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Healthcare workers’ knowledge of and adherence to evidence-based guidelines for the prevention of healthcare-associated infection have been reported to be very limited. This may be due to the unattractive, complex and therefore difficult-to-study format in which printed guidelines are issued. Therefore, we developed a user-friendly e-learning course on these guidelines with integrated exercises for self-evaluation to assess whether this more attractive format could help enhance healthcare workers’ knowledge about the guidelines.
Methods:
The course was developed in Dutch and subsequently to- and back-translated in English, Portuguese, Spanish and Turkish. Content validity was approved by an international team of infection prevention experts. A sample of 50 potential users agreed upon its face validity and usability by means of the Software Usability Measurement Inventory. The e-learning course was accessible via a study website. A pretest–repeated posttest design was organized through the website. After submission of a pretest to determine baseline guideline knowledge, participants voluntarily studied the e-course. Subsequently, a pretest and two posttests assessed immediate and residual learning effects. The immediate learning effect is the change in test scores as compared to the pretest scores, immediately after studying the e-course; the residual learning effect is the change in test scores as compared to pretest scores, 3 months after studying the course and without course access.
Results:
3587 voluntary healthcare workers from 79 nationalities registered on the study website. Of these, 1011 completed the entire study path. Median study time was 194 minutes. Median scores were 54% (46%-64%) at the pretest; 82% (72%-90%) at posttest 1; and 74% (64%-84%) at posttest 2. As such, the immediate learning effect was 21% (14%–34%; P<.001) and the residual effect 18% (8%–28%; P<.001). Multivariate linear regression identified a longer study time, a longer work experience and living in a country with high or very high Human Development Index to associate with better immediate learning effects; a higher score on the pretest, female gender, and a higher age category were independently associated with lower effects (R²=0·36). For the residual effect, longer study time, female gender, and longer work experience were identified as predictors of better learning effects; a higher score on the pretest and a higher age category were associated with lower effects (R²=0·29).
Conclusion:
Moderate time invested in a well-designed, low-cost e-course significantly enhanced knowledge. Therefore, professional societies should consider translating their evidence-based recommendations in e-learning modules, parallel to printed guidelines.