Improving capacity for advanced training in obstetric surgery: Evaluation of a blended learning approach

Introduction Significant differences in outcomes for mothers and babies following obstetric surgical interventions between low- and middle-income countries and high-income settings have demonstrated a need for improvements in quality of care and training of obstetric surgical and anaesthetic providers. To address this a five-day face-to-face training intervention was developed. When the COVID-19 pandemic interrupted its roll-out, the course was redesigned for delivery by blended learning. Methods This 3-part blended-learning course (part-1: 15 hours self-directed online learning, part-2: 13 hours facilitated virtual workshops and part-3: 10 hours face-to-face delivery), was conducted in Kenya. We assessed the completion rate of part-1 (21 assignments), participation rate in parts 2 and 3, participant satisfaction, change in knowledge and skills and compared the cost of the blended delivery compared to the 5-day face-to-face delivery, in GB Pounds. Results 65 doctors took part in part 1, 53 completing at least 90% of the assignments. 60 doctors participated in part 2, and 53 participated in part 3. Participants completing an evaluation reported (n=53) attending the training was a good use of their time (each of parts-1 and 3: 98%, part-2: 94%) and would recommend this to other colleagues (part-1 and 3: 98%, part-2: 90%). Mean (SD) knowledge score improved from 64% (7%) to 80% (8%) and practical skills from 44% (14%) to 87% (7%). The blended course achieved a cost-saving of £207 per participant compared to the 5-day face-to-face delivery approach. Conclusion We have demonstrated that a blended learning approach to clinical training in a low resource setting is feasible, acceptable and more cost effective. More studies are required to investigate the effectiveness of this approach on health outcomes.