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Mentors TrainingJuly 18-22, 2011
THE AMREF eLearning Story
African Medical and Research Foundation (AMREF)
Training @ AMREF
1950’s -1960’s
AMREF is founded core
activities – Flying
Doctors Services
delivering health care to remote
areas
1960s -1970s
Introduction of Radio
programmes on
National Radio for
health workers
1980s -1990s
Introduction of Print-based
distance education
2000 & beyond
Introduction of technology
supported learning including
telemedicine, eLearning and
mLearning
Programme Goals• Upgrade 22,000 Kenya Enrolled Community Health Nurses (KECHNs) from ‘enrolled’ status to ‘registered’ (KRCHNs) level in order:
– Address the shortage of qualified nurses in Kenya rapidly and cost-effectively
– Improve standards of nursing care and the health of disadvantaged people in Kenya quickly
– Increase access to affordable, continuing and higher education for professional development of practicing nurses, majority of who are women and located in the rural area.
– Respond to growing worldwide consensus that nurses can take a greater role in patient care and clinical health care management (task shifting)
– Work towards health-related Millennium Development Goals (4, 5 & 6)
Programme Rationale
• Inadequate facilities to up-skill nurses in Kenya– Shortage of qualified nurses – As at 2004, over 80%
of nurses in Kenya were ENs– Only 4 government nursing colleges offering
upgrading from enrolled to registered nurse as at 2004 (100 nurses / annum)
– Health facilities in rural areas run by EN who do not have the requisite skills to offer quality services (clinical, managerial, research)
– Relatively high cost of education - Nurses earn £160/month on average
– Moratorium on hiring new nurses
5
enhanced
enabled
enriched
electronic
effective
exciting
What is eLearning?
6
Audience/Locations
Audience/Locations
Technology/Efficiency
Technology/Efficiency
Access/Quality
Access/Quality
FlexibilityFlexibility
Speed & Budget
Speed & Budget
eLearning•Lower cost of delivery
•In-service nurses can learn at work•Across geographic regions in Kenya
•Anytime anywhere learning•Innovative, interactive•Self-paced - Learn at own pace & time
•Enhanced quality of nursing service•Increased access to quality education•Consistent quality of material
•IT Skills for nurses•Ease of revision•Immediate application of learning
Why eLearning?
7
Course Structure
Course Structure
Capacity & Learner Support
Capacity & Learner Support
Technology Infrastructure
Technology Infrastructure
DeploymentDeployment
4 modulecurriculum
4 modulecurriculum
eLearning
•General Nursing•Reproductive Health•Community Health Nursing•Nursing Psychiatry and Management
•Over 1,100 hours of learning•48 weeks of clinical experience
•Conversion to electronic content•Learning Management System & CD-ROMs
•Computers installed in hospitals•eLearning centres set up where nurses work•24-hour access for nursing students•Help Desk set-up at AMREF
•Tutors trained in schools•Mentors in the clinical areas•Face-to-face sessions•End of module examinations
Structure and Implementation
8
Curriculum Component
Description Hours / Timeframe
Theory • 4 Course Modules, each with multiple units 143 hours
Practicum (Rotations) • 2 – 6 Rotations within each Module; minimum of 2 weeks per clinical area.
• Supervisory visits completed by Tutors, which involves assessment of student performance and feedback on student documented for submission to NCK
48 weeks
Face-to-Face Sessions • Minimum of 2 weeks per module (1 week at start of module, 1 week at end of module).
8 weeks
Module Assignments • Minimum of 3 / module (assignments are set by the school) N/A
Module Exams • 1 exam / module; each school writes its own exams.
• Students must pass the exam to continue on to the next module. Students who fail the exam can take a supplementary exam. If they fail that one, they must repeat the module.
3 to 5 days
Final Programme Exam • Similar to NCK Exam. Only students who pass the exam can then sit for the NCK exam.
• If a student does not pass the exam they complete a supplementary exam. If they do not pass the supplementary exam, they must wait for the next exam cycle.
• Each school develops their own final Programme exam.
1 week
Basic Kenyan Registered Community Health Nursing Licensing Exam
• Conducted by NCK
• Students must be presented to the NCK for the exam at least one month prior.1 week
Curriculum Illustration
9
Learners click on highlighted links to learn
more about a topic.
Solution is easy to navigate, and developed with new computer users in mind.
11
eLearning
• Funding in cash and kind • Skills transfer to AMREF & NCK• Quarterly meetings.
• Regulations & Examinations• Standards & Guidelines definition • Coordinating school activities
• Policy issues • Release of nurses to learn• Course approval
• Student enrollment• Programme implementation• Tutoring, assessments & examinations
• Content development • Programme management • Infrastructure deployment• Capacity building
Ministry of Health
• Funding• Advocacy• Student enrolment
• Civil Society Organizations
• Faith based • Private instns
Programme Partnerships
Progress to Date• Increased access to health
education • 34 schools with an enrollment
of over 7000 nurses• 108 eCentres across the
country• Over 400 faculty members &
mentors trained to support eLearners
• Improved nursing care - immediate application into practice.
• Reduced cost of learning• Replicating eLearning across
other cadre and other countries
• Handing over of the programme to stakeholders after building their capacity
Some Key Successes
• Improvement in nurses’ knowledge, skills and attitudes
• Nurses can immediately translate theory into practice
• Minimises nursing shortage and enables nurses to work and learn at the same time, hence service provision continues
• Motivates other staff to learn and encourages a reading culture amongst mentors
• Upgrading of more nurses enabled • Lack of family separation and social continuity is
instrumental in motivating students.
14
1. How do you manage between slow and fast learners? As the eLearning content is available to all learners at any time and on any day, students are
able to learn the theory at the pace that each requires. In addition, tutors and mentors are available to answer any student’s questions.
2. What about low computer knowledge? Both tutors and students are provided with basic computer training when commencing the
eLearning Upgrade Programme. Further, the eLearning programme is designed to be intuitive and easy to use for users at any level of computer knowledge.
3. How long does it take to implement and have the first intake of students? The implementation timeframe can vary, depending on the location and readiness for the
programme. The pilot programme began in 2005 and since then, 27 schools have been able to implement the programme and intake students, and learning centres have been set up across the entire country.
4. Do students pay fees? If so, what is the cost per student? Yes, students pay fees, which vary by schools. Tuition for the AMREF-run school is $2000 for
the entire programme.5. Is the upgrade programme really a priority for strengthening nursing in our
developing countries? The eLearning Upgrade programme strengthens nursing and midwifery by providing skill
enhancement, improved knowledge and motivates nurses (via potential for increased pay, career progression and increased responsibility)
Frequently Asked Questions
15
6. What is the link between the normal nursing training programme and the eLearning programme? Both the normal nursing training and the eLearning programme leverage the same content.
Practicals are also required by both programmes. The eLearning programme simply leverages the use of technology to expand access to more nurses.
7. Do you have to add workforce to be able to implement this programme? Course Coordinators, Tutors and Mentors are required to run a school. Each school needs to
assess its capacity and needs based on the # of students it intends to enroll.8. What about nurses in rural health centres where they don’t get any placements? Will they be able
to exchange for a long period of time or how is s/he supported? Support is offered through the nearby hospitals and schools. Stakeholder involvement and
participation ensures maximum support to the support.
Frequently Asked Questions
Beyond the Nurse Upgrading eLearning Programme
• Mlearning• eDCH• Replication of the programme in Uganda and
Tanzania• CPDs (Continuous professional development
courses)• Developed courses for organisations (CDC –
Infection prevention course), UCLA (MDI – HIV management course), Capacity Kenya (Reproductive Health – Centre of excellence launched in Kitui)
Evaluation of the Programme
• Kirkpatrick Level 1 – Interactivity and access to eLearning material (70% citing satisfaction)
• Kirkpatrick Level 2 – Performance of classroom based compared to eLearning
• Kirkpatrick level 3 – Theory learnt translated practically at work
• Kirkpatrick level 4 – How everything has been learnt improves health indicators (reducing mortality, reducing morbidity, health service coverage)
Conclusion
‘The mediocre mentor tells. The good mentor explains. The superior mentor demonstrates. The great mentor inspires,
encourages and takes you into the trenches.
Thank You!
www.amref.orgPeter.otieno@amref.orgwww.amref.org@peshpet
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