ABSTRACT
Background: Despite continuing medical education (CME) programmes on evidence-based diabetes care, evidence-based best practice and actual GP practice remain scant. Online CME offers numerous benefits to general practitioners (GPs), particularly during the coronavirus disease 2019 (COVID-19) pandemic. In Thailand, CME is a voluntary process and is yet to be established as a mandatory requirement. This study examined GP uptake of online diabetes CME and the changes in GPs' attitudes to and knowledge of Type 2 diabetes management. Methods: A cross-sectional study and a before-and-after study were employed with 279 GP trainees who voluntarily undertook a newly-developed online diabetes programme. A follow-up survey was conducted six months after the GP trainees completed their training. Results: One hundred and twelve out of 279 GP trainees (40.1%) participated in the study, of whom 37 (13.3%) enrolled in the online diabetes programme, and 20 (7.2%) completed the programme. Before enrolling in the programme, the participants' mean diabetes knowledge score was 61.5%. The participants' confidence in effective insulin treatment increased significantly after the programme (95% Confidence interval [CI], -0.51-0.00; P = 0.05), but their knowledge scores before and after the programme were not statistically different (95% CI, -3.93-0.59; P = 0.14). Conclusion: Uptake of the online diabetes CME was poor, although appropriate recruitment strategies were employed, and the online educational option was attractive and accessible during the COVID-19 pandemic. This study emphasises the gap between evidence-based practice and actual GP practice and the need for mandatory CME.
ABSTRACT
BACKGROUND: There are obstacles for medical schools in low- and middle-income countries (LMIC) to implement an online learning management system (LMS) during the pandemic of coronavirus disease 2019. Our medical school has developed and implemented tailored LMS for medical students and examine the acceptance and effects of this LMS on the medical students' learning outcomes and identify factors influencing their adoption of online learning. METHODS: This was a mixed-methods study using an online questionnaire and online semi-structured interviews with first-year medical students at one medical school in Thailand. The platform's monitoring system and questionnaire data were analysed using descriptive statistics and binary logistic regression. RESULTS: The response rate was 55.5% (157/283). Most of the respondents agreed on the advantages and were very satisfied with their learning experience. The logistic regression showed that content quality (adjusted odds ratio (AOR) = 2.43; 95% CI = 1.11-5.31) and perceived usefulness (AOR = 2.75; 95% CI = 1.02-7.39) were significantly associated with the acceptance of online learning among medical students. There was no association between the test scores and time spent in the course. CONCLUSION: Despite limited evidence of LMS effectiveness in medical schools in LMIC, learning on a customised LMS appeared to be accepted, useful, user-friendly, and effective among medical students. The perceived usefulness and the content quality are associated with the acceptance of online learning. Medical schools in LMIC can develop their own LMS to ensure that it meets their learners' and faculties' needs. This study is a single-institution study, further large-scale studies are needed to ensure generalisability.