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Rourke L, Leong J, Chatterly P. Conditions-Based Learning Theory as a Framework for Comparative-Effectiveness Reviews: A Worked Example. TEACHING AND LEARNING IN MEDICINE 2018; 30:386-394. [PMID: 29452002 DOI: 10.1080/10401334.2018.1428611] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Phenomenon: An evidence-informed era of medical education encourages the generation and use of comparative-effectiveness reviews, yet the reviews often conclude, curiously, that all instructional approaches are equally effective. Approach: We used a conditions-based learning theory to structure a review of the comparative-effectiveness literature on electrocardiogram instruction. We searched MEDLINE, EMBASE (Ovid), ERIC (Ovid), PsycINFO (Ovid), and CINAHL (EBSCO) from inception to June 2016. We selected prospective studies that examined the effect of instructional interventions on participants' knowledge and skill with electrocardiogram interpretation. Two reviewers extracted information on the quality of the studies, the effect of instruction on the acquisition of knowledge and skill, and instructional quality. Instructional quality is an index of the extent to which instruction incorporates 4 practices of Gagne's conditions-based learning theory: presenting information, eliciting performance, providing feedback, and assessing learning. Findings: Twenty-five studies (3,286 participants) evaluating 47 instructional interventions were synthesized. The methodological quality of most studies was moderate. Instructional quality varied: All interventions presented information and assessed learning, but fewer than half elicited performances or provided feedback. Instructional interventions that incorporated all 4 components improved trainees' abilities considerably more than those that incorporated 3 or fewer; respectively, standardized mean difference (SMD) = 2.80, 95% confidence interval (CI) [2.05, 3.55], versus SMD = 1.44, 95% CI [1.18, 1.69]. Studies that compared "innovative" to "traditional" types of instruction did not yield a significant pooled effect: SMD = 0.18, 95% CI [-0.09, 0.45]. Insights: The use of a conditions-based learning theory to organize the comparative-effectiveness literature reveals differences in the instructional impact of different instructional approaches. It overturns the unlikely, but common, conclusion that all approaches are equally effective.
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Affiliation(s)
- Liam Rourke
- a Department of Medicine , University of Alberta , Edmonton Alberta , Canada
| | - Jessica Leong
- a Department of Medicine , University of Alberta , Edmonton Alberta , Canada
| | - Patricia Chatterly
- a Department of Medicine , University of Alberta , Edmonton Alberta , Canada
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Eilayyan O, Thomas A, Hallé MC, Ahmed S, Tibbles AC, Jacobs C, Mior S, Davis C, Evans R, Schneider MJ, Alzoubi F, Barnsley J, Long CR, Bussières A. Promoting the use of self-management in novice chiropractors treating individuals with spine pain: the design of a theory-based knowledge translation intervention. BMC Musculoskelet Disord 2018; 19:328. [PMID: 30205825 PMCID: PMC6134709 DOI: 10.1186/s12891-018-2241-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 08/24/2018] [Indexed: 12/19/2022] Open
Abstract
Background Clinical practice guidelines generally recommend clinicians use self-management support (SMS) when managing patients with spine pain. However, even within the educational setting, the implementation of SMS remains suboptimal. The objectives of this study were to 1) estimate the organizational readiness for change toward using SMS at the Canadian Memorial Chiropractic College (CMCC), Toronto, Ontario from the perspective of directors and deans, 2) estimate the attitudes and self-reported behaviours towards using evidence-based practice (EBP), and beliefs about pain management among supervisory clinicians and chiropractic interns, 3) identify potential barriers and enablers to using SMS, and 4) design a theory-based tailored Knowledge Translation (KT) intervention to increase the use of SMS. Methods Mixed method design. We administered three self-administered questionnaires to assess clinicians’ and interns’ attitudes and behaviours toward EBP, beliefs about pain management, and practice style. In addition, we conducted 3 focus groups with clinicians and interns based on the Theoretical Domain Framework (TDF) to explore their beliefs about using SMS for patients with spine pain. Data were analysed using deductive thematic analysis by 2 independent assessors. A panel of 7 experts mapped behaviour change techniques to key barriers identified informing the design of a KT intervention. Results Participants showed high level of EBP knowledge, positive attitude of EBP, and moderate frequency of EBP use. A number of barrier factors were identified from clinicians (N = 6) and interns (N = 16) corresponding to 7 TDF domains: Knowledge; Skills; Environmental context and resources; Emotion; Beliefs about Capabilities; Memory, attention & decision making; and Social Influence. To address these barriers, the expert panel proposed a multifaceted KT intervention composed of a webinar and online educational module on a SMS guided by the Brief Action Planning, clinical vignettes, training workshop, and opinion leader support. Conclusion SMS strategies can help maximizing the health care services for patients with spine pain. This may in turn optimize patients’ health. The proposed theory-based KT intervention may facilitate the implementation of SMS among clinicians and interns. Electronic supplementary material The online version of this article (10.1186/s12891-018-2241-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Owis Eilayyan
- School of Physical and Occupational Therapy, McGill University, 3654 Prom Sir-William-Osler, Montréal, QC, H3G 1Y5, Canada. .,Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, Canada.
| | - Aliki Thomas
- School of Physical and Occupational Therapy, McGill University, 3654 Prom Sir-William-Osler, Montréal, QC, H3G 1Y5, Canada.,Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, Canada
| | - Marie-Christine Hallé
- School of Physical and Occupational Therapy, McGill University, 3654 Prom Sir-William-Osler, Montréal, QC, H3G 1Y5, Canada.,Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, Canada
| | - Sara Ahmed
- School of Physical and Occupational Therapy, McGill University, 3654 Prom Sir-William-Osler, Montréal, QC, H3G 1Y5, Canada.,Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, Canada
| | | | - Craig Jacobs
- Canadian Memorial Chiropractic College, North York, Canada
| | - Silvano Mior
- Canadian Memorial Chiropractic College, North York, Canada
| | - Connie Davis
- University of British Columbia, Vancouver, Canada.,Centre for Collaboration, Motivation and Innovation, Vancouver, Canada
| | - Roni Evans
- University of Minnesota, Minneapolis, USA
| | | | - Fadi Alzoubi
- School of Physical and Occupational Therapy, McGill University, 3654 Prom Sir-William-Osler, Montréal, QC, H3G 1Y5, Canada.,Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, Canada
| | | | | | - Andre Bussières
- School of Physical and Occupational Therapy, McGill University, 3654 Prom Sir-William-Osler, Montréal, QC, H3G 1Y5, Canada.,Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, Canada
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153
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Draper-Rodi J, Vogel S, Bishop A. Design and development of an e-learning programme: An illustrative commentary. INT J OSTEOPATH MED 2018. [DOI: 10.1016/j.ijosm.2018.07.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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154
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McLeod D, Esplen MJ, Wong J, Hack TF, Fillion L, Howell D, Fitch M, Dufresne J. Enhancing clinical practice in the management of distress: The Therapeutic Practices for Distress Management (TPDM) project. Psychooncology 2018; 27:2289-2295. [PMID: 29956392 DOI: 10.1002/pon.4831] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 06/16/2018] [Accepted: 06/19/2018] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The Therapeutic Practices for Distress Management (TPDM) project was carried out to support clinicians in integrating recommendations from four clinical practice guidelines (CPGs) in routine care at five Pan Canadian cancer care sites. METHODS Using a concurrent, mixed-method study design and knowledge translation (KT) activities, this project included two phases: phase I-a baseline/preparation phase and phase II-an intervention phase plus evaluation. The intervention phase (the focus of this report) included a one-year education and supervision program (24 hours in virtual class; 12-hour group supervision). Primary outcomes were knowledge and self-efficacy in practicing CPGs as measured by a Knowledge and Self-Efficacy Survey (KSES). A secondary outcome was observer-rated performances with standardized patients (objective structured clinical exams). Participants included 80 (90%) nurses, and 9 (10%) social workers (N = 89). RESULTS The TPDM program was effective in accomplishing change in knowledge, self-efficacy, and performance. All measures demonstrated significant change pre and post module, with evidence of increasing knowledge (P < .01) and confidence (P < .01) over time. Further, there was evidence of a shift in barriers and enablers to practicing in alignment with the CPGs. CONCLUSIONS A tailored education program using case-based learning and supervision over time improves knowledge and practice among front line clinicians. The findings have implications for quality improvement in cancer care.
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Affiliation(s)
- Deborah McLeod
- Psychosocial Oncology, NS Health Authority, School of Nursing, Dalhousie University, Halifax, NS, Canada
| | - Mary Jane Esplen
- de Souza Institute, University Health Network, Toronto, Canada.,Faculty of Medicine, University of Toronto, Toronto, Canada.,Clinical and Basic Sciences, Department of Psychiatry, University of Toronto, Toronto, Canada.,Princess Margaret Cancer Centre, Toronto, Canada
| | - Jiahui Wong
- de Souza Institute, University Health Network, Toronto, Canada.,Faculty of Medicine, University of Toronto, Toronto, Canada.,Clinical and Basic Sciences, Department of Psychiatry, University of Toronto, Toronto, Canada.,Princess Margaret Cancer Centre, Toronto, Canada
| | - Thomas F Hack
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnepeg, Canada.,Research Institute in Oncology and Hematology, CancerCare Manitoba, Winnepeg, Canada.,Psychosocial Oncology & Cancer Nursing Research, I.H. Asper Clinical Research Institute, Winnepeg, Canada
| | - Lise Fillion
- Nursing Research Unit, Centre de Recherche du CHU de Québec, L'Hôtel Dieu de Québec, Quebec, Canada
| | - Doris Howell
- Oncology Nursing Research and Education, University Health Networks, Toronto, Canada.,Lawrence Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada.,Institute for Clinical Evaluative Sciences, Toronto, Canada
| | - Margaret Fitch
- Lawrence Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada.,Canadian Association of Nurses in Oncology, Toronto, Canada
| | - Julie Dufresne
- Yukon Chamber of Commerce, Whitehorse, Yukon, Canada.,Touché Consulting, Whitehorse, Yukon, Canada
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Rat AC, Ricci L, Guillemin F, Ricatte C, Pongy M, Vieux R, Spitz E, Muller L. Development of a Web-Based Formative Self-Assessment Tool for Physicians to Practice Breaking Bad News (BRADNET). JMIR MEDICAL EDUCATION 2018; 4:e17. [PMID: 30026180 PMCID: PMC6072977 DOI: 10.2196/mededu.9551] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 03/22/2018] [Accepted: 04/22/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Although most physicians in medical settings have to deliver bad news, the skills of delivering bad news to patients have been given insufficient attention. Delivering bad news is a complex communication task that includes verbal and nonverbal skills, the ability to recognize and respond to patients' emotions and the importance of considering the patient's environment such as culture and social status. How bad news is delivered can have consequences that may affect patients, sometimes over the long term. OBJECTIVE This project aimed to develop a Web-based formative self-assessment tool for physicians to practice delivering bad news to minimize the deleterious effects of poor way of breaking bad news about a disease, whatever the disease. METHODS BReaking bAD NEws Tool (BRADNET) items were developed by reviewing existing protocols and recommendations for delivering bad news. We also examined instruments for assessing patient-physician communications and conducted semistructured interviews with patients and physicians. From this step, we selected specific themes and then pooled these themes before consensus was achieved on a good practices communication framework list. Items were then created from this list. To ensure that physicians found BRADNET acceptable, understandable, and relevant to their patients' condition, the tool was refined by a working group of clinicians familiar with delivering bad news. The think-aloud approach was used to explore the impact of the items and messages and why and how these messages could change physicians' relations with patients or how to deliver bad news. Finally, formative self-assessment sessions were constructed according to a double perspective of progression: a chronological progression of the disclosure of the bad news and the growing difficulty of items (difficulty concerning the expected level of self-reflection). RESULTS The good practices communication framework list comprised 70 specific issues related to breaking bad news pooled into 8 main domains: opening, preparing for the delivery of bad news, communication techniques, consultation content, attention, physician emotional management, shared decision making, and the relationship between the physician and the medical team. After constructing the items from this list, the items were extensively refined to make them more useful to the target audience, and one item was added. BRADNET contains 71 items, each including a question, response options, and a corresponding message, which were divided into 8 domains and assessed with 12 self-assessment sessions. The BRADNET Web-based platform was developed according to the cognitive load theory and the cognitive theory of multimedia learning. CONCLUSIONS The objective of this Web-based assessment tool was to create a "space" for reflection. It contained items leading to self-reflection and messages that introduced recommended communication behaviors. Our approach was innovative as it provided an inexpensive distance-learning self-assessment tool that was manageable and less time-consuming for physicians with often overwhelming schedules.
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Affiliation(s)
- Anne-Christine Rat
- EA 4360 APEMAC, Université de Lorraine, Nancy, France
- Rheumatology, Nancy University Hospital, Nancy, France
- CIC 1433 Clinical Epidemiology, INSERM, Nancy University Hospital, Nancy, France
| | - Laetitia Ricci
- CIC 1433 Clinical Epidemiology, INSERM, Nancy University Hospital, Nancy, France
- Equipe de psychologie de la santé de Metz, EA 4360 APEMAC, Université de Lorraine, Metz, France
| | - Francis Guillemin
- EA 4360 APEMAC, Université de Lorraine, Nancy, France
- CIC 1433 Clinical Epidemiology, INSERM, Nancy University Hospital, Nancy, France
| | - Camille Ricatte
- Equipe de psychologie de la santé de Metz, EA 4360 APEMAC, Université de Lorraine, Metz, France
| | - Manon Pongy
- Equipe de psychologie de la santé de Metz, EA 4360 APEMAC, Université de Lorraine, Metz, France
| | - Rachel Vieux
- EA 4360 APEMAC, Université de Lorraine, Nancy, France
- Department of Pediatrics, Besançon University, Besançon, France
| | - Elisabeth Spitz
- Equipe de psychologie de la santé de Metz, EA 4360 APEMAC, Université de Lorraine, Metz, France
| | - Laurent Muller
- Equipe de psychologie de la santé de Metz, EA 4360 APEMAC, Université de Lorraine, Metz, France
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156
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Sox CM, Tenney-Soeiro R, Lewin LO, Ronan J, Brown M, King M, Thompson R, Noelck M, Sutherell JS, Silverstein M, Cabral HJ, Dell M. Efficacy of a Web-Based Oral Case Presentation Instruction Module: Multicenter Randomized Controlled Trial. Acad Pediatr 2018; 18:535-541. [PMID: 29325913 DOI: 10.1016/j.acap.2017.12.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Revised: 12/11/2017] [Accepted: 12/22/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Effective self-directed educational tools are invaluable. Our objective was to determine whether a self-directed, web-based oral case presentation module would improve medical students' oral case presentations compared to usual curriculum, and with similar efficacy as structured oral presentation faculty feedback sessions. METHODS We conducted a pragmatic multicenter cluster randomized controlled trial among medical students rotating in pediatric clerkships at 7 US medical schools. In the clerkship's first 14 days, subjects were instructed to complete an online Computer-Assisted Learning in Pediatrics Program (CLIPP) oral case presentation module, an in-person faculty-led case presentation feedback session, or neither (control). At the clerkship's end, evaluators blinded to intervention status rated the quality of students' oral case presentations on a 10-point scale. We conducted intention-to-treat multivariable analyses clustered on clerkship block. RESULTS Study participants included 256 CLIPP (32.5%), 263 feedback (33.3%), and 270 control (34.2%) subjects. Only 51.1% of CLIPP subjects completed the assigned presentation module, while 98.5% of feedback subjects participated in presentation feedback sessions. Compared to controls, oral presentation quality was significantly higher in the feedback group (adjusted difference in mean quality, 0.28; 95% confidence interval, 0.08, 0.49) and trended toward being significantly higher in the CLIPP group (0.19; 95% confidence interval, -0.006, 0.38). The quality of presentations in the CLIPP and feedback groups was not significantly different (-0.10; 95% confidence interval, -0.31, 0.11). CONCLUSIONS The quality of oral case presentations delivered by students randomized to complete the CLIPP module did not differ from faculty-led presentation feedback sessions and was not statistically superior to control.
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Affiliation(s)
- Colin M Sox
- Department of Pediatrics, Boston Medical Center & Boston University School of Medicine, Boston, Mass.
| | - Rebecca Tenney-Soeiro
- Department of Pediatrics, Perelman School of Medicine at University of Pennsylvania & The Children's Hospital of Philadelphia, Philadelphia, Pa
| | - Linda O Lewin
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Md
| | - Jeanine Ronan
- Department of Pediatrics, Perelman School of Medicine at University of Pennsylvania & The Children's Hospital of Philadelphia, Philadelphia, Pa
| | - Mary Brown
- Department of Pediatrics, Tufts University School of Medicine at the Floating Hospital for Children, Boston, Mass
| | - Marta King
- Department of Pediatrics, Saint Louis University School of Medicine, St Louis, Mo
| | - Rachel Thompson
- Department of Pediatrics, Boston Medical Center & Boston University School of Medicine, Boston, Mass
| | - Michelle Noelck
- Department of Pediatrics, Oregon Health & Science University, Portland, Ore
| | - Jamie S Sutherell
- Department of Pediatrics, Saint Louis University School of Medicine, St Louis, Mo
| | - Michael Silverstein
- Department of Pediatrics, Boston Medical Center & Boston University School of Medicine, Boston, Mass
| | - Howard J Cabral
- Department of Biostatistics, Boston University School of Public Health, Boston, Mass
| | - Michael Dell
- Department of Pediatrics, Case Western Reserve University School of Medicine, Cleveland, Ohio
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157
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Karvinen KH, Balneaves L, Courneya KS, Perry B, Truant T, Vallance J. Evaluation of Online Learning Modules for Improving Physical Activity Counseling Skills, Practices, and Knowledge of Oncology Nurses. Oncol Nurs Forum 2018; 44:729-738. [PMID: 29052662 DOI: 10.1188/17.onf.729-738] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To examine the effectiveness of online learning modules for improving physical activity counseling practices among oncology nurses.
. DESIGN Randomized, controlled trial.
. SETTING Online.
. SAMPLE 54 oncology nurses.
. METHODS Oncology nurses were randomly assigned to the learning modules group or control group. The learning modules group completed six online learning modules and quizzes focused on physical activity for cancer survivors, general physical activity principles, and motivational interviewing.
. MAIN RESEARCH VARIABLES Percentage of cancer survivors counseled, self-efficacy for physical activity counseling, knowledge of physical activity, and perceived barriers and benefits of physical activity counseling.
. FINDINGS Analyses of covariance revealed no significant difference between the learning modules and control groups in the percentage of cancer survivors that oncology nurses counseled. Significant differences were found in self-efficacy for physical activity counseling and perceived barriers to physical activity counseling at postintervention.
. CONCLUSIONS The online learning intervention tested in this study improved some parameters of physical activity counseling but did not increase the percentage of cancer survivors that oncology nurses counseled. Additional pilot work is needed to refine the intervention.
. IMPLICATIONS FOR NURSING This study suggests the potential utility of an evidence-based online learning strategy for oncology nurses that includes information on physical activity and its benefits in cancer survivorship. The findings offer a framework on how to implement physical activity counseling skills in oncology nursing practice.
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Affiliation(s)
| | | | - Kerry S Courneya
- Faculty of Physical Education, University of Alberta, Edmonton, Canada
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158
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Kranenburg LJC, Reerds STH, Cools M, Alderson J, Muscarella M, Magrite E, Kuiper M, Abdelgaffar S, Balsamo A, Brauner R, Chanoine JP, Deeb A, Fechner P, German A, Holterhus PM, Juul A, Mendonca BB, Neville K, Nordenstrom A, Oostdijk W, Rey RA, Rutter MM, Shah N, Luo X, Grijpink K, Drop SLS. Global Application of the Assessment of Communication Skills of Paediatric Endocrinology Fellows in the Management of Differences in Sex Development Using the ESPE E-Learning.Org Portal. Horm Res Paediatr 2018; 88:127-139. [PMID: 28689203 DOI: 10.1159/000475992] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 04/19/2017] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Information sharing in chronic conditions such as disorders of/differences in sex development (DSD) is essential for a comprehensive understanding by parents and patients. We report on a qualitative analysis of communication skills of fellows undergoing training in paediatric endocrinology. Guidelines are created for the assessment of communication between health professionals and individuals with DSD and their parents. METHODS Paediatric endocrinology fellows worldwide were invited to study two interactive online cases (www.espe-elearning.org) and to describe a best practice communication with (i) the parents of a newborn with congenital adrenal hyperplasia and (ii) a young woman with 46,XY gonadal dysgenesis. The replies were analysed regarding completeness, quality, and evidence of empathy. Guidelines for structured assessment of responses were developed by 22 senior paediatric endocrinologists worldwide who assessed 10 selected replies. Consensus of assessors was established and the evaluation guidelines were created. RESULTS The replies of the fellows showed considerable variation in completeness, quality of wording, and evidence of empathy. Many relevant aspects of competent clinical communication were not mentioned; 15% (case 1) and 17% (case 2) of the replies were considered poor/insufficient. There was also marked variation between 17 senior experts in the application of the guidelines to assess communication skills. The guidelines were then adjusted to a 3-level assessment with empathy as a separate key item to better reflect the qualitative differences in the replies and for simplicity of use by evaluators. CONCLUSIONS E-learning can play an important role in assessing communication skills. A practical tool is provided to assess how information is shared with patients with DSD and their families and should be refined by all stakeholders, notably interdisciplinary health professionals and patient representatives.
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Affiliation(s)
- Laura J C Kranenburg
- Department of Rheumatology, Maasstad Ziekenhuis, Rotterdam, the Netherlands.,Department of Pediatrics, Division of Pediatric Endocrinology, Sophia Children's Hospital/Erasmus MC, Rotterdam, the Netherlands
| | - Sam T H Reerds
- Department of Pediatrics, Division of Pediatric Endocrinology, Sophia Children's Hospital/Erasmus MC, Rotterdam, the Netherlands
| | - Martine Cools
- Department of Pediatrics, Division of Pediatric Endocrinology, Ghent University, Ghent University Hospital, Ghent, Belgium
| | - Julie Alderson
- Psychological Health Services, University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom
| | - Miriam Muscarella
- USCF School of Medicine, Class of 2019, San Francisco, California, USA
| | - Ellie Magrite
- Founder and Trustee, dsdfamilies, Edinburgh, United Kingdom
| | - Martijn Kuiper
- Department of Rheumatology, Maasstad Ziekenhuis, Rotterdam, the Netherlands
| | | | - Antonio Balsamo
- Department of Medical and Surgical Sciences, Division of Pediatric Endocrinology, University Hospital S. Orsola-Malpighi, Bologna, Italy
| | - Raja Brauner
- Fondation Ophtalmologique Adolphe de Rothschild and Université Paris Descartes, Paris, France
| | - Jean Pierre Chanoine
- Department of Paediatrics, British Columbia Children's Hospital, Vancouver, British Columbia, Canada
| | - Asma Deeb
- Department of Paediatrics, Mafraq Hospital, Abu Dhabi, United Arab Emirates
| | - Patricia Fechner
- Department of Pediatrics, University of Washington, Seattle Children's Hospital, Seattle, Washington, USA
| | - Alina German
- Department of Pediatrics, Bnai-Zion Medical Center, Technion, Haifa, Israel
| | - Paul Martin Holterhus
- Department of Pediatrics, Division of Pediatric Endocrinology and Diabetes, University Hospital of Schleswig-Holstein, Campus Kiel/Christian Albrecht University of Kiel, Kiel, Germany
| | - Anders Juul
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Berenice B Mendonca
- Department of Internal Medicine, Medical School, University of São Paulo, São Paulo, Brazil
| | - Kristen Neville
- Department of Pediatric Endocrinology, Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - Anna Nordenstrom
- Department of Women's and Children's Health, Karolinka Institutet, Stockholm, Sweden
| | - Wilma Oostdijk
- Department of Pediatrics, Leiden University Medical Center, Leiden, the Netherlands
| | - Rodolfo A Rey
- Pediatrics Centro de Investigaciones Endocrinológicas "Dr. César Bergadá" (CEDIE), CONICET-FEI División de Endocrinología, Hospital de Niños Ricardo Gutiérrez, Buenos Aires, Argentina
| | - Meilan M Rutter
- Division of Endocrinology, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio, USA
| | - Nalini Shah
- Department of Endocrinology, Seth GS Medical College & KEM Hospital, Mumbai, India
| | - Xiaoping Luo
- Department of Pediatrics, Tongji Hospital, Wuhan, China
| | - Kalinka Grijpink
- Division Education and Student Support, Faculty EEMS, Delft University of Technology, Delft, the Netherlands
| | - Stenvert L S Drop
- Department of Pediatrics, Division of Pediatric Endocrinology, Sophia Children's Hospital/Erasmus MC, Rotterdam, the Netherlands
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Extavour RM, Allison GL. Students' perceptions of a blended learning pharmacy seminar course in a Caribbean school of pharmacy. CURRENTS IN PHARMACY TEACHING & LEARNING 2018; 10:517-522. [PMID: 29793716 DOI: 10.1016/j.cptl.2017.12.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2016] [Revised: 08/14/2017] [Accepted: 12/23/2017] [Indexed: 06/08/2023]
Abstract
BACKGROUND AND PURPOSE Blended learning (BL) integrates face-to-face and online instructional methods, with applications in pharmacy education. This study aimed to assess pharmacy students' perceptions of BL in a pharmacy seminar course at The University of the West Indies, St. Augustine campus, Trinidad and Tobago. EDUCATIONAL ACTIVITY AND SETTING Topics based on the use of medicines and public health were presented by student groups during live seminars, supplemented with online activities. An online survey of students' perceptions was administered at the end of the course. The usefulness of learning resources and course activities were assessed using 5-point Likert-like scales (1 = not helpful to 5 = very helpful). The effectiveness of the instructor, blended delivery, time value, and development of critical-thinking were rated on a 5-point Likert scale for agreement (1 = strongly disagree to 5 = strongly agree). Topics that were most instructive and additional topics of interest were also identified. FINDINGS Approximately 51% of students (37/72) completed the questionnaire; 73% were female and mean age was 24 years. The learning resources and most course activities were generally helpful (median = 4) in facilitating learning. There was strong agreement (median = 5) on the ease of navigating the online platform, and instructor encouraging interest in pharmacy issues. Students agreed (median = 4) that the course facilitated critical thinking, the BL approach was effective, and the time spent was worthwhile. The most instructive topics included medication errors, antibiotic resistance, and medicines in children and the elderly. SUMMARY BL in pharmacy seminars is a valuable approach to engage students learning about pharmacy and public health.
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Affiliation(s)
- Rian Marie Extavour
- School of Pharmacy, Faculty of Medical Sciences, The University of the West Indies, St. Augustine Building 39, Eric Williams Medical Sciences Complex, Champs Fleurs, Trinidad and Tobago.
| | - Gillian L Allison
- Optometry Programme, Office of the Dean, Faculty of Medical Sciences, The University of the West Indies, St. Augustine Building 39, Eric Williams Medical Sciences Complex, Champs Fleurs, Trinidad and Tobago.
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160
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Maheu-Cadotte MA, Cossette S, Dubé V, Fontaine G, Mailhot T, Lavoie P, Cournoyer A, Balli F, Mathieu-Dupuis G. Effectiveness of serious games and impact of design elements on engagement and educational outcomes in healthcare professionals and students: a systematic review and meta-analysis protocol. BMJ Open 2018; 8:e019871. [PMID: 29549206 PMCID: PMC5857654 DOI: 10.1136/bmjopen-2017-019871] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Serious games (SGs) are interactive and entertaining digital software with an educational purpose. They engage the learner by proposing challenges and through various design elements (DEs; eg, points, difficulty adaptation, story). Recent reviews suggest the effectiveness of SGs in healthcare professionals' and students' education is mixed. This could be explained by the variability in their DEs, which has been shown to be highly variable across studies. The aim of this systematic review is to identify, appraise and synthesise the best available evidence regarding the effectiveness of SGs and the impact of DEs on engagement and educational outcomes of healthcare professionals and students. METHODS AND ANALYSIS A systematic search of the literature will be conducted using a combination of medical subject headings terms and keywords in Cumulative Index of Nursing and Allied Health, Embase, Education Resources Information Center, PsycInFO, PubMed and Web of Science. Studies assessing SGs on engagement and educational outcomes will be included. Two independent reviewers will conduct the screening as well as the data extraction process. The risk of bias of included studies will also be assessed by two reviewers using the Effective Practice and Organisation of Care criteria. Data regarding DEs in SGs will first be synthesised qualitatively. A meta-analysis will then be performed, if the data allow it. Finally, the quality of the evidence regarding the effectiveness of SGs on each outcome will be assessed using the Grading of Recommendations Assessment, Development and Evaluation approach. ETHICS AND DISSEMINATION As this systematic review only uses already collected data, no Institutional Review Board approval is required. Its results will be submitted in a peer-reviewed journal by the end of 2018. PROSPERO REGISTRATION NUMBER CRD42017077424.
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Affiliation(s)
- Marc-André Maheu-Cadotte
- Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada
- Montreal Heart Institute Research Center, Montreal, Canada
- Centre de recherche du Centre hospitalier de l'Université de Montréal, Montreal, Canada
| | - Sylvie Cossette
- Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada
| | - Véronique Dubé
- Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada
- Montreal Heart Institute Research Center, Montreal, Canada
| | - Guillaume Fontaine
- Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada
- Montreal Heart Institute Research Center, Montreal, Canada
| | - Tanya Mailhot
- Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada
- Department of Anesthesiology, Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Patrick Lavoie
- William F Connell School of Nursing, Boston College, Boston, Massachusetts, USA
| | - Alexis Cournoyer
- Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada
- Resident in Medicine, Clinician-Scientist Program, Université de Montreal, Montréal, Montreal, Canada
- Hôpital du Sacré-Cœur de Montréal, Montreal, Canada
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Rosen BL, Bishop JM, McDonald SL, Kahn JA, Kreps GL. Quality of Web-Based Educational Interventions for Clinicians on Human Papillomavirus Vaccine: Content and Usability Assessment. JMIR Cancer 2018; 4:e3. [PMID: 29453187 PMCID: PMC5834755 DOI: 10.2196/cancer.9114] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 12/13/2017] [Accepted: 12/13/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Human papillomavirus (HPV) vaccination rates fall far short of Healthy People 2020 objectives. A leading reason is that clinicians do not recommend the vaccine consistently and strongly to girls and boys in the age group recommended for vaccination. Although Web-based HPV vaccine educational interventions for clinicians have been created to promote vaccination recommendations, rigorous evaluations of these interventions have not been conducted. Such evaluations are important to maximize the efficacy of educational interventions in promoting clinician recommendations for HPV vaccination. OBJECTIVE The objectives of our study were (1) to expand previous research by systematically identifying HPV vaccine Web-based educational interventions developed for clinicians and (2) to evaluate the quality of these Web-based educational interventions as defined by access, content, design, user evaluation, interactivity, and use of theory or models to create the interventions. METHODS Current HPV vaccine Web-based educational interventions were identified from general search engines (ie, Google), continuing medical education search engines, health department websites, and professional organization websites. Web-based educational interventions were included if they were created for clinicians (defined as individuals qualified to deliver health care services, such as physicians, clinical nurses, and school nurses, to patients aged 9 to 26 years), delivered information about the HPV vaccine and how to increase vaccination rates, and provided continuing education credits. The interventions' content and usability were analyzed using 6 key indicators: access, content, design, evaluation, interactivity, and use of theory or models. RESULTS A total of 21 interventions were identified, out of which 7 (33%) were webinars, 7 (33%) were videos or lectures, and 7 (33%) were other (eg, text articles, website modules). Of the 21 interventions, 17 (81%) identified the purpose of the intervention, 12 (57%) provided the date that the information had been updated (7 of these were updated within the last 6 months), 14 (67%) provided the participants with the opportunity to provide feedback on the intervention, and 5 (24%) provided an interactive component. None of the educational interventions explicitly stated that a theory or model was used to develop the intervention. CONCLUSIONS This analysis demonstrates that a substantial proportion of Web-based HPV vaccine educational interventions has not been developed using established health education and design principles. Interventions designed using these principles may increase strong and consistent HPV vaccination recommendations by clinicians.
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Affiliation(s)
- Brittany L Rosen
- School of Human Services, University of Cincinnati, Cincinnati, OH, United States
| | - James M Bishop
- School of Human Services, University of Cincinnati, Cincinnati, OH, United States
| | - Skye L McDonald
- School of Human Services, University of Cincinnati, Cincinnati, OH, United States
| | - Jessica A Kahn
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
- College of Medicine, University of Cincinnati, Cincinnati, OH, United States
| | - Gary L Kreps
- Center for Health and Risk Communication, Department of Communication, George Mason University, Fairfax, VA, United States
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Impact of Interactive Video Communication Versus Text-Based Feedback on Teaching, Social, and Cognitive Presence in Online Learning Communities. Nurse Educ 2018; 43:18-22. [PMID: 28858951 DOI: 10.1097/nne.0000000000000448] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A key element to online learning is the ability to create a sense of presence to improve learning outcomes. This quasi-experimental study evaluated the impact of interactive video communication versus text-based feedback and found a significant difference between the 2 groups related to teaching, social, and cognitive presence. Recommendations to enhance presence should focus on providing timely feedback, interactive learning experiences, and opportunities for students to establish relationships with peers and faculty.
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Vaona A, Banzi R, Kwag KH, Rigon G, Cereda D, Pecoraro V, Tramacere I, Moja L. E-learning for health professionals. Cochrane Database Syst Rev 2018; 1:CD011736. [PMID: 29355907 PMCID: PMC6491176 DOI: 10.1002/14651858.cd011736.pub2] [Citation(s) in RCA: 129] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND The use of e-learning, defined as any educational intervention mediated electronically via the Internet, has steadily increased among health professionals worldwide. Several studies have attempted to measure the effects of e-learning in medical practice, which has often been associated with large positive effects when compared to no intervention and with small positive effects when compared with traditional learning (without access to e-learning). However, results are not conclusive. OBJECTIVES To assess the effects of e-learning programmes versus traditional learning in licensed health professionals for improving patient outcomes or health professionals' behaviours, skills and knowledge. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, five other databases and three trial registers up to July 2016, without any restrictions based on language or status of publication. We examined the reference lists of the included studies and other relevant reviews. If necessary, we contacted the study authors to collect additional information on studies. SELECTION CRITERIA Randomised trials assessing the effectiveness of e-learning versus traditional learning for health professionals. We excluded non-randomised trials and trials involving undergraduate health professionals. DATA COLLECTION AND ANALYSIS Two authors independently selected studies, extracted data and assessed risk of bias. We graded the certainty of evidence for each outcome using the GRADE approach and standardised the outcome effects using relative risks (risk ratio (RR) or odds ratio (OR)) or standardised mean difference (SMD) when possible. MAIN RESULTS We included 16 randomised trials involving 5679 licensed health professionals (4759 mixed health professionals, 587 nurses, 300 doctors and 33 childcare health consultants).When compared with traditional learning at 12-month follow-up, low-certainty evidence suggests that e-learning may make little or no difference for the following patient outcomes: the proportion of patients with low-density lipoprotein (LDL) cholesterol of less than 100 mg/dL (adjusted difference 4.0%, 95% confidence interval (CI) -0.3 to 7.9, N = 6399 patients, 1 study) and the proportion with glycated haemoglobin level of less than 8% (adjusted difference 4.6%, 95% CI -1.5 to 9.8, 3114 patients, 1 study). At 3- to 12-month follow-up, low-certainty evidence indicates that e-learning may make little or no difference on the following behaviours in health professionals: screening for dyslipidaemia (OR 0.90, 95% CI 0.77 to 1.06, 6027 patients, 2 studies) and treatment for dyslipidaemia (OR 1.15, 95% CI 0.89 to 1.48, 5491 patients, 2 studies). It is uncertain whether e-learning improves or reduces health professionals' skills (2912 health professionals; 6 studies; very low-certainty evidence), and it may make little or no difference in health professionals' knowledge (3236 participants; 11 studies; low-certainty evidence).Due to the paucity of studies and data, we were unable to explore differences in effects across different subgroups. Owing to poor reporting, we were unable to collect sufficient information to complete a meaningful 'Risk of bias' assessment for most of the quality criteria. We evaluated the risk of bias as unclear for most studies, but we classified the largest trial as being at low risk of bias. Missing data represented a potential source of bias in several studies. AUTHORS' CONCLUSIONS When compared to traditional learning, e-learning may make little or no difference in patient outcomes or health professionals' behaviours, skills or knowledge. Even if e-learning could be more successful than traditional learning in particular medical education settings, general claims of it as inherently more effective than traditional learning may be misleading.
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Affiliation(s)
- Alberto Vaona
- Azienda ULSS 20 ‐ VeronaPrimary CareOspedale di MarzanaPiazzale Ruggero Lambranzi 1VeronaItaly37142
| | - Rita Banzi
- IRCCS ‐ Mario Negri Institute for Pharmacological ResearchLaboratory of Regulatory Policiesvia G La Masa 19MilanItaly20156
| | - Koren H Kwag
- IRCCS Galeazzi Orthopaedic InstituteClinical Epidemiology UnitVia R. Galeazzi, 4MilanItaly20161
| | - Giulio Rigon
- Azienda ULSS 20 ‐ VeronaPrimary CareOspedale di MarzanaPiazzale Ruggero Lambranzi 1VeronaItaly37142
| | | | - Valentina Pecoraro
- IRCCS ‐ Mario Negri Institute for Pharmacological ResearchLaboratory of Regulatory Policiesvia G La Masa 19MilanItaly20156
| | - Irene Tramacere
- Fondazione IRCCS Istituto Neurologico Carlo BestaDepartment of Research and Clinical Development, Scientific DirectorateVia Giovanni Celoria, 11MilanItaly20133
| | - Lorenzo Moja
- University of MilanDepartment of Biomedical Sciences for HealthVia Pascal 36MilanSwitzerland20133
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Detroyer E, Dobbels F, Teodorczuk A, Deschodt M, Depaifve Y, Joosten E, Milisen K. Effect of an interactive E-learning tool for delirium on patient and nursing outcomes in a geriatric hospital setting: findings of a before-after study. BMC Geriatr 2018; 18:19. [PMID: 29351772 PMCID: PMC5775580 DOI: 10.1186/s12877-018-0715-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Accepted: 01/14/2018] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Education of healthcare workers is a core element of multicomponent delirium strategies to improve delirium care and, consequently, patient outcomes. However, traditional educational strategies are notoriously difficult to implement. E-learning is hypothesised to be easier and more cost effective, but research evaluating effectiveness of delirium education through e-learning is scarce at present. Aim is to determine the effect of a nursing e-learning tool for delirium on: (1) in-hospital prevalence, duration and severity of delirium or mortality in hospitalized geriatric patients, and (2) geriatric nurses' knowledge and recognition regarding delirium. METHODS A before-after study in a sample of patients enrolled pre-intervention (non-intervention cohort (NIC); n = 81) and post-intervention (intervention cohort (IC); n = 79), and nurses (n = 17) of a geriatric ward (university hospital). The intervention included an information session about using the e-learning tool, which consisted of 11 e-modules incorporating development of knowledge and skills in the prevention, detection and management of delirium, and the completion of a delirium e-learning tool during a three-month period. Key patient outcomes included in-hospital prevalence and duration of delirium (Confusion Assessment Method), delirium severity (Delirium Index) and mortality (in-hospital; 12 months post-admission); key nurse outcomes included delirium knowledge (Delirium Knowledge Questionnaire) and recognition (Case vignettes). Logistic regression and linear mixed models were used to analyse patient data; Wilcoxon Signed Rank tests, McNemar's or paired t-tests for nursing data. RESULTS No significant difference was found between the IC and NIC for in-hospital prevalence (21.5% versus 25.9%; p = 0.51) and duration of delirium (mean 4.2 ± SD 4.8 days versus 4.9 ± SD 4.8 days; p = 0.38). A trend towards a statistically significant lower delirium severity (IC versus NIC: difference estimate - 1.59; p = 0.08) was noted for delirious IC patients in a linear mixed model. No effect on patient mortality and on nurses' delirium knowledge (p = 0.43) and recognition (p = 1.0) was found. CONCLUSION Our study, the first in its area to investigate effects of delirium e-learning on patient outcomes, demonstrated no benefits on both geriatric patients and nurses. Further research is needed to determine whether delirium e-learning nested within a larger educational approach inclusive of enabling and reinforcing strategies, would be effective. TRIAL REGISTRATION ISRCTN ( 82,293,702 , 27/06/2017).
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Affiliation(s)
- Elke Detroyer
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Kapucijnenvoer 35-PB 7001/4, B-3000, Leuven, Belgium
| | - Fabienne Dobbels
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Kapucijnenvoer 35-PB 7001/4, B-3000, Leuven, Belgium
| | - Andrew Teodorczuk
- School of Medicine, Griffith University, Gold Coast Campus, Southport, Qld, Australia.,Campus for Ageing and Vitality, Newcastle upon Tyne, Northumberland Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Mieke Deschodt
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Kapucijnenvoer 35-PB 7001/4, B-3000, Leuven, Belgium.,Department of Geriatrics, University Hospitals Leuven, Leuven, Belgium
| | - Yves Depaifve
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Kapucijnenvoer 35-PB 7001/4, B-3000, Leuven, Belgium
| | - Etienne Joosten
- Department of Geriatrics, University Hospitals Leuven, Leuven, Belgium
| | - Koen Milisen
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Kapucijnenvoer 35-PB 7001/4, B-3000, Leuven, Belgium. .,Department of Geriatrics, University Hospitals Leuven, Leuven, Belgium.
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Sinclair P, Kable A, Levett-Jones T. The effectiveness of internet-based e-learning on clinician behavior and patient outcomes: a systematic review protocol. ACTA ACUST UNITED AC 2018; 13:52-64. [PMID: 26447007 DOI: 10.11124/jbisrir-2015-1919] [Citation(s) in RCA: 91] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
REVIEW QUESTION/OBJECTIVE The objective of this systematic review is to identify, appraise and synthesize the best available evidence for the effectiveness of internet-based e-learning programs on health care professional behavior and patient outcomes. BACKGROUND Technological innovation has not only impacted social change in recent years but has been the prime driver of educational transformation.The newest consumers of post-secondary education, the so-called 'digital natives', have come to expect education to be delivered in a way that offers increased usability and convenience. Health care professionals (HCPs) in the clinical setting, particularly those in rural and remote communities, are no different. Today's health workforce has a professional responsibility to maintain competency in practice through achieving a minimum number of hours of continuing professional development. Consequently, HCPs seeking professional development opportunities are reliant on sourcing these independently according to individual learning needs. However, difficulties exist in some health professionals' access to ongoing professional development opportunities, particularly those with limited access face-to-face educationdue to geographical isolation or for those not enrolled in a formal program of study.These issues challenge traditional methods of teaching delivery; electronic learning (e-learning) is at the nexus of overcoming these challenges.The term e-learning originated in the mid-1990s as the internet began to gather momentum.Electronic learning can be broadly defined as any type of educational media that is delivered in an electronic form.Terms such as computer-assisted learning, online learning, web-based learning and e-learning are often used synonymously but all reflect knowledge transfer via an electronic device. This broad definition allows for a gamut of multimedia to be used for the purpose of constructing and assessing knowledge. Multimedia typically used in e-learning range from the now archaic Compact Disc Read-Only Memory (CD-ROMs), to the simple Microsoft PowerPoint, or the more advanced and complex virtual worlds such a second life. Electronic learning can be delivered in asynchronous or synchronous formats, with the latter (for example interactive online lectures via platforms such as BlackboardCollaborate or WebEx) more commonly used in formal educational settings according to set timetables of study.Person-to-person interactivity is an important enabler of knowledge generation and while functionalities such as web 1.0 (discussion board and email) and more recently web 2.0 (Wikis and blogs) allow for this to occur both synchronously and asynchronously, it is usually utilized in formal educational contexts only. However, the economy of formal education does not allow for free access to courses which proves challenging for HCPs seeking quality educational opportunities who choose not to undergo a formal program of study or are just looking to meet a specific learning need. Alternatively, asynchronous e-learning is a more learner-centred approach that affords the opportunity to engage in learning at a time and location that is convenient and enables the learner to balance professional development with personal and work commitments.These learning opportunities are self-directed and do not require a human to facilitate learning, rather, technology officiates/facilitates the learning process and, in the asynchronous e-learning context, the learner negotiates meaning independently.Health-related e-learning research has focused on several domains including media comparative designs, self-efficacy, user satisfaction, instructional design, knowledge outcomes, clinical skills development, and facilitators/barriers to its use.The benefits of e-learning are well documented in terms of increased accessibility to education, efficacy, cost effectiveness, learner flexibility and interactivity.However, some fundamental methodological and philosophical flaws exist in e-learning research, not least the use of comparative design studies. Comparison between e-learning and traditional teaching methods are illogical and methodologically flawed because comparison groups are heterogeneous, lack uniformity and have multiple confounders that cannot be adjusted for.As early as 1994, researchersin computer-assisted learning were citing these limitations and called for a fresh research agenda in this area. Cookrepeated this call in 2005 and again in 2009 and noted a paucity of research related to patient or clinical practice outcomes. Electronic learning is not an educational panacea and research needs to progress from pre- and post-interventional and comparative designs that evaluate knowledge increases and user satisfaction. It is time to move towards determining whether improved self-efficacy or knowledge gained through e-learning improves patient outcomes or influences clinical behavior change and whether these changes are sustained. In order to develop the empirical evidence base in e-learning, research needs to be guided by established theoretical frameworks and use validated instruments to move from assessing knowledge generation towards improving our understanding of whether e-learning improves HCP behavior and more importantly, patient outcomes.One suitable framework that is congruent with e-learning research is Kirkpatrick'sfour levels of evaluation. Kirkpatrick's model is hierarchically based with level one relating to student reaction and how well the learner is satisfied with the education program. Level two pertains to learning and the evaluation of knowledge, level three expands on this and considers whether the education has influenced behavior. In the context of this review, behavior change is any practice that is intrinsically linked with the outcomes of the e-learning program undertaken. Finally, level four evaluates the impact on outcomes such as cost benefit or quality improvements.The majority of e-learning research has focused on participant experience and knowledge acquisition, outcomes that correspond with the first two levels of Kirkpatrick's model.To date, few studies have examined the effectiveness of internet-based e-learning programs on HCP behavior, which aligns with Level 3 of Kirkpatrick's model.Studies exist that use self-reported measures of intention to change behavior, however self-reported intention to change does not necessarily translate into actual behavior change. Studies that have not used self-reported measures of behavior change have used objectively measured evaluation criteria including objective structured assessment of technical skills (OSATS) using various methods including simulation task trainers and clinical simulations using standardized patients scored by a panel of experts using standardized assessment tools. Carney et al. used a national reporting and data system to measure the impact of a single one hour e-learning program undertaken by radiologists (n=31) aimed at reducing unnecessary recall during mammography screening. Carney et al. reported a null effect and attributed this to the complexities of behavior change, suggesting that longer term reinforcement of principles relating to mammography recall was required to effect behavior change. These findings also suggest that a multi-modal intervention may be required in order to reduce excessive recall rates in this area, rather than a single intervention. Contrary to Carney et al., Pape-Koehler et al. and Smeekins et al. reported positive findings using randomized controlled designs to test the efficacy of e-learning interventions on individual's surgical performance and the detection of child abuse, respectively. Pape-Koehler et al. used a 2x2 factorial design to demonstrate that an e-learning intervention significantly improved novice surgeon (n=70) surgical performance of a laparoscopic cholecystectomy (change between pre-post test OSATS p 0.001) when used in isolation or in combination with a practical training session compared to practical training alone. Smeekins et al. demonstrated that a 2 hour e-learning program improved nurses' (n=25) ability to detect child abuse in an emergency department. The nurses in the intervention (n=13) group demonstrated significantly better (p=0.022) questioning techniques and consequently, higher quality history taking, to determine children at risk of child abuse when compared with the control group who received no training at all.These three exemplar studies demonstrate the broad range of applications e-learning has in HCP education, as each study used different designs, had different subject areas and target health care professionals. This reflects the conceptual and practical challenges of the area of research that addresses levels three of Kirkpatrick's model. For this reason, the e-learning research agenda in health should focus on whether knowledge generated through e-learning is able to be re-contextualized into clinical practice, and influence sustained clinical behavior change and patient outcomes.A preliminary search of PubMed, CINAHL, The Cochrane Library, The JBI Database of Systematic Reviews and Implementation Reports, ERIC and PROSPERO was conducted to determine if a systematic review on the topic of interest already existed. This search identified four systematic reviews that specifically reviewed outcome measures of knowledge and skill improvement in the domain of e-learning. Two examined research conducted in nursing, with the other two in orthodontics. Lahti et al. systematic review examined the impact of e-learning on nurses' and nursing students' knowledge, skills and satisfaction. Lahti et al. were unable to demonstrate a statistical difference between cohorts undertaking e-learning compared to conventional teaching methods, findings that were not replicated by Du et al. This may be due to the decision by Lahti et al. (ABSTRACT TRUNCATED)
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Affiliation(s)
- Peter Sinclair
- 1 School of Nursing and Midwifery, Faculty of Health and Medicine, University of Newcastle, New South Wales2 University of Newcastle Evidence Based Health Care Group, affiliated with the New South Wales Centre for Evidence Based Health Care Australia: a Collaborating Centre of the Joanna Briggs Institute
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Rose E, Jhun P, Baluzy M, Hauck A, Huang J, Wagner J, Kearl YL, Behar S, Claudius I. Flipping the Classroom in Medical Student Education: Does Priming Work? West J Emerg Med 2017; 19:93-100. [PMID: 29383062 PMCID: PMC5785208 DOI: 10.5811/westjem.2017.8.35162] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2017] [Revised: 07/18/2017] [Accepted: 09/06/2017] [Indexed: 12/29/2022] Open
Abstract
Introduction The emergency medicine (EM) clerkship curriculum at Los Angeles County + University of Southern California Medical Center includes monthly lectures on pediatric fever and shortness of breath (SOB). This educational innovation evaluated if learning could be enhanced by "priming" the students with educational online videos prior to an in-class session. Factors that impacted completion rates were also evaluated (planned specialty and time given for video viewing). Methods Twenty-minute videos were to be viewed prior to the didactic session. Students were assigned to either the fever or SOB group and received links to those respective videos. All participating students took a pre-test prior to viewing the online lectures. For analysis, test scores were placed into concordant groups (test results on fever questions in the group assigned the fever video and test results on SOB questions in the group assigned the SOB video) and discordant groups (crossover between video assigned and topic tested). Each subject contributed one set of concordant results and one set of discordant results. Descriptive statistics were performed with the Mann-Whitney U test. Lecture links were distributed to students two weeks prior to the in-class session for seven months and three days prior to the in-class session for eight months (in which both groups included both EM-bound and non-EM bound students). Results In the fifteen-month study period, 64% of students rotating through the EM elective prepared for the in class session by watching the videos. During ten months where exclusively EM-bound students were rotating (n=144), 71.5% of students viewed the lectures. In four months where students were not EM-bound (n=54), 55.6% of students viewed the lectures (p=0.033). Participation was 60.2% when lecture links were given three days in advance and 68.7% when links were given two weeks in advance (p=0.197). In the analysis of concordant scores, the pre-test averaged 56.7% correct, the immediate post-test averaged 78.1% correct, and the delayed post-test was 67.2%. In the discordant groups, the pretest averaged 51.9%, the immediate posttest was 67.1% and the delayed by 68.8%. In the concordant groups, the immediate post-test scores improved by 21.4%, compared with 15.2% in the discordant groups (p = 0.655). In the delayed post-test the concordant scores improved by 10.5% and discordant scores by 16.9 percent (p=0.609). Sixty-two percent of students surveyed preferred the format of online videos with in-class case discussion to a traditional lecture format. Conclusion Immediate post-tests and delayed post-tests improved but priming was not demonstrated to be a statistically superior educational method in this study. Medical student completion of the preparatory materials for the EM rotation session increased when the students were EM-bound. Participation rates were not significantly different when given at two weeks versus three days.
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Affiliation(s)
- Emily Rose
- Los Angeles County-University of Southern California Medical Center, Department of Emergency Medicine, Los Angeles, California
| | - Paul Jhun
- University of California San Francisco, San Francisco General Hospital, Department of Emergency Medicine, San Francisco, California
| | - Matthew Baluzy
- Los Angeles County-University of Southern California Medical Center, Department of Emergency Medicine, Los Angeles, California
| | - Aaron Hauck
- Keck School of Medicine of the University of Southern California, Los Angeles, California
| | - Jonathan Huang
- Keck School of Medicine of the University of Southern California, Los Angeles, California
| | - Jonathan Wagner
- Los Angeles County-University of Southern California Medical Center, Department of Emergency Medicine, Los Angeles, California
| | - Yvette L Kearl
- Los Angeles County-University of Southern California Medical Center, Department of Emergency Medicine, Los Angeles, California
| | - Solomon Behar
- Los Angeles County-University of Southern California Medical Center, Department of Emergency Medicine, Los Angeles, California
| | - Ilene Claudius
- Los Angeles County-University of Southern California Medical Center, Department of Emergency Medicine, Los Angeles, California
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Richmond H, Copsey B, Hall AM, Davies D, Lamb SE. A systematic review and meta-analysis of online versus alternative methods for training licensed health care professionals to deliver clinical interventions. BMC MEDICAL EDUCATION 2017; 17:227. [PMID: 29169393 PMCID: PMC5701457 DOI: 10.1186/s12909-017-1047-4] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Accepted: 11/02/2017] [Indexed: 05/07/2023]
Abstract
BACKGROUND Online training is growing in popularity and yet its effectiveness for training licensed health professionals (HCPs) in clinical interventions is not clear. We aimed to systematically review the literature on the effectiveness of online versus alternative training methods in clinical interventions for licensed Health Care Professionals (HCPs) on outcomes of knowledge acquisition, practical skills, clinical behaviour, self-efficacy and satisfaction. METHODS Seven databases were searched for randomised controlled trials (RCTs) from January 2000 to June 2015. Two independent reviewers rated trial quality and extracted trial data. Comparative effects were summarised as standardised mean differences (SMD) and 95% confidence intervals. Pooled effect sizes were calculated using a random-effects model for three contrasts of online versus (i) interactive workshops (ii) taught lectures and (iii) written/electronic manuals. RESULTS We included 14 studies with a total of 1089 participants. Most trials studied medical professionals, used a workshop or lecture comparison, were of high risk of bias and had small sample sizes (range 21-183). Using the GRADE approach, we found low quality evidence that there was no difference between online training and an interactive workshop for clinical behaviour SMD 0.12 (95% CI -0.13 to 0.37). We found very low quality evidence of no difference between online methods and both a workshop and lecture for knowledge (workshop: SMD 0.04 (95% CI -0.28 to 0.36); lecture: SMD 0.22 (95% CI: -0.08, 0.51)). Lastly, compared to a manual (n = 3/14), we found very low quality evidence that online methods were superior for knowledge SMD 0.99 (95% CI 0.02 to 1.96). There were too few studies to draw any conclusions on the effects of online training for practical skills, self-efficacy, and satisfaction across all contrasts. CONCLUSIONS It is likely that online methods may be as effective as alternative methods for training HCPs in clinical interventions for the outcomes of knowledge and clinical behaviour. However, the low quality of the evidence precludes drawing firm conclusions on the relative effectiveness of these training methods. Moreover, the confidence intervals around our effect sizes were large and could encompass important differences in effectiveness. More robust, adequately powered RCTs are needed.
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Affiliation(s)
- Helen Richmond
- Warwick Clinical Trials Unit, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Bethan Copsey
- Centre for Rehabilitation Research, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Amanda M. Hall
- The George Institute for Global Health, University of Oxford, Oxford, UK
| | - David Davies
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Sarah E. Lamb
- Warwick Clinical Trials Unit, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
- Centre for Rehabilitation Research, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, UK
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168
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Abbott EF, Thompson W, Pandian TK, Zendejas B, Farley DR, Cook DA. Personalized Video Feedback and Repeated Task Practice Improve Laparoscopic Knot-Tying Skills: Two Controlled Trials. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2017; 92:S26-S32. [PMID: 29065020 DOI: 10.1097/acm.0000000000001924] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
PURPOSE Compare the effect of personalized feedback (PF) vs. task demonstration (TD), both delivered via video, on laparoscopic knot-tying skills and perceived workload; and evaluate the effect of repeated practice. METHOD General surgery interns and research fellows completed four repetitions of a simulated laparoscopic knot-tying task at one-month intervals. Midway between repetitions, participants received via e-mail either a TD video (demonstration by an expert) or a PF video (video of their own performance with voiceover from a blinded senior surgeon). Each participant received at least one video per format, with sequence randomly assigned. Outcomes included performance scores and NASA Task Load Index (NASA-TLX) scores. To evaluate the effectiveness of repeated practice, scores from these trainees on a separate delayed retention test were compared against historical controls who did not have scheduled repetitions. RESULTS Twenty-one trainees completed the randomized study. Mean change in performance scores was significantly greater for those receiving PF (difference = 23.1 of 150 [95% confidence interval (CI): 0, 46.2], P = .05). Perceived workload was also significantly reduced (difference = -3.0 of 20 [95% CI: -5.8, -0.3], P = .04). Compared with historical controls (N = 93), the 21 with scheduled repeated practice had higher scores on the laparoscopic knot-tying assessment two weeks after the final repetition (difference = 1.5 of 10 [95% CI: 0.2, 2.8], P = .02). CONCLUSIONS Personalized video feedback improves trainees' procedural performance and perceived workload compared with a task demonstration video. Brief monthly practice sessions support skill acquisition and retention.
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Affiliation(s)
- Eduardo F Abbott
- E.F. Abbott is a simulation fellow, Mayo Clinic Multidisciplinary Simulation Center, Mayo Clinic College of Medicine, Rochester, Minnesota, and adjunct instructor of internal medicine, Department of Internal Medicine, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile; ORCID: http://orcid.org/0000-0001-5713-4809. W. Thompson is a medical student, University of Minnesota Medical School, Minneapolis, Minnesota. T.K. Pandian is a resident, Department of Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota. B. Zendejas is a pediatric surgery fellow, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts. D.R. Farley is professor of surgery and consultant, Department of Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota. D.A. Cook is professor of medicine and professor of medical education; research chair, Mayo Clinic Multidisciplinary Simulation Center; director of research, Office of Applied Scholarship and Education Science; and Consultant in the Division of General Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota; ORCID: http://orcid.org/0000-0003-2383-4633
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169
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Lawn S, Zhi X, Morello A. An integrative review of e-learning in the delivery of self-management support training for health professionals. BMC MEDICAL EDUCATION 2017; 17:183. [PMID: 29017521 PMCID: PMC5634849 DOI: 10.1186/s12909-017-1022-0] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Accepted: 09/29/2017] [Indexed: 05/07/2023]
Abstract
BACKGROUND E-learning involves delivery of education through Information and Communication Technology (ITC) using a wide variety of instructional designs, including synchronous and asynchronous formats. It can be as effective as face-to-face training for many aspects of health professional training. There are, however, particular practices and skills needed in providing patient self-management support, such as partnering with patients in goal-setting, which may challenge conventional practice norms. E-learning for the delivery of self-management support (SMS) continuing education to existing health professionals is a relatively new and growing area with limited studies identifying features associated with best acquisition of skills in self-management support. METHODS An integrative literature review examined what is known about e-learning for self-management support. This review included both qualitative and quantitative studies that focused on e-learning provided to existing health professionals for their continuing professional development. Papers were limited to those published in English between 2006 and 2016. Content analysis was used to organize and focus and describe the findings. RESULTS The search returned 1505 articles, with most subsequently excluded based on their title or abstract. Fifty-two full text articles were obtained and checked, with 42 excluded because they did not meet the full criteria. Ten peer-reviewed articles were included in this review. Seven main themes emerged from the content analysis: participants and professions; time; package content; guiding theoretical framework; outcome measures; learning features or formats; and learning barriers. These themes revealed substantial heterogeneity in instructional design and other elements of e-learning applied to SMS, indicating that there is still much to understand about how best to deliver e-learning for SMS skills development. CONCLUSIONS Few e-learning approaches meet the need for high levels of interactivity, reflection, practice and application to practice for health professionals learning to deliver effective SMS. Findings suggest that the context of SMS for patients with chronic condition matters to how health professional training is delivered, to ensure partnership and person-centred care. Further creative approaches and their rigorous evaluation are needed to deliver completely online learning in this space. Blended learning that combines e-learning and face-to-face methods is suggested to support SMS skills development for health professionals.
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Affiliation(s)
- Sharon Lawn
- Flinders Human Behaviour & Health Research Unit, Department of Psychiatry, Flinders University, PO Box 2100, Adelaide, South Australia 5001 Australia
| | - Xiaojuan Zhi
- Flinders Human Behaviour & Health Research Unit, Department of Psychiatry, Flinders University, PO Box 2100, Adelaide, South Australia 5001 Australia
| | - Andrea Morello
- Flinders Human Behaviour & Health Research Unit, Department of Psychiatry, Flinders University, PO Box 2100, Adelaide, South Australia 5001 Australia
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Thomsen JLD, Mathiesen O, Hägi-Pedersen D, Skovgaard LT, Østergaard D, Engbaek J, Gätke MR. Improving Neuromuscular Monitoring and Reducing Residual Neuromuscular Blockade With E-Learning: Protocol for the Multicenter Interrupted Time Series INVERT Study. JMIR Res Protoc 2017; 6:e192. [PMID: 28986337 PMCID: PMC5650673 DOI: 10.2196/resprot.7527] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 06/19/2017] [Accepted: 06/20/2017] [Indexed: 12/18/2022] Open
Abstract
Background Muscle relaxants facilitate endotracheal intubation under general anesthesia and improve surgical conditions. Residual neuromuscular blockade occurs when the patient is still partially paralyzed when awakened after surgery. The condition is associated with subjective discomfort and an increased risk of respiratory complications. Use of an objective neuromuscular monitoring device may prevent residual block. Despite this, many anesthetists refrain from using the device. Efforts to increase the use of objective monitoring are time consuming and require the presence of expert personnel. A neuromuscular monitoring e-learning module might support consistent use of neuromuscular monitoring devices. Objective The aim of the study is to assess the effect of a neuromuscular monitoring e-learning module on anesthesia staff’s use of objective neuromuscular monitoring and the incidence of residual neuromuscular blockade in surgical patients at 6 Danish teaching hospitals. Methods In this interrupted time series study, we are collecting data repeatedly, in consecutive 3-week periods, before and after the intervention, and we will analyze the effect using segmented regression analysis. Anesthesia departments in the Zealand Region of Denmark are included, and data from all patients receiving a muscle relaxant are collected from the anesthesia information management system MetaVision. We will assess the effect of the module on all levels of potential effect: staff’s knowledge and skills, patient care practice, and patient outcomes. The primary outcome is use of neuromuscular monitoring in patients according to the type of muscle relaxant received. Secondary outcomes include last recorded train-of-four value, administration of reversal agents, and time to discharge from the postanesthesia care unit as well as a multiple-choice test to assess knowledge. The e-learning module was developed based on a needs assessment process, including focus group interviews, surveys, and expert opinions. Results The e-learning module was implemented in 6 anesthesia departments on 21 November 2016. Currently, we are collecting postintervention data. The final dataset will include data from more than 10,000 anesthesia procedures. We expect to publish the results in late 2017 or early 2018. Conclusions With a dataset consisting of thousands of general anesthesia procedures, the INVERT study will assess whether an e-learning module can increase anesthetists’ use of neuromuscular monitoring. Trial Registration Clinicaltrials.gov NCT02925143; https://clinicaltrials.gov/ct2/show/NCT02925143 (Archived by WebCite® at http://www.webcitation.org/6s50iTV2x)
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Affiliation(s)
| | - Ole Mathiesen
- Department of Anesthesiology, Zealand University Hospital, Koege, Denmark
| | | | | | - Doris Østergaard
- Copenhagen Academy for Medical Education and Simulation, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Jens Engbaek
- Department of Anesthesiology, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Mona Ring Gätke
- Department of Anesthesiology, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark
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171
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Berman AH, Biguet G, Stathakarou N, Westin-Hägglöf B, Jeding K, McGrath C, Zary N, Kononowicz AA. Virtual Patients in a Behavioral Medicine Massive Open Online Course (MOOC): A Qualitative and Quantitative Analysis of Participants' Perceptions. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2017; 41:631-641. [PMID: 28390054 PMCID: PMC5617876 DOI: 10.1007/s40596-017-0706-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Accepted: 02/20/2017] [Indexed: 05/10/2023]
Abstract
OBJECTIVE The purpose of this article is to explore learners' perceptions of using virtual patients in a behavioral medicine Massive Open Online Course (MOOCs) and thereby describe innovative ways of disseminating knowledge in health-related areas. METHODS A 5-week MOOC on behavioral medicine was hosted on the edX platform. The authors developed two branched virtual patients consisting of video recordings of a live standardized patient, with multiple clinical decision points and narration unfolding depending on learners' choices. Students interacted with the virtual patients to treat stress and sleep problems. Answers to the exit survey and participant comments from the discussion forum were analyzed qualitatively and quantitatively. RESULTS In total, 19,236 participants enrolled in the MOOC, out of which 740 received the final certificate. The virtual patients were completed by 2317 and 1640 participants respectively. Among survey respondents (n = 442), 83.1% agreed that the virtual patient exercise was helpful. The qualitative analysis resulted in themes covering what it was like to work with the virtual patient, with subthemes on learner-centered education, emotions/eustress, game comparisons, what the participants learned, what surprised them, how confident participants felt about applying interventions in practice, suggestions for improvement, and previous experiences of virtual patients. CONCLUSIONS Students were enthusiastic about interacting with the virtual patients as a means to apply new knowledge about behavioral medicine interventions. The most common suggestion was to incorporate more interactive cases with various levels of complexity. Further research should include patient outcomes and focus on interprofessional aspects of learning with virtual patients in a MOOC.
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Affiliation(s)
- Anne H Berman
- Karolinska Institutet, Center for Psychiatry Research, Stockholm, Sweden.
| | - Gabriele Biguet
- Karolinska Institutet, Center for Psychiatry Research, Stockholm, Sweden
| | | | | | | | - Cormac McGrath
- Karolinska Institutet, Center for Psychiatry Research, Stockholm, Sweden
| | - Nabil Zary
- Karolinska Institutet, Center for Psychiatry Research, Stockholm, Sweden
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172
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Shin JY, Issenberg SB, Roh YS. The effects of neurologic assessment E-learning in nurses. NURSE EDUCATION TODAY 2017; 57:60-64. [PMID: 28734188 DOI: 10.1016/j.nedt.2017.07.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Revised: 02/06/2017] [Accepted: 07/10/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND A firm understanding of the preliminary assessment of a patient with neurological disorders is needed for ensuring optimal patient outcomes. OBJECTIVES The purpose of this study is to evaluate the effects of using e-learning on neurologic assessment knowledge, ability, and self-confidence among nurses. DESIGN This study used a non-equivalent control group pretest-posttest design. SETTINGS Nurses working in the neurology and neurosurgery wards, Republic of Korea PARTICIPANTS: A convenience sample of 50 nurses was assigned to either the experimental group (n=24) or the control group (n=26). METHODS The experimental group participated in the self-directed e-learning program related to neurologic assessment, and control group underwent self-directed learning with handout. Knowledge, ability, and self-confidence were measured at pretest and posttest. RESULTS There were no significant differences in knowledge (U=270, p=0.399) and self-confidence (U=241.5, p=0.171) between the two groups. Nurses in the experimental group showed higher neurologic assessment ability compared with those in the control group (U=199, p=0.028). CONCLUSIONS Self-directed neurologic assessment e-learning induced improvement in the neurologic assessment ability among nurses. Self-directed e-learning can be applied for improving competencies in neurologic assessment.
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Affiliation(s)
- Ji Yeon Shin
- Chung-Ang University Hospital, Seoul, Republic of Korea.
| | - S Barry Issenberg
- Gordon Center for Research in Medical Education, University of Miami Miller School of Medicine, USA.
| | - Young Sook Roh
- Red Cross College of Nursing, Chung-Ang University, 84 Heukseok-ro Dongjak-gu, Seoul, 06974, Republic of Korea.
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173
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Anderson LC, Krichbaum KE. Best practices for learning physiology: combining classroom and online methods. ADVANCES IN PHYSIOLOGY EDUCATION 2017; 41:383-389. [PMID: 28679576 DOI: 10.1152/advan.00099.2016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 06/05/2017] [Accepted: 06/06/2017] [Indexed: 06/07/2023]
Abstract
Physiology is a requisite course for many professional allied health programs and is a foundational science for learning pathophysiology, health assessment, and pharmacology. Given the demand for online learning in the health sciences, it is important to evaluate the efficacy of online and in-class teaching methods, especially as they are combined to form hybrid courses. The purpose of this study was to compare two hybrid physiology sections in which one section was offered mostly in-class (85% in-class), and the other section was offered mostly online (85% online). The two sections in 2 yr (year 1 and year 2) were compared in terms of knowledge of physiology measured in exam scores and pretest-posttest improvement, and in measures of student satisfaction with teaching. In year 1, there were some differences on individual exam scores between the two sections, but no significant differences in mean exam scores or in pretest-posttest improvements. However, in terms of student satisfaction, the mostly in-class students in year 1 rated the instructor significantly higher than did the mostly online students. Comparisons between in-class and online students in the year 2 cohort yielded data that showed that mean exam scores were not statistically different, but pre-post changes were significantly greater in the mostly online section; student satisfaction among mostly online students also improved significantly. Education researchers must investigate effective combinations of in-class and online methods for student learning outcomes, while maintaining the flexibility and convenience that online methods provide.
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Affiliation(s)
- Lisa C Anderson
- Department of Integrative Biology and Physiology, University of Minnesota, Minneapolis, Minnesota; and
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174
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Novotny NL, Stapleton SJ, Hardy EC. Enhancing Critical Thinking in Graduate Nursing Online Asynchronous Discussions. J Nurs Educ 2017; 55:514-21. [PMID: 27560119 DOI: 10.3928/01484834-20160816-05] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Accepted: 06/09/2016] [Indexed: 11/20/2022]
Abstract
BACKGROUND Graduate nursing students in online courses often have limited success in developing the critical thinking (CT) skills essential for advanced roles. This study describes the use of complementary strategies in a graduate-level nursing course to enhance CT in online discussions. METHOD Using Paul and Elder's framework for understanding the components of CT, the authors designed an asynchronous online course using multiple strategies to promote CT. We used mixed methods to collect descriptive and numerical data and content and repeated measures analyses to identify changes in CT skills and student perceptions across the semester. RESULTS CT scores increased significantly and aligned with students' perceived improvements in CT. CONCLUSION Evidence of CT in online discussions increased significantly across the semester with the use of multiple instructional strategies and substantial student and faculty efforts. The findings are a useful benchmark for future studies comparing combinations of strategies to identify those most effective and least arduous. [J Nurs Educ. 2016;55(9):514-521.].
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175
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Damarell RA, Tieman JJ. How Do Clinicians Learn About Knowledge Translation? An Investigation of Current Web-Based Learning Opportunities. JMIR MEDICAL EDUCATION 2017; 3:e12. [PMID: 28705788 PMCID: PMC5532514 DOI: 10.2196/mededu.7825] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 05/26/2017] [Accepted: 05/26/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Clinicians are important stakeholders in the translation of well-designed research evidence into clinical practice for optimal patient care. However, the application of knowledge translation (KT) theories and processes may present conceptual and practical challenges for clinicians. Online learning platforms are an effective means of delivering KT education, providing an interactive, time-efficient, and affordable alternative to face-to-face education programs. OBJECTIVE This study investigates the availability and accessibility of online KT learning opportunities for health professionals. It also provides an analysis of the types of resources and associated disciplines retrieved by a range of KT synonyms. METHODS We searched a range of bibliographic databases and the Internet (Google advanced option) using 9 KT terms to identify online KT learning resources. To be eligible, resources had to be free, aimed at clinicians, educational in intent, and interactive in design. Each term was searched using two different search engines. The details of the first 100 websites captured per browser (ie, n=200 results per term) were entered into EndNote. Each site was subsequently visited to determine its status as a learning resource. Eligible websites were appraised for quality using the AACODS (Authority, Accuracy, Coverage, Objectivity, Date, Significance) tool. RESULTS We identified 971 unique websites via our multiple search strategies. Of these, 43 were health-related and educational in intent. Once these sites were evaluated for interactivity, a single website matched our inclusion criteria (Dementia Knowledge Translation Learning Centre). CONCLUSIONS KT is an important but complex system of processes. These processes overlap with knowledge, practice, and improvement processes that go by a range of different names. For clinicians to be informed and competent in KT, they require better access to free learning opportunities. These resources should be designed from the viewpoint of the clinician, presenting KT's multifaceted theories and processes in an engaging, interactive way. This learning should empower clinicians to contextualize and apply KT strategies within their own care settings.
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Affiliation(s)
- Raechel A Damarell
- Palliative and Supportive Services, Flinders University, Adelaide SA, Australia
| | - Jennifer J Tieman
- Palliative and Supportive Services, Flinders University, Adelaide SA, Australia
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176
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Wittich CM, Agrawal A, Cook DA, Halvorsen AJ, Mandrekar JN, Chaudhry S, Dupras DM, Oxentenko AS, Beckman TJ. E-learning in graduate medical education: survey of residency program directors. BMC MEDICAL EDUCATION 2017; 17:114. [PMID: 28697744 PMCID: PMC5504987 DOI: 10.1186/s12909-017-0953-9] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 06/26/2017] [Indexed: 05/06/2023]
Abstract
BACKGROUND E-learning-the use of Internet technologies to enhance knowledge and performance-has become a widely accepted instructional approach. Little is known about the current use of e-learning in postgraduate medical education. To determine utilization of e-learning by United States internal medicine residency programs, program director (PD) perceptions of e-learning, and associations between e-learning use and residency program characteristics. METHODS We conducted a national survey in collaboration with the Association of Program Directors in Internal Medicine of all United States internal medicine residency programs. RESULTS Of the 368 PDs, 214 (58.2%) completed the e-learning survey. Use of synchronous e-learning at least sometimes, somewhat often, or very often was reported by 85 (39.7%); 153 programs (71.5%) use asynchronous e-learning at least sometimes, somewhat often, or very often. Most programs (168; 79%) do not have a budget to integrate e-learning. Mean (SD) scores for the PD perceptions of e-learning ranged from 3.01 (0.94) to 3.86 (0.72) on a 5-point scale. The odds of synchronous e-learning use were higher in programs with a budget for its implementation (odds ratio, 3.0 [95% CI, 1.04-8.7]; P = .04). CONCLUSIONS Residency programs could be better resourced to integrate e-learning technologies. Asynchronous e-learning was used more than synchronous, which may be to accommodate busy resident schedules and duty-hour restrictions. PD perceptions of e-learning are relatively moderate and future research should determine whether PD reluctance to adopt e-learning is based on unawareness of the evidence, perceptions that e-learning is expensive, or judgments about value versus effectiveness.
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Affiliation(s)
- Christopher M. Wittich
- Division of General Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905 USA
| | - Anoop Agrawal
- Departments of Medicine and Pediatrics, Baylor College of Medicine, Houston, TX USA
| | - David A. Cook
- Division of General Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905 USA
| | | | | | - Saima Chaudhry
- Department of Medicine, Memorial Healthcare System, Fort Lauderdale, FL USA
| | - Denise M. Dupras
- Division of Primary Care Internal Medicine, Mayo Clinic, Rochester, MN USA
| | - Amy S. Oxentenko
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN USA
| | - Thomas J. Beckman
- Division of General Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905 USA
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Fontaine G, Cossette S, Maheu-Cadotte MA, Mailhot T, Deschênes MF, Mathieu-Dupuis G. Effectiveness of Adaptive E-Learning Environments on Knowledge, Competence, and Behavior in Health Professionals and Students: Protocol for a Systematic Review and Meta-Analysis. JMIR Res Protoc 2017; 6:e128. [PMID: 28679491 PMCID: PMC5517824 DOI: 10.2196/resprot.8085] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Accepted: 06/17/2017] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Adaptive e-learning environments (AEEs) can provide tailored instruction by adapting content, navigation, presentation, multimedia, and tools to each user's navigation behavior, individual objectives, knowledge, and preferences. AEEs can have various levels of complexity, ranging from systems using a simple adaptive functionality to systems using artificial intelligence. While AEEs are promising, their effectiveness for the education of health professionals and health professions students remains unclear. OBJECTIVE The purpose of this systematic review is to assess the effectiveness of AEEs in improving knowledge, competence, and behavior in health professionals and students. METHODS We will follow the Cochrane Collaboration and the Effective Practice and Organisation of Care (EPOC) Group guidelines on systematic review methodology. A systematic search of the literature will be conducted in 6 bibliographic databases (CINAHL, EMBASE, ERIC, PsycINFO, PubMed, and Web of Science) using the concepts "adaptive e-learning environments," "health professionals/students," and "effects on knowledge/skills/behavior." We will include randomized and nonrandomized controlled trials, in addition to controlled before-after, interrupted time series, and repeated measures studies published between 2005 and 2017. The title and the abstract of each study followed by a full-text assessment of potentially eligible studies will be independently screened by 2 review authors. Using the EPOC extraction form, 1 review author will conduct data extraction and a second author will validate the data extraction. The methodological quality of included studies will be independently assessed by 2 review authors using the EPOC risk of bias criteria. Included studies will be synthesized by a descriptive analysis. Where appropriate, data will be pooled using meta-analysis by applying the RevMan software version 5.1, considering the heterogeneity of studies. RESULTS The review is in progress. We plan to submit the results in the beginning of 2018. CONCLUSION Providing tailored instruction to health professionals and students is a priority in order to optimize learning and clinical outcomes. This systematic review will synthesize the best available evidence regarding the effectiveness of AEEs in improving knowledge, competence, and behavior in health professionals and students. It will provide guidance to policy makers, hospital managers, and researchers in terms of AEE development, implementation, and evaluation in health care.
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Affiliation(s)
- Guillaume Fontaine
- Montreal Heart Institute Research Center, Montreal, QC, Canada.,Faculty of Nursing, Université de Montréal, Montreal, QC, Canada
| | - Sylvie Cossette
- Montreal Heart Institute Research Center, Montreal, QC, Canada.,Faculty of Nursing, Université de Montréal, Montreal, QC, Canada
| | - Marc-André Maheu-Cadotte
- Montreal Heart Institute Research Center, Montreal, QC, Canada.,Faculty of Nursing, Université de Montréal, Montreal, QC, Canada
| | - Tanya Mailhot
- Montreal Heart Institute Research Center, Montreal, QC, Canada.,Faculty of Nursing, Université de Montréal, Montreal, QC, Canada.,Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Marie-France Deschênes
- Faculty of Nursing, Université de Montréal, Montreal, QC, Canada.,Center for Innovation in Nursing Education, Université de Montréal, Montreal, QC, Canada
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McConnell KA, Krisher LK, Lenssen M, Bunik M, Bunge Montes S, Domek GJ. Telehealth to Expand Community Health Nurse Education in Rural Guatemala: A Pilot Feasibility and Acceptability Evaluation. Front Public Health 2017; 5:60. [PMID: 28405582 PMCID: PMC5370395 DOI: 10.3389/fpubh.2017.00060] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 03/10/2017] [Indexed: 11/25/2022] Open
Abstract
Telehealth education has the potential to serve as an important, low-cost method of expanding healthcare worker education and support, especially in rural settings of low- and middle-income countries. We describe an innovative educational strategy to strengthen a long-term health professional capacity building partnership between Guatemalan and US-based partners. In this pilot evaluation, community health nurses in rural Guatemala received customized, interactive education via telehealth from faculty at the supporting US-based institution. Program evaluation of this 10 lecture series demonstrated high levels of satisfaction among learners and instructors as well as knowledge gain by learners. An average of 5.5 learners and 2 instructors attended the 10 lectures and completed surveys using a Likert scale to rate statements regarding lecture content, technology, and personal connection. Positive statements about lecture content and the applicability to daily work had 98% or greater agreement as did statements regarding ease of technology and convenience. The learners agreed with feeling connected to the instructors 100% of the time, while instructors had 86.4% agreement with connection related statements. Instructors, joining at their respective work locations, rated convenience statements at 100% agreement. This evaluation also demonstrated effectiveness with an average 10.7% increase in pre- to posttest knowledge scores by learners. As the global health community considers efficiency in time, money, and our environment, telehealth education is a critical method to consider and develop for health worker education. Our pilot program evaluation shows that telehealth may be an effective method of delivering education to frontline health workers in rural Guatemala. While larger studies are needed to quantify the duration and benefits of specific knowledge gains and to perform a cost-effectiveness analysis of the program, our initial pilot results are encouraging and show that a telehealth program between a US-based university and a rural community health program in a low- and middle-income country is both feasible and acceptable.
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Affiliation(s)
- Kelly A. McConnell
- Center for Global Health, Colorado School of Public Health, Aurora, CO, USA
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Lyndsay K. Krisher
- Center for Health, Work & Environment, Colorado School of Public Health, Aurora, CO, USA
| | - Maureen Lenssen
- Center for Global Health, Colorado School of Public Health, Aurora, CO, USA
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Maya Bunik
- Center for Global Health, Colorado School of Public Health, Aurora, CO, USA
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Saskia Bunge Montes
- Center for Global Health, Colorado School of Public Health, Aurora, CO, USA
- Center for Human Development at the Southwest Trifinio, Retalhuleu, Guatemala
| | - Gretchen J. Domek
- Center for Global Health, Colorado School of Public Health, Aurora, CO, USA
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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179
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Ens A, Janzen K, Palmert MR. Development of an Online Learning Module to Improve Pediatric Residents' Confidence and Knowledge of the Pubertal Examination. J Adolesc Health 2017; 60:292-298. [PMID: 27986457 DOI: 10.1016/j.jadohealth.2016.10.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 09/30/2016] [Accepted: 10/11/2016] [Indexed: 11/15/2022]
Abstract
PURPOSE Pediatric residents must know how to perform pubertal examinations. The initial objective of this study was to evaluate pediatric resident knowledge and comfort related to the pubertal examination and to determine whether and why these examinations are avoided. The subsequent objective was to develop and assess a learning module (LM) addressing identified education gaps. METHODS A learning needs assessment (LNA) was administered to residents in four Canadian pediatric training programs. Identified themes and knowledge gaps were used to develop an online, case-based LM. A randomized assessment of the LM was conducted among residents from nine training programs across Canada. RESULTS Sixty-four residents completed the LNA. About 52% reported discomfort introducing the pubertal examination, 50% reported a lack of confidence related to the examination, and 56% reported having avoided a warranted examination. Ninety-seven residents participated in the LM assessment. The baseline results were similar to those from the LNA in terms of discomfort, lack of confidence, and avoidance related to pubertal examinations. However, the intervention group showed improvement on a knowledge assessment compared with control group (p < .001). Confidence levels also improved in the intervention group LM (p < .01). Most residents (95%) stated they found the LM to be useful. CONCLUSIONS Residents report being uncomfortable with and avoiding the pubertal examination and have significant knowledge gaps. The online, case-based LM used in this study improved the knowledge and confidence related to this aspect of pediatric care and may be an effective adjunct to pediatric training.
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Affiliation(s)
- Andrea Ens
- Division of Endocrinology, Department of Pediatrics, Hospital for Sick Children, Toronto, Canada; Department of Leadership, Higher and Adult Education, Ontario Institute for Studies in Education, University of Toronto, Toronto, Canada; Department of Pediatrics, Markham Stouffville Hospital, Markham, Canada.
| | - Katharine Janzen
- Department of Leadership, Higher and Adult Education, Ontario Institute for Studies in Education, University of Toronto, Toronto, Canada
| | - Mark R Palmert
- Division of Endocrinology, Department of Pediatrics, Hospital for Sick Children, Toronto, Canada; Department of Physiology, University of Toronto, Toronto, Canada
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180
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Pan HH, Wu LF, Hung YC, Chu CM, Wang KY. Long-Term Effectiveness of Two Educational Methods on Knowledge, Attitude, and Practice Toward Palliative Care Consultation Services Among Nursing Staff: A Longitudinal Follow-Up Study. Clin Nurs Res 2017; 27:483-496. [PMID: 29228811 DOI: 10.1177/1054773817692082] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This experimental study investigated long-term effectiveness of two educational methods on knowledge, attitude, and practice (KAP) about palliative care consultation services (PCCS) among nurses, recruited from a medical center located in Northern Taiwan in 2015, using a stratified cluster sampling method, with 88 participants in multimedia (experimental) and 92 in traditional paper education (control) group. Data were collected using KAP-PCCS questionnaire before education, immediately after, and 3rd and 6th month after education. Results showed that both K-PCCSI and P-PCCSI significantly increased immediately after, and at the 3rd month after education for the experimental group; the K-PCCSI remained significantly higher for the experimental group at the 6th month. The highest increase in scores for both K-PCCSI and P-PCCSI was observed at the 3rd month. There was no significant change in A-PCCS in both groups after follow-up periods, when compared before education. Therefore, using multimedia every 3 months to continue strengthening their knowledge may increase the referrals of terminal patients to PCCS.
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Affiliation(s)
| | - Li-Fen Wu
- 1 National Defense Medical Center, Taipei City, Taiwan.,2 Tri-Service General Hospital, Taipei City, Taiwan
| | - Yu-Chun Hung
- 1 National Defense Medical Center, Taipei City, Taiwan.,2 Tri-Service General Hospital, Taipei City, Taiwan
| | - Chi-Ming Chu
- 1 National Defense Medical Center, Taipei City, Taiwan
| | - Kwua-Yun Wang
- 1 National Defense Medical Center, Taipei City, Taiwan.,3 Taipei Veterans General Hospital, Taipei City, Taiwan.,4 National Yang-Ming University, Taipei City, Taiwan
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181
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Sinclair PM, Levett-Jones T, Morris A, Carter B, Bennett PN, Kable A. High engagement, high quality: A guiding framework for developing empirically informed asynchronous e-learning programs for health professional educators. Nurs Health Sci 2017; 19:126-137. [PMID: 28090732 DOI: 10.1111/nhs.12322] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 10/27/2016] [Accepted: 11/02/2016] [Indexed: 12/15/2022]
Abstract
E-learning involves the transfer of skills and knowledge via technology so that learners can access meaningful and authentic educational materials. While learner engagement is important, in the context of healthcare education, pedagogy must not be sacrificed for edu-tainment style instructional design. Consequently, health professional educators need to be competent in the use of current web-based educational technologies so that learners are able to access relevant and engaging e-learning materials without restriction. The increasing popularity of asynchronous e-learning programs developed for use outside of formal education institutions has made this need more relevant. In these contexts, educators must balance design and functionality to deliver relevant, cost-effective, sustainable, and accessible programs that overcome scheduling and geographic barriers for learners. This paper presents 10 guiding design principles and their application in the development of an e-learning program for general practice nurses focused on behavior change. Consideration of these principles will assist educators to develop high quality, pedagogically sound, engaging, and interactive e-learning resources.
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Affiliation(s)
- Peter M Sinclair
- School of Nursing and Midwifery, University of Newcastle, Newcastle, New South Wales, Australia
| | - Tracey Levett-Jones
- School of Nursing and Midwifery, University of Newcastle, Newcastle, New South Wales, Australia
| | - Amanda Morris
- School of Nursing and Midwifery, University of Newcastle, Newcastle, New South Wales, Australia
| | - Ben Carter
- School of Nursing and Midwifery, University of Newcastle, Newcastle, New South Wales, Australia
| | - Paul N Bennett
- School of Medicine, Stanford University, Palo Alto, California, USA.,Satellite Healthcare, San Jose, California, USA
| | - Ashley Kable
- School of Nursing and Midwifery, University of Newcastle, Newcastle, New South Wales, Australia
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182
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Bonnes SL, Ratelle JT, Halvorsen AJ, Carter KJ, Hafdahl LT, Wang AT, Mandrekar JN, Oxentenko AS, Beckman TJ, Wittich CM. Flipping the Quality Improvement Classroom in Residency Education. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2017; 92:101-107. [PMID: 27680317 DOI: 10.1097/acm.0000000000001412] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
PURPOSE The flipped classroom (FC), in which instructional content is delivered before class with class time devoted to knowledge application, has the potential to engage residents. A Mayo Clinic Internal Medicine Residency Program study was conducted to validate an FC perception instrument (FCPI); determine whether participation improved FC perceptions; and determine associations between resident characteristics, change in quality improvement (QI) knowledge, and FC perception scores. METHOD All 143 internal medicine residents at Mayo Clinic, Rochester participated from 2014 to 2015; some experienced a flipped QI curriculum and others completed the traditional nonflipped course. The FCPI was developed, and factor analysis revealed an intuitive two-factor structure: preclass activity and in-class application. Residents were surveyed before and after the monthlong curriculum to measure changes in perception, and the QI Knowledge Assessment Tool was employed to measure knowledge improvement. RESULTS Postcourse FCPI scores significantly increased for three of the eight items. QI knowledge increased significantly among residents who experienced the FC compared with residents who completed the non-FC curriculum. Those without prior FC exposure demonstrated a significant increase in QI knowledge compared with those with previous FC experience. The FCPI had compelling validity evidence with improved scores after curriculum exposure and associations with greater engagement in online modules. CONCLUSIONS Residents who participated in the FC demonstrated improved QI knowledge compared with the control group. Residents valued the in-class application sessions more than the online component. These findings have important implications for graduate medical education as residency training programs increasingly use FC models.
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Affiliation(s)
- Sara L Bonnes
- S.L. Bonnes is senior associate consultant, Division of General Internal Medicine, Mayo Clinic, and assistant professor of medicine, Mayo Clinic College of Medicine, Rochester, Minnesota. J.T. Ratelle is senior associate consultant, Division of Hospital Internal Medicine, Mayo Clinic, and assistant professor of medicine, Mayo Clinic College of Medicine, Rochester, Minnesota. A.J. Halvorsen is a statistician, Division of General Internal Medicine, Mayo Clinic, and assistant professor of medicine, Mayo Clinic College of Medicine, Rochester, Minnesota. K.J. Carter is assistant professor of general and geriatric medicine, University of Kansas Medical Center, Kansas City, Kansas. L.T. Hafdahl is senior associate consultant, Division of Primary Care Internal Medicine, Mayo Clinic, and instructor of medicine, Mayo Clinic College of Medicine, Rochester, Minnesota. A.T. Wang is assistant professor, Division of General Internal Medicine, Harbor-UCLA Medical Center, Torrance, California. J.N. Mandrekar is consultant, Division of Biomedical Statistics and Informatics and Division of Behavioral Neurology, Mayo Clinic, and professor of biostatistics and neurology, Mayo Clinic College of Medicine, Rochester, Minnesota. A.S. Oxentenko is consultant, Division of Gastroenterology and Hepatology, Mayo Clinic, and associate professor of medicine, Mayo Clinic College of Medicine, Rochester, Minnesota. T.J. Beckman is consultant, Division of General Internal Medicine, Mayo Clinic, and professor of medical education and medicine, Mayo Clinic College of Medicine, Rochester, Minnesota. C.M. Wittich is consultant, Division of General Internal Medicine, Mayo Clinic, and associate professor of medicine, Mayo Clinic College of Medicine, Rochester, Minnesota
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183
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Scott KM, Baur L, Barrett J. Evidence-Based Principles for Using Technology-Enhanced Learning in the Continuing Professional Development of Health Professionals. THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS 2017; 37:61-66. [PMID: 28252469 DOI: 10.1097/ceh.0000000000000146] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Increasingly, health professional training involves the use of educational technologies through what is broadly termed "Technology-Enhanced Learning" (TEL). TEL includes hardware, such as computers and mobile devices, and software, such as software applications (apps), learning management systems, and discussion boards. For many years, TEL has formed an integral part of health professional programs and is growing in acceptance, if not expectation, in postgraduate training and continuing education. TEL generally aims to be flexible, engaging, learner focused and interactive, and may involve collaboration and communication. It offers many benefits for learning and teaching, whether used on its own or in conjunction with face-to-face teaching through blended learning. The ubiquity of mobile devices in clinical settings means TEL is ideal for busy clinicians, both as learners and teachers. TEL enables participants to learn at a time and place that is convenient to them, so learners living in geographically dispersed locations can access standardized courses. To realize these potential benefits, we recommend that those developing TEL programs for health professionals take a systematic approach to planning, development, implementation, and evaluation. To that end, we propose 10 principles: clarify purpose and conduct a needs assessment; allocate adequate time and technology; incorporate proven approaches to improve learning; consider the need for a skills component; enable interaction between learners and with others; create different resources for different groups; pilot before implementing; incorporate measures to retain learners; provide opportunities for revision to aid retention; and evaluate learning outcomes, not just satisfaction.
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Affiliation(s)
- Karen M Scott
- Dr. Scott: Senior Lecturer, Discipline of Child and Adolescent Health, The University of Sydney, Sydney, Australia. Dr. Baur: Professor of Child and Adolescent Health, Discipline of Child and Adolescent Health, The University of Sydney, Sydney, Australia, and The Children's Hospital at Westmead, Sydney, Australia. Dr. Barrett: Honorary Research Fellow, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
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Law M, Rapoport MJ, Seitz D, Davidson M, Madan R, Wiens A. Evaluation of a National Online Educational Program in Geriatric Psychiatry. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2016; 40:923-927. [PMID: 26108395 PMCID: PMC5102959 DOI: 10.1007/s40596-015-0377-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Accepted: 05/19/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVE This study provides evaluation results of an online study group (OSG) for geriatric psychiatry continuing professional development. METHODS The OSG is an interactive, expert-facilitated, asynchronous educational experience for psychiatrists and residents in Canada. A retrospective web survey assessed self-efficacy, knowledge in geriatric psychiatry, comfort with online learning, and perceived effectiveness of the instructional methods. Wilcoxon signed-rank tests and descriptive statistics were calculated. RESULTS Twenty-nine (of 50) participants (58 %) completed the questionnaire. Although only 48 % of respondents reported improved perceived knowledge, 79 % reported improved efficacy beliefs, and 76 % reported improved comfort with online learning. Most (79 %) would consider taking OSG again, and 93 % would recommend it to others. CONCLUSIONS The OSG was well-received, with greater benefits for self-efficacy with the material and comfort with online learning than for perceived knowledge itself. Further research is needed to ascertain actual knowledge change in the context of online learning in medical education.
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Affiliation(s)
- Marcus Law
- University of Toronto, Toronto, ON, Canada.
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185
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Arunasalam N. Technology-enhanced learning in transnational higher education. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2016; 25:1201-1205. [PMID: 27882796 DOI: 10.12968/bjon.2016.25.21.1201] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Some university schools of nursing in Australia and the UK have developed collaborative links with Malaysia to deliver part-time Transnational Higher Education (TNHE) post-registration top-up nursing degree courses. It enables nurses trained to diploma level to upgrade to a degree qualification. The views of 18 Malaysian nurses who had studied with one Australian and two UK TNHE universities were explored using a hermeneutic phenomenological approach. Participants recruited via convenience and snowball sampling methods were interviewed in English and Bahasa Malaysia (Malaysian language). Thematic analysis were used to analyse data. Findings indicated nurses' frustration with technology-enhanced teaching and learning and a lack of support throughout the programme. Although nurses developed confidence in using computer technology, they remained disappointed with the level of academic support. The data and some useful strategies outlined provide important insights for TNHE providers, the Malaysian Nursing Board and private hospital employers to consider for enhancing nurses learning and experiences.
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186
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Emergency medicine residents' beliefs about contributing to an online collaborative slideshow. CAN J EMERG MED 2016; 17:374-86. [PMID: 26134054 DOI: 10.1017/cem.2014.49] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Collaborative writing applications (CWAs), such as the Google DocsTM platform, can improve skill acquisition, knowledge retention, and collaboration in medical education. Using CWAs to support the training of residents offers many advantages, but stimulating them to contribute remains challenging. The purpose of this study was to identify emergency medicine (EM) residents' beliefs about their intention to contribute summaries of landmark articles to a Google DocsTM slideshow while studying for their Royal College of Physicians and Surgeons of Canada (RCPSC) certification exam. METHOD Using the Theory of Planned Behavior, the authors interviewed graduating RCPSC EM residents about contributing to a slideshow. Residents were asked about behavioral beliefs (advantages/disadvantages), normative beliefs (positive/negative referents), and control beliefs (barriers/facilitators). Two reviewers independently performed qualitative content analysis of interview transcripts to identify salient beliefs in relation to the defined behaviors. RESULTS Of 150 eligible EM residents, 25 participated. The main reported advantage of contributing to the online slideshow was learning consolidation (n=15); the main reported disadvantage was information overload (n=3). The most frequently reported favorable referents were graduating EM residents writing the certification exam (n=16). Few participants (n=3) perceived any negative referents. The most frequently reported facilitator was peer-reviewed high-quality scientific information (n=9); and the most frequently reported barrier was time constraints (n=22). CONCLUSION Salient beliefs exist regarding EM residents' intention to contribute content to an online collaborative writing project using a Google DocsTM slideshow. Overall, participants perceived more advantages than disadvantages to contributing and believed that this initiative would receive wide support. However, participants reported several barriers that need to be addressed to increase contributions. Our intention is for the beliefs identified in this study to contribute to the design of a theory-based questionnaire to explore determinants of residents' intentions to contribute to an online collaborative writing project. This will help develop implementation strategies for increasing contributions to other CWAs in medical education.
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187
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Luetsch K, Burrows J. Certainty rating in pre-and post-tests of study modules in an online clinical pharmacy course - A pilot study to evaluate teaching and learning. BMC MEDICAL EDUCATION 2016; 16:267. [PMID: 27741945 PMCID: PMC5065079 DOI: 10.1186/s12909-016-0783-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Accepted: 09/27/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Graduate and post-graduate education for health professionals is increasingly delivered in an e-learning environment, where automated, continuous formative testing with integrated feedback can guide students' self-assessment and learning. Asking students to rate the certainty they assign to the correctness of their answers to test questions can potentially provide deeper insights into the success of teaching, with test results informing course designers whether learning outcomes have been achieved. It may also have implications for decision making in clinical practice. METHODS A study of pre-and post-tests for five study modules was designed to evaluate the teaching and learning within a pharmacotherapeutic course in an online postgraduate clinical pharmacy program. Certainty based marking of multiple choice questions (MCQ) was adapted for formative pre- and post-study module testing by asking students to rate their certainty of correctness of MCQ answers. Paired t-tests and a coding scheme were used to analyse changes in answers and certainty between pre-and post-tests. A survey evaluated students' experience with the novel formative testing design. RESULTS Twenty-nine pharmacists enrolled in the postgraduate program participated in the study. Overall 1315 matched pairs of MCQ answers and certainty ratings between pre- and post-module tests were available for evaluation. Most students identified correct answers in post-tests and increased their certainty compared to pre-tests. Evaluation of certainty ratings in addition to correctness of answers identified MCQs and topic areas for revision to course designers. A survey of students showed that assigning certainty ratings to their answers assisted in structuring and focusing their learning throughout online study modules, facilitating identification of areas of uncertainty and gaps in their clinical knowledge. CONCLUSIONS Adding certainty ratings to MCQ answers seems to engage students with formative testing and feedback and focus their learning in a web-based postgraduate pharmacy course. It also offers deeper insight into the successful delivery of online course content, identifying areas for improvement of teaching and content delivery as well as test question design.
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Affiliation(s)
- Karen Luetsch
- School of Pharmacy, The University of Queensland, 21 Cornwall St, Woolloongabba, Qld 4102 Australia
| | - Judith Burrows
- School of Pharmacy, The University of Queensland, 21 Cornwall St, Woolloongabba, Qld 4102 Australia
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Shaw T, Yates P, Moore B, Ash K, Nolte L, Krishnasamy M, Nicholson J, Rynderman M, Avery J, Jefford M. Development and evaluation of an online educational resource about cancer survivorship for cancer nurses: a mixed-methods sequential study. Eur J Cancer Care (Engl) 2016; 26. [PMID: 27726221 DOI: 10.1111/ecc.12576] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2016] [Indexed: 11/26/2022]
Abstract
Cancer survivorship is recognised globally as a key issue. In spite of the key role played by nurses in survivorship care, there is an identified gap in nurse's knowledge in this area. This study reports on the development and evaluation of an educational resource for nurses working with people affected by cancer. The resource was designed using adult learning principles and includes a variety of learning materials and point of care resources. A mixed-methods sequential exploratory design was used to undertake an evaluation of the programme. This included the use of online surveys and semi-structured interviews with pilot participants. A total of 21 participants completed an online survey and 11 participants completed a telephone interview. Overall, the participants found the Cancer Survivorship resource to be engaging, practical and intuitive. A major theme emerging from the survey and interview data was that the resource was applicable to practice and useful in developing survivorship care plans. Respondents requested additional information be included on the role of various health professionals working in survivorship as well as guidelines on when to make referrals. This study provides evidence that the Cancer Survivorship tool may be a promising vehicle for delivering evidence-based education on survivorship care.
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Affiliation(s)
- T Shaw
- Faculty of Health Sciences, Charles Perkins Center, University of Sydney, Sydney, NSW, Australia
| | - P Yates
- Queensland University of Technology, Brisbane, QLD, Australia
| | - B Moore
- Faculty of Health Sciences, Charles Perkins Center, University of Sydney, Sydney, NSW, Australia
| | - K Ash
- Queensland University of Technology, Brisbane, QLD, Australia
| | - L Nolte
- Australian Cancer Survivorship Centre, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - M Krishnasamy
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - J Nicholson
- Faculty of Health Sciences, Charles Perkins Center, University of Sydney, Sydney, NSW, Australia
| | - M Rynderman
- Australian Cancer Survivorship Centre, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - J Avery
- Faculty of Health Sciences, Charles Perkins Center, University of Sydney, Sydney, NSW, Australia
| | - M Jefford
- Australian Cancer Survivorship Centre, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
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Knestrick JM, Wilkinson MR, Pellathy TP, Lange-Kessler J, Katz R, Compton P. Predictors of Retention of Students in an Online Nurse Practitioner Program. J Nurse Pract 2016. [DOI: 10.1016/j.nurpra.2016.06.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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190
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Alam F, Boet S, Piquette D, Lai A, Perkes CP, LeBlanc VR. E-learning optimization: the relative and combined effects of mental practice and modeling on enhanced podcast-based learning-a randomized controlled trial. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2016; 21:789-802. [PMID: 26846221 DOI: 10.1007/s10459-016-9666-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2015] [Accepted: 01/11/2016] [Indexed: 06/05/2023]
Abstract
Enhanced podcasts increase learning, but evidence is lacking on how they should be designed to optimize their effectiveness. This study assessed the impact two learning instructional design methods (mental practice and modeling), either on their own or in combination, for teaching complex cognitive medical content when incorporated into enhanced podcasts. Sixty-three medical students were randomised to one of four versions of an airway management enhanced podcast: (1) control: narrated presentation; (2) modeling: narration with video demonstration of skills; (3) mental practice: narrated presentation with guided mental practice; (4) combined: modeling and mental practice. One week later, students managed a manikin-based simulated airway crisis. Knowledge acquisition was assessed by baseline and retention multiple-choice quizzes. Two blinded raters assessed all videos obtained from simulated crises to measure the students' skills using a key-elements scale, critical error checklist, and the Ottawa global rating scale (GRS). Baseline knowledge was not different between all four groups (p = 0.65). One week later, knowledge retention was significantly higher for (1) both the mental practice and modeling group than the control group (p = 0.01; p = 0.01, respectively) and (2) the combined mental practice and modeling group compared to all other groups (all ps = 0.01). Regarding skills acquisition, the control group significantly under-performed in comparison to all other groups on the key-events scale (all ps ≤ 0.05), the critical error checklist (all ps ≤ 0.05), and the Ottawa GRS (all ps ≤ 0.05). The combination of mental practice and modeling led to greater improvement on the key events checklist (p = 0.01) compared to either strategy alone. However, the combination of the two strategies did not result in any further learning gains on the two other measures of clinical performance (all ps > 0.05). The effectiveness of enhanced podcasts for knowledge retention and clinical skill acquisition is increased with either mental practice or modeling. The combination of mental practice and modeling had synergistic effects on knowledge retention, but conveyed less clear advantages in its application through clinical skills.
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Affiliation(s)
- Fahad Alam
- Department of Anaesthesia, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Room M3200, Toronto, ON, M4N 3M5, Canada.
- The Wilson Centre for Research in Education, 200 Elizabeth Street, 1ES-565, Toronto, ON, M5G 2C4, Canada.
| | - Sylvain Boet
- Department of Anaesthesia and Department of Innovation in Medical Innovation, The Ottawa Hospital, University of Ottawa, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada
| | - Dominique Piquette
- Department of Critical Care, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada
- The Wilson Centre for Research in Education, 200 Elizabeth Street, 1ES-565, Toronto, ON, M5G 2C4, Canada
| | - Anita Lai
- Department of Emergency Medicine, The Ottawa Hospital, University of Ottawa, 1053 Carling Avenue, E-Main, Room EM-206, Box 227, Ottawa, ON, K1Y 4E9, Canada
| | - Christopher P Perkes
- Belleville General Hospital, 265 Dundas Street East, Belleville, ON, K8N 5A9, Canada
| | - Vicki R LeBlanc
- Department of Innovation in Medical Education and University of Ottawa Skills and Simulation Centre, The Ottawa Hospital, University of Ottawa, 451 Smyth Road, RGN 2211, Ottawa, ON, K1H 8M5, Canada
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Fontaine G, Cossette S, Heppell S, Boyer L, Mailhot T, Simard MJ, Tanguay JF. Evaluation of a Web-Based E-Learning Platform for Brief Motivational Interviewing by Nurses in Cardiovascular Care: A Pilot Study. J Med Internet Res 2016; 18:e224. [PMID: 27539960 PMCID: PMC5010651 DOI: 10.2196/jmir.6298] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 08/03/2016] [Accepted: 08/08/2016] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Brief motivational interviewing (MI) can contribute to reductions in morbidity and mortality related to coronary artery disease, through health behavior change. Brief MI, unlike more intensive interventions, was proposed to meet the needs of clinicians with little spare time. While the provision of face-to-face brief MI training on a large scale is complicated, Web-based e-learning is promising because of the flexibility it offers. OBJECTIVE The primary objective of this pilot study was to examine the feasibility and acceptability of a Web-based e-learning platform for brief MI (MOTIV@CŒUR), which was evaluated by nurses in cardiovascular care. The secondary objective was to assess the preliminary effect of the training on nurses' perceived brief MI skills and self-reported clinical use of brief MI. METHODS We conducted a single-group, pre-post pilot study involving nurses working in a coronary care unit to evaluate MOTIV@CŒUR, which is a Web-based e-learning platform for brief MI, consisting of two sessions lasting 30 and 20 minutes. MOTIV@CŒUR covers 4 real-life clinical situations through role-modeling videos showing nurse-client interactions. A brief introduction to MI is followed by role playing, during which a nurse practitioner evaluates clients' motivation to change and intervenes according to the principles of brief MI. The clinical situations target smoking, medication adherence, physical activity, and diet. Nurses were asked to complete both Web-based training sessions asynchronously within 20 days, which allowed assessment of the feasibility of the intervention. Data regarding acceptability and preliminary effects (perceived skills in brief MI, and self-reported clinical use of conviction and confidence interventions) were self-assessed through Web-based questionnaires 30 days (±5 days) after the first session. RESULTS We enrolled 27 women and 4 men (mean age 37, SD 9 years) in March 2016. Of the 31 participants, 24 (77%, 95% CI 63%-91%) completed both sessions in ≤20 days. At 30 days, 28 of the 31 participants (90%) had completed at least one session. The training was rated as highly acceptable, with the highest scores observed for information quality (mean 6.26, SD 0.60; scale 0-7), perceived ease of use (mean 6.16, SD 0.78; scale 0-7), and system quality (mean 6.15, SD 0.58; scale 0-7). Posttraining scores for self-reported clinical use of confidence interventions were higher than pretraining scores (mean 34.72, SD 6.29 vs mean 31.48, SD 6.75, respectively; P=.03; scale 10-50). Other results were nonsignificant. CONCLUSIONS Brief MI training using a Web-based e-learning platform including role-modeling videos is both feasible and acceptable according to cardiovascular care nurses. Further research is required to evaluate the e-learning platform in a randomized controlled trial. TRIAL REGISTRATION International Standard Randomized Controlled Trial Number (ISRCTN): 16510888; http://www.isrctn.com/ISRCTN16510888 (Archived by WebCite at http://www.webcitation.org/6jf7dr7bx).
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192
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Taveira-Gomes T, Ferreira P, Taveira-Gomes I, Severo M, Ferreira MA. What Are We Looking for in Computer-Based Learning Interventions in Medical Education? A Systematic Review. J Med Internet Res 2016; 18:e204. [PMID: 27480053 PMCID: PMC4985611 DOI: 10.2196/jmir.5461] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Revised: 06/01/2016] [Accepted: 06/21/2016] [Indexed: 11/13/2022] Open
Abstract
Background Computer-based learning (CBL) has been widely used in medical education, and reports regarding its usage and effectiveness have ranged broadly. Most work has been done on the effectiveness of CBL approaches versus traditional methods, and little has been done on the comparative effects of CBL versus CBL methodologies. These findings urged other authors to recommend such studies in hopes of improving knowledge about which CBL methods work best in which settings. Objective In this systematic review, we aimed to characterize recent studies of the development of software platforms and interventions in medical education, search for common points among studies, and assess whether recommendations for CBL research are being taken into consideration. Methods We conducted a systematic review of the literature published from 2003 through 2013. We included studies written in English, specifically in medical education, regarding either the development of instructional software or interventions using instructional software, during training or practice, that reported learner attitudes, satisfaction, knowledge, skills, or software usage. We conducted 2 latent class analyses to group articles according to platform features and intervention characteristics. In addition, we analyzed references and citations for abstracted articles. Results We analyzed 251 articles. The number of publications rose over time, and they encompassed most medical disciplines, learning settings, and training levels, totaling 25 different platforms specifically for medical education. We uncovered 4 latent classes for educational software, characteristically making use of multimedia (115/251, 45.8%), text (64/251, 25.5%), Web conferencing (54/251, 21.5%), and instructional design principles (18/251, 7.2%). We found 3 classes for intervention outcomes: knowledge and attitudes (175/212, 82.6%), knowledge, attitudes, and skills (11.8%), and online activity (12/212, 5.7%). About a quarter of the articles (58/227, 25.6%) did not hold references or citations in common with other articles. The number of common references and citations increased in articles reporting instructional design principles (P=.03), articles measuring online activities (P=.01), and articles citing a review by Cook and colleagues on CBL (P=.04). There was an association between number of citations and studies comparing CBL versus CBL, independent of publication date (P=.02). Conclusions Studies in this field vary highly, and a high number of software systems are being developed. It seems that past recommendations regarding CBL interventions are being taken into consideration. A move into a more student-centered model, a focus on implementing reusable software platforms for specific learning contexts, and the analysis of online activity to track and predict outcomes are relevant areas for future research in this field.
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Affiliation(s)
- Tiago Taveira-Gomes
- Department of Medical Education and Simulation, Faculty of Medicine, University of Porto, Porto, Portugal.
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193
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Blake H, Gartshore E. Workplace wellness using online learning tools in a healthcare setting. Nurse Educ Pract 2016; 20:70-5. [PMID: 27486706 DOI: 10.1016/j.nepr.2016.07.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 06/30/2016] [Accepted: 07/04/2016] [Indexed: 10/21/2022]
Abstract
The aim was to develop and evaluate an online learning tool for use with UK healthcare employees, healthcare educators and healthcare students, to increase knowledge of workplace wellness as an important public health issue. A 'Workplace Wellness' e-learning tool was developed and peer-reviewed by 14 topic experts. This focused on six key areas relating to workplace wellness: work-related stress, musculoskeletal disorders, diet and nutrition, physical activity, smoking and alcohol consumption. Each key area provided current evidence-based information on causes and consequences, access to UK government reports and national statistics, and guidance on actions that could be taken to improve health within a workplace setting. 188 users (93.1% female, age 18-60) completed online knowledge questionnaires before (n = 188) and after (n = 88) exposure to the online learning tool. Baseline knowledge of workplace wellness was poor (n = 188; mean accuracy 47.6%, s.d. 11.94). Knowledge significantly improved from baseline to post-intervention (mean accuracy = 77.5%, s.d. 13.71) (t(75) = -14.801, p < 0.0005) with knowledge increases evident for all included topics areas. Usability evaluation showed that participants perceived the tool to be useful (96.4%), engaging (73.8%) and would recommend it to others (86.9%). Healthcare professionals, healthcare educators and pre-registered healthcare students held positive attitudes towards online learning, indicating scope for development of further online packages relating to other important health parameters.
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Affiliation(s)
- Holly Blake
- School of Health Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, UK.
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194
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De Leeuw RA, Westerman M, Nelson E, Ket JCF, Scheele F. Quality specifications in postgraduate medical e-learning: an integrative literature review leading to a postgraduate medical e-learning model. BMC MEDICAL EDUCATION 2016; 16:168. [PMID: 27390843 PMCID: PMC4939034 DOI: 10.1186/s12909-016-0700-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 06/11/2016] [Indexed: 05/10/2023]
Abstract
BACKGROUND E-learning is driving major shifts in medical education. Prioritizing learning theories and quality models improves the success of e-learning programs. Although many e-learning quality standards are available, few are focused on postgraduate medical education. METHODS We conducted an integrative review of the current postgraduate medical e-learning literature to identify quality specifications. The literature was thematically organized into a working model. RESULTS Unique quality specifications (n = 72) were consolidated and re-organized into a six-domain model that we called the Postgraduate Medical E-learning Model (Postgraduate ME Model). This model was partially based on the ISO-19796 standard, and drew on cognitive load multimedia principles. The domains of the model are preparation, software design and system specifications, communication, content, assessment, and maintenance. CONCLUSION This review clarified the current state of postgraduate medical e-learning standards and specifications. It also synthesized these specifications into a single working model. To validate our findings, the next-steps include testing the Postgraduate ME Model in controlled e-learning settings.
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Affiliation(s)
- R. A. De Leeuw
- />Athena Institute for Trans-disciplinary Research, VU University Amsterdam, De Boelelaan 1118, Amsterdam, 1081 HZ The Netherlands
| | - M. Westerman
- />VUmc, School of Medical Sciences, Amsterdam, The Netherlands
| | - E. Nelson
- />Division of Pediatric Infectious Diseases, Department of Pediatrics, Stanford University School of Medicine, Stanford, USA
| | - J. C. F. Ket
- />VU University Amsterdam, University Library, Amsterdam, The Netherlands
| | - F. Scheele
- />Athena Institute for Trans-disciplinary Research, VU University Amsterdam, De Boelelaan 1118, Amsterdam, 1081 HZ The Netherlands
- />VUmc, School of Medical Sciences, Amsterdam, The Netherlands
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195
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Richmond H, Hall AM, Hansen Z, Williamson E, Davies D, Lamb SE. Using mixed methods evaluation to assess the feasibility of online clinical training in evidence based interventions: a case study of cognitive behavioural treatment for low back pain. BMC MEDICAL EDUCATION 2016; 16:163. [PMID: 27316705 PMCID: PMC4912756 DOI: 10.1186/s12909-016-0683-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 06/07/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Cognitive behavioural (CB) approaches are effective in the management of non-specific low back pain (LBP). We developed the CB Back Skills Training programme (BeST) and previously provided evidence of clinical and cost effectiveness in a large pragmatic trial. However, practice change is challenged by a lack of treatment guidance and training for clinicians. We aimed to explore the feasibility and acceptability of an online programme (iBeST) for providing training in a CB approach. METHODS This mixed methods study comprised an individually randomised controlled trial of 35 physiotherapists and an interview study of 8 physiotherapists. Participants were recruited from 8 National Health Service departments in England and allocated by a computer generated randomisation list to receive iBeST (n = 16) or a face-to-face workshop (n = 19). Knowledge (of a CB approach), clinical skills (unblinded assessment of CB skills in practice), self-efficacy (reported confidence in using new skills), attitudes (towards LBP management), and satisfaction were assessed after training. Engagement with iBeST was assessed with user analytics. Interviews explored acceptability and experiences with iBeST. Data sets were analysed independently and jointly interpreted. RESULTS Fifteen (94 %) participants in the iBeST group and 16 (84 %) participants in the workshop group provided data immediately after training. We observed similar scores on knowledge (MD (95 % CI): 0.97 (-1.33, 3.26)), and self-efficacy to deliver the majority of the programme (MD (95 % CI) 0.25 (-1.7; 0.7)). However, the workshop group showed greater reduction in biomedical attitudes to LBP management (MD (95 % CI): -7.43 (-10.97, -3.89)). Clinical skills were assessed in 5 (33 %) iBeST participants and 7 (38 %) workshop participants within 6 months of training and were similar between groups (MD (95 % CI): 0.17(-0.2; 0.54)). Interviews highlighted that while initially sceptical, participants found iBeST acceptable. A number of strategies were identified to enhance future versions of iBeST such as including more skills practice. CONCLUSIONS Combined quantitative and qualitative data indicated that online training was an acceptable and promising method for providing training in an evidence based complex intervention. With future enhancement, the potential reach of this training method may facilitate evidence-based practice through large scale upskilling of the workforce. TRIAL REGISTRATION Current Controlled Trials ISRCTN82203145 (registered prospectively on 03.09.2012).
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Affiliation(s)
- Helen Richmond
- />Centre for Rehabilitation Research in Oxford, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
- />Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - Amanda M. Hall
- />The George Institute for Global Health, University of Oxford, Oxford, UK
| | - Zara Hansen
- />Centre for Rehabilitation Research in Oxford, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Esther Williamson
- />Centre for Rehabilitation Research in Oxford, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - David Davies
- />Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - Sarah E. Lamb
- />Centre for Rehabilitation Research in Oxford, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
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Gentry S, L'Estrade Ehrstrom B, Gauthier A, Alvarez J, Wortley D, van Rijswijk J, Car J, Lilienthal A, Tudor Car L, Nikolaou CK, Zary N. Serious Gaming and Gamification interventions for health professional education. Hippokratia 2016. [DOI: 10.1002/14651858.cd012209] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Sarah Gentry
- Norfolk and Norwich University Hospital; Norwich Norfolk UK NR4 7UY
- University of East Anglia; Norwich Medical School; Norwich Norfolk UK NR4 7TJ
- School of Public Health, Imperial College London; Department of Primary Care and Public Health; Charing Cross Campus Reynolds Building London UK W6 8RP
| | - Beatrice L'Estrade Ehrstrom
- Karolinska Institutet; Department of Learning, Informatics, Management and Ethics (LIME); Solna, Stockholm Sweden
| | - Andrea Gauthier
- Faculty of Medicine, University of Toronto; Institute of Medical Science; Medical Sciences Building, 1 King's College Circle Toronto Ontario Canada
| | - Julian Alvarez
- University of Lille; CIREL Laboratory of the Educational Science Department; Lille France
| | | | | | - Josip Car
- Lee Kong Chian School of Medicine, Nanyang Technological University; Health Services and Outcomes Research Programme; 3 Fusionopolis Link, #03-08 Nexus@one-north Singapore Singapore 138543
- Imperial College London; Global eHealth Unit, Department of Primary Care and Public Health, School of Public Health; Reynolds Building St Dunstans Road London UK W6 8RP
- University of Ljubljana; Department of Family Medicine, Faculty of Medicine; Ljubljana Slovenia
| | - Anneliese Lilienthal
- Karolinska Institutet; Department of Learning, Informatics, Management and Ethics (LIME); Solna, Stockholm Sweden
| | - Lorainne Tudor Car
- School of Public Health, Imperial College London; Department of Primary Care and Public Health; Charing Cross Campus Reynolds Building London UK W6 8RP
| | - Charoula K Nikolaou
- Universite Catholique de Louvain; Centre de philosophie du droit (Cellule Biogov); Faculté de droit et de criminologie Collège Thomas More Place Montesquieu 2, bte L2.07.01, B-1348 Louvain-la-Neuve Belgium
| | - Nabil Zary
- Karolinska Institutet; Department of Learning, Informatics, Management and Ethics (LIME); Solna, Stockholm Sweden
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197
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Kam J, Ainsworth H, Handmer M, Louie-Johnsun M, Winter M. Portable Video Media Versus Standard Verbal Communication in Surgical Information Delivery to Nurses: A Prospective Multicenter, Randomized Controlled Crossover Trial. Worldviews Evid Based Nurs 2016; 13:363-370. [PMID: 27176121 DOI: 10.1111/wvn.12162] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/01/2016] [Indexed: 12/26/2022]
Abstract
BACKGROUND Continuing education of health professionals is important for delivery of quality health care. Surgical nurses are often required to understand surgical procedures. Nurses need to be aware of the expected outcomes and recognize potential complications of such procedures during their daily work. Traditional educational methods, such as conferences and tutorials or informal education at the bedside, have many drawbacks for delivery of this information in a universal, standardized, and timely manner. The rapid uptake of portable media devices makes portable video media (PVM) a potential alternative to current educational methods. OBJECTIVE To compare PVM to standard verbal communication (SVC) for surgical information delivery and educational training for nurses and evaluate its impact on knowledge acquisition and participant satisfaction. DESIGN Prospective, multicenter, randomized controlled crossover trial. SETTING Two hospitals: Gosford District Hospital and Wyong Hospital. PARTICIPANTS Seventy-two nursing staff (36 at each site). INTERVENTION Information delivery via PVM--7-minute video compared to information delivered via SVC. OUTCOME MEASURES Knowledge acquisition was measured by a 32-point questionnaire, and satisfaction with the method of education delivery was measured using the validated Client Satisfaction Questionnaire (CSQ-8). RESULTS Knowledge acquisition was higher via PVM compared to SVC 25.9 (95% confidence interval [CI] 25.2-26.6) versus 24.3 (95% CI 23.5-25.1), p = .004. Participant satisfaction was higher with PVM 29.5 (95% CI 28.3-30.7) versus 26.5 (95% CI 25.1-27.9), p = .003. Following information delivery via SVC, participants had a 6% increase in knowledge scores, 24.3 (95% CI 23.5-25.1) versus 25.7 (95% CI 24.9-26.5) p = .001, and a 13% increase in satisfaction scores, 26.5 (95% CI 25.1-27.9) versus 29.9 (95% CI 28.8-31.0) p < .001, when they crossed-over to information delivery via PVM. LINKING EVIDENCE TO ACTION PVM provides a novel method for providing education to nurses that improves knowledge retention and satisfaction with the educational process.
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Affiliation(s)
- Jonathan Kam
- Resident Medical Officer, Gosford District Hospital, Gosford, NSW, and Conjoint Fellow, Faculty of Medicine, University of Newcastle, Australia.
| | - Hannah Ainsworth
- Resident Medical Officer, Gosford District Hospital, Gosford, NSW, Australia
| | - Marcus Handmer
- Urology Registrar, Gosford District Hospital, Gosford, NSW, Australia
| | - Mark Louie-Johnsun
- Consultant Urological Surgeon, Gosford District Hospital, Gosford, NSW, Australia
| | - Matthew Winter
- Senior Urology Registrar, Gosford District Hospital, Gosford, NSW, Australia
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198
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Attardi SM, Choi S, Barnett J, Rogers KA. Mixed methods student evaluation of an online systemic human anatomy course with laboratory. ANATOMICAL SCIENCES EDUCATION 2016; 9:272-285. [PMID: 26588051 DOI: 10.1002/ase.1584] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Revised: 10/28/2015] [Accepted: 10/28/2015] [Indexed: 06/05/2023]
Abstract
A fully online section of an existing face-to-face (F2F) systemic human anatomy course with a prosection laboratory was offered for the first time in 2012-2013. Lectures for F2F students (N = 365) were broadcast in both live and archived format to online students (N = 40) using virtual classroom software. Laboratories were delivered online by a teaching assistant who manipulated 3D computer models in the virtual classroom environment. An exploratory sequential mixed methods approach was undertaken to determine the most important deciding factors that drive students' preferences for a given format and then to generate theory on the strengths and weaknesses of the online format. Students (20 online; 310 F2F) volunteered to participate in a crossover period of one week to expose them to the course section in which they were not originally registered. Open ended interviews (20 online; 20 F2F) and quantitative surveys (270 F2F) were conducted following a crossover. Students valued pace control, schedule, and location flexibility of learning from archived materials and being assessed online. In the online laboratory they had difficulty using the 3D models and preferred the unique and hands-on experiences of cadaveric specimens. The F2F environment was conducive to learning in both lecture and laboratory because students felt more engaged by instructors in person and were less distracted by their surroundings. These results suggest the need to improve the online experience by increasing the quality of student-instructor communication and in turn student-content interaction with the 3D models. Anat Sci Educ 9: 272-285. © 2015 American Association of Anatomists.
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Affiliation(s)
- Stefanie M Attardi
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
- Department of Biomedical Sciences, Oakland University William Beaumont School of Medicine, Rochester, Michigan
| | - Suwhan Choi
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada
| | - John Barnett
- Faculty of Education, Western University, London, Ontario, Canada
| | - Kem A Rogers
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
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199
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Isaacs AN, Nisly S, Walton A. Student-generated e-learning for clinical education. CLINICAL TEACHER 2016; 14:129-133. [PMID: 27091138 DOI: 10.1111/tct.12526] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Within clinical education, e-learning facilitates a standardised learning experience to augment the clinical experience while enabling learner and teacher flexibility. With the shift of students from consumers to creators, student-generated content is expanding within higher education; however, there is sparse literature evaluating the impact of student-developed e-learning within clinical education. The aim of this study was to implement and evaluate a student-developed e-learning clinical module series within ambulatory care clinical pharmacy experiences. METHODS Three clinical e-learning modules were developed by students for use prior to clinical experiences. E-learning modules were created by fourth-year professional pharmacy students and reviewed by pharmacy faculty members. A pre-/post-assessment was performed to evaluate knowledge comprehension before and after participating in the e-learning modules. Additionally, a survey on student perceptions of this educational tool was performed at the end of the clinical experience. There is sparse literature evaluating the impact of student-developed e-learning within clinical education RESULTS: Of the 31 students eligible for study inclusion, 94 per cent participated in both the pre- and post-assessments. The combined post-assessment score was significantly improved after participating in the student-developed e-learning modules (p = 0.008). The student perception survey demonstrated positive perceptions of e-learning within clinical education. DISCUSSION Student-generated e-learning was able to enhance knowledge and was positively perceived by learners. As e-learning continues to expand within health sciences education, students can be incorporated into the development and execution of this educational tool.
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Affiliation(s)
- Alex N Isaacs
- Purdue University College of Pharmacy, Department of Pharmacy Practice, West Lafayette, Indiana, USA.,Eskenazi Health, Department of Pharmacy Services, Indianapolis, Indiana, USA
| | - Sarah Nisly
- Butler University College of Pharmacy and Health Sciences, Department of Pharmacy Practice, Indianapolis, Indiana, USA.,Indiana University Health - Methodist Hospital, Department of Pharmacy, Indianapolis, Indiana, USA
| | - Alison Walton
- Butler University College of Pharmacy and Health Sciences, Department of Pharmacy Practice, Indianapolis, Indiana, USA.,St. Vincent Health, Department of Pharmacy, Indianapolis, Indiana, USA
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Van Lancker A, Baldewijns K, Verhaeghe R, Robays H, Buyle F, Colman R, Van Hecke A. The effectiveness of an e-learning course on medication calculation in nursing students: a clustered quasi-experimental study. J Adv Nurs 2016; 72:2054-64. [PMID: 27060466 DOI: 10.1111/jan.12967] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2016] [Indexed: 11/26/2022]
Abstract
AIM To evaluate the effectiveness of an e-learning course compared with a face-to-face lecture on medication calculation. BACKGROUND The current knowledge on medication calculation of nursing students and nurses is insufficient to provide safe care. DESIGN A stratified-clustered quasi-experimental study. METHODS A random selection of nursing schools were allocated to the e-learning course (intervention group) (seven schools; 189 students) or face-to-face lecture (control group) (six schools, 222 students). Students in both groups completed a validated medication calculation test (maximum score: 16) prior to the course (T0), immediately after the course (T1) and 3 months later (T2). A linear mixed model was used for data analysis. RESULTS Medication calculation skills improved significantly more by the face-to-face lecture than e-learning course. Students in both groups significantly improved in medication calculation skills immediately after the course (T1) and 3 months later. The results flattened at T2 with a significant decline in the intervention group between T1 and T2 and a non-significant decline in the control group. Based on a subgroup analysis, improvement in medication calculation skills at T2 could only be observed in vocational-level (sub degree) nursing students receiving a face-to-face course. CONCLUSIONS Both medication calculation courses had a positive effect on medication calculation skills. Students receiving traditional face-to-face lecture improved significantly more than the students receiving the e-learning course.
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Affiliation(s)
- Aurélie Van Lancker
- University Centre for Nursing and Midwifery, Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Belgium
| | - Katleen Baldewijns
- Technical Institute of Higher Professional Education, Department Nurse Education, Hasselt, Belgium
| | - Rik Verhaeghe
- Nursing Department, Ghent University Hospital, Belgium
| | - Hugo Robays
- Department of Pharmacy, Ghent University Hospital, Belgium
| | - Franky Buyle
- Department of Pharmacy, Ghent University Hospital, Belgium
| | - Roos Colman
- Medical Informatics, Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Belgium
| | - Ann Van Hecke
- University Centre for Nursing and Midwifery, Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Belgium.,Nursing Department, Ghent University Hospital, Belgium
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