3 health centers in Mwanza, Tanzania. To assess implementation success, we used the RE-AIM framework and to describe baseline provider knowledge and metacognition we used Howell’s conscious-competence model. Additionally, we explored provider characteristics associated with initial learning completion or persistent activity. Results. aESNC reached 85% (195/231) of providers: 75 medical, 53 nursing, and 21 clinical officers; 110 (56%) were at the zonal hospital and 85 (44%) at health centers. Median clinical experience was 4 years [IQR 1,9] and 45 (23%) had previous in-service training for both newborn essential and sick newborn care. Efficacy was 42% (SD±17%). Providers averaged 78% (SD±31%) completion of initial learning and 7%(SD±11%) of refresher assignments. 130 (67%) providers had ≥1 episode of inactivity >30 day, no episodes were due to lack of internet access. Baseline conscious-competence was 53% [IQR:38-63%], unconscious-incompetence 32% [IQR:23-42%], conscious-incompetence 7% [IQR:2- 15%], and unconscious-competence 2% [IQR:0-3%]. Higher baseline conscious-competence (OR 31.6 [95%CI:5.8, 183.5) and being a nursing officer (aOR: 5.6 [95%CI:1.8, 18.1]), compared to medical officer) were associated with initial learning completion or persistent activity. Conclusion. aESNC reach was high in a population of frontline providers across diverse levels of care in Tanzania. Use of in-person support and nudging increased reach, initial learning, and refresher assignment completion, but refresher assignment completion remains low. Providers were often unaware of knowledge gaps, and lower baseline knowledge may decrease initial learning completion or activity. Further study to identify barriers to adaptive e-learning normalization is needed.	en_US
dc.identifier.citation	Meaney, P.A., Hokororo, A., Ndosi, H., Dahlen, A., Jacob, T., Mwanga, J.R., Kalabamu, F.S., Joyce, C., Mediratta, R., Rozenfeld, B. and Berg, M., 2023. Feasibility of an Adaptive E-Learning Environment to Improve Provider Proficiency in Essential and Sick Newborn Care in Mwanza, Tanzania. medRxiv, pp.2023-07.	en_US
dc.identifier.other	https://doi.org/10.1101/2023.07.11.23292406
dc.identifier.uri	http://hdl.handle.net/123456789/1241
dc.language.iso	en	en_US
dc.publisher	MedRxiv	en_US
dc.subject	Newborn Care in Mwanza	en_US
dc.subject	Tanzania	en_US
dc.subject	Feasibility of Adaptive Essential	en_US
dc.title	Feasibility of an adaptive e-learning environment to improve provider proficiency in essential and sick newborn care in Mwanza, Tanzania	en_US
dc.type	Article	en_US