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Romeike BFM. Peer creation and sharing of mnemonics in collaborative documents for pathology education: a pilot study. BMC MEDICAL EDUCATION 2024; 24:742. [PMID: 38982421 PMCID: PMC11234616 DOI: 10.1186/s12909-024-05743-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 07/03/2024] [Indexed: 07/11/2024]
Abstract
BACKGROUND Mnemonic techniques are memory aids that could help improve memory encoding, storage, and retrieval. Using the brain's natural propensity for pattern recognition and association, new information is associated with something familiar, such as an image, a structure, or a pattern. This should be particularly useful for learning complex medical information. Collaborative documents have the potential to revolutionize online learning because they could increase the creativity, productivity, and efficiency of learning. The purpose of this study was to investigate the feasibility of combining peer creation and sharing of mnemonics with collaborative online documents to improve pathology education. METHODS We carried out a prospective, quasi-experimental, pretest-posttest pilot study. The intervention group was trained to create and share mnemonics in collaborative documents for pathological cases, based on histopathological slides. The control group compared analog and digital microscopy. RESULTS Both groups consisted of 41 students and did not reveal demographic differences. Performance evaluations did not reveal significant differences between the groups' pretest and posttest scores. Our pilot study revealed several pitfalls, especially in instructional design, time on task, and digital literacy, that could have masked possible learning benefits. CONCLUSIONS There is a gap in evidence-based research, both on mnemonics and on CD in pathology didactics. Even though, the combination of peer creation and sharing of mnemonics is very promising from a cognitive neurobiological standpoint, and collaborative documents have great potential to promote the digital transformation of medical education and increase cooperation, creativity, productivity, and efficiency of learning. However, the incorporation of such innovative techniques requires meticulous instructional design by teachers and additional time for students to become familiar with new learning methods and the application of new digital tools to promote also digital literacy. Future studies should also take into account validated high-stakes testing for more reliable pre-posttest results, a larger cohort of students, and anticipate technical difficulties regarding new digital tools.
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Affiliation(s)
- Bernd F M Romeike
- Dean's Office for Student Affairs, Medical Education, University Medical Center, Ernst-Heydemann-Strasse 8, D-18057, Rostock, Germany.
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2
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Said Abasse K, Toulouse Fournier A, Paquet C, Côté A, Smith PY, Bergeron F, Archambault P. Collaborative Writing Applications in Support of Knowledge Translation and Management during Pandemics: A Scoping Review. Int J Med Inform 2022; 165:104814. [DOI: 10.1016/j.ijmedinf.2022.104814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 04/17/2022] [Accepted: 06/05/2022] [Indexed: 11/28/2022]
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Nunu WN, Makhado L, Mabunda JT, Lebese RT. Developing Strategies for Integrating Indigenous Health and Modern Health Systems for Improved Adolescent Sexual Health Outcomes in Umguza and Mberengwa Districts in Zimbabwe. Health Serv Insights 2021; 14:11786329211036018. [PMID: 34376991 PMCID: PMC8323425 DOI: 10.1177/11786329211036018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 07/07/2021] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Strategies to improve sexual health outcomes have evolved over the years due to technology's evolution to ensure that they are relevant. Challenges have been noticed in different systems that run parallel, particularly in Low-Income Countries where the majority utilise Indigenous Health Systems. Optimisation of resources and minimisation of conflicts could be realised through integrated health systems in the management of adolescents' sexual health issues. This study sought to develop strategies to facilitate Indigenous Health System and Modern Health System integration to improve the management of Adolescent Sexual Health issues, leveraging results from 3 papers. METHODS A multi-stage approach was utilised, with Phase 1 focussing on a preliminary assessment through merging findings from the 4 papers. The Strengths, Weaknesses, Opportunities, and Threats analyses were then used, followed by the Basic Logic Model to identify critical aspects that needed to be considered in building the strategies. The second phase used the Build, Overcome, Eliminate and Minimise framework to build the strategies. RESULTS A total of 5 strategies were proposed to facilitate this integration, and these included revival of committees that were inclusive of all stakeholders; allocating Indigenous Health System space in clinics to work in; establishing adolescent-friendly clinics; intensifying information dissemination on sexual health-related issues, and developing clear Terms of Reference and procedures to govern this integration and ensure it is a success. CONCLUSIONS Implementing these strategies could facilitate this integration and ensure that programs are planned and implemented in a complementary manner, thereby reducing conflicts between the 2 systems and ensuring collaborative efforts towards shared goals that would transform to better Sexual Health Outcomes for adolescents.
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Affiliation(s)
- Wilfred Njabulo Nunu
- Department of Public Health, School of
Health Sciences, University of Venda, Thohoyandou, South Africa
- Department of Environmental Science and
Health, Faculty of Applied Sciences, National University of Science and Technology,
Bulawayo, Zimbabwe
| | - Lufuno Makhado
- Department of Public Health, School of
Health Sciences, University of Venda, Thohoyandou, South Africa
| | - Jabu Tsakani Mabunda
- Department of Public Health, School of
Health Sciences, University of Venda, Thohoyandou, South Africa
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4
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Cohen CL, Walker KH, Hsiang M, Sonenthal PD, Riviello ED, Rouhani SA, Lipnick MS, Merriam LT, Kim EY. Combating information chaos: a case for collaborative clinical guidelines in a pandemic. CELL REPORTS MEDICINE 2021; 2:100375. [PMID: 34337553 PMCID: PMC8313756 DOI: 10.1016/j.xcrm.2021.100375] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The speed and scale of new information during the COVID-19 pandemic required a new approach toward developing best practices and evidence-based clinical guidance. To address this need, we produced COVIDProtocols.org, a collaborative, evidence-based, digital platform for the development and dissemination of COVID-19 clinical guidelines that has been used by over 500,000 people from 196 countries. We use a Collaborative Writing Application (CWA) to facilitate an expedited expert review process and a web platform that deploys content directly from the CWA to minimize any delays. Over 200 contributors have volunteered to create open creative-commons content that spans over 30 specialties and medical disciplines. Multiple local and national governments, hospitals, and clinics have used the site as a key resource for their own clinical guideline development. COVIDprotocols.org represents a model for efficiently launching open-access clinical guidelines during crisis situations to share expertise and combat misinformation.
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Affiliation(s)
- C Lee Cohen
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA.,Harvard Medical School, Boston, MA 02115, USA
| | - Katherine H Walker
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA.,Harvard Medical School, Boston, MA 02115, USA
| | - Mina Hsiang
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Paul D Sonenthal
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA.,Harvard Medical School, Boston, MA 02115, USA.,Partners In Health, Boston, MA 02115, USA
| | - Elisabeth D Riviello
- Harvard Medical School, Boston, MA 02115, USA.,Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02115, USA
| | - Shada A Rouhani
- Harvard Medical School, Boston, MA 02115, USA.,Partners In Health, Boston, MA 02115, USA.,Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Michael S Lipnick
- Center for Health Equity in Surgery and Anesthesia, University of California, San Francisco, CA 94110, USA
| | - Louis T Merriam
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Edy Y Kim
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA.,Harvard Medical School, Boston, MA 02115, USA
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5
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Garvelink MM, Agbadjé TT, Freitas A, Bergeron L, Petitjean T, Dugas M, Blair L, Archambault P, Roy N, Jones A, Légaré F. Improving a Web-Based Tool to Support Older Adults to Stay Independent at Home: Qualitative Study. JMIR Mhealth Uhealth 2020; 8:e16979. [PMID: 32412908 PMCID: PMC7407259 DOI: 10.2196/16979] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 02/28/2020] [Accepted: 05/14/2020] [Indexed: 01/16/2023] Open
Abstract
Background Older adults desire to stay independent at home for as long as possible. We developed an interactive website to inform older adults and caregivers about ways to achieve this. Objective This study aimed to perform an in-depth exploration among potential end users about how to improve the interactive website to better inform older adults and caregivers about ways to stay independent at home. Methods To complement the results of a quantitative survey on the usability and acceptability of the website before implementation, we conducted a qualitative descriptive study. Using multiple recruitment strategies, we recruited a purposeful sample of older adults (aged ≥65 years) and caregivers of older adults struggling to stay independent at home. We conducted face-to-face or telephonic interviews in either English or French. In addition, we collected sociodemographic characteristics, other characteristics of participants (eg, health, digital profile, and perception of retirement homes), and experiences with using the website (factors facilitating the use of the website, barriers to its use, and suggestions for improvement). Interviews were audio recorded, transcribed verbatim, and thematically analyzed by two researchers. Results We recruited 15 participants, including 5 older adults (mean age 75 years, SD 6) and 10 caregivers (mean age 57 years, SD 14). The mean interview time was 32 min (SD 14). Most older adults had either mobility or health problems or both, and many of them were receiving home care services (eg, blood pressure measurement and body care). Overall, participants found the website easy to navigate using a computer, reassuring, and useful for obtaining information. Barriers were related to navigation (eg, difficult to navigate with a cellphone), relevance (eg, no specific section for caregivers), realism (eg, some resources presented are not state funded), understandability (eg, the actors’ accents were difficult to understand), and accessibility (eg, not adapted for low digital literacy). Suggestions for improvement included a needs assessment section to direct users to the support appropriate to their needs, addition of information about moving into residential care, a section for caregivers, distinction between state-provided and private support services, simpler language, expansion of content to be relevant to all of Canada, and video subtitles for the hearing impaired. Conclusions Users provided a wealth of information about the needs of older adults who were facing a loss of autonomy and about what such a website could usefully provide. The request for less generic and more personalized information reflects the wide range of needs that electronic health innovations, such as our interactive website, need to address. After integrating the changes suggested, the new website—Support for Older Adults to Stay Independent at Home (SUSTAIN)—will be implemented and made available to better assist older adults and caregivers in staying independent at home.
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Affiliation(s)
- Mirjam Marjolein Garvelink
- Canada Research Chair in Shared Decision Making and Knowledge Translation, Laval University, Québec, QC, Canada.,Centre de recherche en santé durable (VITAM), Québec, QC, Canada
| | - Titilayo Tatiana Agbadjé
- Canada Research Chair in Shared Decision Making and Knowledge Translation, Laval University, Québec, QC, Canada.,Centre de recherche en santé durable (VITAM), Québec, QC, Canada.,Centre intégré universitaire de santé et services sociaux de la Capitale-Nationale (CIUSSS-CN), Québec, QC, Canada
| | - Adriana Freitas
- Canada Research Chair in Shared Decision Making and Knowledge Translation, Laval University, Québec, QC, Canada.,Centre de recherche en santé durable (VITAM), Québec, QC, Canada.,Centre intégré universitaire de santé et services sociaux de la Capitale-Nationale (CIUSSS-CN), Québec, QC, Canada
| | - Lysa Bergeron
- Canada Research Chair in Shared Decision Making and Knowledge Translation, Laval University, Québec, QC, Canada.,Centre de recherche en santé durable (VITAM), Québec, QC, Canada.,Department of Social and Preventive Medicine, Faculty of Medicine, Laval University, Québec, QC, Canada
| | - Thomas Petitjean
- Centre for Digital Media, Simon Fraser University, Vancouver, BC, Canada
| | - Michèle Dugas
- Centre de recherche en santé durable (VITAM), Québec, QC, Canada.,Centre intégré universitaire de santé et services sociaux de la Capitale-Nationale (CIUSSS-CN), Québec, QC, Canada.,Health and Social Services Systems, Knowledge Translation and Implementation Component of the Quebec SPOR SUPPORT Unit, Laval University, Québec, QC, Canada
| | - Louisa Blair
- Canada Research Chair in Shared Decision Making and Knowledge Translation, Laval University, Québec, QC, Canada.,Centre de recherche en santé durable (VITAM), Québec, QC, Canada.,Centre intégré universitaire de santé et services sociaux de la Capitale-Nationale (CIUSSS-CN), Québec, QC, Canada
| | - Patrick Archambault
- Centre de recherche en santé durable (VITAM), Québec, QC, Canada.,Centre intégré de santé et de services sociaux de Chaudière-Appalaches, Ste-Marie, QC, Canada.,Centre de recherche intégré pour un système apprenant en santé et services sociaux, Lévis, QC, Canada.,Division of Critical Care Medicine, Department of Anesthesiology and Critical Care Medicine, Université Laval, Québec, QC, Canada.,Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Québec, QC, Canada
| | - Noémie Roy
- Canada Research Chair in Shared Decision Making and Knowledge Translation, Laval University, Québec, QC, Canada.,Centre de recherche en santé durable (VITAM), Québec, QC, Canada.,School of Architecture, Faculty of Planning, Architecture, Arts and Design, Université Laval, Québec, QC, Canada
| | - Allyson Jones
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - France Légaré
- Canada Research Chair in Shared Decision Making and Knowledge Translation, Laval University, Québec, QC, Canada.,Centre de recherche en santé durable (VITAM), Québec, QC, Canada.,Centre intégré universitaire de santé et services sociaux de la Capitale-Nationale (CIUSSS-CN), Québec, QC, Canada.,Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Québec, QC, Canada
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6
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Yoong SL, Hall A, Stacey F, Grady A, Sutherland R, Wyse R, Anderson A, Nathan N, Wolfenden L. Nudge strategies to improve healthcare providers' implementation of evidence-based guidelines, policies and practices: a systematic review of trials included within Cochrane systematic reviews. Implement Sci 2020; 15:50. [PMID: 32611354 PMCID: PMC7329401 DOI: 10.1186/s13012-020-01011-0] [Citation(s) in RCA: 78] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 06/16/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Nudge interventions are those that seek to modify the social and physical environment to enhance capacity for subconscious behaviours that align with the intrinsic values of an individual, without actively restricting options. This study sought to describe the application and effects of nudge strategies on clinician implementation of health-related guidelines, policies and practices within studies included in relevant Cochrane systematic reviews. METHODS As there is varied terminology used to describe nudge, this study examined studies within relevant systematic reviews. A two-stage screening process was undertaken where, firstly, all systematic reviews published in the Cochrane Library between 2016 and 2018 were screened to identify reviews that included quantitative studies to improve implementation of guidelines among healthcare providers. Secondly, individual studies within relevant systematic reviews were included if they were (i) randomised controlled trials (RCTs), (ii) included a nudge strategy in at least one intervention arm, and (iii) explicitly aimed to improve clinician implementation behaviour. We categorised nudge strategies into priming, salience and affect, default, incentives, commitment and ego, and norms and messenger based on the Mindspace framework. SYNTHESIS The number and percentage of trials using each nudge strategy was calculated. Due to substantial heterogeneity, we did not undertake a meta-analysis. Instead, we calculated within-study point estimates and 95% confidence intervals, and used a vote-counting approach to explore effects. RESULTS Seven reviews including 42 trials reporting on 57 outcomes were included. The most common nudge strategy was priming (69%), then norms and messenger (40%). Of the 57 outcomes, 86% had an effect on clinician behaviour in the hypothesised direction, and 53% of those were statistically significant. For continuous outcomes, the median effect size was 0.39 (0.22, 0.45), while for dichotomous outcomes the median Odds Ratio was 1.62 (1.13, 2.76). CONCLUSIONS This review of 42 RCTs included in Cochrane systematic reviews found that the impact of nudge strategies on clinician behaviour was at least comparable to other interventions targeting implementation of evidence-based guidelines. While uncertainty remains, the review provides justification for ongoing investigation of the evaluation and application of nudge interventions to support provider behaviour change. TRIAL REGISTRATION This review was not prospectively registered.
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Affiliation(s)
- Sze Lin Yoong
- Hunter New England Population Health, University of Newcastle, Locked Bag 10, Wallsend, New South Wales, 2287, Australia.
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, 2308, Australia.
- Hunter Medical Research Institute, Newcastle, New South Wales, 2300, Australia.
- Priority Research Centre for Health Behaviour, The University of Newcastle, Callaghan, New South Wales, 2308, Australia.
| | - Alix Hall
- Hunter Medical Research Institute, Newcastle, New South Wales, 2300, Australia
| | - Fiona Stacey
- Hunter New England Population Health, University of Newcastle, Locked Bag 10, Wallsend, New South Wales, 2287, Australia
| | - Alice Grady
- Hunter New England Population Health, University of Newcastle, Locked Bag 10, Wallsend, New South Wales, 2287, Australia
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, 2308, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, 2300, Australia
- Priority Research Centre for Health Behaviour, The University of Newcastle, Callaghan, New South Wales, 2308, Australia
| | - Rachel Sutherland
- Hunter New England Population Health, University of Newcastle, Locked Bag 10, Wallsend, New South Wales, 2287, Australia
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, 2308, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, 2300, Australia
- Priority Research Centre for Health Behaviour, The University of Newcastle, Callaghan, New South Wales, 2308, Australia
| | - Rebecca Wyse
- Hunter New England Population Health, University of Newcastle, Locked Bag 10, Wallsend, New South Wales, 2287, Australia
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, 2308, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, 2300, Australia
- Priority Research Centre for Health Behaviour, The University of Newcastle, Callaghan, New South Wales, 2308, Australia
| | - Amy Anderson
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, 2308, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, 2300, Australia
| | - Nicole Nathan
- Hunter New England Population Health, University of Newcastle, Locked Bag 10, Wallsend, New South Wales, 2287, Australia
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, 2308, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, 2300, Australia
- Priority Research Centre for Health Behaviour, The University of Newcastle, Callaghan, New South Wales, 2308, Australia
| | - Luke Wolfenden
- Hunter New England Population Health, University of Newcastle, Locked Bag 10, Wallsend, New South Wales, 2287, Australia
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, 2308, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, 2300, Australia
- Priority Research Centre for Health Behaviour, The University of Newcastle, Callaghan, New South Wales, 2308, Australia
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7
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Arrazola J, Polster M, Etkind P, Moran JS, Vogt RL. Lessons Learned From an Intensive Writing Training Course for Applied Epidemiologists. Public Health Rep 2020; 135:428-434. [PMID: 32579862 DOI: 10.1177/0033354920932659] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Although writing is a valued public health competency, authors face a multitude of barriers (eg, lack of time, lack of mentorship, lack of appropriate instruction) to publication. Few writing courses for applied public health professionals have been documented. In 2017 and 2018, the Council of State and Territorial Epidemiologists and the Centers for Disease Control and Prevention partnered to implement a Morbidity and Mortality Weekly Report Intensive Writing Training course to improve the quality of submissions from applied epidemiologists working at health departments. The course included 3 webinars, expert mentorship from experienced authors, and a 2-day in-person session. As of April 2020, 39 epidemiologists had participated in the course. Twenty-four (62%) of the 39 epidemiologists had submitted manuscripts, 17 (71%) of which were published. The program's evaluation demonstrates the value of mentorship and peer feedback during the publishing process, the importance of case study exercises, and the need to address structural challenges (eg, competing work responsibilities or supervisor support) in the work environment.
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Affiliation(s)
- Jessica Arrazola
- 158351Council of State and Territorial Epidemiologists, Atlanta, GA, USA
| | - Malorie Polster
- 158351Council of State and Territorial Epidemiologists, Atlanta, GA, USA
| | | | - John S Moran
- Independent Consultant, Cornwall-on-Hudson, NY, USA
| | - Richard L Vogt
- Colorado School of Public Health Denver, Denver, CO, USA
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8
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McLinden D, Myers S, Seid M, Busch M, Davis D, Murphy J. The Learning Exchange, a Community Knowledge Commons for Learning Networks: Qualitative Evaluation to Test Acceptability, Feasibility, and Utility. JMIR Form Res 2019; 3:e9858. [PMID: 30869643 PMCID: PMC6437610 DOI: 10.2196/formative.9858] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 09/03/2018] [Accepted: 11/25/2018] [Indexed: 11/17/2022] Open
Abstract
Background Learning Networks are distributed learning health systems that enable collaboration at scale to improve health and health care. A key requirement for such networks is having a way to create and share information and knowledge in furtherance of the work of the community. Objective We describe a Learning Exchange—a bespoke, scalable knowledge management and exchange platform initially built and tested for improving pediatric inflammatory bowel disease outcomes in the ImproveCareNow (ICN) Network—and assess evidence of its acceptability, feasibility, and utility in facilitating creation and sharing of information in furtherance of the work of the community and as a model for other communities. Methods Acceptability was assessed via growth in active users and activity. Feasibility was measured in terms of the percentage of users with a log-in who became active users as well as user surveys and a case study. Utility was measured in terms of the type of work that the Learning Exchange facilitated for the community. Results The ICNExchange has over 1000 users and supported sharing of resources across all care centers in ICN. Users reported that the Learning Exchange has facilitated their work and resulted in increased ability to find resources relevant to local information needs. Conclusions The ICNExchange is acceptable, feasible, and useful as a knowledge management and exchange platform in service of the work of ICN. Experience with the ICNExchange suggests that the design principles are extensible to other chronic care Learning Networks.
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Affiliation(s)
- Daniel McLinden
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, United States.,Idea Networks, Covington, KY, United States
| | - Sarah Myers
- James M Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Michael Seid
- James M Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.,Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Melida Busch
- Edward L Pratt Research Library, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - David Davis
- Learning Sciences, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - John Murphy
- Evaluation, Research and Measurement, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
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9
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Buja A, Toffanin R, Claus M, Ricciardi W, Damiani G, Baldo V, Ebell MH. Developing a new clinical governance framework for chronic diseases in primary care: an umbrella review. BMJ Open 2018; 8:e020626. [PMID: 30056378 PMCID: PMC6067352 DOI: 10.1136/bmjopen-2017-020626] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 04/18/2018] [Accepted: 04/20/2018] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVES Our goal is to conceptualise a clinical governance framework for the effective management of chronic diseases in the primary care setting, which will facilitate a reorganisation of healthcare services that systematically improves their performance. SETTING Primary care. PARTICIPANTS Chronic Care Model by Wagner et aland Clinical Governance statement by Scally et alwere taken for reference. Each was reviewed, including their various components. We then conceptualised a new framework, merging the relevant aspects of both. INTERVENTIONS We conducted an umbrella review of all systematic reviews published by the Cochrane Effective Practice and Organisation of Care Group to identify organisational interventions in primary care with demonstrated evidence of efficacy. RESULTS All primary healthcare systems should be patient-centred. Interventions for patients and their families should focus on their values; on clinical, professional and institutional integration and finally on accountability to patients, peers and society at large. These interventions should be shaped by an approach to their clinical management that achieves the best clinical governance, which includes quality assurance, risk management, technology assessment, management of patient satisfaction and patient empowerment and engagement. This approach demands the implementation of a system of organisational, functional and professional management based on a population health needs assessment, resource management, evidence-based and patient-oriented research, professional education, team building and information and communication technologies that support the delivery system. All primary care should be embedded in and founded on an active partnership with the society it serves. CONCLUSIONS A framework for clinical governance will promote an integrated effort to bring together all related activities, melding environmental, administrative, support and clinical elements to ensure a coordinated and integrated approach that sustains the provision of better care for chronic conditions in primary care setting.
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Affiliation(s)
- Alessandra Buja
- Unit of Hygiene and Public Health, Department of Cardiologic, Vascular, Thoracic Sciences and Public Health, Laboratory of Health Care Services and Health Promotion Evaluation, University of Padova, Padova, Italy
| | | | - Mirko Claus
- Department of Cardiologic, Vascular, Thoracic Sciences and Public Health, School of Hygiene and Preventive Medicine, University of Padova, Padova, Italy
| | - Walter Ricciardi
- Department of Public Health, Università Cattolica Sacro Cuore - Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Gianfranco Damiani
- Department of Public Health, Università Cattolica Sacro Cuore - Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Vincenzo Baldo
- Unit of Hygiene and Public Health, Department of Cardiologic, Vascular, Thoracic Sciences and Public Health, Laboratory of Health Care Services and Health Promotion Evaluation, University of Padova, Padova, Italy
| | - Mark H Ebell
- College of Public Health, University of Georgia, Athens, Greece, USA
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