Table 1.

Advantages and challenges of online continuing professional development programmes

Advantages	Description
Cost effectiveness	E-learning allows better use to be made of existing educational resources and the delivery of good quality content while working around outdated practices in training institutions and responding to the growing need for change in the field of health workforce education.11 40
“Just-for-you” learning	Learning programmes can be customised to the needs of individual participants, who can access a wide range of education resources and can select and use them in the manner best suited to their own learning goals and interests.35
“Just-in-time” learning	Learning programmes make educational resources available to participants whenever they need them.40
On-the-job learning	Learning programmes can be delivered on site (ie, within health facilities). On-the-job learning promotes the integration of theory and practice and makes continuing professional development programmes more educationally effective and relevant to health workers’ day-to-day clinical practice.35 40 41
Globalisation of health workforce education	E-learning can help standardise health workforce education across countries and overcome differences, by making content universally available. It can also promote the development of “international learners” by facilitating collaboration between health workers across the globe.42
Self directed learning	Online programmes for continuing professional development allow health workers to complete the training at a self directed pace.35 43-45 These programmes overcome one of the most commonly reported challenges among health workers which is the lack of time to engage in continuing professional development while working full time.35 46
Improved digital literacy	E-learning can help build digital competency among health workers by enhancing their understanding of how information and communications technology can be used to improve access to and quality of healthcare services11
Challenges
Acceptability among health workers	The success of online programmes for continuing professional development depends on several factors, including the extent to which health workers embrace new technologies and their level of digital literacy.47 48 For instance, participants who are not familiar with the technologies used for the course will likely not engage in or complete the training, unless they receive adequate support and technical assistance35
Technological challenges	Technological challenges, such as access to the necessary equipment (eg, computers, handsets, and tablets), and sound and network quality are among the main barriers to completing online programmes for continuing professional development, especially in low and middle income countries and rural areas.35 49 Potential solutions to technological challenges, which disproportionately affect women, include the use of radios as an alternative to the internet or mobile telephones, or the provision of devices for educational purposes.
Insufficient financial resources	The lack of funding to develop and implement e-learning programmes is an important barrier in many countries.11 Thus, new models of funding online programmes for continuing professional development need to be developed.47 48
Poor evaluation methods	Most online programmes for continuing professional development have not been evaluated or have only been evaluated by assessing participant engagement, satisfaction, and educational outcomes. Assessments of transfer of learning to practice and the effect on health outcomes are largely absent.50 Hence, more thorough evaluation and longitudinal analyses of the content areas and activities in programmes for continuing professional development are needed, as well as economic evaluations.36 51 52
Assessment of achievement of learning objectives and educational outcomes	While participants’ newly acquired knowledge and skills can be evaluated through online platforms, clinical competence can only be assessed in person. Competency based education has a whole of programme approach to learning and assessment. The method of assessment (eg, online versus face to face) must be appropriate for the educational outcomes being assessed.28
Inadequate standards and formal certification	Standards of quality for online programmes for continuing professional development must be developed based on widely agreed best practices and the latest available evidence. In addition, formally certified courses are needed.35 53 54