A descriptive analysis of the role of a WhatsApp clinical discussion group as a forum for continuing medical education in the management of complicated HIV and TB clinical cases in a group of doctors in the Eastern Cape, South Africa

摘要

As South Africa's (SA) HIV programme increases in size, HIV/TB cases occur that are often beyond the clinical scope of primary healthcare clinicians. In SA's Eastern Cape (EC) province, health facilities are geographically widespread, with a discrepancy in specialist availability outside of academic institutions. The aim of this study is to describe WhatsApp and its use as an alternative learning tool to improve clinicians' access to specialised management of complicated HIV/TB cases. To analyse clinicians' use of the WhatsApp chat group as a learning tool; to assess clinicians' confidence in managing complicated HIV and TB patients after participating in the WhatsApp case discussion group; to describe the perceived usefulness of the chat group as a learning tool; to understand clinicians' knowledge and use of informed consent when sharing patient case details on a public platform such as WhatsApp. An observational, cross-sectional study was conducted among a group of clinicians from the EC that formed part of a WhatsApp HIV/TB clinical discussion group. Data were collected using a structured anonymous Internet questionnaire and analysed with Epi Info, using descriptive and analytic statistics. The analysis found the majority of participants had gained new clinical confidence from group participation. This was associated with the increased group engagement in group follow-up (odds ratio [OR] 48.13 [95% confidence interval [CI] 4.99-464.49]); in posting questions (OR 3.81 [95% CI 1.02-18.48]); in reports of 'new' clinical insights (OR 23.75 [95% CI 3.95-142.88]); in referencing old case material (OR 21.42 [95% CI 4.39-104.84]) and in the use of peer guidance to manage cases (OR 48.13 [95% CI 4.99-464.49]). However, there was a discrepancy in participants' knowledge and actual use of informed consent when posting patient details on social media. Our study findings support the use of WhatsApp in a medical setting as an effective means of communication, long distance learning and support between peers and specialists.