Collaborative Online Interactions and Clinical Skills Acquisition of Students at Kenya Medical Training College Campuses in Rift Valley
DOI:
https://doi.org/10.70619/vol6iss5pp58-77821Keywords:
Collaborative online interactions, clinical skills, teacher-student interactions, peer-student interactions, forum discussion, blended learningAbstract
The acquisition of clinical skills is a central objective of a country’s health science education. However, a deficiency in quality clinical skills among students and healthcare workers persists in Kenya. Blended learning, comprising collaborative online interactions (COI) among instructors and students, possesses the capability to improve learners' skills and deliver a learning experience that is more adaptable and flexible. However, there is a lack of empirical studies investigating the relationship between collaborative online interactions and clinical skills acquisition (CSA) in Kenya. The purpose of this study was to determine the relationship between collaborative online interactions and students' acquisition of clinical skills at Kenya Medical Training College Campuses in the Rift Valley, Kenya. Specifically, the study analyzed the effects of teacher-student (T-S) and Peer-Student (P-S) interactions and discussion forums on CSA. Further, the study analyzed the effects of COI on the components of CSA. The study used a cross-sectional design. The target population for the study comprised 13,174 students and 62 heads of departments (HODs) in 16 Kenya Medical Training Colleges campuses, from which 373 students and 9 HODs were sampled using stratified random and purposive sampling. Data were collected using structured questionnaires and key informant interviews. Results showed that all the components of COI: T-S interactions (b=0.201, t=6.28, p<0.001), P-S interactions (b=0.111, t=1.98, p=0.048), and forum interactions (b=0.125, t=2.34, p=0.018), significantly predicted CSA. Teacher-student interactions were the most important predictor of CSA (predictive score = 0.75), followed by forum discussion (predictive score = 0.13), and, lastly, P-S interactions (predictive score = 0.12). This study recommends that medical education colleges implement instructor-guided online teacher-student and peer-student interactions, as well as online forum discussions, as part of a blended learning approach to effectively acquire clinical skills.
References
Bach, A., & Thiel, F. (2024). Collaborative online learning in higher education—quality of digital interaction and associations with individual and group-related factors. Front. Educ. 9, 1356271. doi: 10.3389/feduc.2024.1356271
Carvalho, D. P., Azevedo, I. C., Cruz, G. K., Mafra, G. A., Rego, A. L., Vitor, A. F., ...& Júnior, M. A. F. (2017). Strategies used for the promotion of critical thinking in nursing undergraduate education: A systematic review. Nurse education today, 57, 103–107.
Celestin, M., Vasuki, M., Kumar, A. D., & Sujatha, S. (2024). The Future of Education. DK International Research Foundation.
Chaeruman, U., Wibawa, B., & Syahrial, Z. (2018). Creating a blended learning model for an online learning system in Indonesia. International Journal of Engineering & Technology, 7 (3.36), 156–159.
Chatterjee, S., & Simonoff, J.S. (2012). Handbook of regression analysis. John Wiley & Sons, Inc. doi: 10.1002/9781118532843.
Cooney, M.A., Iademarco, M.F., Huang, M., MacKenzie, W.R. & Davidson, A.J. (2018). The public health community platform, electronic case reporting, and the digital bridge. J Public Health Manag Pract., 24(2),185–9.
Creswell, J. W. (2014). Research design: Qualitative, quantitative, and mixed methods approaches, 4th edition. Sage.
Dangwal, K. L. (2017). Blended learning: An innovative approach. Universal Journal of Educational Research, 5(1), 129–136.
Elder A. (2018). Clinical skills assessment in the twenty-first century. Medical Clinics of North America 102(3):545–558 DOI 10.1016/j.mcna.2017.12.014.
Gillies, R. M. (2016). Cooperative learning: Review of research and practice. Aust. J. Teach. Educ. 41, 39–54. doi: 10.14221/ajte.2016v41n3.3
Gong, J., Ruan, M., Yang, W., Peng, M., Wang, Z., Ouyang, L. & Yang, G. (2021). Application of blended learning approach in clinical skills to stimulate active learning attitudes and improve clinical practice among medical students. PeerJ, 9:e11690 http://doi.org/10.7717/peerj.11690
Greene, W.H. (2008). Econometric Analysis 6th ed. Prentice Hall.
Jadhav, E.D., Holsinger, J.W., Anderson, B.W., & Homant, N. (2017). Leadership for public health 3.0: a preliminary assessment of competencies for local health department leaders. Front Public Health, 5, 272.
Jeong, H., & Hmelo-Silver, C. E. (2016). Seven affordances of computer-supported collaborative learning: how to support collaborative learning? How can technologies help? Educ. Psychol. 51, 247–265. doi: 10.1080/00461520.2016.1158654
Johnson, D. W., & Johnson, R. T. (2009). An educational psychology success story: social interdependence theory and cooperative learning. Educ. Res. 38, 365–379. doi: 10.3102/0013189X09339057
Kenya Medical Training College (2019). Expansion policy: Training for better health
Kimathi, L. (2017). Challenges of the devolved health sector in Kenya: teething problems or systemic contradictions? Africa development, 42(1), 55–77.
Kintu, M. J., Zhu, C., & Kagambe, E. (2017). Blended learning effectiveness: The relationship between student characteristics, learning environment, and academic performance. International Journal of Educational Technology in Higher Education, 14(1), 1-18.
Kweya J. O, Konyole O. S, Wanzala M (2020). Factors Influencing Clinical Performance of Diploma Nursing Students in Kenya Medical Training Colleges in Western Kenya. International Journal of Healthcare Sciences, 8(1), 136-142).
La Chimea, T., Kanji, Z., & Schmitz, S. (2020). Assessment of clinical competence in competency-based education. Canadian Journal of Dental Hygiene, 54(2), 83.
Leidl D, Ritchie L & Moslemi N (2020). Blended learning in undergraduate nursing education–A scoping review. Nurse Education Today, 86, 104318.
Lewis, T. P., Roder‐DeWan, S., Malata, A., Ndiaye, Y., & Kruk, M. E. (2019). Clinical performance among recent graduates in nine low‐and middle‐income countries. Tropical Medicine & International Health, 24(5), 620-635.
Niu, Y., Xi, H., Liu, J., Sui, X., Li, F., Xu, H., ... & Guo, L. (2023). Effects of blended learning on undergraduate nursing students’ knowledge, skills, critical thinking ability, and mental health: A systematic review and meta-analysis. Nurse Education in Practice, 72, 103786.
Noordzij, M., Tripepi, G., Dekker, F., Zoccali, C., Tanck, M., & Jager, K. (2010). Sample size calculations: Basic principles and common pitfalls. Nephrol Dial Transplant, 25, 1388-1393
Parker, S.T. (1979). Mind in society: The development of higher psychological processes. L.S. Vygotsky. American Anthropologist, 81(4). https://doi.org/10.1525/aa.1979.81.4.02a00580
Peramunugamage, A., Ratnayake, U., Karunanayaka, S., Barbosa, E., de Deus, W., Jayawardena, C., & de Silva, R. (2025). Monitoring collaborative interactions in online learning: insights from Moodle log records. Journal of Learning for Development, 12(2), 290–312.
Prihadi, M., Murtono, L., & Setiadi, G. (2021). Effectiveness of blended learning to improve critical thinking skills and student science learning outcomes. J. Phys.: Conf. Ser., 1823 012095. doi:10.1088/1742-6596/1823/1/012095
Shahkarami, F., Taghavi, A. A., Dolama, R. H., Khajavirad, N., Mirzazadeh, A., & Gandomkar, R. (2025). Students’ and faculty members’ perceptions of the online component of a blended internal medicine clerkship course: a mixed-method evaluation. BMC Medical Education, 25(1), 1221.
StataCorp. (2025). Stata 19 Structural Equation Modeling Reference Manual. College Station, TX: Stata Press.
Sterner, A., Sköld, R., & Andersson, H. (2023). Effects of blended simulation on nursing students’ critical thinking skills: A quantitative study. SAGE Open Nursing, 9, 23779608231177566.
Sapra, R.L. (2022). How to calculate an adequate sample size? In S. Nundy, A., Kakar, & Z. Bhutta (Eds.), How to practice academic medicine and publish from developing countries? (pp. 81-93). Springer. https://doi.org/10.1007/978-981-16-5248-6_9
Tucker, C. R., Wycoff, T., & Green, J. T. (2016). Blended learning in action: A practical guide toward sustainable change. Corwin Press.
van Dorresteijn, C., Fajardo-Tovar, D., Pareja Roblin, N., Cornelissen, F., Meij, M., Voogt, J., et al. (2024). What factors contribute to effective online higher education? A Meta-Review. Technol. Knowl. Learn., 1–32. doi: 10.1007/s10758-024-09750-5
VerLinden, J. (2010). A beginner’s guide to communication research. https://www.users.humboldt.edu.
Wachira, S., Karani, A., Kimani, S., & Mageto, I. (2020). Effect of Combining Clinical Teaching Tools on Clinical Judgment Skills of Undergraduate Nursing Students in Kenya.
Wachira, S., Mageto, I., & Mapesa, J. (2017). The Self-Assessed Clinical Judgment Competencies of Newly Graduated Nurses Post Internship in Kenya
Walsh, K. & Maloney, S. (2018). Self-directed learning using clinical decision support: Costs and outcomes. Br J Hosp Med., 79(7), 408–9.
Waqas, A., Khan, S., Sharif, W., Khalid, U. & Ali, A. (2015). Association of academic stress with sleeping difficulties in medical students of a Pakistani medical school: A cross-sectional survey. PeerJ;3, e840.
World Health Organization. (2020). State of the world’s nursing 2020: Investing in education, jobs and leadership. WHO. https://iris.who.int/server/api/core/bitstreams/5d564226-7418-4c10-9fb3-08d7e09626ec/content.
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