Health Informatics Education Effectiveness in Nepal (HI-EDU)

July 7, 2026 updated by: Dip Bahadur Singh, Axon Infotech Research Academy Pvt. Ltd.

Assessing the Comparative Effectiveness of Health Informatics Education: Knowledge Retention and Technological Awareness in Health Science Students

This study evaluates the effectiveness of a blended Health Informatics (HI) course (HI471) on knowledge retention and technology awareness among health science students in Nepal. Bachelor of Public Health (BPH) students (intervention group, n=17) received a 14-week HI471 course combining online, virtual, and in-person practical sessions. A control group of Bachelor of Pharmacy (B.Pharm) students (n=17) continued their standard curriculum without dedicated HI instruction. Both groups completed a validated 44-item knowledge assessment and an 11-item technology awareness survey at baseline (Week 1) and post-intervention (Week 15). The primary outcome was the between-group difference in knowledge gain scores. Results showed that BPH students significantly improved their total knowledge scores (median +31.5 points, r=0.879), while the B.Pharm control group showed no significant change. BPH students achieved 100% awareness of 9 out of 11 digital health tools at post-test. This study provides strong evidence that the HI471 blended course is highly effective in building informatics competencies in a low- and middle-income country (LMIC) academic setting. The study was retrospectively registered.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

This controlled pre-test/post-test quasi-experimental study with a non-equivalent control group evaluated the effectiveness of the Health Informatics-471 (HI471) blended course at Madan Bhandari Academy of Health Sciences (MBAHS) in Nepal. The intervention group (G1) consisted of all 17 Bachelor of Public Health (BPH) students enrolled in the 7th semester, who received the HI471 course. The control group (G2) consisted of 17 Bachelor of Pharmacy (B.Pharm) 7th-semester students, randomly sampled from 29 eligible students, who received no dedicated HI instruction. The HI471 course integrated three blended modalities over 14 weeks: (i) online asynchronous LMS instruction (pre-recorded lectures, readings, quizzes), (ii) live synchronous Google Meet sessions, and (iii) in-person practical laboratory sessions covering EHR platforms, DHIS2, SPSS/R, and telemedicine interfaces. A validated 44-item Health Informatics Knowledge Assessment Tool (with weighted partial-credit scoring, maximum 100 points) and an 11-item binary technology awareness instrument were administered at T1 (Week 1, baseline) and T2 (Week 15, post-intervention). The primary outcome was the between-group difference in total knowledge gain scores (Δ = T2 - T1), analyzed using non-parametric statistics (Mann-Whitney U, Wilcoxon signed-rank, Friedman, McNemar) with bootstrap effect sizes. The study demonstrated large, significant knowledge gains in the intervention group (median +31.5 points, r=0.824, p<0.001) compared to the control group, with robust findings across three pre-specified sensitivity analyses. The intervention group achieved near-complete technology awareness (100% on 9 out of 11 tools). This research addresses the evidence gap for controlled educational evaluations in low- and middle-income country (LMIC) academic settings. The study protocol was approved by the MBAHS Institutional Review Committee (IRC-134-082-083), and all participants provided written informed consent. The study was conducted in compliance with the Declaration of Helsinki (revised 2013). The study was registered retrospectively.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
34

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Nepal
    • Bagmati
      • Hetauda, Bagmati, Nepal, 31206
        • Madan Bhandari Academy of Health Sciences

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Active enrollment in the 7th semester of the Bachelor of Public Health (BPH) program (intervention group) or the Bachelor of Pharmacy (B.Pharm) program (control group) at Madan Bhandari Academy of Health Sciences (MBAHS).
  • Voluntary written informed consent obtained prior to any study procedure.
  • Completion of both T1 (Week 1, baseline) and T2 (Week 15, post-intervention) assessments.

Exclusion Criteria:

  • Withdrawal from the study before completion of all study procedures.
  • Incomplete paired data (missing T1 or T2 assessment).

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Other
  • Allocation: Non-Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: BPH Intervention Group
Bachelor of Public Health (BPH) 7th-semester students (n=17) who received the 14-week Health Informatics-471 (HI471) blended course, consisting of online asynchronous LMS instruction, live synchronous Google Meet sessions, and in-person practical laboratory work covering seven HI content domains.
Other: Health Informatics-471 Blended Course
A 14-week blended educational course combining: (i) online asynchronous LMS instruction (pre-recorded lectures, readings, quizzes); (ii) live synchronous Google Meet sessions (2 hours, 3 days per week); and (iii) in-person practical laboratory sessions (4 hours per week) covering Electronic Health Records (EHR), DHIS2, SPSS/R, and telemedicine interfaces. No drug, device, biological product, or surgical procedure was involved. This is a purely educational/behavioral intervention delivered in an academic setting.
No Intervention: B.Pharm Control Group
Bachelor of Pharmacy (B.Pharm) 7th-semester students (n=17) who continued their standard curriculum without any dedicated Health Informatics instruction. This group served as the non-equivalent control group.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Change in Total Health Informatics Knowledge Score
Time Frame: Baseline (Week 1) to post-intervention (Week 15)
Measured using the Health Informatics Knowledge Assessment Tool (HIKAT) - a validated 44-item multiple-select instrument with weighted partial-credit scoring. Scores range from 0 to 100 points, where higher scores indicate better health informatics knowledge. Administered to both groups at T1 (Week 1, pre-test) and T2 (Week 15, post-test). The primary causal contrast is the between-group difference in gain scores (Δ = T2 - T1), analyzed using Mann-Whitney U test with bootstrapped effect sizes.
Baseline (Week 1) to post-intervention (Week 15)

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Domain-Specific Knowledge Gains Across Six HI Content Areas
Time Frame: Baseline (Week 1) to post-intervention (Week 15)
Change in knowledge scores across six domain areas assessed using the Health Informatics Knowledge Assessment Tool (HIKAT): D1 General HI/Introduction to IT, D2 Operating Systems & Software, D3 Public Health & IT, D4 Database Management, D5+6 Data Analysis & Coding, and D7 Telemedicine. Each domain score is expressed as a percentage of the domain maximum (minimum: 0%, maximum: 100%), where higher scores indicate greater domain-specific health informatics knowledge. Domain gains are analyzed using Friedman test with Kendall W and Holm-corrected post-hoc Wilcoxon signed-rank tests within the intervention group.
Baseline (Week 1) to post-intervention (Week 15)

Other Outcome Measures

Other Outcome Measures

For clinical trials, a planned measurement described in the protocol that is used to determine the effect of an intervention/treatment on participants. For observational studies, a measurement or observation that is used to describe patterns of diseases or traits, or associations with exposures, risk factors, or treatment. Types of outcome measures include primary outcome measure and secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Change in Technological Awareness Across Digital Health Tools
Time Frame: Baseline (Week 1) to post-intervention (Week 15)
Change in binary (Yes/No) awareness of 11 digital health tools: EHR, Telemedicine, HMIS, Public Health Informatics, GIS, HIMS, DBMS, Python, Programming Language, Telehealth Platforms, and Remote Patient Monitoring.
Baseline (Week 1) to post-intervention (Week 15)

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Axon Infotech Research Academy Pvt. Ltd.

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Principal Investigator: Dip Bahadur Singh, Axon Infotech Research Academy

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
April 15, 2026

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
June 20, 2026

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
June 30, 2026

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
July 2, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
July 7, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
July 8, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
July 8, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
July 7, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
July 1, 2026

More Information

Terms related to this study

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • HI471-MBAHS-2026
  • IRC-134-082-083 (Registry Identifier: Madan Bhandari Academy of Health Sciences IRC)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Individual participant data (IPD) will not be shared because participants did not provide consent for their individual-level data to be shared with external researchers. Additionally, the small sample size (n=34) increases the risk of participant re-identification, even with de-identification. All aggregated, anonymized summary data are presented in the published manuscript and supplementary materials

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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