The NMCN digital learning platform was developed to deliver, manage, and monitor educational content for approximately 2000 preservice midwifery students across 20 pilot institutions in 11 states in Nigeria. In this pilot, 2 of the researchers, both international midwifery experts, codeveloped the digital modules. Each module features podcasts, simulations with first-person point-of-view videos, animations, and interactive technology-enhanced learning content focused on 3 maternal health conditions: postpartum hemorrhage and the E-MOTIVE bundle, multiple micronutrient supplementation for maternal anemia, and maternal sepsis. The 3 digital learning modules were developed to address major contributors to preventable maternal morbidity and mortality in Nigeria and other low-resource settings. They were designed to strengthen students’ exposure to contemporary, evidence-informed maternal health content through interactive and technology-enhanced learning approaches that could supplement existing classroom and clinical education. Midwifery students across the pilot sites will access the platform over a 12-month implementation period, during which iterative refinement of the platform and educational content will be undertaken alongside ongoing evaluation of the technology-enhanced learning intervention’s feasibility, acceptability, and usability.

This study is part of a broader implementation research project introducing a digital learning platform into preservice midwifery education in Nigeria. The ADDIE (Analysis, Design, Development, Implementation, and Evaluation) instructional design model guided the development of the educational products and learning resources for the TTT program. This model is used as a structured framework for instructional design [24]. The model includes analysis of learner needs and educational objectives, design and development of instructional content and delivery approaches, implementation of the training, and evaluation to inform ongoing refinement and improvement. Although presented in phases, the ADDIE model is iterative and nonlinear in practice. As part of the evaluation phase, a qualitative descriptive study was conducted to explore the perspectives and initial experiences of midwifery educators and institutional ICT officers who participated in the TTT workshop.

A qualitative descriptive design [25] was used, as it enables researchers to remain close to the data while providing a comprehensive summary of participants’ perspectives and experiences without aiming to generate theory or explore deeper, lived, or cultural meanings [26]. Qualitative description is particularly suited to examining who, what, and the context of events or experiences and is useful for exploring poorly understood phenomena through the accounts of participants [25]. This approach was selected because little is currently known about the perspectives and experiences of midwifery educators in Nigeria regarding the introduction of technology-enhanced learning resources and the expectations associated with adopting and disseminating new digital approaches within preservice midwifery education. Consequently, a qualitative descriptive methodology was considered appropriate for exploring participants’ perceptions, experiences, and responses to this educational change introduced by the NMCN. Findings from the evaluation were used to identify areas requiring additional support, refinement, and future capacity-building activities.

Participants were purposively selected by the NMCN from participating institutions based on their teaching responsibilities in courses linked to the digital learning modules, as course allocations are predetermined for the academic year. Institutional ICT officers were also included due to their roles in supporting digital infrastructure and platform implementation within the schools. Eligible participants included seasoned midwifery educators and ICT officers attending the TTT workshops who were not on leave, were involved in the relevant courses, and were willing to participate in the qualitative evaluation conducted before and after the training. A total of 80 participants attended 2 separate 3-day workshops. Although participants were nominated by their institutions to attend the training, participation in the qualitative evaluation component was voluntary, and participants were informed that their decision to participate or decline would not affect their involvement in the training program.

Qualitative data were collected through anonymous, written, open-ended responses before and after the workshops. This qualitative method can generate meaningful and rich insights, even when individual responses are brief, and minimizes participant discomfort [27]. This approach was selected based on participant preference, as some attendees were uncomfortable with audio-recorded interviews or group discussions, and it enabled participants to share their perspectives in their own words while minimizing burden within the intensive training schedule. Surveys were completed individually at the venue. Participants could remain at their allocated seats or choose another suitable location within the premises and were given approximately 30 minutes to record their responses. They wrote their responses by hand on the paper-based surveys and could request extra sheets as needed.

The pre-training survey comprised 5 questions that assessed participants’ prior experience, expectations, and concerns about the training (Multimedia Appendix 2). The post-training survey included 9 open-ended questions that evaluated participant satisfaction, key learnings, intended actions, and areas requiring further training to inform future program planning (Multimedia Appendix 3).

Despite the anonymous, written format, social desirability bias may still have influenced responses, with participants potentially feeling inclined to provide favorable feedback due to their institutional nomination to attend the training and the broader implementation context.

The research team followed the systematic steps of qualitative content analysis as described by Erlingsson and Brysiewicz [28], which include familiarization with the data, identifying meaning units, condensing those units, coding, categorizing, and formulating themes. Content analysis was chosen because it provides a systematic and transparent method for analyzing open-ended qualitative data across multiple participants. Data were analyzed manually without the use of qualitative software. Manual coding was selected to support collaborative analysis across the international research team and ensure accessibility for all researchers involved in the project. Two researchers independently reviewed and coded the responses before meeting to compare interpretations and discuss coding differences. Any discrepancies were resolved through discussion and consensus within the broader research team. Meaningful data segments relevant to the study objectives, including perceptions of the training, perceived learning gains, challenges, and anticipated application of skills, were identified and coded. The research team met regularly via Zoom to discuss coding decisions, resolve discrepancies through consensus, merge overlapping codes, and refine categories. Related codes were grouped into broader descriptive categories, which were subsequently developed into higher-level themes. Throughout the analytic process, categories and themes were repeatedly reviewed against the original written responses to ensure they accurately reflected participants’ perspectives and experiences. Given the qualitative descriptive nature of the study and the use of brief written responses, the analysis aimed to achieve sufficient informational richness relevant to the study objectives rather than formal theoretical data saturation associated with interpretive methodologies.

To enhance the trustworthiness of the findings, several strategies were used throughout the analysis [29]. Credibility was enhanced through independent coding by members of the research team, followed by consensus discussions to resolve differences in interpretation and refine the coding framework. Dependability was supported through consistent data collection and analysis procedures, and by documenting coding decisions as the analysis progressed. To ensure confirmability, regular team meetings were held in which interpretations were critically examined and grounded in participants’ responses rather than in individual assumptions. Transferability was facilitated by providing detailed information about the participants, training, and the study context. Researcher reflexivity was embedded throughout the analytic process and involved ongoing consideration of the researchers’ roles, assumptions, and involvement in the program, as well as their potential influence on data collection, analysis, and interpretation.

Ethical approval for this study was obtained from the Human Research Ethics Committee of Charles Darwin University, Australia (ethics number H25071), and the institutional Research Ethics Committee at the Liverpool School of Tropical Medicine (ethics number 24‐074). The study was conducted in accordance with internationally accepted ethical principles for research involving human participants. All participants were provided with adequate information about the study objectives, procedures, potential risks, and benefits. Informed consent was obtained from all participants before data collection. Consent was sought both verbally and in writing, and participation was not compulsory. Confidentiality and anonymity were maintained throughout the study, and participation was entirely voluntary, with the right to withdraw at any stage without penalty. Prior to data collection, participants were informed verbally and in writing that completion of the evaluation activities was optional and would not affect their participation in the training or their professional roles. None of the participants objected to participating. Participants were also informed that they could decline to answer any question or withdraw at any time without consequence.

Pre-training responses revealed considerable variation in participants’ prior exposure to digital tools, current technology use, and expectations for the training. Although some participants reported prior digital training, these experiences were often described as basic, outdated, or insufficient, whereas others relied mainly on self-directed learning and trial-and-error. This finding suggests limited access to structured and ongoing digital capacity development across participating institutions.

Participants’ current use of digital tools was generally limited to basic applications, such as PowerPoint, WhatsApp, and online videos, with only a few having prior experience with platforms like Moodle. Despite these limitations, participants expressed strong interest in developing practical digital teaching skills, particularly in navigating learning management systems, creating digital content, integrating multimedia resources, improving online student engagement, and enhancing digital assessment practices. The findings indicate a strong demand for hands-on, practice-oriented training to strengthen educators’ readiness for technology-enhanced teaching.

Participants identified infrastructure and ongoing support as critical determinants of successful implementation. Common concerns included unreliable internet connectivity, unstable power supply, limited sensitization, and access to timely technical support. The provision of free internet access was frequently proposed, underscoring the need to address systemic and infrastructural barriers to the sustainable integration of technology-enhanced learning.

Participants identified technical support and access to adequate resources as essential for sustaining digital learning and the effective implementation of the program. Participants also emphasized that resource availability, including access to laptops and embedded training materials, could enhance the consistency and ease of training delivery.

Participants highlighted the importance of collaboration between educators and ICT officers, emphasizing the need for shared training opportunities and equal access to the platform. This finding suggests that successful implementation of technology-enhanced learning requires a team-based approach, with clearly defined roles and shared responsibility to support sustainability and reduce reliance on individual staff members.

Participants highlighted the importance of continuity in future training activities, expressing a preference for the same facilitators who introduced the platform to lead subsequent training sessions, thereby providing continuity in learning, reinforcing key concepts, and supporting a deeper understanding of both the platform and its educational applications.

Participants identified several strategies to support successful implementation and ongoing engagement with the platform. These included regular system maintenance and updates to enhance usability, development of user-friendly navigation tutorials such as YouTube videos, routine check-ins to monitor progress and address challenges, and the establishment of clear expectations for appropriate behavior in both classroom and online learning environments.

Participants generally valued the training but suggested that online sessions could be made more engaging through greater visual interaction with facilitators. This finding highlights the importance of facilitator presence in online learning environments and reflects the practical challenges of delivering technology-enhanced learning in settings where limited internet bandwidth may restrict the use of video and other interactive features.

Together, these findings suggest that sustained implementation requires ongoing capacity strengthening, resource investment, and responsive support systems, rather than one-off training interventions.

Participants in this study perceived that the TTT program enhanced their understanding of technology-enhanced learning and increased their confidence in supporting its implementation in preservice midwifery education. They also expressed a willingness to champion digital learning in their institutions. However, participants consistently identified inadequate digital infrastructure, limited technical support, and the need for ongoing training as important considerations for sustaining its implementation. The study’s insights contribute to a growing evidence base by identifying contextual factors that educators perceive as important for integrating digital learning into preservice midwifery education in resource-constrained settings.

The findings suggest that the success of TTT programs for technology-enhanced learning extends beyond knowledge acquisition and requires attention to implementation readiness, contextual barriers, and strategies that support long-term sustainability, consistent with evidence synthesized in a recent scoping review [19]. Such evidence is scarce in midwifery education, particularly in the context of nationwide initiatives in countries with high maternal mortality, where strengthening the midwifery workforce is critical to improving maternal and newborn outcomes [9].

Prior studies have demonstrated that TTT initiatives can improve knowledge, confidence, and teaching competencies [21,30,31]. Although this study did not measure these outcomes quantitatively, participants reported increased confidence, readiness to train others, and motivation to apply newly acquired skills, all of which are required for successful implementation and sustainability [30,32]. In contexts where educator shortages and limited resources constrain professional development opportunities, such gains may be critical for supporting the successful implementation and scale-up of technology-enhanced learning. These qualitative findings extend the existing evidence by providing a deeper understanding of the processes through which TTT programs build implementation capacity and foster sustainable educational change.

Gaps in pedagogical and digital competencies can directly affect the quality, implementation, and sustainability of technology-enhanced learning, as well as training outcomes at different levels. Although participants were enthusiastic about the TTT program and eager to apply their new knowledge, many lacked a foundational understanding of teaching and learning principles, reflecting a reliance on traditional didactic approaches. These findings should be understood within the broader Nigerian educational environment, where educator shortages, limited professional development opportunities, and inadequate digital skills training are well-documented [7,15]. Within midwifery education, large student cohorts and high educator-to-student ratios further reinforce didactic teaching practices [15]. In this context, the program addressed an important capacity gap by strengthening educators’ pedagogical and digital competencies and equipping them to support teaching and learning despite significant workforce and resource constraints.

In this study, resistance to educational innovation was not the issue. Participants demonstrated openness to change and a willingness to experiment with new teaching approaches. While participants were enthusiastic about technology-enhanced learning, they frequently highlighted unreliable internet connectivity and electricity supply as key barriers to implementation. These infrastructure challenges were viewed as important considerations for successful implementation, as reported in other settings [6,16,33,34], and are also consistent with broader reports describing digital infrastructure limitations across Nigeria [35,36]. While planned national investments in fiber-optic infrastructure may improve future connectivity, these findings suggest that digital education initiatives must be accompanied by investments in reliable internet connectivity, digital infrastructure, devices, and ongoing technical support that enable educators and students to fully engage with these resources to achieve their intended impact [34].

Sustaining digital learning initiatives requires supportive policy, leadership commitment, and ongoing training [34]. In low- and middle-income countries, where resources are constrained and priorities shift, understanding sustainability is critical [37]. Given Nigeria’s size and security challenges, technology-enhanced learning strategies may offer a viable and scalable solution. Notably, there is a strong political commitment to advancing midwifery in Nigeria, as reflected in the Nigeria Strategic Directions for Nursing and Midwifery (NSDNM) 2025 to 2030, which acknowledges ongoing gaps in training, deployment, and retention of skilled midwives [38]. Situating participant-identified barriers within this national reform agenda highlights that, while targeted training to build educator capacity is essential, sustainable improvement will require continued investment in educational infrastructure, workforce development, and supportive policy frameworks.

The findings have several practical implications. First, digital capacity-building programs should incorporate both technological skills and foundational pedagogical training to support meaningful educational transformation. Second, implementation strategies should include ongoing mentorship, technical support, and opportunities for peer learning to reinforce skills gained during training [34]. This also includes diffusing expertise within the system through a strong community of practice, which was set up via WhatsApp group chats in this case. Third, policymakers and educational leaders should recognize that investments in educator capacity alone are unlikely to achieve sustainable change without concurrent improvements in digital infrastructure, internet access, and institutional support systems [16].

Overall, the findings suggest that the TTT approach is a feasible and practical strategy for implementing technology-enhanced learning at scale. Future studies should examine the longer-term impact of the TTT model on behavioral outcomes, including educator practice, institutional adoption of technology-enhanced learning, and student learning outcomes. Evaluation of the planned training cascade will be particularly important in determining whether knowledge and skills are successfully transferred to additional educators and sustained over time. Further studies should also explore factors that influence implementation across different institutional and geographical contexts and identify strategies that support long-term sustainability of digital education initiatives in resource-constrained settings.

This study has several limitations. First, a quantitative assessment of participants’ pre-training and post-training knowledge and skills was not conducted, as the training was intentionally designed to foster a supportive, nonthreatening learning environment. Second, although a paper-based open-ended survey was deemed appropriate, it may have limited opportunities for deeper exploration of individual experiences and perspectives. Third, participants were nominated by their institutions to attend the training, which may have influenced perceptions of voluntariness, despite the evaluation being optional and anonymous. As the findings were based on self-reported written feedback collected within a funded implementation project, socially desirable responses cannot be excluded. Moreover, we did not objectively assess knowledge, skills, competence, or the extent of change attributable to the program. Therefore, the findings reflect perceived readiness, usefulness, and acceptability rather than measurable improvements in teaching practice or digital competence. In addition, the short duration of the training may have limited participants’ confidence to cascade the training, and the absence of a structured buddying approach may have reduced opportunities for peer support and ongoing capacity building. As the broader implementation project is ongoing, future phases of the study will evaluate longer-term educational, institutional, and implementation outcomes associated with the technology-enhanced learning platform.

This study evaluated participants’ perceptions of a needs-informed TTT program and their preparedness to implement a technology-enhanced learning platform in preservice midwifery education in Nigeria. It provides novel evidence in an underresearched area by showing how targeted educator training can strengthen digital competencies and support the implementation and sustained use of technology-based learning. Rather than evaluating educational outcomes or changes in practice, this study provides early evidence of educators’ readiness to adopt student-centered innovative learning resources. Participants are motivated to share their learning and are enthusiastic about adopting the new resources on a digital learning platform. Nevertheless, our findings suggest that national implementation may require a structured strategy to equip educators with pedagogical principles to advance the widespread application across Nigeria. The findings also indicate that expanding technology-enhanced learning in preservice midwifery education in Nigeria is likely to require sustained institutional and government commitment to strengthening the infrastructure required to support digital learning platforms.