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Author Notes:

E-mail: caitrinkelly@gmail.com

Contributed equally as senior authors: DLC and HMB.

Caitrin M. Kelly, Conceptualization, Data curation, Formal analysis, Funding acquisition, Investigation, Methodology, Project administration, Resources, Writing – original draft, Writing – review & editing

Holly Vins, Conceptualization, Data curation, Funding acquisition, Investigation, Methodology, Project administration, Resources, Writing – review & editing

Jennifer O. Spicer, Conceptualization, Data curation, Formal analysis, Funding acquisition, Investigation, Methodology, Project administration, Resources, Supervision, Writing – review & editing

Brittney S. Mengistu, Conceptualization, Funding acquisition, Investigation, Methodology, Project administration, Resources, Writing – review & editing

Daphne R. Wilson, Conceptualization, Investigation, Methodology, Project administration, Writing – review & editing

Miliard Derbew, Conceptualization, Funding acquisition, Investigation, Methodology, Project administration, Supervision, Writing – review & editing

Abebe Bekele, Conceptualization, Data curation, Investigation, Methodology, Project administration, Resources, Supervision, Writing – review & editing

Damen Haile Mariam, Conceptualization, Data curation, Investigation, Methodology, Project administration, Supervision, Writing – review & editing

Carlos del Rio, Conceptualization, Supervision

Russell R. Kempker, Formal analysis, Methodology, Supervision, Writing – review & editing

Dawn L. Comeau, Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Project administration, Resources, Software, Supervision, Writing – review & editing

Henry M. Blumberg, Conceptualization, Data curation, Formal analysis, Funding acquisition, Investigation, Methodology, Project administration, Resources, Software, Supervision, Writing – review & editing

Denis Bourgeois, Editor

Subjects:

Research Funding:

This study was supported in part by the Medical Education Partnership Initiative – Ethiopia (Grant number: T84HA21124-08-00), NIH Fogarty International Center (D43 TW010143), NIH National Center for Advancing Translational Science (UL1TR002378) and The Emory Global Health Institute (CK, HV, DW, BM).

Keywords:

  • Ethiopia
  • physician shortage
  • flooding policy
  • e-learning initiatives
  • attitude
  • practice
  • Likert scale
  • medical education

The rapid scale up of medical education in Ethiopia: Medical student experiences and the role of e-learning at Addis Ababa University

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Journal Title:

PLoS ONE

Volume:

Volume 14, Number 9

Publisher:

, Pages e0221989-e0221989

Type of Work:

Article | Final Publisher PDF

Abstract:

Background In response to a physician shortage in Ethiopia, the number of medical students admitted to public universities was rapidly increased through a “flooding” policy. Objectives To assess medical student perceptions on the impact of the “flooding” policy on medical education and e-learning initiatives, as well as plans for future emigration. Design A cross-sectional survey of medical students at AAU was implemented in 2014. Attitude and practice items were assessed using a Likert scale. Logistic regression analysis was performed to identify characteristics associated with an interest in future emigration. Results 673 (99.6%) of 676 students approached completed the survey, representing 39.5% of all 1705 medical students enrolled at AAU in 2014. Most students felt the “flooding” policy had a negative impact on their medical education and >90% felt there was not adequate infrastructure to support the increased student body. E-learning activities to accommodate increased class size included distribution of electronic tablets, but at the time of the survey only 34.8% of students still had a working tablet and 82.3% reported problems with internet connectivity. Most preclinical students (85.1%) who had attended live-streamed lectures preferred traditional classroom lectures. Half of the students (49.5%) intended to practice medicine in Ethiopia. Independent risk factors for planning to emigrate included age <21 years (aOR = 1.30, 95% CI 1.04, 1.97); having applied to medical school for reasons other than “wanting to be a physician” (aOR = 1.55, 95% CI 1.14, 2.20), and not believing that “flooding” policy would increase the number of physicians working in Ethiopia (aOR = 1.87, 95% CI 1.33, 2.58). Conclusions The “flooding” policy lead to significant educational challenges that were not fully alleviated by e-learning initiatives. Concomitant increases in resources for infrastructure development and faculty expansion are needed to maintain quality medical education. Additional research is needed on factors that influence medical graduates decision to emigrate.

Copyright information:

© 2019 Kelly et al.

This is an Open Access work distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/).
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