Internet or dvd for distance learning to isolated rural health professionals, what is the best approach?

Distance Learning (DL) is a means to overcome the barriers that prevent health workers access to medical education and training sessions to update their knowledge. The main objective of this study is to compare the knowledge acquisition among practitioners Heads of Health Based Center (HBC) for the management of hypertension in two training modalities, one interactive, via internet (by Visio conferencing and video Conferencing), and other non-interactive, via DVD in the three regions (Miarinarivo, Moramanga and Manjakandriana) of Madagascar.

This is a quasi-experimental study comparing two distance learning methodologies, one via internet (VS or VD) and the other via DVD before and after training. Ninety-two (92) Heads of HBC participated in the training, including 56 via the Internet (24 doctors and 32 paramedics) and 36 via DVD (24 doctors and 12 paramedics).

According to the training mode: the mean score of knowledge of the participants was 7 (+ -2) for two terms before training. It is 14 (+ -2.5) in the internet group (VS or VD) and 15 (+ -2.7) in the DVD group after training. The difference between the two groups was not significant p = 0.076. For doctors, the score was 7 (+ -3.1) via internet and 8 (+ -2.3) via DVD in pre test and 14 (+ - 2.4) via internet and 16 (+ -. 2.7) via DVD in post test, the difference between the two training methods was significant (p = 0.008). Among the paramedics, the results are the same for both conditions, 7 (+ - 2.4 to + -3.2) in pre test and 14 (+ - 2.2 to + -2.7) in post test.

Both training methods have improved participants' knowledge and the DVD mode is the first choice for Heads HBC of Madagascar with the majority located in remote areas.