Internet-based teaching to improve patient & health-care provider interaction in chronic diseases

International education project:
Establishment of an internet-based teaching instrument using annotated videos and web-based supervision to improve patient & health-care provider interaction in chronic diseases

Wolf Langewitz^a MD, Christof Daetwyler^a MD, G. Abongomera^b MD, PhD, Jan Fehr^b, Dunja Nicca^b

a: Department of Internal Medicine, Communication in Medicine, University Hospital and University Basel
b: Department of Public Health, Epidemiology Biostatitics & Prevention Institute, University of Zurich

Partner: Infectious Diseases Institute, Makere University, Kampala, Uganda

Needs Analysis and context conditions

The burden of chronic infectious diseases like HIV/AIDS and Tbc in African countries is still high and is predicted to remain high for the next 20 years. In addition, disease burden from obesity and metabolic disorders will increase because e.g. improving longevity and better access to high-caloric food. In resource-limited settings, usually, great distances between teaching  hospitals  and universities and small medical facilities in the countryside must be  overcome,  if  in-person  training and supervision on the job is mandatory. Furthermore, most African countries are multi-lingual requiring teaching material that uses local languages instead  of the language with the largest coverage within a country. lf knowledge of such a lingua franca is limited, teaching material may be useless for the local population.

Logic of the intervention

Understanding the patient’s perspective is crucial to reach readiness to start therapy and to persist with potentially life-long treatment. Patients know best whether their social environment  is supportive or inhibiting healthy behaviours. If health care providers (hcp) wish to identify these patient characteristics, they must invite patients to, share their perspective. Such a patient-centred communication is uncommon in Sub-Saharan Africa, yet preferred by patients e.g. in Mali and successful in the assessment of adherence in Tanzania.

Aims of the intervention and description of activities

Participants are working clinically as health care professionals (nurses, medical doctors, psychologists). They acquire competence to train other hcp’s in the use of patient-centred communication and in the use of internet-lbased programs that
a. Allow for the development of teaclhing material in local languages and
b. Setup a network of mutual supervision and feedback on the job.

Outcomes
Participants know how to communicate in a patient-centred way. They are able to train other hcp’s in this regard. They are able to produce instruction material on their own and to supervise their trainees on the job, using an internet-based supervision tool. In the lang run, a network of communication professionals is established, fosteriing e.g. the test and treat strategy in adolescent and adult patients.