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Jang A, Kim MR, Lee SMK, Ha IH, Shin JY, McClain R, Lee J. Evaluating the effectiveness of online Continuing medical education during the COVID-19 pandemic. MEDICAL TEACHER 2023:1-7. [PMID: 37013818 DOI: 10.1080/0142159x.2023.2183787] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
OBJECTIVES The study determined the effects of online continuing medical education (CME) on the clinical competency, performance, and patient outcomes of physicians and other healthcare professionals during the COVID-19 pandemic regarding the topics of COVID-19 and back pain. METHODS Survey studies on six online CME activities were conducted from April 2020 to February 2021 at a South Korean hospital. Surveys were conducted immediately after and three months after the CME activity to measure the effectiveness of the CME activity regarding professional competence and performance, as well as patient outcomes. RESULTS A total of 624 individuals participated in the six CME activities. Of the 2007 post-activity responses, a total of 1135 out of 1332 (85.21%) participants indicated that they were satisfied with the online education activities, and a total of 1752 out of 2007 (87.29%) participants responded that the content would influence their clinical practice. Upon a three-month follow-up, 477 out of 611 (78.07%) respondents indicated that they had made actual changes to their clinical practice. CONCLUSIONS The online delivery method is effective for delivering CME. The results suggest that online CME ultimately influences physicians' clinical competency and performance, which leads to enforcing change in clinical practice.
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Affiliation(s)
- Andrew Jang
- Jaseng Medical Academy, Seoul, Republic of Korea
| | - Me-Riong Kim
- Jaseng Medical Academy, Seoul, Republic of Korea
| | | | - In-Hyuk Ha
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
| | - Ji-Yun Shin
- Jaseng Medical Academy, Seoul, Republic of Korea
| | - Rance McClain
- Arkansas College of Osteopathic Medicine, Arkansas Colleges of Health Education, Fort Smith, USA
| | - Jinho Lee
- Jaseng Hospital of Korean Medicine, Seoul, South Korea
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Sachidanandan G, Bechard LE, Hodgson K, Sud A. Education as drug policy: A realist synthesis of continuing professional development for opioid agonist therapy. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2022; 108:103807. [PMID: 35930903 DOI: 10.1016/j.drugpo.2022.103807] [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: 04/05/2022] [Revised: 06/29/2022] [Accepted: 07/17/2022] [Indexed: 10/16/2022]
Abstract
BACKGROUND Continuing professional development (CPD) for opioid agonist therapy (OAT) has been identified as a key health policy strategy to improve care for people living with opioid use disorder (OUD) and to address rising opioid-related harms. To design and deliver effective CPD programs, there is a need to clarify how they work within complex health system and policy contexts. This review synthesizes the literature on OAT CPD programs and educational theory to clarify which interventions work, for whom, and in what contexts. METHODS A systematic review and realist synthesis of evaluations of CPD programs focused on OAT was conducted. This included record identification and screening, theory familiarization, data collection, analysis, expert consultation, and iterative context-intervention-mechanism-outcome (CIMO) configuration development. RESULTS Twenty-four reports comprising 21 evaluation studies from 5 countries for 3373 providers were reviewed. Through iterative testing of included studies with relevant theory, five CIMO configurations were developed. The programs were categorized by who drove the learning outcomes (i.e., system/policy, instructor, learner) and their spheres of influence (i.e., micro, meso, macro). There was a predominance of instructor-driven programs driving change at the micro level, with few policy-driven macro-influential programs, inconsistent with the promotion of CPD as a clear opioid crisis policy-level intervention. CONCLUSION OAT CPD is challenged by mismatches in program justifications, objectives, activities, and outcomes. Depending on how these program factors interact, OAT CPD can operate as a barrier or facilitator to OUD care. With more deliberate planning and consideration of program theory, programs more directly addressing diverse learner and system needs may be developed and delivered. OAT CPD as drug policy does not operate in isolation; programs may feed into each other and intercalate with other policy initiatives to have micro, meso, and macro impacts on educational and population health outcomes.
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Affiliation(s)
- Grahanya Sachidanandan
- Department of Health Sciences, McMaster University, 1280 Main Street West, Hamilton, Ontario, L8S 3L8, Canada; Bridgepoint Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health, 600 University Avenue, Toronto, Ontario, M5G 1X5, Canada
| | - Lauren E Bechard
- Department of Kinesiology and Health Sciences, Faculty of Health, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada
| | - Kate Hodgson
- Continuing Professional Development, Temerty Faculty of Medicine, University of Toronto, 500 University Avenue, 6th Floor, Toronto, Ontario, M5G 1V7, Canada
| | - Abhimanyu Sud
- Bridgepoint Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health, 600 University Avenue, Toronto, Ontario, M5G 1X5, Canada; Department of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto, 500 University Avenue, Toronto, Ontario, M5G 1V7, Canada; Humber River Hospital, 1235 Wilson Avenue, Toronto, Ontario, M3M 0B2, Canada.
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Koeder C, Kranz RM, Anand C, Husain S, Alzughayyar D, Schoch N, Hahn A, Englert H. Effect of a 1-Year Controlled Lifestyle Intervention on Body Weight and Other Risk Markers (the Healthy Lifestyle Community Programme, Cohort 2). Obes Facts 2022; 15:228-239. [PMID: 34923493 PMCID: PMC9021650 DOI: 10.1159/000521164] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 11/23/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION The prevalence of obesity is high and increasing worldwide. Obesity is generally associated with an increased risk of chronic disease and mortality. The objective of the study was to test the effect of a lifestyle intervention on body weight and other chronic disease risk markers. METHODS A non-randomized controlled trial was conducted, including mostly middle-aged and elderly participants recruited from the general population in rural northwest Germany (intervention: n = 114; control: n = 87). The intervention consisted of a 1-year lifestyle programme, focussing on four key areas: a largely plant-based diet (strongest emphasis), physical activity, stress management, and community support. Parameters were assessed at baseline, 10 weeks, 6 months, and 1 year. The control group received no intervention. RESULTS Compared to the control, in the intervention group, significantly lower 1-year trajectories were observed for body weight, body mass index (BMI), waist circumference (WC), total cholesterol, calculated LDL cholesterol, non-HDL cholesterol, remnant cholesterol (REM-C), glucose, HbA1c, and resting heart rate (RHR). However, between-group differences at 1 year were small for glucose, HbA1c, and cholesterol (apart from REM-C). No significant between-group differences were found for 1-year trajectories of measured LDL cholesterol, HDL cholesterol, triglycerides, insulin, blood pressure, and pulse pressure. CONCLUSION The intervention successfully reduced body weight, BMI, WC, REM-C, and RHR. However, at 1 year, effectiveness of the intervention regarding other risk markers was either very modest or could not be shown.
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Affiliation(s)
- Christian Koeder
- Institute of Food Science and Human Nutrition, Leibniz University Hannover, Hannover, Germany
- Department of Nutrition, University of Applied Sciences Münster, Münster, Germany
- *Christian Koeder,
| | - Ragna-Marie Kranz
- Department of Nutrition, University of Applied Sciences Münster, Münster, Germany
| | - Corinna Anand
- Department of Nutrition, University of Applied Sciences Münster, Münster, Germany
| | - Sarah Husain
- Department of Nutrition, University of Applied Sciences Münster, Münster, Germany
| | - Dima Alzughayyar
- Department of Nutrition, University of Applied Sciences Münster, Münster, Germany
| | - Nora Schoch
- Department of Nutrition, University of Applied Sciences Münster, Münster, Germany
| | - Andreas Hahn
- Institute of Food Science and Human Nutrition, Leibniz University Hannover, Hannover, Germany
| | - Heike Englert
- Department of Nutrition, University of Applied Sciences Münster, Münster, Germany
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Parikh SV, Bostwick JR, Taubman DS. Videoconferencing Technology to Facilitate a Pilot Training Course in Advanced Psychopharmacology for Psychiatrists. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2019; 43:411-416. [PMID: 30891683 DOI: 10.1007/s40596-019-01050-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 02/26/2019] [Indexed: 05/04/2023]
Abstract
OBJECTIVE Psychopharmacology requires practitioners to continually upgrade knowledge and skills, but attendance at live continuing medical education events presents many barriers. In addition, technology has generated new learning approaches. In response, a videoconference-based course on psychopharmacology was developed and evaluated for feasibility and acceptability. Specific goals included whether learners would engage and whether the technology would work well for both learners and instructors. Additional aims included providing guideline-concordant psychopharmacology training, enhancing patient safety, and fostering case discussion. METHODS The course used BlueJeans® videoconferencing technology. Each of the six weekly sessions was taught by a facilitator and a speaker. Every class incorporated a 1-h interactive didactic presentation, followed by 1 h for case reviews. Topics included six major psychiatric disorders, managing key drug interactions, and pharmacogenomics. Three types of online self-report evaluations were conducted-individual session evaluation, overall evaluation, and faculty speaker evaluation. RESULTS Nineteen participants enrolled, with 85% of respondents reporting course objectives were met as "very good" or "excellent." Moreover, 92% of respondents rated the course as "very good" or "excellent." Sixty percent of the faculty were "somewhat satisfied" and 40% were "extremely satisfied" with the videoconferencing tool. Qualitative responses from both participants and faculty were positive overall. CONCLUSIONS This course provides preliminary evidence that an online, live longitudinal course in psychopharmacology is both acceptable and effective, both for CME learners and teachers. The authors plan to disseminate this model of CME to other institutions while extending the reach of the present course to more diverse practitioners.
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Keshmiri F, Rezai M, Mosaddegh R, Moradi K, Hafezimoghadam P, Zare MA, Tavakoli N, Cheraghi MA, Shirazi M. Effectiveness of an interprofessional education model based on the transtheoretical model of behaviour change to improve interprofessional collaboration. J Interprof Care 2017; 31:307-316. [PMID: 28276841 DOI: 10.1080/13561820.2016.1276051] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This study aimed to assess the effectiveness of an interprofessional education model (IPE) based on the transtheoretical model to improve the participants' interprofessional collaborative practice. The study was conducted in Iran using a controlled before-and-after study design. The participants (n = 91) were the residents of emergency medicine and nurses of the emergency units from two teaching hospitals affiliated to Iran University of Medical Sciences. The participants in the intervention group (n = 40) were 22 residents and 18 nurses. The control group (n = 51) consisted of 20 residents and 31 nurses. The participants were classified based on their stage of readiness to change. The interventions were two-day workshops for each stage (i.e., attitude and intention). We used the Interprofessional Collaborator Assessment Rubric (ICAR) to assess the effectiveness of the developed model. The interprofessional collaboration of the participants in the intervention and control groups was assessed at four time points before and after the intervention in the real emergency unit environment. Student's t-test and repeated measures analysis of variance (RM-ANOVA) were used to analyse the data. We used partial eta-squared (η2) for effect size calculations. The mean values of ICAR scores in the intervention and control groups were 95.63 ± 19.14 and 89.19 ± 16.11 before the intervention. The mean values of ICAR scores at 3 months after the intervention were 99.82 ± 22.32 and 88.29 ± 16.87 in the intervention and control groups, respectively. After 6 months, the mean values of ICAR scores of the intervention and control groups were 98.6 ± 23.40 and 87.98 ± 16.01, respectively. The results showed that the intervention had a medium educational effect size (partial η2 = 0.06) on performance of the participants. Our results showed that an IPE model that is tailored to the learners' stage of readiness to change improves interprofessional collaboration in the participants. The developed model could be applied for improving interprofessional collaborative performance in other IPE programmes.
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Affiliation(s)
- Fatemeh Keshmiri
- a Department of Medical Education, Faculty of Medicine , Tehran University of Medical Sciences , Tehran , Iran
| | - Mahdi Rezai
- b Emergency Medicine Management Research Center , Iran University of Medical Sciences , Tehran , Iran
| | - Reza Mosaddegh
- b Emergency Medicine Management Research Center , Iran University of Medical Sciences , Tehran , Iran
| | - Kamran Moradi
- c Evidence-Based Medicine and Critical Thinking Group, Endocrine and Metabolism Research Institute, Shariati Hospital , Tehran University of Medical Sciences , Tehran , Iran
| | - Peyman Hafezimoghadam
- d Emergency Medicine Management Research Center, Rasoul-e-Akram Hospital , Iran University of Medical Sciences , Tehran , Iran
| | - Mohammad Amin Zare
- e Department of Emergency Medicine, Hazrat-e-Rasoul Akram Medical Center , Iran University of Medical Sciences , Tehran , Iran
| | - Nader Tavakoli
- f Hazrat-e-Rasoul Akram Medical Center , Iran University of Medical Sciences , Tehran , Iran
| | - Mohammad Ali Cheraghi
- g School of Nursing and Midwifery , Tehran University of Medical Sciences , Tehran , Iran
| | - Mandana Shirazi
- a Department of Medical Education, Faculty of Medicine , Tehran University of Medical Sciences , Tehran , Iran.,h Educational Development Center , Tehran University of Medical Sciences , Tehran , Iran.,i Department of Clinical Science and Education , Södersjukhuset, Karolinska Institute , Stockholm , Sweden
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Epstein-Sher S, Jaffe DH, Lahad A. Are They Complying? Physicians' Knowledge, Attitudes, and Readiness to Change Regarding Low Back Pain Treatment Guideline Adherence. Spine (Phila Pa 1976) 2017; 42:247-252. [PMID: 28207666 DOI: 10.1097/brs.0000000000001714] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Cross-sectional survey of 145 primary care practitioners (PCPs). OBJECTIVE To examine low back pain (LBP) guideline knowledge, readiness to implement (RTI) these guidelines, and LBP attitudes and beliefs among Israeli PCPs and determine whether physician age, guideline familiarity, and medical specialty affect these variables. SUMMARY OF BACKGROUND DATA LBP is a common condition managed primarily by PCPs. Little is known, however, about physician's LBP knowledge, attitudes, and beliefs and how these factors (knowledge, A&B) influence their practice behavior. Knowledge, attitudes, and beliefs of PCPs have been shown to influence the course of their patients' LBP, and guidelines were devised in an attempt to improve the effectiveness and quality of LBP care. Research worldwide and in Israel has shown that LBP guideline implementation is not yet optimal. METHODS Participants completed a questionnaire. Variables were measured using a translated, validated version of the Health Care Providers' Pain and Impairment Relationship Scale; demographic and professional characteristics were analyzed for correlation with the outcome variables. RESULTS The likelihood of PCPs having nonguideline-consistent attitudes and beliefs (A&B) was greater among those older than 50 years (P < 0.05). Family medicine specialists (family practitioners [FPs]) were more likely to have a high level of guideline knowledge as compared to nonfamily medicine specialists (general practitioners (83.8 vs. 61.9, respectively; P < 0.001). Differences between FPs and general practitioners were also observed for the mean Health Care Providers' Pain and Impairment Relationship Scale score (34.6 vs. 41.1, respectively, P = 0.00), indicating a higher consistency of attitudes and beliefs with guidelines among FPs. No significant association was found between PCPs' knowledge level and RTI the guidelines. CONCLUSION The present study showed that PCPs, especially FPs, had high levels of LBP guideline knowledge, although RTI was limited. The need for greater exposure to and understanding of the importance of implementation of LBP guidelines is essential for future guideline adherence. LEVEL OF EVIDENCE 3.
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Affiliation(s)
| | - Dena H Jaffe
- Health Outcomes Practice, Kantar Health, Jerusalem, Israel
| | - Amnon Lahad
- Department of Family Medicine, Hebrew University, Jerusalem, Israel
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Matta TJ, O'Neal KS, Johnson JL, Carter SM, Lamb MM, Planas LG. Interventions to improve dissemination and implementation of Hepatitis B vaccination in patients with diabetes. J Am Pharm Assoc (2003) 2017; 57:183-187. [PMID: 28073686 DOI: 10.1016/j.japh.2016.11.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 11/02/2016] [Accepted: 11/23/2016] [Indexed: 12/01/2022]
Abstract
OBJECTIVE The purpose of this study was to assess provider awareness of routine vaccinations recommended for patients with diabetes and to determine whether pharmacist-led interventions are associated with increased provider implementation of recommendations for hepatitis B vaccination. METHODS This study was conducted in 3 phases at 2 outpatient clinics affiliated with an academic institution. In phase 1, adults with diabetes who visited the clinics between January and November 2012 and who were eligible for the hepatitis B vaccine were identified. In phase 2, medical residents were surveyed twice for vaccine recommendations and reasons for (not) recommending the hepatitis B vaccine, specifically. Residents were then provided a pharmacist-led in-service about hepatitis B vaccine recommendations. The third phase was initiated in April 2013, following postintervention observation from December 2012 through March 2013. RESULTS Forty-eight of 100 (48%) medical residents attended the in-service and completed both surveys, with 77% indicating they did not recommend the hepatitis B vaccine. During phase 1, 1441 patients were identified, 0.6% (n = 8) of whom had received at least the first dose of the series. In phase 3, 946 patients were identified with 1.7% (n = 16) having received at least the first dose (P = 0.007). CONCLUSION An attempt to disseminate updated recommendations to providers via educational in-service was successful in increasing the percentage of eligible patients vaccinated with the hepatitis B vaccine.
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Leach V, Tonkin E, Lancastle D, Kirk M. A strategy for implementing genomics into nursing practice informed by three behaviour change theories. Int J Nurs Pract 2016; 22:307-15. [DOI: 10.1111/ijn.12431] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 01/08/2016] [Accepted: 02/28/2016] [Indexed: 12/30/2022]
Affiliation(s)
- Verity Leach
- PhD Student, Genomics Policy Unit; Faculty of Life Sciences and Education, University of South Wales; Pontypridd Wales UK
| | - Emma Tonkin
- Senior Research Fellow, Genomics Policy Unit; Faculty of Life Sciences and Education, University of South Wales; Pontypridd Wales UK
| | - Deborah Lancastle
- Registered Psychologist, Senior Lecturer in Psychology, School of Psychology, Early Years and Therapeutic Studies; University of South Wales; Pontypridd Wales UK
| | - Maggie Kirk
- Upsilon Xi at large, Professor, Genomics Policy Unit, Past President, International Society of Nurses in Genomics, Faculty of Life Sciences and Education; University of South Wales; Pontypridd Wales UK
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Johnson SS, Castle PH, Van Marter D, Roc A, Neubauer D. The effect of physician continuing medical education on patient-reported outcomes for identifying and optimally managing obstructive sleep apnea. J Clin Sleep Med 2015; 11:197-204. [PMID: 25845903 DOI: 10.5664/jcsm.4524] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 11/04/2014] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVE To evaluate the effect of continuing medical education (CME) activities on patient reported outcomes with regard to (1) screening for excessive sleepiness (ES) and obstructive sleep apnea (OSA) and (2) appropriate referral and treatment. METHODS A total of 725 patients were recruited from 75 providers who either participated or did not participate in Transtheoretical Model (TTM)-based OSA CME activities. Patient reported outcomes from participating (n = 36) and non-participating providers (n = 39) were compared using generalized estimating equations examining random effects of provider as unit of assignment. RESULTS Patients' reports demonstrate that participating physicians were 1.7 times more likely to initiate discussion of sleep problems than non-participating physicians (t1,411 = 3.71, p = 0.05) and 2.25-2.86 times more likely to administer validated measures for OSA (Epworth Sleepiness Scale and STOP-BANG). Patient reports also indicated that participating clinicians (79.9%) were significantly more likely to recommend seeing a sleep specialist compared to non-participating clinicians (60.7%; t1,348 = 9.1, p < 0.01, OR = 2.6). Furthermore, while 89.4% of participating clinicians recommended a sleep study, only 73.2% of the non-participating physicians recommended one (t1,363 = 11.46, p < 0.001, OR = 3.1). CONCLUSIONS Participation in TTM-based OSA CME activities was associated with improved patient reported outcomes compared to the non-participating clinicians.
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Tamler R, Green DE, Skamagas M, Breen TL, Looker HC, LeRoith D. Effect of Case-Based Training for Medical Residents on Confidence, Knowledge, and Management of Inpatient Glycemia. Postgrad Med 2015; 123:99-106. [DOI: 10.3810/pgm.2011.07.2309] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Validation of a survey tool assessing effectiveness of an educational intervention on the caring behaviors and referral activities of community pharmacists for migraineurs. Res Social Adm Pharm 2014; 11:352-63. [PMID: 25483402 DOI: 10.1016/j.sapharm.2014.08.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Revised: 08/26/2014] [Accepted: 08/27/2014] [Indexed: 11/20/2022]
Abstract
BACKGROUND Community pharmacists are in an ideal position to ameliorate migraineur under-consulting, under-diagnosis, and under-treatment. Contemporary education/training on developing therapeutic alliances with patients and in advanced pharmacotherapy may further motivate pharmacists to impact the care of migraineurs. OBJECTIVES The objectives of this study were to assess pharmacists' perceptions of a migraine training program and their self-assessment of subsequent impact on patient care and to develop and assess a tool evaluating the impact of the training program from the patients' perspectives: (1) for patients diagnosed with migraines - identify perceptions of care by pharmacists who have undergone specialty training in migraine vs. pharmacists who have not; and (2) for patients with recurrent headaches and not diagnosed with migraines - identify perceptions of pharmacist effectiveness and thoroughness, after specialty training, to identify a potential migraine diagnosis and referral for advanced care vs. pharmacists that have not undergone specialty training. METHODS This study employed a mixed method survey design using community pharmacies from the Tulsa, Oklahoma and Pittsburgh, Pennsylvania greater metropolitan areas. Pharmacists from intervention pharmacies received specialty training on migraine and were surveyed on their current practices and about the education program. Approximately 1 month after the training, control and intervention pharmacists were surveyed on current practices. Additionally, patients from both pharmacies were surveyed to assess Migraine Disability Assessment (MIDAS) and pharmacists' delivery of care derived from the Pharmacists' Care of Migraineurs Scale (PCMS). Surveys were handed out for a period of 3-months. RESULTS There were 16 pharmacists and 61 patients recruited. There was no difference in patient perceptions of pharmacists' care or in patient self-perceptions between migraineurs and recurrent headache sufferers. Ninety-two percent of pharmacists agreed that the program could be transferred to an internet-based educational program. The 14-item patient survey, however, demonstrated good internal consistency reliability, with each question having a Cronbach's alpha 0.80 or higher. CONCLUSIONS There are few studies evaluating the role and potential impact community pharmacists can have on patients suffering from migraines or recurrent headaches. While no difference was found between the groups, the internal reliability of the survey questions and the need to address needs of migraineurs warrants tool dissemination and a larger-scale study.
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Luchtefeld M, Kerwel TG. Continuing medical education, maintenance of certification, and physician reentry. Clin Colon Rectal Surg 2013; 25:171-6. [PMID: 23997673 DOI: 10.1055/s-0032-1322546] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Continuing medical education serves a central role in the licensure and certification for practicing physicians. This chapter explores the different modalities that constitute CME along with their effectiveness, including simulation and best education practices. The evolution to maintenance of certification and the requirements for both the American Board of Surgery and the American Board of Colon and Rectal Surgery are delineated. Further progress in the education of practicing surgeons is evidenced through the introduction of laparoscopic colectomy and the improvements made from the introduction of laparoscopic cholecystectomy. Finally, reentry of physicians into practice following a voluntary leave of absence, a new and challenging issue for surgeons, is also discussed.
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Affiliation(s)
- Martin Luchtefeld
- Department of Colorectal Surgery, Spectrum Health Medical Group/Ferguson Clinic, Grand Rapids, Michigan
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O'Neal KS, Crosby KM, Miller MJ, Murray KA, Condren ME. Assessing health literacy practices in a community pharmacy environment: Experiences using the AHRQ Pharmacy Health Literacy Assessment Tool. Res Social Adm Pharm 2013; 9:564-96. [DOI: 10.1016/j.sapharm.2012.09.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2012] [Revised: 09/14/2012] [Accepted: 09/15/2012] [Indexed: 10/27/2022]
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Shirazi M, Lonka K, Parikh SV, Ristner G, Alaeddini F, Sadeghi M, Wahlstrom R. A tailored educational intervention improves doctor's performance in managing depression: a randomized controlled trial. J Eval Clin Pract 2013; 19:16-24. [PMID: 21883718 DOI: 10.1111/j.1365-2753.2011.01761.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
RATIONAL AND OBJECTIVES To assess the effects of a tailored and activating educational intervention, based on a three-stage modified Prochaska model of readiness-to-change, on the performance of general physicians in primary care (GPs) regarding management of depressive disorders. METHODS Parallel group, randomized control trial. Primary hypothesis was that performance would improve by 20 percentage units in the intervention arm. The setting was primary care in southern Tehran. The participants were 192 GPs stratified on stage of readiness-to-change, sex, age and work experience. The intervention was a 2-day interactive workshop for a small group of GPs' at a higher stage of readiness-to-change ('intention') and a 2-day interactive large group meeting for those with lower propensity to change ('attitude') at the pre-assessment. GPs in the control arm participated in a standard educational programme on the same topic. The main outcome measures were validated tools to assess GPs' performance by unannounced standardized patients, regarding diagnosis and treatment of depressive disorders. The assessments were made 2 months before and 2 months after the intervention. RESULTS GPs in the intervention arm significantly improved their overall mean scores for performance regarding both diagnosis, with an intervention effect of 14 percentage units (P = 0.007), and treatment and referral, with an intervention effect of 20 percentage units (P < 0.0001). The largest improvement after the intervention appeared in the small group: 30 percentage units for diagnosis (P = 0.027) and 29 percentage units for treatment and referral (P < 0.0001). CONCLUSIONS Activating learning methods, tailored according to the participants' readiness to change, improved clinical performance of GPs in continuing medical education and can be recommended for continuing professional development.
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Jho MY, Kim M. Development of the Program Evaluation Measurement of Continuing Nursing Education Programs. J Korean Acad Nurs 2013; 43:236-46. [DOI: 10.4040/jkan.2013.43.2.236] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Mi Young Jho
- Department of Nursing, Dongnam Health College, Suwon, Korea
| | - Miyoung Kim
- Department of Nursing, Dongnam Health College, Suwon, Korea
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Randhawa S. Using the Transtheoretical Model for outcome evaluation in continuing education. J Contin Educ Nurs 2012; 43:148-9. [PMID: 22475229 DOI: 10.3928/00220124-20120327-09] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Measuring the outcomes of continuing education programs can be challenging for providers. One method to measure change behavior is to measure learners' readiness to act using the Transtheoretical Model. Outcomes for this evaluation method can also assist providers in planning future education programs designed to meet learners' needs in their stage of behavior change.
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Affiliation(s)
- Simmy Randhawa
- Children's National Medical Center, Washington, DC, USA.
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Aylward M, Vawter L, Roth C. An interactive handoff workshop to improve intern readiness in patient care transitions. J Grad Med Educ 2012; 4:68-71. [PMID: 23451310 PMCID: PMC3312537 DOI: 10.4300/jgme-d-11-00067.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2011] [Revised: 08/09/2011] [Accepted: 08/09/2011] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION Patient handoffs are common during residency and are often performed with little or no training. We devised a simple intervention to improve the readiness of interns to perform handoffs. METHODS We administered a 90-minute interactive workshop during intern orientation in 2009 and 2010. It consisted of a discussion, a case presentation, and a trigger video, followed by debriefing and a role-play exercise. The workshop required minimal technology and materials. Interns were surveyed on their readiness to perform handoffs before and after the workshop as well as 3 to 6 months after the workshop. RESULTS Eighty-nine interns participated in the workshop during a 2-year period. Seventy-four survey responses were collected. Self-reported readiness to perform a handoff increased by 26%. A total of 91% and 81% of respondents in 2010 and 2009, respectively, reported using aspects of the workshop up to 6 months later. CONCLUSION A brief workshop can improve interns' readiness to perform handoffs.
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Tamler R, Green DE, Skamagas M, Breen TL, Looker HC, Babyatsky M, Leroith D. Effect of case-based training for medical residents on inpatient glycemia. Diabetes Care 2011; 34:1738-40. [PMID: 21715520 PMCID: PMC3142044 DOI: 10.2337/dc11-0517] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To determine whether an educational intervention for medical house staff improves blood glucose (BG) in hospitalized patients. RESEARCH DESIGN AND METHODS All 116 medicine residents at an academic medical center were assigned to online or classroom training on inpatient dysglycemia in fall 2008. Both groups were offered an online refresher course in spring 2009 addressing gaps in clinical practice identified on chart review. We assessed event BG, the first BG of any 3-h period, on two teaching wards. RESULTS A total of 108 residents (93.1%) completed the initial training. The primary outcome, median event BG, decreased from 152 mg/dL in August 2008 to 139 mg/dL in December 2008 (P < 0.0001). Prevalence of event BG >200 mg/dL decreased from 25.5 to 22.7% (P = 0.0207), at the expense of more event BGs <70 mg/dL (2.0-3.9%, P = 0.0124). CONCLUSIONS A curriculum for medicine residents on inpatient glycemia led to lower inpatient BG.
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Shirazi M, Parikh SV, Alaeddini F, Lonka K, Zeinaloo AA, Sadeghi M, Arbabi M, Nejatisafa AA, Shahrivar Z, Wahlström R. Effects on knowledge and attitudes of using stages of change to train general practitioners on management of depression: a randomized controlled study. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2009; 54:693-700. [PMID: 19835676 DOI: 10.1177/070674370905401006] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To assess the impact on knowledge and attitudes of a tailored educational intervention on depression using a modified version of the Prochaska stages of change model, compared with standard continuing medical education, for general practitioners (GPs) in primary care in Iran. METHOD Using a randomized controlled trial, a total of 192 GPs were evenly randomized to intervention or control arm. The topic for the educational intervention was depressive disorders. The participants were divided in to small and large groups, depending on their initial stage of change. The GPs' knowledge and skills regarding management of depressive disorders were assessed through a questionnaire with 7 multiple choice questions, 11 Likert statements, 3 case vignettes, and 1 essay question. Attitudes toward management of depressive disorders were also assessed. Both questionnaires were validated. RESULTS There was a significant improvement in knowledge mean scores regarding multiple choice and Likert questions (intervention effect 6%; P = 0.002), as well as for the case vignettes and essay question (intervention effect 12%; P = 0.011) in the intervention arm, in comparison with the control arm. There were significant changes in mean attitude scores in both study arms, but no difference between them. CONCLUSIONS A theoretical model of medical learning and behavioural change can be used to devise educational formats that suit different stages of learning. Such tailored educational formats can improve GPs' knowledge and skills regarding management of depressive disorders.
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Affiliation(s)
- Mandana Shirazi
- Division of Global Health (IHCAR), Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
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Nieuwenhuijsen ER, Zemper E, Miner KR, Epstein M. Health behavior change models and theories: contributions to rehabilitation. Disabil Rehabil 2009; 28:245-56. [PMID: 16492619 DOI: 10.1080/09638280500197743] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE This article highlights the importance of health behavior change (HBC) theory, and its relevance to rehabilitation research and practice. METHOD An extensive review of HBC-related literature pertinent to rehabilitation was conducted, focusing on the potential impact of these theories and models in enhancing long-term results of rehabilitation with regard to lifestyle change and health promotion, and outlining the benefits of incorporating HBC themes into rehabilitation practice. For our purposes, the HBC concept is based on initiation and maintenance of health behaviors, functioning, wellness, and self-management of chronic conditions or disabilities within an environmental context. While comparing and contrasting three widely known theories of HBC, the contributions of these theories to rehabilitation research and practice are discussed. RESULTS Three propositions are put forward: (1) HBC variables should regularly be used as outcome measures in evidence-based rehabilitation research; (2) there should be a better understanding of the role of the rehabilitation provider as a facilitator in eliciting healthy behaviors; and (3) there is a need to expand the HBC concept into a more comprehensive view encompassing a person's functioning within the environmental context. CONCLUSIONS A conceptual merger between HBC theories and rehabilitation practice can have major implications for individuals with disabilities, their functioning, health, and well-being.
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Affiliation(s)
- Els R Nieuwenhuijsen
- Department of Physical Medicine and Rehabilitation, University of Michigan Health System, Ann Arbor, MI 48108, USA.
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21
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Lowe MM, Aparicio A, Galbraith R, Dorman T, Dellert E. The Future of Continuing Medical Education. Chest 2009; 135:69S-75S. [DOI: 10.1378/chest.08-2522] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Bowman J, Lannin N, Cook C, McCluskey A. Development and psychometric testing of the Clinician Readiness for Measuring Outcomes Scale. J Eval Clin Pract 2009; 15:76-84. [PMID: 19239585 DOI: 10.1111/j.1365-2753.2008.00957.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND If allied health professionals are to begin measuring outcomes routinely, a change in attitudes and behaviour is necessary. However, individuals need to be ready to change and often move through several stages before practice change is observed. AIM To develop and test the psychometric properties of a questionnaire that determines clinicians' readiness to measure outcomes. METHODS A study of instrument development, validation and reliability. Ten expert allied health professionals were involved in content validity testing. A further 396 allied health professionals completed the questionnaire to establish content and construct validity, internal consistency and temporal reliability (or stability). Of these 396 allied health professionals, 70 participated in the temporal reliability assessment. Content validity was established using the Content Validity Index (CVI). Construct validity was determined using confirmatory factor analysis (CFA) and internal consistency was ascertained using Cronbach's alpha. Temporal reliability was confirmed using intraclass correlation coefficients (ICC 3,1). RESULTS A 30-item questionnaire was developed, reflecting the five stages of change from the Transtheoretical Model of Change, and commonly cited barriers to outcome measurement. Content validity was excellent (CVI = 0.96). Using CFA, a two-factor model provided best fit. Based on CFA results, four items were dropped resulting in a 26-item questionnaire (range 26-156). Internal consistency reliability was excellent (alpha = 0.94). Temporal (stability) reliability ICC (3,1) was very good (r = 0.86, P = 0.0001). CONCLUSIONS The final 26-item questionnaire takes 10 minutes to complete and 5 minutes to score. The Clinician Readiness for Measuring Outcomes Scale provides educators with useful information about clinician readiness and helps identify strategies for affecting behaviour change.
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Affiliation(s)
- Julia Bowman
- School of Biomedical and Health Sciences, College of Health and Science, University of Western Sydney, Australia.
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Moore DA, Payne M. An Evaluation of Dairy Producer Emergency Preparedness and Farm Security Education. J Dairy Sci 2007; 90:2052-7. [PMID: 17369248 DOI: 10.3168/jds.2006-563] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Dairy producer education on securing the milk and meat supply is important to reduce the food system's vulnerability to contamination, and reduce the likelihood for disease transmission onto and within the farm. The purpose of this project was to develop and test a producer-audience curriculum on emergency preparedness and biosecurity awareness. Forty-three attendees from 3 organizations responded to pre- and posttests and a course evaluation. After the program, most of the participants found the program relevant (95%), that it provided practical solutions to biosecurity (97%), were very likely to assess their farms for biosecurity and security (70%), and would suggest the program to other producers (98%). Participants who strongly agreed that the program was relevant and provided practical solutions to biosecurity were very likely to assess their farms. Awareness and knowledge are the first steps toward changing attitudes and behavior and can be accomplished with directed, relevant, practical educational programs.
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Affiliation(s)
- D A Moore
- Veterinary Medicine Extension, University of California, Davis 95616, USA.
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Shirazi M, Assadi SM, Sadeghi M, Zeinaloo AA, Kashani AS, Arbabi M, Alaedini F, Lonka K, Wahlstrom R. Applying a modified Prochaska's model of readiness to change for general practitioners on depressive disorders in CME programmes: validation of tool. J Eval Clin Pract 2007; 13:298-302. [PMID: 17378879 DOI: 10.1111/j.1365-2753.2006.00735.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To assess the validity and reliability of an 11-item questionnaire for stages of readiness to change according to a modified Prochaska model (including attitude, intention and action stage) in the context of continuing medical education (CME) on depressive disorders for general practitioners (GPs) in Tehran, Iran. METHODS Three hundred and fifty GPs were recruited for filling in a questionnaire in order to assess content validity and modifying the questionnaire. Fifty-nine GPs were involved for testing reliability and 39 GPs for testing concurrent validity. Content validity of the questionnaire was assessed by expert consensus. Concurrent validity was assessed by correlating the results of a semi-structured interview with those of the self-assessment questionnaire. For testing reliability there was a test-retest approach with an interval of 3-7 days. RESULTS A panel of experts was held at four times and the final version of modified Prochaska questionnaire (MPQ) was compiled by the panel. Total kappa coefficient for concurrent validity of the whole questionnaire was 0.80. Only two of the questions had a kappa coefficient lower than 0.70. In the test-retest, 96% of participants reassigned to the same stage and the total kappa coefficient of reliability was 0.89 for the whole questionnaire. CONCLUSION The validity and reliability of the MPQ for assessing GPs' readiness to change in the field of depressive disorders were found to be high in the Iranian context. These findings support its application in tailoring and evaluating CME programmes for GPs in Iran.
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Affiliation(s)
- Mandana Shirazi
- Educational Development Centre, Tehran University of Medical Sciences, Tehran, Iran.
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MacDermid JC, Solomon P, Law M, Russell D, Stratford P. Defining the effect and mediators of two knowledge translation strategies designed to alter knowledge, intent and clinical utilization of rehabilitation outcome measures: a study protocol [NCT00298727]. Implement Sci 2006; 1:14. [PMID: 16820055 PMCID: PMC1557530 DOI: 10.1186/1748-5908-1-14] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2006] [Accepted: 07/04/2006] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A substantial number of valid outcome measures have been developed to measure health in adult musculoskeletal and childhood disability. Regrettably, national initiatives have merely resulted in changes in attitude, while utilization remains unacceptably low. This study will compare the effectiveness and mediators of two different knowledge transfer (KT) interventions in terms of their impact on changing knowledge and behavior (utilization and clinical reasoning) related to health outcome measures. METHOD/DESIGN Physical and occupational therapists (n = 144) will be recruited in partnership with the national professional associations to evaluate two different KT interventions with the same curriculum: 1) Stakeholder-Hosted Interactive Problem-Based Seminar (SHIPS), and 2) Online Problem-Based course (e-PBL). SHIPS will consist of face-to-face problem-based learning (PBL) for 2 1/2 days with outcome measure developers as facilitators, using six problems generated in consultation with participants. The e-PBL will consist of a 6-week web-based course with six generic problems developed by content experts. SHIPS will be conducted in three urban centers in Canada. Participants will be block-allocated by a minimization procedure to either of the two interventions to minimize any prognostic differences. Trained evaluators at each site will conduct chart audits and chart-stimulated recall. Trained interviewers will conduct semi-structured interviews focused on identifying critical elements in KT and implementing practice changes. Interviews will be transcribed verbatim. Baseline predictors including demographics, knowledge, attitudes/barriers regarding outcome measures, and Readiness to Change will be assessed by self-report. Immediately post-intervention and 6 months later, these will be re-administered. Primary qualitative and quantitative evaluations will be conducted 6-months post-intervention to assess the relative effectiveness of KT interventions and to identify elements that contribute to changing clinical behavior. Chart audits will determine the utilization of outcome measures (counts). Incorporation of outcome measures into clinical reasoning will be assessed using an innovative technique: chart-stimulated recall. DISCUSSION A strategy for optimal transfer of health outcome measures into practice will be developed and shared with multiple disciplines involved in primary and specialty management of musculoskeletal and childhood disability.
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Affiliation(s)
- Joy C MacDermid
- School of Rehabilitation Science, McMaster University, 1400 Main St. West, IAHS-403, Hamilton, Ontario, L8S 1C7, Canada
- Hand and Upper Limb Centre Clinical Research Laboratory, St. Joseph's Health Centre, 268 Grosvenor St., London, Ontario, N6A 3A8, Canada
| | - Patty Solomon
- School of Rehabilitation Science, McMaster University, 1400 Main St. West, IAHS-403, Hamilton, Ontario, L8S 1C7, Canada
| | - Mary Law
- School of Rehabilitation Science, McMaster University, 1400 Main St. West, IAHS-403, Hamilton, Ontario, L8S 1C7, Canada
| | - Dianne Russell
- School of Rehabilitation Science, McMaster University, 1400 Main St. West, IAHS-403, Hamilton, Ontario, L8S 1C7, Canada
| | - Paul Stratford
- School of Rehabilitation Science, McMaster University, 1400 Main St. West, IAHS-403, Hamilton, Ontario, L8S 1C7, Canada
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Weinstein P. Behavioral problems in the utilization of new technology to control caries: patients and provider readiness and motivation. BMC Oral Health 2006; 6 Suppl 1:S5. [PMID: 16934122 PMCID: PMC2147589 DOI: 10.1186/1472-6831-6-s1-s5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
New research developments frequently are neither adopted by providers nor utilized by patients. This dual problem of impacting the behaviors of providers and patients presents a challenge. This paper will present behavioral theories and technologies that can be utilized to impact both provider and patient behaviors.
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Affiliation(s)
- Philip Weinstein
- Department of Dental Public Health Sciences, University of Washington, Seattle, WA 98195, USA.
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Lau MA, Dubord GM, Parikh SV. Design and feasibility of a new cognitive-behavioural therapy course using a longitudinal interactive format. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2004; 49:696-700. [PMID: 15560317 DOI: 10.1177/070674370404901008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE This report describes the design and feasibility of conducting a unique longitudinal supervision course incorporating both therapist and patient evaluation measures in teaching cognitive-behavioural therapy (CBT) to a group of mental health practitioners. METHOD We designed a 10-session longitudinal supervision course to teach CBT by applying key continuing medical education (CME) principles. Each session consisted of 30 minutes of didactics and demonstrations followed by 90 minutes of group case supervision. Course participants were mental health practitioners who treated patients from their own practice; most of the patients suffered from a depressive and (or) anxiety disorder. We assessed therapists for CBT skill acquisition at the beginning and at the end of the course, using the Cognitive Therapy Scale (CTS). We assessed patients' symptoms weekly, using the Beck Depression Inventory, the Beck Anxiety Inventory, and the Clinical Global Impression scale. RESULTS A total of 34 participants enrolled in three 10-session courses. Most participants submitted audiotapes for rating at the beginning and end of the course, and most submitted patient symptom information. CONCLUSIONS This course shows promise as an effective way to teach complex skills in CBT to mental health providers. In limited samples, the course showed clear improvement in therapist adherence to CBT and in patients' clinical outcomes. Future research is required to validate the potential benefit of this CME intervention for mental health practitioners treating patients with mood and anxiety disorders.
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Affiliation(s)
- Mark A Lau
- Department of Psychiatry, Centre for Addiction and Mental Health, University of Toronto, Ontario.
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Abdolrasulnia M, Collins BC, Casebeer L, Wall T, Spettell C, Ray MN, Weissman NW, Allison JJ. Using email reminders to engage physicians in an Internet-based CME intervention. BMC MEDICAL EDUCATION 2004; 4:17. [PMID: 15453911 PMCID: PMC521491 DOI: 10.1186/1472-6920-4-17] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2004] [Accepted: 09/29/2004] [Indexed: 05/24/2023]
Abstract
BACKGROUND Engaging practicing physicians in educational strategies that reinforce guideline adoption and improve the quality of healthcare may be difficult. Push technologies such as email offer new opportunities to engage physicians in online educational reinforcing strategies. The objectives are to investigate 1) the effectiveness of email announcements in engaging recruited community-based primary care physicians in an online guideline reinforcement strategy designed to promote Chlamydia screening, 2) the characteristics of physicians who respond to email announcements, as well as 3) how quickly and when they respond to email announcements. METHODS Over a 45-week period, 445 recruited physicians received up to 33 email contacts announcing and reminding them of an online women's health guideline reinforcing CME activity. Participation was defined as physician log-on at least once to the website. Data were analyzed to determine participation, to compare characteristics of participants with recruited physicians who did not participate, and to determine at what point and when participants logged on. RESULTS Of 445 recruited physicians with accurate email addresses, 47.2% logged on and completed at least one module. There were no significant differences by age, race, or specialty between participants and non-participants. Female physicians, US medical graduates and MDs had higher participation rates than male physicians, international medical graduates and DOs. Physicians with higher baseline screening rates were significantly more likely to log on to the course. The first 10 emails were the most effective in engaging community-based physicians to complete the intervention. Physicians were more likely to log on in the afternoon and evening and on Monday or Thursday. CONCLUSIONS Email course reminders may enhance recruitment of physicians to interventions designed to reinforce guideline adoption; physicians' response to email reminders may vary by gender, degree, and country of medical training. Repetition of email communications contributes to physician online participation.
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Affiliation(s)
- Maziar Abdolrasulnia
- Division of Continuing Medical Education, University of Alabama at Birmingham, JNWB 406, 1530 3Avenue South, Birmingham, AL 35294-0500, USA
- Center for Outcomes and Effectiveness Research Education, University of Alabama at Birmingham, MT 401, 1530 3Avenue South, Birmingham, AL 35294-1170, USA
| | - Blanche C Collins
- Division of Continuing Medical Education, University of Alabama at Birmingham, JNWB 406, 1530 3Avenue South, Birmingham, AL 35294-0500, USA
| | - Linda Casebeer
- Division of Continuing Medical Education, University of Alabama at Birmingham, JNWB 406, 1530 3Avenue South, Birmingham, AL 35294-0500, USA
- Center for Outcomes and Effectiveness Research Education, University of Alabama at Birmingham, MT 401, 1530 3Avenue South, Birmingham, AL 35294-1170, USA
| | - Terry Wall
- Center for Outcomes and Effectiveness Research Education, University of Alabama at Birmingham, MT 401, 1530 3Avenue South, Birmingham, AL 35294-1170, USA
- Department of Pediatrics, University of Alabama at Birmingham, MTC 201 1600 7Avenue South 35294-0011, USA
| | - Claire Spettell
- Aetna Integrated Informatics, Inc. 151 Farmington Avenue Hartford, CT 06156, USA
| | - Midge N Ray
- Center for Outcomes and Effectiveness Research Education, University of Alabama at Birmingham, MT 401, 1530 3Avenue South, Birmingham, AL 35294-1170, USA
- School of Health Related Professions, University of Alabama at Birmingham, Webb Building 564, 1530 3Avenue South, Birmingham, AL 35294-3361, USA
| | - Norman W Weissman
- Center for Outcomes and Effectiveness Research Education, University of Alabama at Birmingham, MT 401, 1530 3Avenue South, Birmingham, AL 35294-1170, USA
- School of Health Related Professions, University of Alabama at Birmingham, Webb Building 564, 1530 3Avenue South, Birmingham, AL 35294-3361, USA
| | - Jeroan J Allison
- Center for Outcomes and Effectiveness Research Education, University of Alabama at Birmingham, MT 401, 1530 3Avenue South, Birmingham, AL 35294-1170, USA
- Division of General Medicine, University of Alabama at Birmingham, FOT 720D 20Street South, Birmingham, AL 35294-3407, USA
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Buckley LL, Goering P, Parikh SV, Butterill D, Foo EKH. Applying a 'stages of change' model to enhance a traditional evaluation of a research transfer course. J Eval Clin Pract 2003; 9:385-90. [PMID: 14758960 DOI: 10.1046/j.1365-2753.2003.00407.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The aim of this study was to utilize an evaluation tool based on Prochaska's model of change in order to assess behaviour change as part of an evaluation process for a research transfer training programme (RTTP). The RTTP was a training programme offered to scientists in a psychiatry department and research institute to gain skills in research transfer. In addition to a traditional course evaluation framework evaluating overall satisfaction with the course and whether or not learning objectives were met, an additional 'stages of change' evaluation tool designed to assess change along a continuum was utilized. This instrument measured change in participants' attitudes, intentions and actions with respect to research transfer practice and consisted of a 12-question survey completed by participants prior to taking the course and 3 months post-course. In two out of the three categories, attitudes and intention to practice, there was positive change from pre- to post-course (P < 0.05). Although there was a trend of increased RT-related action, this was less robust and did not reach significance. For the RTTP transfer course, a 'stages of change' model of evaluation provided an enhanced understanding by showing changes in participants that would otherwise have been overlooked if only changes in RT behaviour were measured. Additionally, evaluating along a change continuum specifically identifies areas for improvement in future courses. The instrument developed for this study could also be used as a pre-course, participant needs assessment to tailor a course to the change needs of participants. Finally, this 'stages of change' approach provides insight into where barriers to change may exist for research transfer action.
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