Catalysing Interprofessional Eye Health Education Using the Arclight diagnostic tool and simulation eyes in Rwanda: Outcomes from a Mixed Methods Randomised Trial

BackgroundVision loss represents a significant public health concern according to the World Health Organisation, with increasing global age-standardised prevalence rates. Visual impairments are disproportionately distributed, occurring eight times more frequently in Sub-Saharan Africa and Southeast Asia compared to high-income regions. The Interprofessional Education (IPE) approach, utilizing the Arclight package as an implementation vehicle, offers promising potential for collaborative early detection and management of eye conditions in resource-constrained environments. This research aimed to implement validated Interprofessional Eye Health Education(IPEHE) in Rwanda, assess fundamental eye health knowledge and skills acquisition, evaluate medium to long-term learning retention, and explore IPEs role in developing these competencies. MethodsThe study employed a mixed-methods approach combining a Randomised Controlled Trial (RCT) with qualitative assessment at the University of Rwanda. Researchers invited 443 final-year students from diverse healthcare programs including nursing, pharmacy, midwifery, medicine, and ophthalmic clinical officers. With statistical power set at 0.80 and alpha error probability at 0.05, the design aimed to detect pre-post training score differences of 10% or greater. The calculated sample size of 54 participants per group was expanded to 280 total participants (180 intervention, 100 control) to accommodate potential attrition. ResultsIn the intervention group, 161 students (89.4%) attended the training, and 113 (70.2%) participated in the 10-month follow-up assessment (POST2). Of the control group, 90 participants (90%) attended assessments at 10 months post-intervention (POST2). Knowledge scores in the intervention group increased by 58.9% (SD=20.8, Z=10.82 p<0.001) immediately post-training, while skills improved by 49.7% (SD=14, Z=-8.382, P<0.001). At the 10-month follow-up, these gains remained significantly above baseline levels. Intervention participants significantly outperformed the control group at follow-up in both knowledge, with a 54.1% difference (SE= 2.0, df (201) = 27.3, P<0.001), and skills, with a 44% difference (SE=1.1, t(155)=38.7, p<0.001). Qualitative data from the intervention group indicated an appreciation for interprofessional collaboration, holistic patient care approaches, and the practical skills acquired. ConclusionThe IPEHE intervention significantly enhanced collaborative eye health knowledge and skills among Rwandan healthcare students, with demonstrated retention up to 10 months post-intervention. These findings suggest that pre-qualification interprofessional education effectively produces collaborative practice-ready professionals capable of addressing eye health challenges in resource-limited settings.