Text box 2 Digital learning — reflections and lessons learned from VCH

The ED leadership team at VCH elected to support triage implementation with online learning for staff. The IITT module on Médecins Sans Frontières’ Tembo system was utilised [30].

As part of a multimodal approach to IITT training, clinicians were supported to access Tembo by visiting nurse advisors. Given that many VCH staff had never undertaken online learning, a hospital computer laboratory was utilised to ensure all participants were able to navigate the online modules (Fig. 1). When clinicians felt confident using the platform, they were able to continue their engagement with Tembo using computers in the ED.

Through an interval evaluation process, staff reported that use of the digital platform effectively augmented their learning. They found the modules to be highly beneficial because they were interactive and used case examples that were relevant to the VCH context. The prospect of a certificate of completion provided additional motivation.

The main challenge with this approach was computer literacy. As a manifestation of this, many clinicians did not have an email address, which is a Tembo login requirement. Visiting nurse advisors supported the creation of email addresses and encouraged local clinicians to set up an inbox on their smartphones for continued use. Although all nurses at VCH are issued with government email addresses, many had never accessed their accounts.

Despite these challenges, Tembo proved an effective means of conveying important triage principles and concepts. Additionally, because it is free to access, the platform remains an efficient and effective way of onboarding new ED staff.