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Tostain JB, Mathieu M, Oude Engberink A, Clary B, Amouyal M, Lognos B, Demoly P, Annesi-Maesano I, Ninot G, Molinari N, Richard A, Badreddine M, Duflos C, Carbonnel F. The Primary Care and Environmental Health e-Learning Course to Integrate Environmental Health in General Practice: Before-and-After Feasibility Study. JMIR Form Res 2024; 8:e56130. [PMID: 38722679 PMCID: PMC11117128 DOI: 10.2196/56130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Revised: 02/13/2024] [Accepted: 03/16/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND Environmental and behavioral factors are responsible for 12.6 million deaths annually and contribute to 25% of deaths and chronic diseases worldwide. Through the One Health initiative, the World Health Organization and other international health organizations plan to improve these indicators to create healthier environments by 2030. To meet this challenge, training primary care professionals should be the priority of national policies. General practitioners (GPs) are ready to become involved but need in-depth training to gain and apply environmental health (EH) knowledge to their practice. In response, we designed the Primary Care Environment and Health (PCEH) online course in partnership with the Occitanie Regional Health Agency in France. This course was used to train GP residents from the Montpelier-Nimes Faculty of Medicine in EH knowledge. The course was organized in 2 successive parts: (1) an asynchronous e-learning modular course focusing on EH knowledge and tools and (2) 1 day of face-to-face sessions. OBJECTIVE This study assessed the impact of the e-learning component of the PCEH course on participants' satisfaction, knowledge, and behavior changes toward EH. METHODS This was a pilot before-and-after study. Four modules were available in the 6-hour e-learning course: introduction to EH, population-based approach (mapping tools and resources), clinical cases, and communication tools. From August to September 2021, we recruited first-year GP residents from the University of Montpellier (N=130). Participants' satisfaction, knowledge improvements for 19 EH risks, procedure to report EH risks to health authorities online, and behavior change (to consider the possible effects of the environment on their own and their patients' health) were assessed using self-reported questionnaires on a Likert scale (1-5). Paired Student t tests and the McNemar χ2 test were used to compare quantitative and qualitative variables, respectively, before and after the course. RESULTS A total of 74 GP residents completed the e-learning and answered the pre- and posttest questionnaires. The mean satisfaction score was 4.0 (SD 0.9) out of 5. Knowledge scores of EH risks increased significantly after the e-learning course, with a mean difference of 30% (P<.001) for all items. Behavioral scores improved significantly by 18% for the participant's health and by 26% for patients' health (P<.001). These improvements did not vary significantly according to participant characteristics (eg, sex, children, place of work). CONCLUSIONS The e-learning course improved knowledge and behavior related to EH. Further studies are needed to assess the impact of the PCEH course on clinical practice and potential benefits for patients. This course was designed to serve as a knowledge base that could be reused each year with a view toward sustainability. This course will integrate new modules and will be adapted to the evolution of EH status indicators and target population needs.
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Affiliation(s)
- Jean-Baptiste Tostain
- Desbrest Institute of Epidemiology and Public Health, University of Montpellier, National Institute for Health and Medical Research, Montpellier, France
- Departement of General Practice, University of Montpellier, Montpellier, France
| | - Marina Mathieu
- Clinical Research and Epidemiology Unit, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Agnès Oude Engberink
- Desbrest Institute of Epidemiology and Public Health, University of Montpellier, National Institute for Health and Medical Research, Montpellier, France
- Departement of General Practice, University of Montpellier, Montpellier, France
- Maison de Santé Pluriprofessionnelle Universitaire Avicennne, Cabestany, France
| | - Bernard Clary
- Departement of General Practice, University of Montpellier, Montpellier, France
| | - Michel Amouyal
- Departement of General Practice, University of Montpellier, Montpellier, France
| | - Béatrice Lognos
- Desbrest Institute of Epidemiology and Public Health, University of Montpellier, National Institute for Health and Medical Research, Montpellier, France
- Departement of General Practice, University of Montpellier, Montpellier, France
| | - Pascal Demoly
- Desbrest Institute of Epidemiology and Public Health, University of Montpellier, National Institute for Health and Medical Research, Montpellier, France
| | - Isabella Annesi-Maesano
- Desbrest Institute of Epidemiology and Public Health, University of Montpellier, National Institute for Health and Medical Research, Montpellier, France
- Service de Pneumologie, Allergologie et Oncologie Thoracique, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Grégory Ninot
- Desbrest Institute of Epidemiology and Public Health, University of Montpellier, National Institute for Health and Medical Research, Montpellier, France
| | - Nicolas Molinari
- Desbrest Institute of Epidemiology and Public Health, University of Montpellier, National Institute for Health and Medical Research, Montpellier, France
| | | | - Maha Badreddine
- Department of Pedagogical Engineering and Audiovisual Production, Faculty of Medicine, University of Montpellier, Montpellier, France
| | - Claire Duflos
- Clinical Research and Epidemiology Unit, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Francois Carbonnel
- Desbrest Institute of Epidemiology and Public Health, University of Montpellier, National Institute for Health and Medical Research, Montpellier, France
- Departement of General Practice, University of Montpellier, Montpellier, France
- Maison de Santé Pluriprofessionnelle Universitaire Avicennne, Cabestany, France
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Subiza-Pérez M, Vrotsou K, Esnal H, Kortajarena M, Mujika A, Marinelarena E, Aizpurua P, Arrue M, Mitxelena X, Larrinaga-Torrontegui U, Apalategi U, Campillo I Lopez F, Ibarluzea J. Environmental health knowledge and competences in Basque health workers. A comparison of different professional profiles. ENVIRONMENTAL RESEARCH 2024; 243:117789. [PMID: 38052356 DOI: 10.1016/j.envres.2023.117789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 11/22/2023] [Accepted: 11/23/2023] [Indexed: 12/07/2023]
Abstract
Environmental exposures are responsible for a quarter of morbidity and mortality rates globally. Primary care professionals work in a privileged position to detect and intervene on environmental health matters. Nevertheless, due to lack of specific training, international literature shows that primary care health professionals have limited skills to deal with those. The objectives of this study were to assess the levels of environmental health (EH) knowledge and competence of a sample of 446 health professionals and students in the Basque Country and explore the presence that EH has on their daily practice. Only a very small proportion of participants had received training and took environmental clinical history regularly. Participants were confident to deal, and actually dealt, with tobacco, pollen and sun exposures but less able to address topics like biomarkers, pesticides and endocrine disruptors. Finally, and in accordance to previous works, we found moderate levels of EH knowledge and skills in our sample, and observed that nurses and nursing students reported higher EH skills than other professional profiles but scored lower in knowledge. Despite the manifold impacts of environmental exposures on health, interventions to strengthen health professionals' EH competence are required.
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Affiliation(s)
- Mikel Subiza-Pérez
- Department of Clinical and Health Psychology and Research Methods, University of the Basque Country UPV/EHU, Avenida Tolosa 70, 20018, Donostia-San Sebastián, Spain; Bradford Institute for Health Research, Temple Bank House, Bradford Royal Infirmary, Duckworth Lane, Bc 6RJ, Bradford, UK; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, c/ Monforte de Lemos 3-5, Madrid, 280, Spain; Biodonostia Health Research Institute, Group of Environmental Epidemiology and Child Development, Paseo Doctor Begiristain s/n, 20014, Donostia- San Sebastián, Spain.
| | - Kalliopi Vrotsou
- Osakidetza Basque Health Service, Directorate of Health Care, PC-IHOs Research Group of Gipuzkoa, Spain; Biodonostia Health Research Institute, Primary Care Research Group, San Sebastian, Spain; Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Spain.
| | - Haritz Esnal
- Department of Preventive Medicine and Public Health, University of the Basque Country UPV/EHU, Paseo Dr Beguiristain, 105, 20014, Donostia-San Sebastian, Spain; Emergency Department, Donostia University Hospital, Paseo Dr Beguiristain, 20014, Donostia-San Sebastian, Spain.
| | - Maider Kortajarena
- Faculty of Medicine and Nursing, University of the Basque Country UPV/EHU, Paseo Doctor Begiristain 105, 20014, Donostia-San Sebastian, Spain.
| | - Agurtzane Mujika
- Faculty of Medicine and Nursing, University of the Basque Country UPV/EHU, Paseo Doctor Begiristain 105, 20014, Donostia-San Sebastian, Spain.
| | - Eulalia Marinelarena
- Multiprofessional Teaching Unit of Family and Community Care of Gipuzkoa, Gipuzkoa, Spain.
| | - Pilar Aizpurua
- Health Centre of Ondarreta, ESI Donostialdea, Basque Health Service, Avenida de Zumalakarregi, 24, 2008, Donostia-San Sebastian, Spain.
| | - Miren Arrue
- Department of Obstetrics and Gynecology, Donostia University Hospital, Paseo Doctor Begiristain s/n, 20014, Donostia- San Sebastián, Spain.
| | - Xabier Mitxelena
- Health Centre of Ibarra, ESI Tolosaldea, Osakidetza. Basque Health Service, Euskalherria kalea 14, 20400, Ibarra, Spain.
| | - Unai Larrinaga-Torrontegui
- Preventive Medicine, Mendaro Hospital, Debabarrena Integrated Health Organization, Osakidetza. Mendarozabal z/g, 20850, Mendaro, Gipuzkoa, Spain.
| | - Uxune Apalategi
- Biodonostia Health Research Institute, Primary Care Research Group, San Sebastian, Spain; Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Spain; Osakidetza, Central Services, Multiprofessional Family and Community Care Teaching Unit of Araba, Lakuabizkarra Health Center, 01010, Vitoria-Gasteiz, Spain; Department of Pharmacology, University of the Basque Country UPV/EHU, 20018, Donostia-San Sebastián, Spain.
| | - Ferran Campillo I Lopez
- Pediatric Environmental Health Specialty Unit (PEHSU), Garrotxa Region Pediatric Team, Fundació Hospital d'Olot I Comarcal de la Garrotxa, Avinguda Països Catalans 86, 17800, Olot, Girona, Catalonia, Spain; Vall d'en Bas Primary Healthcare Centre, Garrotxa Region Pediatric Team, Fundació Hospital d'Olot I Comarcal de la Garrotxa, Carrer Doctor Turró, 2, 17176, Sant Esteve d'en Bas, Girona, Girona, Catalonia, Spain; Working Group on Environmental Health, Catalan Society of Pediatrics, Spain; Comitte on Environmental Health, Spanish Association of Pediatrics, Spain.
| | - Jesús Ibarluzea
- Faculty of Psychology, University of the Basque Country UPV/EHU, Avenida Tolosa 70, 20018, Donostia-San Sebastián, Spain; Ministry of Health of the Basque Government, Sub Directorate for Public Health and Addictions of Gipuzkoa, 20013, Donostia-San Sebastián, Spain.
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Woolf AD, Baum CR, Burns M. Poison Centers and Pediatric Environmental Health Specialty Units: Productive Two-Way Partnerships. J Med Toxicol 2023; 19:241-243. [PMID: 36988816 PMCID: PMC10293540 DOI: 10.1007/s13181-023-00942-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 03/21/2023] [Accepted: 03/21/2023] [Indexed: 03/30/2023] Open
Affiliation(s)
- Alan D Woolf
- Region 1 Pediatric Environmental Health Specialty Unit, Division of General Pediatrics, Boston Children's Hospital, Professor of Pediatrics, Harvard Medical School, 300 Longwood Ave, Boston, MA, USA.
| | - Carl R Baum
- Department of Emergency Medicine, Yale New Haven Hospital, Professor of Pediatrics, Yale School of Medicine, 20 York Street, New Haven, CT, USA
| | - Michele Burns
- Massachusetts/Rhode Island Poison Center, Department of Emergency Medicine, Boston Children's Hospital, Assistant Professor of Pediatrics, Harvard Medical School, 300 Longwood Ave, Boston, MA, USA
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Bani Hani A, Hijazein Y, Hadadin H, Jarkas AK, Al-Tamimi Z, Amarin M, Shatarat A, Abu Abeeleh M, Al-Taher R. E-Learning during COVID-19 pandemic; Turning a crisis into opportunity: A cross-sectional study at The University of Jordan. Ann Med Surg (Lond) 2021; 70:102882. [PMID: 34603721 PMCID: PMC8479466 DOI: 10.1016/j.amsu.2021.102882] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 09/19/2021] [Accepted: 09/21/2021] [Indexed: 11/26/2022] Open
Abstract
Objectives To assess the medical students' satisfaction and knowledge attainment through distant learning during the COVID-19 pandemic. Methods This is a cross-sectional, self-reported, questionnaire-based study that was conducted at the School of Medicine at the University of Jordan in April 2020. The targeted population was the students at the school of medicine. An online questionnaire was created using Google Forms. Satisfaction and knowledge attainment among students were assessed using independent-samples t-test. Results A total of 1000 medical students completed the survey, 506 (50.6%) basic science students and 494 (49.4%) were clinical science students. 655 (65.5%) of all students were either satisfied or neutral with e-learning. 63.6% of basic science students and 59.5% of clinical students stated that they gained and understood knowledge in the same way as or better than they did before initiation of exclusive e-learning. Satisfaction and knowledge gain were significantly affected by student preparedness (p < 0.000), teacher performance (p < 0.000), and website accessibility (p < 0.000). Conclusion Transition from traditional in-class teaching to distant learning, whether full or blended, is an inevitable step. In our sample, students were generally satisfied with e-learning and the knowledge attained using it. There was a significant relation between satisfaction and attainment and preparedness of students, teachers, and the medical school. There is a difference in student’s satisfaction from e-learning between basic science students and clinical students. Teachers' performance, and Accessibility to websites had a significant impact on student satisfaction. Students' experience in using e-learning platforms and websites, also had a significant impact on student satisfaction. 76.3% of all the students believe that the electronic devices did not cause any financial burden. The most popular devices used to connect to the internet were mobile phones and laptops.
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Affiliation(s)
- Amjad Bani Hani
- Department of General Surgery, School of Medicine, University of Jordan, Amman, Jordan
| | - Yazan Hijazein
- Department of General Surgery, School of Medicine, University of Jordan, Amman, Jordan
| | - Hiba Hadadin
- Department of General Surgery, School of Medicine, University of Jordan, Amman, Jordan
| | - Alma K Jarkas
- Department of General Surgery, School of Medicine, University of Jordan, Amman, Jordan
| | - Zahraa Al-Tamimi
- Department of General Surgery, School of Medicine, University of Jordan, Amman, Jordan
| | - Marzouq Amarin
- Department of General Surgery, School of Medicine, University of Jordan, Amman, Jordan
| | - Amjad Shatarat
- Department of Anatomy and Histology, School of Medicine, University of Jordan, Amman, Jordan
| | - Mahmoud Abu Abeeleh
- Department of General Surgery, School of Medicine, University of Jordan, Amman, Jordan
| | - Raed Al-Taher
- Department of General Surgery, School of Medicine, University of Jordan, Amman, Jordan
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Goldman RH, Zajac L, Geller RJ, Miller MD. Developing and implementing core competencies in children's environmental health for students, trainees and healthcare providers: a narrative review. BMC MEDICAL EDUCATION 2021; 21:503. [PMID: 34560874 PMCID: PMC8464086 DOI: 10.1186/s12909-021-02921-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 09/01/2021] [Indexed: 05/29/2023]
Abstract
Knowledge of the health impacts of environmental exposures (such as pollution disasters, poor air quality, water contamination, climate change) on children's health has dramatically increased in the past 40 years. The World Health Organization (WHO) estimated that 23% of all deaths worldwide were attributable to the environment, and 26% of deaths in children less than 5 years old could be prevented with removal of environmental risks factors. Yet, little has permeated medical education, leaving pediatric providers ill equipped to address these issues. To address this gap, members from the Pediatric Environmental Health Specialty Units, a United States nationwide network of academically affiliated experts who have created numerous environmental health educational materials and programs, have identified fifteen core environmental health (EH) competencies needed by health care providers to enable them to effectively address environmental health concerns. These competencies can serve as the foundation for the development and implementation of relevant educational programs. The core EH competencies are based upon these foundational elements: 1) Definition of "children's environmental health" that describes how environmental exposures (positive and negative) in early life influence the health and development in childhood and across the entire human life span 2) Children are not "little adults" and so have unique vulnerabilities to environmental hazards; 3) Environmental health inequities exist, causing some children to have a disproportionate amount of unhealthy exposures and consequently a greater risk of adverse effects; 4) Climate change will translate to numerous adverse health effects that will particularly affect children worldwide. In this article, the authors describe the core environmental health competencies and provide resources, online tools, strategies, and examples targeted to all levels of training and practice to better enable leaders and educators to bring this important content to the forefront.
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Affiliation(s)
- Rose Hannah Goldman
- Department of Medicine, Cambridge Health Alliance, Cambridge Massachusetts, Cambridge Hospital, Macht Center 427, Cambridge, MA, 02139, USA.
- Department of Medicine, Harvard Medical School, Boston, MA, USA.
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Lauren Zajac
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Robert J Geller
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
| | - Mark D Miller
- Division of Occupational and Environmental Medicine, Department of Medicine, University of California, California, San Francisco, USA
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Häusler M, Bosse HM, Fischbach T, Graf N, von Kleist-Retzow J, Kreuder J. [Alice in the digital wonderland-pediatric teaching during the COVID-19 pandemic]. Monatsschr Kinderheilkd 2020; 169:151-158. [PMID: 33281226 PMCID: PMC7709092 DOI: 10.1007/s00112-020-01076-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The COVID-19 pandemic led to a rapid switch from undergraduate classroom teaching to online-teaching; a challenging process for teachers and students. Based on a recent online survey among German pediatric university hospitals the "AG Lehre der DGKJ" (teaching working group of the German Society of Pediatrics and Adolescent Medicine) summarizes latest experiences with e‑learning during the summer term of 2020. The survey participants from 17 pediatric university hospitals report that the large spectrum of e‑learning formats could sufficiently replace classical lectures and seminars but could not fully replace teaching involving direct contact to patients. The introduction of new digital teaching formats is time-consuming, needs high-quality IT infrastructure, should be embedded in a continuous curriculum and provide the possibility of regular exchange between students and teachers. Teachers should be provided with the opportunity for training in didactic methods and IT skills. These results correspond to the literature on e‑learning in general and undergraduate medical education during the COVID-19 pandemic in particular. The experiences summarized here should not only facilitate the development of e‑learning tools during the ongoing pandemic but also stimulate to establish e‑learning as a valuable component of future pediatric medical education. New digital substitutes for teaching involving pediatric patients need to be developed.The statement was drafted by consensus by the German Society of Pediatrics and Adolescent Medicine Working Group on Teaching and approved by the DGKJ board.
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Affiliation(s)
- Martin Häusler
- Sektion Neuropädiatrie und Sozialpädiatrie, Klinik für Kinder- und Jugendmedizin, Uniklinikum RWTH Aachen, Pauwelsstr. 30, 52074 Aachen, Deutschland
| | - Hans Martin Bosse
- Klinik für Allgemeine Pädiatrie, Neonatologie und Kinderkardiologie, Universitätsklinikum Düsseldorf UKD, Moorenstr. 5, 40225 Düsseldorf, Deutschland
| | - Thomas Fischbach
- Berufsverband der Kinder- und Jugendärzte, BVKJ e. V. Köln, Mielenforster Str. 2, 51069 Köln, Deutschland
| | - Norbert Graf
- Klinik f. Päd. Onkologie und Hämatologie, Universitätsklinikum, Universität des Saarlandes, Campus Homburg, Gebäude 9, 66421 Homburg, Deutschland
| | | | - Joachim Kreuder
- Zentrum für Kinderheilkunde und Jugendmedizin, Universitätsklinikum Gießen und Marburg, Feulgenstr. 10–12, 35385 Gießen, Deutschland
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