Page 290 - SAHCS HIVMed Journal Vol 20 No 1 2019

Page 6 of 9 Original Research

TABLE 3: Increased clinician confidence in managing patients based on their perceived usefulness of the group as a learning tool (n = 91).
Variable Greater clinical confidence (%) OR 95% Confidence interval p
Used guidance to manage patients 91 48.13 4.99–464.49 < 0.05
Referred to old chat cases 91 21.42 4.39–104.84 < 0.05
New clinical insights 90 23.75 3.95–142.88 < 0.05
Practical application of pre-existing knowledge 94 Undefined Undefined < 0.05
Guidance according to national or international guidelines 89 Undefined Undefined < 0.05
OR, odds ratios.

TABLE 4: Clinician recommendation of the WhatsApp group based on their perceived usefulness of it as a learning tool (n = 91).
Variable Recommend group (%) OR 95% Confidence interval p
Used guidance to manage patients 89 1.69 0.17–16.1 0.32
Referred to old chat cases 90 2.64 0.46–14.95 0.16
New clinical insights 93 17.33 3.13–96.01 < 0.05
Practical application of pre-existing knowledge 93 12.83 2.55–64.56 < 0.05
Guidance according to National or international guidelines 91 20 1.63–245.63 < 0.05
OR, odds ratios

TABLE 5: Clinician recommendation of the WhatsApp group based on their level distributed healthcare settings. Our research adds to the
of engagement in the group (n = 91) literature by further clarifying that the knowledge gained
Variable Recommend OR 95% Confidence p
group (%) interval (whether from peers or specialists) in belonging to such a
Posted responses 88 0.83 0.19–3.28 0.4 group aids in the application of new clinical insights and
Posted questions 88 0.97 0.24–3.89 0.46 previous medical knowledge, as well as contributing to
Followed group 93 4.79 1.19–21.10 0.01 clinical confidence by facilitating distance learning.
OR, odds ratios
Lastly, our study found that participants were more likely
posting of cases or responses, was regular. The results to recommend the group to other colleagues if they had
further demonstrated that there was a statistically significant followed the group regularly (OR 4.79), and in those
association between engagement in the group and increased who reported the group as a useful learning tool. The
clinical confidence – those who followed the group regularly investigators therefore surmised that the WhatsApp group
were 8.44 times more likely to report an increase in clinical seems to have promoted good group engagement which,
confidence and 3.8 times more confident if they posted a in turn, facilitated learning, decreasing professional
case. This correlates with findings by Raiman et al., who isolation and produced a recommendation of a similar
discussed in their article that the use of mobile applications platform to other colleagues. Such a mobile learning
has been shown to increase student participation and platform is therefore an important adjunct to current CME
therefore foster improved learning. Similarly, Rambe et al. practices. E-learning (of which WhatsApp forms a part)
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also reported that WhatsApp facilitated, in learners, the can result in greater educational opportunities for
ability to more confidently engage with peers and participants, while at the same time enhancing student
educators. 19
effectiveness and efficiency, as is the reported outcome in
our study. 22
This form of engagement and success can be described
through the theory of cooperative learning. In cooperative Clinical confidence in managing complicated
learning, students who maximally engage in a group are HIV and TB cases
able to extend their current knowledge base, as they are in
control of the discussion construct. In our study’s context, The majority of the participants in the study agreed that
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participants posted a case they are most interested in and they had gained greater clinical confidence in managing
there develops a close relationship between theory, research their patients after participating in the group. The findings
and a practical working through the case; this underpins showed that there was also an improvement in clinical
long-term retention of knowledge and maximises student confidence among those participants who perceived the
learning. 21 group as a useful learning tool (it has been previously
mentioned how engagement in the group had a similar
Furthermore, the participants also reported that the group effect). Participants who used the chat group guidance to
gave them new clinical insights; helped them to practically manage their patients were 48 times more likely to feel
apply pre-existing knowledge and felt that the guidance was clinically confident. There was an increase in clinical
aligned with international or national guidelines. In a systemic confidence in those who referred to old chat cases (OR
review of medical literature, Kamel Boulos et al. found 21.42) and those who gained new clinical insights
collective evidence that WhatsApp has been successfully used while participating in the group (OR 23.75). Raiman et al.
in health and medical education and learning. They also reported similar findings in their study – a WhatsApp group
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concluded that apps can help to create virtual communities provided a unique environment to be able to quickly
of enquiry and practice, and bridge distances of busy access learning resources while participating in a discussion

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