Use and effect of distance education in health care [i.e. health care] : what do we know?

This paper reviews the current body of published and unpublished research on the use and effect of distance education in health care. Special focus is made on its implementation in developing country setting, studies that use objective evaluation methodologies, and on areas needing further research. Major conclusions are noted below. At the inservice level in both the developed and developing world, distance education courses in health care are here to stay. No longer maligned as the inferior alternative to traditional training, distance education programs are in demand by the busy inservice professional. Though the research is plagued by biases, enough experiences have shown that health professionals successfully pass short courses related to their current employment. However, such experiences in the developing world remain isolated and have not been sustained or replicated over the long-term. At the preservice level, however, desires for socialization with peers and the prestige of going to a "real" university still dominate. As long as distance education has lower prestige and is less efficient in terms of graduation rates, it will remain a poorer quality alternative to conventional education for those who could not afford to or failed to get into the conventional university system. There is no question that distance education has positive effects on student learning. The benefits that health workers, no matter where they come from, will derive from any training modality depends largely on good instructional design and an adequate infrastructure to support the program. More research should be focused on the optimal delivery of distance education programs in a resource-strained environment to increase such benefits.