Overview

The availability of competent, well supported and motivated health workers is critical to the adequate functioning of any health system. Concurrently, the demand for health workers is rapidly growing due to various challenges compounded by the COVID-19 pandemic. Improving the education of health workers using digital tools is one means to address these growing challenges. The successful implementation of digitalized health workforce education (DHWE) depends on the outcome of various factors at each learning and decision-making level. Evaluation frameworks can aid decision-making by helping to identify, understand and systematically analyse these factors. Currently, there is no consistent methodological approach to conduct a thorough evaluation of education technology in health workforce education (HWE).

To cover this gap, this background research report proposes a Health Workforce Education Technology Assessment (HETA) that is derived from, and based on the principles of a Health Technology Assessment (HTA). HETA is proposed following a review of the existing HWE evaluation frameworks, identifying and mapping out common evaluation criteria. Twenty-two existing frameworks in Health Workforce Education were identified comprising outcome-based evaluation (n=6), economic evaluation or cost analysis (n=10) and programme evaluation (n=6). Only nine of these frameworks explicitly focused on using digital tools. Feasibility, needs assessment, usability, effectiveness/outcomes, economic evaluation, technology development and sustainability were identified as the common evaluation criteria. HETA is underpinned by the results of the mapped evaluation criteria, the possible gaps identified through the synthesis of existing frameworks, and the (re)application of the nine core domains of HTA. The two additional domains introduced are information and communication technology (ICT) infrastructure and educational technology device. Each domain is accompanied by a brief description of the evaluation criteria. 

The analysis of the evidence informing this report revealed that the few evaluation frameworks for DHWE are limited in scope and comprehensiveness to guide high-level decision-making. Based on the core HTA domains in the existing frameworks, HETA aims to improve DHWE by establishing its key components to enable its effective and sustainable implementation. While this report does not provide regulatory guidance or managerial advice, it is positioned to encourage reflection, further research and exploration of the ideas presented to inform the selection and adaptation of educational technology, particularly teaching and learning devices or platforms for health workers.

The report thus aims to serve policy-makers, health-care institutions, health and care workers, clinical schools and students in health professions who need actionable evaluation frameworks for decision-making about the most cost–effective, safe, and scalable application of technological learning devices, particularly in resource-constrained contexts.

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