RESOURCE: An Interactive Internet-Based Continuing Education Course on Sexually Transmitted Diseases for Physicians and Midwives in Peru
Background: Clinicians in developing countries have had limited access to continuing education (CE) outside major cities,
and CE strategies have had limited impact on sustainable change in performance. New educational tools could improve CE
accessibility and effectiveness.
Methodology/Principal Findings: The objective of this study was to evaluate an interactive Internet-based CE course on
Sexually Transmitted Diseases (STDs) management for clinicians in Peru. Participants included physicians and midwives in
private practice drawn from a census of 10 Peruvian cities. The CE included a three-hour workshop for improving Internet
skills, followed by a 22-hour online course on STD-syndrome-management, with subsequent educational support. The
course used case-based clinical vignettes tailored to local STD problems. Knowledge and reported practices on STD
management were assessed before, immediately after and at four months after completion of the course. Statistical analysis
included parametric tests-linear regression multivariate analysis, paired t-test and repeated measures ANOVA using SPSS
14.0. Of 1,071 eligible clinicians, 510 agreed to participate, as did an additional 132 public sector clinicians. Of these 642
participants, 619 (96.4%) completed the course, and 596 (96.3%) took the four-month follow-up evaluation. Physician and
midwife scores improved from 64.2% correct answers on the pre-test to 77.9% correct on the four-month follow-up test
(p,0.001). Most participants (95%) found the online course useful for their work needs. Self reported STD management
practices did not change.
Conclusions/Significance: Among physicians and midwives in Peru, an Internet-based CE course was feasible, acceptable
with high participation rates, and led to sustained improvement in knowledge at four months. Further studies are needed to
test it as a model for improving the training of physicians, midwives, and other health care providers.