eLearning is a trendy topic. More and more funding is being channeled into technology-related infrastructure, training, and faculty development. Medical education in Africa is no exception. In fact, as internet access improves in Africa, more medical schools are integrating e-learning into their curricula.
The challenge lies in developing an e-learning strategy that responds to local needs. In the US, the driving force to use technology is to improve the quality of the education. We use it to improve communication skills, physical exam skills and have more opportunities to practice cases. These uses appropriately respond to recognized deficits in our students.
Medical education in Africa has different challenges. According to the Sub-Saharan African Medical School Study, the biggest challenges are lack of faculty and inadequate infrastructure. Now that more countries in Africa are scaling up training of health workers, including physicians, it is critical to address the bottlenecks. So here I suggest there should be 3 explicit goals of e-learning programs in Africa, and I list them in order of priority:
1. Reducing the need for faculty time: Despite inadequate faculty, medical schools in Africa are increasing enrollment. They need to figure out how to teach more students with limited faculty. Technology should be used to meet this need. Self-study curricula (like what the Khan Academy has done for K-12 would be great). Medical schools should select courses to pilot e-learning based on their faculty needs – if there are not enough anatomists, then the anatomy course should be prioritized for integrating e-learning. As schools are testing e-learning in their curricula, one explicit indicator that should be measured is faculty-time required. If it takes faculty more time to upload their curricula, engage in on-line discussions and evaluate – is it really meeting the acute needs?
2. Cost-effectiveness: It takes money to provide educational supplies, classrooms, housing and supervision for the growing number of medical students in Africa. As the enrollment increases, schools will be looking for ways to make their dollars stretch. If we can use technology to provide online access to resources (instead of buying textbooks), give laptops to students so they can study more often at home, reduce the number of faculty it takes to run a school – we most certainly will find cost-savings. To prove this, schools that are pioneering the use of technology must include cost-analysis in their evaluation.
3. Quality – This tends to be the most obvious reason to use technology and is often the driving force, but I put this deliberately third because it is sometimes over-stated. Sure you can use technology to connect a school in Uganda with a US school to watch a lecture on HIV, and sure it will give yet another perspective on a condition commonly seen. But is that really meeting the acute and critical needs of the system? The use of technology to improve the quality of training in Africa should be competency and need-based. By first being explicit about the skills all graduates need, evaluating their competency, and then using technology to provide additional teaching where gaps exist.
Developing an e-learning strategy that prioritizes the reduction of faculty time and cost are increasingly important as technology becomes a more common tool in African medical schools.