title: Blended learning across universities in a South-North-South collaboration: a case study.
abstract: BACKGROUND
  Increased health research capacity is needed in low- and middle-income countries to respond to local health challenges. Technology-aided teaching approaches, such as blended learning (BL), can stimulate international education collaborations and connect skilled scientists who can jointly contribute to the efforts to address local shortages of high-level research capacity. The African Regional Capacity Development for Health Systems and Services Research (ARCADE HSSR) was a European Union-funded project implemented from 2011 to 2015. The project consortium partners worked together to expand access to research training and to build the research capacity of post-graduate students. This paper presents a case study of the first course in the project, which focused on a meta-analysis of diagnostic accuracy studies and was delivered in 2013 through collaboration by universities in Uganda, Sweden and South Africa.
  
  
  METHODS
  We conducted a mixed-methods case study involving student course evaluations, participant observation, interviews with teaching faculty and student feedback collected through group discussion. Quantitative data were analysed using frequencies, and qualitative data using thematic analysis.
  
  
  RESULTS
  A traditional face-to-face course was adapted for BL using a mixture of online resources and materials, synchronous online interaction between students and teachers across different countries complemented by face-to-face meetings, and in-class interaction between students and tutors. Synchronous online discussions led by Makerere University were the central learning technique in the course. The learners appreciated the BL design and reported that they were highly motivated and actively engaged throughout the course. The teams implementing the course were small, with individual faculty members and staff members carrying out many extra responsibilities; yet, some necessary competencies for course design were not available.
  
  
  CONCLUSIONS
  BL is a feasible approach to simultaneously draw globally available skills into cross-national, high-level skills training in multiple countries. This method can overcome access barriers to research methods courses and can offer engaging formats and personalised learning experiences. BL enables teaching and learning from experts and peers across the globe with minimal disruption to students' daily schedules. Transforming a face-to-face course into a blended course that fulfils its full potential requires concerted effort and dedicated technological and pedagogical support.
authors: Department of Public Health Sciences (Global Health/IHCAR), Karolinska Institutet, Tomtebodavägen 18A, 171 77, Stockholm, Sweden. myroslava.protsiv@ki.se.
authors: Myroslava
authors: http://orcid.org/0000-0002-7787-5898
authors: M
authors: Protsiv
authors: Department of Public Health Sciences (Global Health/IHCAR), Karolinska Institutet, Tomtebodavägen 18A, 171 77, Stockholm, Sweden.
authors: Senia
authors: S
authors: Rosales-Klintz
authors: College of Health Sciences, Makerere University, Kampala, Uganda.
authors: Freddie
authors: F
authors: Bwanga
authors: Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, 1151 Richmond St, N6A 3K7, London, Ontario, Canada.|Faculty of health sciences, Stellenbosch University, Francie Van Zijl Dr, Tygerberg Hospital, Cape Town, 7505, South Africa.
authors: Merrick
authors: M
authors: Zwarenstein
authors: Department of Public Health Sciences (Global Health/IHCAR), Karolinska Institutet, Tomtebodavägen 18A, 171 77, Stockholm, Sweden.
authors: Salla
authors: S
authors: Atkins
mesh_terms: D001290:Attitude; D057191:Capacity Building; D003142:Communication; D003299:Cooperative Behavior; D003479:Curriculum; D019049:Developed Countries; D003906:Developing Countries; D005062:European Union; D006801:Humans; D007182:Income; D007391:International Cooperation; D020407:Internet; D007858:Learning; D017145:Models, Educational; D012106:Research / Q000193:education*; D012108:Research Personnel; D013334:Students; D013548:Sweden; D013663:Teaching; D014454:Uganda; D014495:Universities
keywords: Blended learning; Doctoral training; Health services; Health systems; Higher education; Research capacity building; e-learning