title: Evaluation of Computer-Based Training for Health Workers in Echocardiography for RHD.
abstract: The implementation of screening for rheumatic heart disease at a population-scale would require a considerable increase in human resources. Training nonexpert staff in echocardiography requires appropriate methods and materials.
  
  
  
  This pre/post study aims to measure the change in the knowledge and confidence of a group of health workers after a computer-assisted training intervention in basic echocardiography for rheumatic heart disease.
  
  
  
  A syllabus of self-guided, computer-based modules to train nonexpert health workers in basic echocardiography for rheumatic heart disease was developed. Thirty-eight health workers from Uganda participated in the training. Using a pre/post design, identical test instruments were administered before and after the training intervention, assessing the knowledge (using multiple-choice questions) and confidence (using Likert scale questions) in clinical science and echocardiography.
  
  
  
  The mean total score on knowledge tests rose from 44.8% to 85.4% (mean difference: 40.6%, 95% confidence interval [CI]: 35.4% to 45.8%), with strong evidence for an increase in scores across all knowledge theme areas (p < 0.001). Increased confidence with each key aspect was reported, and there was strong evidence for an increase in the mean score for confidence scales in clinical science (difference: 7.1, 95% CI: 6.2 to 8.0; p < 0.001) and echocardiography (difference: 18.3, 95% CI: 16.6 to 20.0; p < 0.001).
  
  
  
  The training program was effective at increasing knowledge and confidence for basic echocardiography in nonexpert health workers. Use of computer-assisted learning may reduce the human resource requirements for training staff in echocardiography.
authors.affiliation: Department of Paediatrics, Centre for International Child Health, University of Melbourne, Melbourne, Australia; Group A Streptococcal Research, Murdoch Childrens Research Institute, Melbourne, Australia. Electronic address: Daniel.Engelman@rch.org.au.
authors.forename: Daniel
authors.initials: D
authors.lastname: Engelman
authors.affiliation: Uganda Heart Institute, Mulago National Referral Hospital, Makerere University, Kampala, Uganda.
authors.forename: Emmy
authors.initials: E
authors.lastname: Okello
authors.affiliation: Department of Cardiology, Children's National Health System, Washington, DC, USA.
authors.forename: Andrea
authors.initials: A
authors.lastname: Beaton
authors.affiliation: Marian Wright Edelman Institute, San Francisco State University, San Francisco, CA, USA; WiRED International, San Francisco, CA, USA.
authors.forename: Gary
authors.initials: G
authors.lastname: Selnow
authors.affiliation: Global and Tropical Health, Menzies School of Health Research, Darwin, Australia.
authors.forename: Bo
authors.initials: B
authors.lastname: Remenyi
authors.affiliation: Department of Haematology, Oxford University Hospitals NHS Trust, Oxford, United Kingdom.
authors.forename: Caroline
authors.initials: C
authors.lastname: Watson
authors.affiliation: Case Western Reserve University School of Medicine, Cleveland, OH, USA; University Hospitals Harrington Heart and Vascular Institute, Cleveland, OH, USA.
authors.forename: Chris T
authors.initials: CT
authors.lastname: Longenecker
authors.affiliation: Department of Cardiology, Children's National Health System, Washington, DC, USA.
authors.forename: Craig
authors.initials: C
authors.lastname: Sable
authors.affiliation: Group A Streptococcal Research, Murdoch Childrens Research Institute, Melbourne, Australia.
authors.forename: Andrew C
authors.initials: AC
authors.lastname: Steer
mesh_terms: D000328:Adult; D000368:Aged; D002983:Clinical Competence / Q000592:standards; D003194:Computer-Assisted Instruction; D004452:Echocardiography; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000193:education*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012214:Rheumatic Heart Disease / Q000000981:diagnostic imaging*; D013663:Teaching; D014454:Uganda