Rohana Marasinghe

This study investigated the level of current use of ICT in general practice in Sri Lanka. The total number of 52 (74 percent) doctors completed and returned the questionnaire which was designed to examine the types of applications, the level of ICT use and the perceptions of GPs about the use of technology in their routine practice. This study found that the tools such as telephone and mobile phones are widely used in healthcare settings. However, the use of technologies including computers, PDAs and the Internet is very limited. Doctors have a positive attitude towards the technologies, and they are keen to use these tools assuming that the ICT may provide them opportunity to improve efficiency and the quality of service. The limited access to new technologies and poor infrastructure are some of the main barriers to wider use of ICT in healthcare settings.

Background In 2007, the Faculty of Medical Sciences, University of Sri Jayewardenepura revised its medical curriculum from discipline-based to one that was student-centered and integrated. This study aimed to evaluate the perceptions of students regarding the educational environment and compare them to those prior to curricular revision. Methods The Dundee Ready Education Environment Measure (DREEM) questionnaire was administered to all volunteering students enrolled in the medical degree programme at the time of the study (n = 595). Results were compared to DREEM scores obtained prior to curricular revision. Results The overall DREEM score and sub-scale scores were positive and showed improvement compared to previous scores. The score for Students’ Perceptions of Atmosphere showed progression from ‘there are many issues which need changing’ to the next highest category ‘a more positive attitude’. The mean scores in pre-clinical, para-clinical and clinical phases also showed an impr...

This chapter reviews the rare use of telemental health modalities in Sri Lanka and challenges facing nationwide implementation of these services in this resource-limited setting. As in other developing countries, cost of, and access to, appropriate infrastructure are key constraints in using such advanced technologies in health service delivery. While healthcare providers and policymakers have realized the value of telemental health as a useful tool, challenges to its implementation remain. These challenges include lack of technology, appropriate infrastructure, knowledge, and skills. This chapter will delve into discussing the current approaches to implement TMH through educating the General public and disseminating mental health services in Sri Lanka.

We developed an electronic Health Information Management System (HIMS) for Public Health Midwives (PHMs) in Sri Lanka. We conducted a needs analysis amongst 16 PHMs, which found that they spent most of their time managing health records. The HIMS was designed so that it could accept data from the PHMs, and generate reports which could be used by the PHMs themselves as well as by their supervisors. The HIMS was trialled by a group of 16 PHMs in a remote area of the Ratnapura district of Sri Lanka. Mini-laptops with the software were distributed to the PHMs and they were given the necessary training. They started entering historical data from the registers into the system by themselves. Nearly 10,000 public health records were generated in the first three months. In a subsequent survey, the PHMs all gave positive answers indicating that they were happy with the pilot system, they would like to continue using it to enhance their service and they wanted to see it expanded across the whole of Ratnapura district. The system seems to be a practical solution for the field activities of PHMs in Sri Lanka.

We conducted a randomized controlled trial to test whether a Brief Mobile Treatment (BMT) intervention could improve outcomes relative to usual care among suicide attempters. The intervention included training in problem solving therapy, meditation, a brief intervention to increase social support as well as advice on alcohol and other drugs, and mobile phone follow-up. The effect of the intervention was measured in terms of a reduction in suicidal ideation, depression and self-harm at Baseline, six and 12 months. A wait-list control group received usual care. A total of 68 participants was recruited from a Sri Lankan hospital following a suicide attempt. Participants who received the intervention were found to achieve significant improvements in reducing suicidal ideation and depression than those receiving usual care. The BMT group also experienced a significant improvement of social support when compared to the control group. However, the BMT group did not demonstrate a significan...

Compared to other fields (such as media, banking and communication), the integration of information and communication technologies (ICT) in health has been slow. Among other factors, the lack of systematic education has been identified as a significant barrier. The use of ICT in healthcare delivery is widely known as e-Health. Evidence shows that if used in right context, e-Health can be efficient and cost effective. While designing e-Health curriculum, there are a number of factors to be considered. Due to the specific nature of the subject matter and the learners, the traditional teaching methods and pedagogical constructs may not be suitable. The choice of education methods must be based on the capacity of achieving the learning outcomes. E-Learning has proven to be an effective way of delivering education, particularly for rural and remote learners. Based on blended learning model, E-Health teaching at the Centre for Online Health University of Queensland, Australia has shown its capacity to provide a unique learning experience to students. While designing e-Health curriculum, a particular attention has been paid to aspects such as flexibility of learning processes, students' control in learning, self observation and self evaluation. These are, in fact, core principles of self-regulated learning (SRL) that have been incorporated in the teaching and learning process of e-Health. This chapter sets out to examine in details the elements of SRL embedded in e-Health teaching and the role of SRL in maximizing the learning outcomes.

We developed, implemented and evaluated a web-based continuing professional development (CPD) programme on medical genetics. Development of the CPD programme followed the ADDIE model, i.e. Analysis, Design, Develop, Implement and Evaluation. An invitation to participate in a needs analysis survey was sent to all doctors on the email list of the Sri Lanka Medical Association. A total of 129 completed surveys was received (57% of the 228 who accessed the online survey). The average age of respondents was 42 years (range 27-81). The male: female ratio was approximately 2 : 1. Almost all respondents (96%) selected web-based CPD programmes, or web-based and conventional lectures, as their preferred method of learning. The programme was piloted on a group of 10 doctors. The average pre-knowledge score was 40.3 and the post-knowledge score was 62.1 marks out of 100 (P = 0.002). We conclude that a web-based CPD programme on medical genetics is feasible in Sri Lanka.

The recent introduction of the Dundee Ready Education Environment Measure (DREEM) has fulfilled a long-felt need for a test instrument specifically meant to evaluate health professions education institutions. It was intended in this study to ascertain the overall DREEM score for the newly established Faculty of Medical Sciences of University of Sri Jayewardenepura (FMS/USJ), Sri Lanka and to compare the DREEM score of the students in the pre-, para- and clinical phases of the traditional curriculum practiced in this school. A total of 339 students belonging to the pre- (n = 147), para- (n = 116) and clinical (n = 76) phases of the medical course participated in this study. The DREEM questionnaire was administered face-to-face after one of their routine lectures to each group of students. The age of the students ranged from 20 to 28 years and the gender distribution was almost equal. The overall DREEM score was 108 (54%) for the pooled data for all three phases. There was no significant difference on the overall DREEM score obtained by each phase of students. The overall DREEM scores of pooled data and also for each domain indicated that the position of the FMS/USJ qualifies to be placed just on the third grade (one below the best) within the overall DREEM scale. However, on analysis of the responses for each domain, Students' Perception of Teachers (SPT), Students' Academic Self-Perceptions (SAP) and Students' Social Self-Perceptions (SSP) showed significant difference between the pre-, para- and clinical phases. Similarly, 22 out of the 50 items showed significant differences between the pre- and clinical phases. Overall, the DREEM demonstrated compatibility of its scores along with the gradual development that took place at this medical school over the last 10 years. Thus, the DREEM could be utilized in a variety of situations.