Abstract
Objective Access to rheumatology education and care is limited in many African countries, leading to suboptimal clinical care and poor outcomes for patients. Virtual education is a feasible means to deliver curricula remotely. A virtual rheumatology course for medical residents in sub-Saharan Africa was developed. We describe the course and its evaluation.
Methods An annual 16-week virtual rheumatology program was delivered to internal medicine residents in Rwanda between 2021 and 2024. Lectures on core rheumatology topics were provided, in English, by an international faculty that included lecturers from Africa to ensure regionally relevant content. In 2023, the virtual course was supplemented by a weeklong in-person visit. Participants completed questionnaires to evaluate their experiences with the course, their confidence in evaluating rheumatologic conditions, and any recommendations for course improvement. Instructors evaluated their experiences with the course. Summary statistics and representative quotations are provided.
Results Postcourse evaluations were available from 55 residents and 7 instructors. All residents who completed the questionnaires reported the lectures were useful. Many (22/54 [41%]) requested additional time for case discussions and in-person teaching. After the course, residents rated their confidence in assessing and managing rheumatologic cases as good (median 7/10 [range 4-10]). Conflicting clinical duties prevented most residents (42/55 [76%]) from attending all lectures. Instructors reported some challenges, especially insufficient interaction during virtual lectures.
Conclusion A virtual rheumatology course is a feasible means to deliver rheumatology education to medical trainees but does not replace the need for in-person education. The program is adaptable to other regions with limited rheumatology resources.
Plain Language Summary
There are very few rheumatologists in many countries in sub-Saharan Africa including Rwanda, which has a population of nearly 14 million. Some African countries have no rheumatologists. Rheumatology teaching and rheumatology care is often provided by nonrheumatologists.
We ran an annual virtual rheumatology course for internal medicine residents in Kigali, Rwanda (2021-2024). The course was integrated into their training program in collaboration with the Department of Internal Medicine, University of Kigali, Rwanda. Teachers were rheumatologists from Africa, North America, and Europe. Several teachers went to Rwanda to provide additional hands-on teaching in 2023. Each year, students and teachers provided written anonymous feedback on their experiences with the course.
The students found the course to be valuable and to have improved their knowledge of rheumatology. Students felt that the topics and content were appropriate for the local conditions of medical practice in their resource-limited regions. Several residents expressed interest in further advanced rheumatology training. However, the students felt in-person teaching was best and asked teachers to continue to visit Kigali to supplement the virtual course. Some challenges were identified that were addressed when possible.
- Accepted for publication April 25, 2025.
- Copyright © 2025 by the Journal of Rheumatology
