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Petit L, Le Pape P, Delestras S, Nguyen C, Marchand V, Belli D, Bonnabry P, Bajwa N, Fonzo‐Christe C. E‐Learning Training to Improve Pediatric Parenteral Nutrition Practice: A Pilot Study in Two University Hospitals. JPEN J Parenter Enteral Nutr 2019; 44:1089-1095. [DOI: 10.1002/jpen.1730] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Revised: 09/29/2019] [Accepted: 10/05/2019] [Indexed: 11/08/2022]
Affiliation(s)
- Laetitia‐Marie Petit
- Geneva University HospitalsDepartment of Pediatrics, Pediatric Gastroenterology, Hepatology, and Nutrition Unit Geneva Switzerland
| | - Pauline Le Pape
- Geneva University HospitalsPharmacy Division Geneva Switzerland
| | | | - Christina Nguyen
- Centre Hospitalier Universitaire Sainte‐JustineDepartment of Pharmacy and University of Montreal Montreal Québec Canada
| | - Valerie Marchand
- Centre Hospitalier Universitaire Sainte‐JustineDepartment of Pediatric Gastroenterology, Hepatology and NutritionUniversity of Montreal Montreal Québec Canada
| | - Dominique Belli
- Geneva University HospitalsDepartment of Pediatrics, Pediatric Gastroenterology, Hepatology, and Nutrition Unit Geneva Switzerland
| | - Pascal Bonnabry
- Geneva University HospitalsPharmacy Division Geneva Switzerland
- University of Geneva – University of LausanneSchool of Pharmaceutical Sciences Geneva Switzerland
| | - Nadia Bajwa
- Geneva University HospitalsDepartment of Pediatrics Geneva Switzerland
- University of Geneva Faculty of MedicineUnit of Development and Research in Medical Education Geneva Switzerland
| | - Caroline Fonzo‐Christe
- Geneva University HospitalsPharmacy Division Geneva Switzerland
- Geneva University HospitalsDepartment of Pediatrics, Neonatology and Paediatric Intensive Care Unit Geneva Switzerland
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Mogre V, Scherpbier AJJA, Stevens F, Aryee P, Cherry MG, Dornan T. Realist synthesis of educational interventions to improve nutrition care competencies and delivery by doctors and other healthcare professionals. BMJ Open 2016; 6:e010084. [PMID: 27797977 PMCID: PMC5093684 DOI: 10.1136/bmjopen-2015-010084] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To determine what, how, for whom, why, and in what circumstances educational interventions improve the delivery of nutrition care by doctors and other healthcare professionals work. DESIGN Realist synthesis following a published protocol and reported following Realist and Meta-narrative Evidence Synthesis: Evolving Standards (RAMESES) guidelines. A multidisciplinary team searched MEDLINE, CINAHL, ERIC, EMBASE, PsyINFO, Sociological Abstracts, Web of Science, Google Scholar and Science Direct for published and unpublished (grey) literature. The team identified studies with varied designs; appraised their ability to answer the review question; identified relationships between contexts, mechanisms and outcomes (CMOs); and entered them into a spreadsheet configured for the purpose. The final synthesis identified commonalities across CMO configurations. RESULTS Over half of the 46 studies from which we extracted data originated from the USA. Interventions that improved the delivery of nutrition care improved skills and attitudes rather than just knowledge; provided opportunities for superiors to model nutrition care; removed barriers to nutrition care in health systems; provided participants with local, practically relevant tools and messages; and incorporated non-traditional, innovative teaching strategies. Operating in contexts where student and qualified healthcare professionals provided nutrition care in developed and developing countries, these interventions yielded health outcomes by triggering a range of mechanisms, which included feeling competent, feeling confident and comfortable, having greater self-efficacy, being less inhibited by barriers in healthcare systems and feeling that nutrition care was accepted and recognised. CONCLUSIONS These findings show how important it is to move education for nutrition care beyond the simple acquisition of knowledge. They show how educational interventions embedded within systems of healthcare can improve patients' health by helping health students and professionals to appreciate the importance of delivering nutrition care and feel competent to deliver it.
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Affiliation(s)
- Victor Mogre
- Department of Health Professions Education and Innovative Learning, School of Medicine and Health Sciences, University for Development Studies, Tamale, Ghana
- Department of Educational Development & Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Albert J J A Scherpbier
- Department of Educational Development & Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Fred Stevens
- Department of Educational Development & Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Paul Aryee
- Department of Community Nutrition, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana
| | - Mary Gemma Cherry
- Department of Health Services Research, Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK
| | - Tim Dornan
- Department of Educational Development & Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
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Lewis KO, Frank GR, Nagel R, Turner TL, Ferrell CL, Sangvai SG, Donthi R, Mahan JD. Pediatric trainees' engagement in the online nutrition curriculum: preliminary results. BMC MEDICAL EDUCATION 2014; 14:190. [PMID: 25223502 PMCID: PMC4179838 DOI: 10.1186/1472-6920-14-190] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2013] [Accepted: 09/03/2014] [Indexed: 05/16/2023]
Abstract
BACKGROUND The Pediatric Nutrition Series (PNS) consists of ten online, interactive modules and supplementary educational materials that have utilized web-based multimedia technologies to offer nutrition education for pediatric trainees and practicing physicians. The purpose of the study was to evaluate pediatric trainees' engagement, knowledge acquisition, and satisfaction with nutrition modules delivered online in interactive and non-interactive formats. METHODS From December 2010 through August 2011, pediatric trainees from seventy-three (73) different U.S. programs completed online nutrition modules designed to develop residents' knowledge of counseling around and management of nutritional issues in children. Data were analyzed using SPSS version 19. Both descriptive and inferential statistics were used in comparing interactive versus non-interactive modules. Pretest/posttest and module evaluations measured knowledge acquisition and satisfaction. RESULTS Three hundred and twenty-two (322) pediatric trainees completed one or more of six modules for a total of four hundred and forty-two (442) accessions. All trainees who completed at least one module were included in the study. Two-way analyses of variance (ANOVA) with repeated measures (pre/posttest by interactive/non-interactive format) indicated significant knowledge gains from pretest to posttest (p < 0.002 for all six modules). Comparisons between interactive and non-interactive formats for Module 1 (N = 85 interactive, N = 95 non-interactive) and Module 5 (N = 5 interactive, N = 16 non-interactive) indicated a parallel improvement from the pretest to posttest, with the interactive format significantly higher than the non-interactive modules (p < .05). Both qualitative and quantitative data from module evaluations demonstrated that satisfaction with modules was high. However, there were lower ratings for whether learning objectives were met with Module 6 (p < 0.03) and lecturer rating (p < 0.004) compared to Module 1. Qualitative data also showed that completion of the interactive modules resulted in higher resident satisfaction. CONCLUSIONS This initial assessment of the PNS modules shows that technology-mediated delivery of a nutrition curriculum in residency programs has great potential for providing rich learning environments for trainees while maintaining a high level of participant satisfaction.
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Affiliation(s)
- Kadriye O Lewis
- />Children’s Mercy Hospital, Department of Pediatrics, University of Missouri Kansas City School of Medicine, Kansas City, MO USA
| | - Graeme R Frank
- />Cohen Children’s Medical Center, Division of Pediatric Endocrinology, Hofstra North Shore-LIJ School of Medicine, New Hyde Park, New York, USA
| | - Rollin Nagel
- />The Ohio State University College of Medicine, Office of Evaluation, Curriculum Research and Development, Columbus, Ohio USA
| | - Teri L Turner
- />Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas USA
| | - Cynthia L Ferrell
- />Oregon Health and Science University, Doernbecher Children’s Hospital, Portland, Oregon USA
| | - Shilpa G Sangvai
- />Nationwide Children’s Hospital, The Ohio State University College of Medicine, Columbus, Ohio USA
| | - Rajesh Donthi
- />Children’s Hospital Los Angeles, Keck School of Medicine of the University of Southern California, Los Angeles, California USA
| | - John D Mahan
- />Nationwide Children’s Hospital, The Ohio State University College of Medicine, Columbus, Ohio USA
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Lenders CM, Deen DD, Bistrian B, Edwards MS, Seidner DL, McMahon MM, Kohlmeier M, Krebs NF. Residency and specialties training in nutrition: a call for action. Am J Clin Nutr 2014; 99:1174S-83S. [PMID: 24646816 PMCID: PMC3985219 DOI: 10.3945/ajcn.113.073528] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Despite evidence that nutrition interventions reduce morbidity and mortality, malnutrition, including obesity, remains highly prevalent in hospitals and plays a major role in nearly every major chronic disease that afflicts patients. Physicians recognize that they lack the education and training in medical nutrition needed to counsel their patients and to ensure continuity of nutrition care in collaboration with other health care professionals. Nutrition education and training in specialty and subspecialty areas are inadequate, physician nutrition specialists are not recognized by the American Board of Medical Specialties, and nutrition care coverage by third payers remains woefully limited. This article focuses on residency and fellowship education and training in the United States and provides recommendations for improving medical nutrition education and practice.
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Affiliation(s)
- Carine M Lenders
- Division of Pediatric Nutrition, Boston Medical Center, and Department of Pediatrics, Boston University School of Medicine, Boston, MA (CML); the Department of Community Health and Social Medicine, City College of New York, New York, NY (DDD); Harvard University Medical School, Boston, MA (BB); University of Texas Medical School, Houston, TX (MSE); the Vanderbilt Center for Human Nutrition, Vanderbilt University Medical Center, Nashville, TN (DLS); the Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, MN (MMM); University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC (MK); and the Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO (NFK)
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Delegge MH, Alger-Mayer S, Van Way CW, Gramlich L. Specialty residency training in medical nutrition education: history and proposal for improvement. JPEN J Parenter Enteral Nutr 2011; 34:47S-56S. [PMID: 21149835 DOI: 10.1177/0148607110378017] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Nutrition education among residents in training is at a critical juncture. There is a general lack of a unified curriculum, a lack of nutrition physician mentors, and a failure to properly train physicians about nutrition. In surveys, residents in training have acknowledged their minimal nutrition education. Published data and training experiences suggest the importance of creating physician mentors in nutrition who are embedded in residency training programs. The development of recurrent short-term nutrition credentialing courses and online nutrition tool kits is also thought to be important in future residency training.
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Affiliation(s)
- Mark H Delegge
- Department of Medicine, Medical University of South Carolina, 256 Courtenay Street, Charleston, SC 29425, USA.
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Westmoreland GR, Counsell SR, Tu W, Wu J, Litzelman DK. Web-based training in geriatrics for medical residents: a randomized controlled trial using standardized patients to assess outcomes. J Am Geriatr Soc 2010; 58:1163-9. [PMID: 20722848 DOI: 10.1111/j.1532-5415.2010.02869.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Although Web-based instruction offers an advantageous approach to medical education, few studies have addressed the use of Web-based education to teach clinical content at the postgraduate level. Even fewer studies have addressed clinical outcomes after the Web-based instruction, yet postgraduate training requirements now focus on outcomes of training. A randomized trial was conducted to compare knowledge of postgraduate year (PGY) 1 residents after Web-based with that after paper-based instruction and to compare residents' clinical application of their instruction using unannounced standardized patients (SPs) and unannounced activated standardized patients (ASPs). PGY 1 residents were assigned to a month-long ambulatory rotation during which they were randomized as a block to Web- or paper-based instruction covering the same four geriatric syndromes (dementia, depression, falls, and urinary incontinence). Outcome measures were mean change scores for before and after testing and scores from SP and ASP clinical encounter forms (checklist, chart abstraction, and electronic order entry). Residents who completed the Web-based instruction showed significantly greater improvement on the knowledge tests than those who received paper-based instruction. There were no significant differences in the scores from the SP and ASP clinical encounters except that the chart abstraction score was better for Web-based group than the paper-based group for dementia. Web-based instruction is an educational tool that medical residents readily accept and can be used to improve knowledge of core geriatrics content as measured using immediate posttesting. More-intensive educational interventions are needed to improve clinical performance by trainees in the care of older patients.
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Bryner BS, Saddawi-Konefka D, Gest TR. The impact of interactive, computerized educational modules on preclinical medical education. ANATOMICAL SCIENCES EDUCATION 2008; 1:247-251. [PMID: 19109853 DOI: 10.1002/ase.55] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Interactive computerized modules have been linked to improved retention of material in clinical medicine. This study examined the effects of a new series of interactive learning modules for preclinical medical education, specifically in the areas of quiz performance, perceived difficulty of concepts, study time, and perceived stress level. We randomly allocated 102 medical student volunteers into control and experimental groups. All participants studied selected anatomical and physiologic concepts using existing material (lecture notes, textbooks, etc.), while those in the experimental groups used the new interactive modules as well. All participants completed a quiz to test their knowledge of the assigned concepts and a survey to assess their subjective experiences in studying with the modules. We found a trend toward higher quiz scores in the experimental group relative to the control group, though it did not reach statistical significance (P = 0.31). Perceived concept difficulty was significantly reduced among those who studied with the modules (P < 0.001), and the number of hours spent studying the concepts was significantly increased (P = 0.028). Of those who used the modules, 83% rated them as "very helpful" or "extremely helpful." No significant differences existed between participants' reported stress levels during the course of the study (P = 0.44). Our data suggest that medical students may learn more effectively and feel less intimidated by difficult concepts when interactive modules supplement traditional instruction.
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Affiliation(s)
- Benjamin S Bryner
- University of Michigan Medical School, Ann Arbor, Michigan 48109, USA
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