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?

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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?

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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

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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

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Learners click on highlighted links to learn

more about a topic.

Solution is easy to navigate, and developed with new computer users in mind.

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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.

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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

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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