Abstract:

Introduction:
Despite achieving many of the Millennium Development Goals spearheaded by the United Nations to eradicate poverty by 2015, there still exists a shortage of skilled health personnel, in low- and middle- income countries. Increasing reliance on mid-level health workers is essential, in order to ensure adequate healthcare coverage and provision to underserved communities (WHO, 2008). However, serious challenges exist including lack of updated training in primary care clinical skills amongst existing healthcare trainers compounded by persistence of outmoded practices (WHO, 2008).

Background:
Skills training is complicated by a shortage of expert trainers as well as remotely located trainee workers, including nurses in primary care. Continued professional training of practical skills including evidence-based safe practices, for instance, to assist births in remote communities is even more critical for health quality improvement in less economically developed countries. Globally, internet penetration and cellular networks have steadily expanded, allowing distance learning to become a more feasible mode of education. At the same time, many bold initiatives in technology-enhanced learning have given rise to pedagogical developments such as virtual classrooms and multicasting incorporating better video and streaming capture technologies.

Objectives:
This study was conducted to critically review distance learning technologies in health education and in particular, teaching of practical skills through distance education.

Methods:
An extensive literature review was conducted regarding the implementation of distance learning for practical skills training among healthcare workers. The search involved the CINAHL, AMED and MEDLINE electronic databases using search terms: “distance learning OR training OR education”, “e-learning”, “learning outcomes”, “practical OR skills” and “health workers”.

Results and Discussion:
The review extracted over 6000 articles from databases under analysis but eventually narrowed to only four papers based on a combination of keywords as filters and relevance to health education. Studies highlighting the use of distance learning technologies for health education theory showed that such technologies are equivalent, or even superior, to traditional mediums of teaching. Hence, technology-enhanced learning, e.g. videoconferencing, needs to be progressively harnessed to educate remote healthcare workers, especially for such critical fields as clinical curative primary care. Yet, the literature search through electronic databases established very few studies focused on the use of distance learning in the practical teaching of clinical skills for this group of workers.

Conclusion:
Considering this notable gap in the literature, there is a pressing need for future research and development to focus on practical skills training via distance education so that 21st century technologies can be utilised to upskill health workers in socially disadvantaged and isolated locations.

Keywords:

Distant education, skills training, technology-enhanced learning, healthcare workers, Millennium Development Goals.