Evaluation of an Online Training Program on COVID-19 for Health Workers in Papua New Guinea
Abstract
:1. Introduction
2. Methods
2.1. COVID-19 Healthcare E-Learning Platform (CoHELP)
2.2. Online Training Platform Data
2.3. Post-Training Survey
2.4. In-Depth Qualitative Interviews
2.5. Facility Audits
2.6. Data Management and Analysis
3. Results
3.1. Engagement with Online Learning Platform
3.2. Post-Training Survey
3.3. Qualitative Data
3.4. Training Relevance
Actually, it has a lot of impact um in the workplace […] I am very conscious of washing my hands, cleaning my table every morning, before I put my things on the table, also to wear mask when I see that I’m with a lot of people.(Health Extension Officer, East New Britain)
3.5. Participation Enablers
For someone who is always busy—having the online training, its good. So, if I miss a webinar … I can still join later. For example, to go out for courses during your work time it’s quite difficult … but you still have the free time after hours to get through the replay.(Nurse, East New Britain)
3.6. Barriers to CoHELP Participation
I was trying to get my colleague to do the training, but some of them have money constraint, they couldn’t buy their data to go in to do this online … the data thing was very expensive for some.(Nurse, Morobe)
3.7. Facility Audits
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Appendix A. Data Collection Tools
Appendix A.1. Quiz Questions
- What is COVID-19Select one:
- COVID-19 is the name of a country.
- COVID-19 is a newly discovered disease which belongs to a family of viruses called Coronaviruses.
- COVID-19 is the name of a virus.
- What is the incubation period for COVID-19?Select one:
- Incubation is a maximum 5 days.
- Incubation period for COVID-19 is exactly 14 days
- The average incubation period is 5 days but can be up to 14.
- Incubation period for COVID-19 is a minimum of 14 days
- What are the two risk factors for death of COVID-19 patients?Select one:
- Comorbidity and youth
- Increased age and wrinkles
- Increased age and Comorbidity
- Youth and insomnia
- None of the above
- What are the 3 most common symptoms of COVID-19?Select one or more:
- Fever
- Myalgia
- Dry Cough
- Hunger
- Fatigue
- Is there any treatment?Select one:
- There is no vaccine and no other ways to help treat COVID-19 patients
- There is a vaccine that is safe for people to use.
- There is no vaccine but treatment plans should follow severe acute respiratory illness treatments.
Appendix A.2. Online Survey
Topic | Question | Response |
Overall satisfaction with the training program |
| Not at all relevant Not very relevant Neutral Somewhat relevant Very relevant |
| No Yes | |
Why/why not? | [free text] | |
Application of the training |
| No Yes |
| No Yes | |
| No Yes | |
| No Yes | |
| Inadequate staffing Content not relevant Lack of resources/supplies Lack of support from colleagues Lack of support from supervisors Lack of supportive policies/guidelines Lack of support from management Other [free text] | |
| Human resources Relevance of content Availability of resources/supplies Support from colleagues Support from supervisors Supportive policies/guidelines Support from management Other [free text] | |
Effectiveness of the training |
| No Yes |
| No Yes | |
Logistics of the training program |
| Network and internet Lack of sufficient data Difficult to navigate Not very interactive Other [free text] |
| Flexible timing/no strict deadlines Could choose modules of interest Additional resources available Other [free text] | |
Suggestions for improving future training programs |
| [free text] |
| [free text] |
Appendix A.3. Interview Guides
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Appendix A.4. Facility Audit
Question | Response | Comments/Instructions | How Long Has This Been in Place? |
Overview of the facility | |||
Is this facility a specific COVID-19 facility? | ☐ Yes ☐ No | ||
Infection prevention and control (IPC) governance | |||
Does the facility have a staff member dedicated to infection control? | ☐ Yes ☐ No ☐ Unsure | If yes, please state how many people:____ | ☐ >6 months ☐ <6 months |
Are there periodic evaluations of the effectiveness of IPC training programmes (e.g., hand hygiene audits/PPE audits?) | ☐ Yes ☐ No ☐ Unsure | If yes, please specify frequency and date: Frequency: ______ Date: ________ | ☐ >6 months ☐ <6 months |
COVID-19 Infection prevention and control governance | |||
Does the facility have an emergency response/preparedness plan for COVID-19? | ☐ Yes ☐ No ☐ Unsure | If no or unsure, is there a provincial COVID-19 preparedness plan? | ☐ >6 months ☐ <6 months |
Does the facility have an infection prevention and control plan for COVID-19? | ☐ Yes ☐ No ☐ Unsure | ☐ >6 months ☐ <6 months | |
Have all clinical staff received training on infection prevention and control for COVID-19? | ☐ Yes ☐ No ☐ Unsure | If yes, please specify frequency and date of last training: Frequency: ______ Date: ________ | ☐ >6 months ☐ <6 months |
Have all non-clinical staff (including cleaners/ancillary staff) received training on infection prevention and control for COVID-19? | ☐ Yes ☐ No ☐ Unsure | If yes, please specify frequency and date of last training: Frequency: ______ Date: ________ | ☐ >6 months ☐ <6 months |
Engineering Controls | |||
How many isolation beds designated for COVID-19 does the facility have? | Number: ____ | ☐ >6 months ☐ <6 months | |
Is there a room/s designated for aerosol generating procedures/sputum collection on COVID-19 wards? | ☐ Yes ☐ No ☐ Unsure | ☐ >6 months ☐ <6 months | |
What type of environmental ventilation is available in patient care areas? | ☐ Natural ☐ Mechanical ☐ Hybrid ☐ Unsure | ☐ >6 months ☐ <6 months | |
Is the adequacy of ventilation being monitored and maintained? (e.g., cleaning/maintenance of fans, monitoring of airflow) | ☐ Yes ☐ No ☐ Unsure | If yes, please describe: | ☐ >6 months ☐ <6 months |
Are functioning hand hygiene stations available at all points of care? | ☐ Yes, with reliably available supplies ☐ Yes, stations present but supplies are not reliably available ☐ No, not present ☐ Unsure | Hand hygiene stations include alcohol-based handrub solution or soap and water and clean single-use towels | ☐ >6 months ☐ <6 months |
Administrative Controls for COVID-19 | |||
Is there screening of all patients for symptoms of COVID-19? | ☐ Yes, all patients are screened (on entry and inpatients) ☐ Yes, patients are screened on entry ☐ Yes, admitted patients are screened ☐ No ☐ Unsure | ☐ >6 months ☐ <6 months | |
Are symptomatic patients cohorted to a separate waiting area and then tested for COVID-19? | ☐ Yes, cohorted and tested ☐ Yes, cohorted and referred to another facility for testing ☐ No ☐ Unsure | ☐ >6 months ☐ <6 months | |
Is there screening of all visitors for symptoms of COVID-19? | ☐ Yes ☐ No ☐ Unsure | ☐ >6 months ☐ <6 months | |
Is there screening of all facility staff for symptoms of COVID-19? | ☐ Yes ☐ No ☐ Unsure | ☐ >6 months ☐ <6 months | |
Are WHO recommended disinfection products available at the facility (70% v/v alcohol or 0.1–0.5% hypochlorite)? | ☐ Yes ☐ No ☐ Unsure | ☐ >6 months ☐ <6 months | |
Are cleaning and disinfection of the environment/surfaces being practiced according to safe protocols for COVID-19? | ☐ Yes ☐ No ☐ Unsure | If no, please describe: | ☐ >6 months ☐ <6 months |
How is clinical waste managed? | ☐ Incinerator on site ☐ Buried on site ☐ Disposal off-site ☐ Other ☐ Unsure | If other, please specify | ☐ >6 months ☐ <6 months |
Personal Protective Equipment (PPE) | |||
Are the following PPE items available for health workers at this facility? | Surgical masks: ___ N95 masks: ___ Gowns: ___ Gloves: ___ Face shields: ___ | Please state: A (continuously available in sufficient quantities) B (not continuously available in sufficient quantities) C (not available) | ☐ >6 months ☐ <6 months |
Is PPE available at all times and in sufficient quantity for all uses for all health care workers? | ☐ Yes, continuously available in sufficient quantities ☐ Yes, but not continuously available in sufficient quantities ☐ No ☐ Unsure | ☐ >6 months ☐ <6 months | |
Have staff been trained in the use of PPE? | ☐ Yes, verbal training ☐ Yes, written training ☐ Yes, practical training (e.g., practicing putting on and taking off PPE) ☐ No training | If yes, please specify frequency and date of last training: Frequency: ______ Date: ________ | ☐ >6 months ☐ <6 months |
Review of Emergency Department set-up (or Outpatient Department if facility has no ED) | |||
Is there a system for screening all patients on arrival for symptoms of COVID-19? | ☐ Yes ☐ No ☐ Unsure | ☐ >6 months ☐ <6 months | |
Is there a safe space for conducting triage/patient assessments? | ☐ Yes ☐ No ☐ Unsure | ☐ >6 months ☐ <6 months | |
Are there single patient rooms or areas for cohorting patients with suspected and confirmed COVID-19 if the number of isolation rooms is insufficient? | ☐ No single rooms or areas suitable for cohorting ☐ No single rooms but rather areas suitable for patient cohorting available ☐ Yes, single rooms are available | ☐ >6 months ☐ <6 months | |
Are all patient beds/chairs at least 1m apart? | ☐ Yes ☐ No ☐ Unsure | ☐ >6 months ☐ <6 months |
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Topic | Expert Organization/s |
---|---|
Module 1: Introduction to COVID-19 | Burnet Institute |
Module 2: Infection Control Basics | Burnet Institute |
Module 3: Principles of Outbreak Control | Burnet Institute |
Module 4: Infection Control Management | Burnet Institute |
Module 5: Clinical Management Basics | Burnet Institute |
Module 6: Emergency Department | Australasian College for Emergency Medicine (ACEM) |
Module 7: Pregnancy and Birthing | Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) |
Module 8: Adapting Essential Services | Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM); Burnet Institute |
Module 9: Clinical Management Advanced | Burnet Institute |
Module 10: Critical Care | Australian and New Zealand Intensive Care Society (ANZICS) |
Module 11: Child Health | Murdoch Children’s Research Institute |
Module 12: Theatre Management | Australian College of Perioperative Nurses (ACORN) |
Module 13: Diagnostics and Testing | PNG Institute of Medical Research |
Module 14: Nursing | Burnet Institute |
Timing | Data Collection Activity | Format | Target Group |
---|---|---|---|
During the training | Pre- and post-knowledge quiz | Multiple choice and short answer questions in online platform | All participants |
Engagement with online platform | % seminars watched; % quizzes completed; % online learning modules completed | All participants | |
After the training | Post training survey | Multiple choice and short answer questions emailed to participants in the last month of the training | All participants |
In-depth interviews and key informant interviews | Qualitative in-depth interviews in the last month of the training | Purposive sample of facilities and participants, a sample of health workers who did not take part in the training, and key stakeholders | |
Facility audits | Facility-level checklists | Purposive sample of facilities |
Variable | % (n/N) |
---|---|
Gender | |
Female | 55 (199/364) |
Male | 39 (141/364) |
Role | |
Nurse/midwife | 32 (108/341) |
Medical officer | 18 (62/341) |
Health extension officer | 13 (43/341) |
Community health worker | 7 (24/341) |
Management/administration | 6 (19/341) |
Other | 25 (85/341) |
Department | |
Emergency | 13 (44/341) |
Hospital administration/management | 15 (50/341) |
ICU | 4 (13/341) |
Infectious diseases | 11 (39/341) |
Maternity/obstetrics | 5 (18/341) |
Surgical/operating theatre | 6 (19/341) |
Paediatrics | 4 (12/341) |
Services | 4 (12/341) |
Other * | 39 (134/341) |
Completed prior COVID-19 training | 48 (175/364) |
Completed prior online training | 34 (123/364) |
Module | Number of Training Participants (N = 364) | Mean % Change between Pre- and Post-Knowledge Quiz Score (SD) | |||
---|---|---|---|---|---|
Completed Online Learning Packages | Viewed Seminars Live a | Viewed Recorded Seminars b | Completed Pre- and Post-Knowledge Quizzes | ||
Module 1: Introduction to COVID-19 | 141 (39%) | 21 (6%) | 95 (26%) | 105 (29%) | 10.8 (16.0) |
Module 2: Infection Control Basics | 93 (26%) | 23 (6%) | 52 (14%) | 40 (11%) | 5.0 (13.4) a |
Module 3: Principles of Outbreak Control | 61 (17%) | 32 (9%) | 23 (6%) | 59 (16%) | 8.8 (11.4) |
Module 4: Infection Control Management | 49 (14%) | 19 (5%) | 25 (7%) | 45 (12%) | 6.9 (20.6) |
Module 5: Clinical Management Basics | 33 (9%) | 27 (7%) | 22 (6%) | 32 (9%) | 2.6 (7.6) |
Module 6: Emergency Department | 27 (7%) | 26 (7%) | 15 (4%) | 25 (7%) | 18.4 (25.8) |
Module 7: Pregnancy and Birthing | 24 (7%) | 19 (5%) | 9 (2%) | 23 (6%) | 32.2 (26.1) |
Module 8: Adapting Essential Services | 20 (6%) | 21 (6%) | 0 (0%) | 19 (5%) | 5.6 (25.8) |
Module 9: Clinical Management Advanced | 22 (6%) | 20 (6%) | 0 (0%) | 19 (5%) | 30.5 (23.4) |
Module 10: Critical Care | 12 (3%) | 10 (3%) | 11 (3%) | 11 (3%) | 9.1 (24.3) |
Module 11: Child Health | 12 (3%) | 10 (3%) | 0 (0%) | 12 (3%) | 26.7 (21.9) |
Module 12: Theatre Management | 8 (2%) | 7 (2%) | 5 (1%) | 8 (2%) | 5.0 (14.1) |
Module 13: Diagnostics and Testing | 14 (4%) | 12 (3%) | 5 (1%) | 13 (4%) | 3.8 (12.3) |
Module 14: Nursing | 8 (2%) | 10 (3%) | 3 (1%) | 8 (2%) | 31.8 (13.7) |
At least one module | 147 (40%) | - | 109 (30%) | 209 (57%) | - |
Evaluation Component | Response | % of Respondents (n/N) |
---|---|---|
Satisfaction | The training was relevant to my current role | 88 (21/24) |
The length of the course was appropriate | 71 (17/24) | |
The content of the course was appropriate | 88 (21/24) | |
I would recommend the training program to others | 92 (22/24) | |
Application of knowledge and skills | I have shared information learnt from the training with others | 83 (20/24) |
I have used the knowledge gained from the training in my current role | 79 (19/24) | |
I have used the skills gained from the training in my current role | 79 (19/24) | |
I have made changes to clinical practice as a result of the training | 54 (13/24) | |
I have observed organizational changes as a result of the training | 63 (15/24) | |
Effectiveness | Since completing the training, I am prepared to manage a patient with COVID-19 | 100 (11/11) |
My organization is prepared for an outbreak of COVID-19 | 60 (12/20) | |
Logistics | The online platform was easy to use | 58 (14/24) |
Challenges with accessing training online: | ||
Network and internet | 67 (16/24) | |
Lack of sufficient data | 54 (13/24) | |
Difficulties navigating the platform | 8 (2/24) | |
Lack of scheduled or allocated time to complete the training | 13 (3/24) | |
Benefits of accessing the training online: | ||
Flexible timing | 79 (19/24) | |
A choice of modules | 58 (14/24) | |
Availability of online resources | 58 (14/24) | |
Usefulness of online training components | The online learning packages were very useful | 90 (18/20) |
The seminars were very useful | 72 (13/18) | |
The pre- and post-knowledge quizzes were very useful | 81 (13/16) | |
The discussion boards were very useful | 62 (8/13) | |
The additional resources were very useful | 56 (5/9) |
Location | No. of Participants | Participated in Training | Gender of Participants | Professional Role | Type of Facility |
---|---|---|---|---|---|
East New Britain | 4 | Yes (n = 3) No (n = 1) | Female (n = 4) Male (n = 0) | Nurse (n = 1) Midwife (n = 1) Research Officer (n = 1) Infection Control (n = 1) | District hospital (n = 2) Provincial hospital (n = 1) Community NGO (n = 1) |
Eastern Highlands | 2 | Yes (n = 1) No (n = 1) | Male (n = 2) Female (n = 0) | Environmental Health Officer (n = 2) | Provincial hospital (n = 1) Community NGO (n = 1) |
Morobe | 5 | Yes (n = 4) No (n = 1) | Male (n = 1) Female (n = 4) | Nurse (n = 4) Doctor (n = 1) | Provincial hospital (n = 5) |
National Capital District | 6 | Yes (n = 5) No (n = 1) | Female (n = 6) Male (n = 0) | Nurse (n = 4) Midwife (n = 1) Chaplain (n = 1) | Referral hospital (n = 6) |
Western Province | 5 | Yes (n = 2) No (n = 3) | Female (n = 2) Male (n = 3) | Nurse (n = 1) Community Health Worker (n = 1) Infectious Diseases (Data Officer/Counsellor (n = 3) | Provincial hospital (n = 4) Community NGO (n = 1) |
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Mohamed, Y.; Hezeri, P.; Kama, H.; Mills, K.; Walker, S.; Hau’ofa, N.; Amol, C.; Jones, M.; du Cros, P.; Lin, Y.D. Evaluation of an Online Training Program on COVID-19 for Health Workers in Papua New Guinea. Trop. Med. Infect. Dis. 2023, 8, 327. https://doi.org/10.3390/tropicalmed8060327
Mohamed Y, Hezeri P, Kama H, Mills K, Walker S, Hau’ofa N, Amol C, Jones M, du Cros P, Lin YD. Evaluation of an Online Training Program on COVID-19 for Health Workers in Papua New Guinea. Tropical Medicine and Infectious Disease. 2023; 8(6):327. https://doi.org/10.3390/tropicalmed8060327
Chicago/Turabian StyleMohamed, Yasmin, Priscah Hezeri, Hinabokiole Kama, Kate Mills, Shelley Walker, Norah Hau’ofa, Carmellina Amol, Madi Jones, Philipp du Cros, and Yi Dan Lin. 2023. "Evaluation of an Online Training Program on COVID-19 for Health Workers in Papua New Guinea" Tropical Medicine and Infectious Disease 8, no. 6: 327. https://doi.org/10.3390/tropicalmed8060327