An education program modified with e-learning brought equivalent outcomes in healthcare students' communication support for people with amyotrophic lateral sclerosis

Introduction: Patients with amyotrophic lateral sclerosis (ALS) often require augmentative and alternative communication (AAC) to support impaired communication. We evaluated the effectiveness of an e-learning program for healthcare students on communication support for patients with ALS, which was adapted from a previous face-to-face program.
Methods: The program included an 85-min preparatory session, 165-min AAC practice session, and 40-min review session. Fifty-five healthcare students completed the program with pre-/post-tests, AAC practices using a transparent communication board (Flick), Kuchimoji, the communication device, subjective burden based on the visual analog scale (VAS), and free-response comments. The participants completed the practice twice over a 6-month interval. Data were analyzed using the Wilcoxon signed-rank sum and chi-square tests. 
Results: The program was effective in improving knowledge and AAC skills, similar to the face-to-face version. The pre-/post-test scores significantly increased for beginners (from 70 to 80, P<.001) and experienced participants (from 75 to 80, P<.001). However, after 6 months, a significant decrease in the pre-/post-test scores was observed (from 80 to 75, P=.017). In AAC practice, the number of letters transmitted in 5 min significantly increased for Flick (beginner: 27, experienced: 30, P<.001) and Kuchimoji (beginner: 21, experienced: 24, P<.001), with a reduction in subjective burden according to the VAS ratio. Text mining revealed a high frequency of positive sentences in participants’ feedback regarding communication devices.
Conclusions: The e-learning program effectively improved ALS communication support knowledge and skills, with a lower perceived burden than face-to-face training.