Best Practices for Improving Blended Learning in Nigeria: Critical Reflections on the Breast Cancer Clinical Pathway Development Course

Abstract

Although cancer clinical pathways (CPs) are standardized care plans for the treatment of specific cancers, they are not commonly used in Nigerian hospitals. Many Nigerian clinicians do not have the requisite skill for developing and implementing the use of CPs. Critical reflections provide an important perspective in the philosophy, design, implementation, and outcome of interventions. This paper critically reflects on the design and implementation of a multidisciplinary, blended learning (i.e. online and in-person) course which sought to improve the competence of local doctors, nurses, and allied students in developing clinical pathways. Reflective feedback was obtained from a mix of project designers (n=4) and participants (n=3). The group critically analyzed the project planning and implementation in comparison with best practices. The analysis considered the design of the online course, the distribution of learners, the conduct of the in-person workshops, and the overall evaluation of the educational intervention. Positive aspects of the online learning included the unique design of the green-themed PowerPoint slides and the vibrant discussions through a WhatsApp group. Poor internet services in many parts of Nigeria affected synchronous online discussions that were conducted on Google Meet. The in-person workshops at the three locations enjoyed great community support, especially because the course provided free cancer screening. Future courses should emphasize asynchronous models while ensuring that online tools that allow for low bandwidth are used for synchronous meetings. Community involvement must be emphasized during the planning of blended learning courses in which participants would need healthy volunteers to practice skills. The use of multidisciplinary teams for the planning and implementation of courses should be the standard of practice