The study sets out to assess whether e-courses can be used to increase knowledge in Continuing Pharmacy Education (CPE) and if the e-course format is accepted by pharmacists. The population represented pharmacists from community and hospital pharmacies and those employed in pharmaceutical wholesales.
The main finding of this study is the effectiveness in terms of increased knowledge (16%) by using an e-learning course. Furthermore, high levels of acceptance and satisfaction of e-courses were found among attendees. The acceptance is explicitly expressed in the questionnaire data, and also by the large number of voluntary participants. Attendees indicated the importance of this form of learning in their continuing education process. It is thus, safe to say that e-learning contributes to an increase in the knowledge of pharmacists. Furthermore, today’s pharmacists do accept e-learning as a medium for continuing education.
We found it interesting and important that the majority of the cohort (92%) stated that e-courses were effective (Figure 4). Ninety one percent of participants enjoyed the course Diabetes as a Problem of Modern Medicine (Figure 3). The pharmacists who responded referred to the need of such form of courses in CPE and emphasised the importance of them.
As noted by Carswell and Venkatesh [17], much of the research on e-learning has examined outcome differences between online and traditional classes [18, 19] or offered experiences of teachers or students. Knowledge increase and acceptance are key issues if e-courses are to be successful tools in CPE. This study is one of the first to assess those aspects in Continuing Pharmacy Education in Poland. This research is relevant as it assesses the effectiveness of e-learning in increasing knowledge and acceptance of this way of learning. In the available literature there are rare evidences of such studies on CPE. There is one experiment conducted in 2009 and published in 2012, which explores the conveyance of skills with the use of e-learning in CPE [6]. The study compared the effectiveness of an e-learning course against a campus-based one by checking the techniques for measurement of blood pressure using a mechanical sphygmomanometer with an aneroid manometer and a stethoscope. There were, however, no significant differences in precision of blood pressure measurement between the intervention (e-learning course) or control group (campus-based course). Pharmacists trained by e-learning and on-site course showed the same level of preparation in measuring blood pressure of their patients. Consequently, e-learning can be used to convey some skills to the same effect as traditional methods.
In the atmosphere of constant changes, updates and new findings in pharmaceutical sciences, nobody doubts the need to keep the knowledge up-to-date in order to stay professionally active and reliable. More and more countries implement CPE as obligatory lifelong learning programmes. The role of e-learning in CPE has become crucial in recent years. It is a convenient way of learning, which can take place anytime and anywhere. This flexibility is particularly attractive to professionally active pharmacists who often have no time to travel and attend conventional courses in big academic centres. E-learning helps to save additional costs for participants (travel, accommodation) and the same as for providers (renting the venue, printing materials). On the other hand, there are advantages of conventional learning over e-learning, like direct interpersonal relations, live contact with the tutor, exact definite time and place of training, more transparent verification of knowledge and training of interpersonal ability. Therefore, e-courses need to be validated and standardised the same as conventional courses, to secure the level of provided information. It is not only the content of e-courses that requires reviewing by specialists, but also the way they are designed and provided to attendees.
CE e-learning courses should be validated regarding its facilitation of knowledge creation. We argue that for this scope the pre- and post-test method is relevant. Besides, we encourage implementing questionnaires on acceptance into e-courses to receive feedback from users and check the level of satisfaction. Furthermore, users should be provided with the possibility to communicate with a tutor and other users (asynchronously, like mailing list or fora and synchronously, like Internet instant messengers, e.g. Skype or Yahoo! Messenger).
The phenomenon of e-learning is very dynamic and it is difficult to predict its exact place and shape in the lifelong learning process in the near future. Undoubtedly, e-learning is going to be more relevant in the future than it is now, and play a larger role in the continuing education of healthcare professionals.
Limitations and recommendations for future studies
The study was not designed as an experiment with a control group, but using a pre- and post-test in a real-life setting. This means that we cannot rule out the possibility that knowledge increase may result from other sources. However, the naturalistic setting contributes to increased ecological validity.
The participation rate in completing pre-and post-test was low (34%) due to the voluntary nature of the pre-test. The same situation applied to the voluntary acceptance questionnaire. The number of attendees who took part in both experiments was, however, reasonably high: 315 in the pre- and post-test and 238 in the acceptance questionnaire. Nevertheless, because of lack of available data about the differences between the respondents and the non-respondents, we cannot rule out the fact that the participants could be biased in their representation. It is reasonable to assume that pharmacists, who do not favour e-learning, will not apply voluntarily to e-courses. Future studies should thus aim to analyse reasons for non-participation in e-courses.
The current study contributes with knowledge on acceptance and increased learning which are crucial for implementing new approaches to education. Following Kirkpatrick’s model of educational evaluation, next steps involve change in behaviour and impact on practice [20]. Future studies should aim for reaching these dimensions in order to establish the effectiveness of e-learning in CPE.
Furthermore, researches are invited to compare different types of platforms and course designs. This is a first step towards increasing knowledge and acceptance for e-learning in this user group (pharmacists in CE).
E-learning enhances significantly educational opportunities for pharmacists. However, this potential requires a certain level of institutional readiness in human and infrastructural resources. One of the major tasks for pharmacy faculties and other health education providers is to find optimal methods to incorporate e-learning into the educational process [21].
