Primary Health Care trainers' and nurses' learning experiences of using educational technology as part of an established in-service training programme in the Western Cape province, South Africa

Master Thesis


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The Practical Approach to Care Kit (PACK) training programme combines an evidence based clinical guide with an educational outreach training programme, focusing on Primary Health Care (PHC) providers in health facilities in South Africa. As the programme expands in South Africa and internationally, the health system challenges of distance, budget constraints, staff attrition, and infrastructure inadequacies require a more sustainable model which is less dependent on face-to-face facilitation. This research study focused on refining the initial design of an e-learning module and examining factors influencing its use prior to further roll out. Department of Health stakeholders, PACK trainers and nurses from PHC clinics in the Western Cape province were interviewed. Qualitative case studies were used to generate a description of nurses' onscreen learning experiences within each specific clinic under study, and to potentially comment on any similarities or differences in these experiences across the three clinics. Initial data were coded thematically, and a list of codes was developed for application to subsequent data. The theory of situated learning in communities of practice was used as a lens to examine the PACK e-learning approach. The coding list was developed and refined as data analysis continued and was the basis for drawing out key issues and themes. PACK stakeholders, trainers and nurses responded positively to the design of the elearning module overall. Key findings highlighted the challenges of access to technology and internet, and digital literacy in the South African PHC context. Learning preferences, clinical content selection, time and motivation impacted learning experiences and uptake. e-Learning completion required support within a community of practice and access on smartphones was identified as a potential enabler. e-Learning for in-service training in the PHC environment requires careful resource allocation to ensure adequate access to technology and the design of a well-supported, blended approach to e-learning to accommodate the specific needs of this group of learners.