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Lim SH, Ang SY, Lim YYA, Leow WXB, Binte Sunari RN, Foo XA, Aloweni F. Effectiveness of spaced education pedagogy in enhancing Nurses' knowledge on emotional resilience-A quasi-experimental trial. J Nurs Scholarsh 2024. [PMID: 39118269 DOI: 10.1111/jnu.13014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/11/2024] [Accepted: 07/29/2024] [Indexed: 08/10/2024]
Abstract
INTRODUCTION Building resilience among nurses has been postulated as one of the key strategies to support nurses and retain them in the profession. This study aimed to evaluate the effectiveness, of spaced education pedagogy in enhancing Nurses' knowledge on emotional resilience. Secondary objectives include evaluation of the usability and acceptability of delivery of the training via a mobile application in one's own mobile device. DESIGN A quasi-experimental study with single group pre-test and post-test trial was conducted. METHODS Full-time registered nurses working in an acute care hospital were invited to participate from June 2021 to June 2022. The group used the mobile application daily for 1 month. Pre-test measurement includes socio-demographic data and baseline resilience level before the intervention. Post-test measurement includes resilience level, usability and acceptability of mobile-assisted cognitive-behavioral therapy measured upon completion of the training. The mobile application enabled the delivery of resilience educational content in small quantities through a repeating manner, with a concurrent evaluation of learner's understanding. RESULTS When compared to their baseline (mean = 24.38, SD = 5.50), participants reported significant increase in the Connor-Davison Resilience Scale score (mean = 26.33, SD = 5.57) (t = -4.40, p < 0.001). Upon 1 month usage of the mobile application, a higher percentage of the participants reported intermediate to high level of resilience (57.4%), as compared to prior usage (54.7%). Respondents reported knowledge of most useful strategies for their daily lives including: (i) managing negative emotions (54.1%); (ii) psychoeducation about mental health and the risks of burnout (44.7%); (iii) achieving work and life balance (43.5%); and (iv) depiction of workplace scenarios to demonstrate what can be and cannot be controlled during times of change (43.5%). Participants reported usability of the mobile application with a mean SUS score 70.5 (SD = 13.0), which was considered "acceptable." Overall, 82.3% of the participants found the mobile application appealing, 64.7% reported they were likely to use the mobile application in the future and 72.9% would recommend it to other nurses. CONCLUSION The mobile application provided nurses with the availability and convenience to access resilience building learning content integrated with the spaced education pedagogy. CLINICAL RELEVANCE The use of mobile-assisted cognitive behavioral training can aid in increasing nurses' resilience level. Nurses provided acceptable usability ratings and satisfactory acceptance of receiving training via the mobile application, showing promising opportunities in the improvement of overall well-being.
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Affiliation(s)
- Siew Hoon Lim
- Division of Nursing, Singapore General Hospital, Singapore, Singapore
| | - Shin Yuh Ang
- Division of Nursing, Singapore General Hospital, Singapore, Singapore
| | - Yann Yu Amber Lim
- Department of Psychosocial Oncology, National Cancer Centre, Singapore, Singapore
| | | | | | | | - Fazila Aloweni
- Division of Nursing, Singapore General Hospital, Singapore, Singapore
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Oropesa I, Sánchez-Peralta LF, Guzmán García C, Chmarra MK, Berner-Juhos K, Tiu C, Mettouris C, Papadopoulos GA, Papadopoulos A, Blas Pagador J, Post J, Dankelman J, González-Segura A, Sánchez-Margallo FM, Gómez EJ. EASIER: A new model for online learning of minimally invasive surgery skills. Int J Med Inform 2023; 180:105269. [PMID: 37907015 DOI: 10.1016/j.ijmedinf.2023.105269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 10/06/2023] [Accepted: 10/21/2023] [Indexed: 11/02/2023]
Abstract
INTRODUCTION Technology Enhanced Learning (TEL) can provide the tools to safely master minimally invasive surgery (MIS) skills in patient-free environments and receive immediate objective feedback without the constant presence of an instructor. However, TEL-based systems tend to work isolated from one another, focus on different skills, and fail to provide contents without a sound pedagogical background. OBJECTIVE The objective of this descriptive study is to present in detail EASIER, an innovative TEL platform for surgical and interventional training, as well as the results of its validation. METHODS EASIER provides a Learning Management System (LMS) for institutions and content creators that can connect and integrate TEL "external assets" (virtual reality simulators, augmented box trainers, augmented videos, etc.) addressing different skills. The platform integrates all skills under an Assessment Module that measures skills' progress in different courses. Finally, it provides content creators with a pedagogical model to scaffold contents while retaining flexibility to approach course design with different training philosophies in mind. Three courses were developed and hosted in the platform to validate it with end-users in terms of usability, performance, learning results in the courses and student self-perception on learning. RESULTS In total 111 volunteers completed the validation. The study was limited due to the COVID-19 pandemic, which limited access to external assets (virtual reality simulators). Nevertheless, usability was rated with 73.1 in the System Usability Scale. Most positive aspects on performance were easiness to access the platform, easiness to change the configuration and not requiring additional plug-ins to use the platform. The platform was rated above average in the six scales of the User Experience Questionnaire. Overall, student results improved significantly across the three courses (p < 0.05). CONCLUSIONS This study provides, within its limitations, evidence on the usefulness of the EASIER platform for distance learning of MIS skills. Results show the potential impact of the platform and are an encouraging boost for the future, especially in the aftermath of the COVID-19 pandemic.
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Affiliation(s)
- Ignacio Oropesa
- Biomedical Engineering and Telemedicine Centre (GBT), ETSI Telecomunicación, Center for Biomedical Technology, Universidad Politécnica de Madrid (UPM), Avda Complutense, 30 28040, Madrid, Spain.
| | - Luisa F Sánchez-Peralta
- Jesús Usón Minimally Invasive Surgery Centre, Carretera Nacional 521, Km 41.8 10071, Cáceres, Spain
| | - Carmen Guzmán García
- Biomedical Engineering and Telemedicine Centre (GBT), ETSI Telecomunicación, Center for Biomedical Technology, Universidad Politécnica de Madrid (UPM), Avda Complutense, 30 28040, Madrid, Spain
| | - Magdalena K Chmarra
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering (3mE), Delft University of Technology, Mekelweg 2 2628 CD, Delft, the Netherlands
| | - Krisztina Berner-Juhos
- Semmelweis University, Faculty of Medicine, HVC, Department of Surgical Research and Techniques, Nagyvaead sqr. 4, Budapest, Hungary H1089
| | - Calin Tiu
- MEDIS Foundation, 83 Grivitei, Campina 105600, Romania
| | - Christos Mettouris
- University of Cyprus, Department of Computer Science, CY-2109, Nicosia, Cyprus
| | | | - Andreas Papadopoulos
- Cyprus Research and Innovation Center Ltd, 28th Octovriou Ave. 72, Office 301, Engomi 2414, Nicosia, Cyprus
| | - José Blas Pagador
- Jesús Usón Minimally Invasive Surgery Centre, Carretera Nacional 521, Km 41.8 10071, Cáceres, Spain
| | - Joeri Post
- SIMENDO BV, Vijverhofstraat 106 3032 SP, Rotterdam, the Netherlands
| | - Jenny Dankelman
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering (3mE), Delft University of Technology, Mekelweg 2 2628 CD, Delft, the Netherlands
| | | | - Francisco M Sánchez-Margallo
- Jesús Usón Minimally Invasive Surgery Centre, Carretera Nacional 521, Km 41.8 10071, Cáceres, Spain; Centro de Investigación Biomédica En Red de Enfermedades Cardiovasculares CIBERCV, Av. Monforte de Lemos, 3-5 28029, Madrid, Spain
| | - Enrique J Gómez
- Biomedical Engineering and Telemedicine Centre (GBT), ETSI Telecomunicación, Center for Biomedical Technology, Universidad Politécnica de Madrid (UPM), Avda Complutense, 30 28040, Madrid, Spain; Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), C/ Melchor Fernández Almagro, 3 28029, Madrid, Spain
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Zeri F, Eperjesi F, Woods C, Bandlitz S, Kumar Bhootra A, Joshi MR, Nagra M, Schweizer H, Naroo SA. Evidence-based teaching in contact lenses education: Teaching and learning strategies. Cont Lens Anterior Eye 2023; 46:101822. [PMID: 36804937 DOI: 10.1016/j.clae.2023.101822] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 02/08/2023] [Indexed: 02/17/2023]
Abstract
INTRODUCTION Contact lens (CL) practice is an ever-changing field with clinical knowledge, techniques and equipment continuously evolving. These new developments are backed with clinical trials and research to ensure that practitioners feel confident that there is an evidence base to support these advances. Evidence-based practice is now a crucial part of CL practice, and its importance also filters down to CL education. For example, lectures are one of the most popular tools for an educator but, is standing at the front of a lecture theatre full of students a more effective way of teaching than providing the same material for students to read by themselves? What evidence exists specific to CL education? METHOD An expert panel of educators completed a comprehensive literature review of current evidence of teaching methods in CL training, or if not available then what can be learnt from other health care professional training that could be potentially applicable to CL education. RESULTS Due to the amount of evidence available in the overall subject area relating to healthcare education, the initial plan of compiling evidence into one narrative review paper was discarded in favour of producing two linked papers. Here, the first paper details definitions of terminology, and also teaching methods. The second paper focuses on assessment and specific clinical training required to attain CL practice competency. In this first paper, no direct evidence of the spreading and benefit of new education strategies evidence such as flipped classrooms, spaced learning, test-enhanced learning, group work, CBL, PBL, TBL, and reflective practice in CL education was found. The only technique that was widely used in the CL field was case reports and the group discussion of them. Nevertheless, the authors found a consensus of opinion from other disciplines that are transferable to CL teaching and could help students meet the intended learning outcomes. CONCLUSION There is a small amount of evidence supporting CL education, but most of this seems to be related to the practical element of the training. However, there is a lot of evidence in the field of healthcare education from related disciplines which provides additional but important learning tools that may be effectively implemented in CL education.
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Affiliation(s)
- Fabrizio Zeri
- University of Milano-Bicocca, Department of Materials Science, Milan, Italy; College of Health and Life Sciences, Aston University, UK; International Association of Contact Lens Educators, Canada
| | | | - Craig Woods
- School of Optometry and Vision Science, University of New South Wales, Australia; International Association of Contact Lens Educators, Canada
| | - Stefan Bandlitz
- College of Health and Life Sciences, Aston University, UK; Höhere Fachschule für Augenoptik Köln, Cologne School of Optometry, Cologne, Germany
| | | | - Mahesh R Joshi
- Eye and Vision Research Group, University of Plymouth, UK
| | | | | | - Shehzad A Naroo
- College of Health and Life Sciences, Aston University, UK; International Association of Contact Lens Educators, Canada.
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Grad R, Leger D, Kaczorowski J, Schuster T, Adler S, Aman M, Archibald D, Beaulieu MC, Chmelicek J, Cornelissen E, Delleman B, Hadj-Mimoune S, Horvey S, Macaluso S, Mintsioulis S, Murdoch S, Ng B, Papineau A, Rangwala S, Rousseau M, Rudkin T, Schabort I, Schultz K, Snow P, Wong E, Wu P, Brailovsky C. Does spaced education improve clinical knowledge among Family Medicine residents? A cluster randomized controlled trial. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2021; 26:771-783. [PMID: 33389233 PMCID: PMC8338813 DOI: 10.1007/s10459-020-10020-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 12/14/2020] [Indexed: 06/12/2023]
Abstract
UNLABELLED Spaced education is a learning strategy to improve knowledge acquisition and retention. To date, no robust evidence exists to support the utility of spaced education in the Family Medicine residency. We aimed to test whether alerts to encourage spaced education can improve clinical knowledge as measured by scores on the Canadian Family Medicine certification examination. METHOD We conducted a cluster randomized controlled trial to empirically and pragmatically test spaced education using two versions of the Family Medicine Study Guide mobile app. 12 residency training programs in Canada agreed to participate. At six intervention sites, we consented 335 of the 654 (51%) eligible residents. Residents in the intervention group were sent alerts through the app to encourage the answering of questions linked to clinical cases. At six control sites, 299 of 586 (51%) residents consented. Residents in the control group received the same app but with no alerts. Incidence rates of case completion between trial arms were compared using repeated measures analysis. We linked residents in both trial arms to their knowledge scores on the certification examination of the College of Family Physicians of Canada. RESULTS Over 67 weeks, there was no statistically significant difference in the completion of clinical cases by participants. The difference in mean exam scores and the associated confidence interval did not exceed the pre-defined limit of 4 percentage points. CONCLUSION Further research is recommended before deploying spaced educational interventions in the Family Medicine residency to improve knowledge.
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Affiliation(s)
- Roland Grad
- Herzl Family Practice Centre, McGill University, 3755 Cote Ste Catherine Road, Montreal, H3T 1E2, Canada.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Brian Ng
- University of British Columbia, Vancouver, Canada
| | | | | | | | - Teresa Rudkin
- Family Medicine, McGill University, Montreal, Canada
| | | | | | - Pamela Snow
- Memorial University of Newfoundland, St. John's, Canada
| | | | - Pearson Wu
- Herzl Family Practice Centre, McGill University, 3755 Cote Ste Catherine Road, Montreal, H3T 1E2, Canada
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Chanes DC, Piza FMDT, San Martin G, Leão ER, Dos Santos OFP. Fall prevention education for people with multiple sclerosis: a randomized clinical trial. Int J Qual Health Care 2021; 33:6151771. [PMID: 33638988 DOI: 10.1093/intqhc/mzab035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 02/01/2021] [Accepted: 02/26/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Online spaced education (OSE) is a method recognized for promoting long-term knowledge retention, changing behaviors and improving outcomes for students and healthcare professionals. However, there is little evidence about its impacts on patient education. OBJECTIVES The aim of this research was to compare knowledge retention using educational brochure and OSE on individuals with multiple sclerosis (MS) and to verify the impact of educational methods on fall outcome. METHODS Individuals with MS (n = 230) were randomly assigned to two types of patient education-educational brochure (control) and OSE (intervention). During 12 weeks, the intervention group received multiple-choice tests on fall prevention. Knowledge retention, behavior change and fall incidence were assessed before intervention and after 3 and 6 months. The participants' satisfaction with the education method was also evaluated. RESULTS Knowledge retention was similar between groups, and behavior change was observed in both groups. There was a significant reduction in fall rate in the intervention group, from 0.60 to 0.27 at 6 months (P < 0.001). Participants' satisfaction achieved an average of 8.75, with no differences between groups. CONCLUSION Individuals demonstrated significant improvement in fall rate outcome in both groups with no significant difference. In regard to test scores and satisfaction, results were similar between groups.
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Affiliation(s)
- Daniella Cristina Chanes
- Learning and Research Center, Hospital Israelita Albert Einstein, Av. Albert Einstein, 627 - Morumbi, Sao Paulo 05652-900, Brazil
| | - Felipe Maia de Toledo Piza
- Intensive Care Unit, Hospital Israelita Albert Einstein, Av. Albert Einstein, 627 - Morumbi, Sao Paulo 05652-900, Brazil
| | - Gustavo San Martin
- Amigos Múltiplos pela Esclerose, Av, R. São João D'Aliança, 282 - Vila Rosalia, Guarulhos 07064-130, Brazil
| | - Eliseth Ribeiro Leão
- Learning and Research Center, Hospital Israelita Albert Einstein, Av. Albert Einstein, 627 - Morumbi, Sao Paulo 05652-900, Brazil
| | - Oscar Fernando Pavão Dos Santos
- Learning and Research Center, Hospital Israelita Albert Einstein, Av. Albert Einstein, 627 - Morumbi, Sao Paulo 05652-900, Brazil
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Gough BL, Gerges M, Weinberger J. Spaced Education With ABSITE Quest Resulting in Improved American Board of Surgery In-Training Examination Performance. JOURNAL OF SURGICAL EDUCATION 2021; 78:597-603. [PMID: 32958421 DOI: 10.1016/j.jsurg.2020.07.039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 06/25/2020] [Accepted: 07/25/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE The American Board of Surgery In-Training Examination (ABSITE) is an annual exam taken by general surgery residents as a cognitive assessment of the knowledge gained throughout each year of training. Several question banks are available for ABSITE preparation. However, ABSITE Quest (AQ) utilizes a method called spaced education which has been demonstrated to help with retaining information longer and improve exam performance. This study hypothesizes that using this method will help residents improve their ABSITE performance. DESIGN Retrospective survey data was collected from residents who participated in AQ, including postgraduate year (PGY) level, as well as 2019 and 2020 ABSITE percentiles. AQ user data was used to match respondent's total number of questions completed and daily engagement level to the survey data. Paired, single-tailed student's t test was used to evaluate the significance of ABSITE percentile change between 2019 and 2020 among AQ users. SETTING ChristianaCare, Newark, DE, United States. Nonclinical. PARTICIPANTS All ABSITE Quest users were surveyed (n = 390), of which 104 responded. 21 responses were from PGY1 residents and were excluded, resulting in a total of 83 responses. RESULTS The mean percentile difference of AQ users from 2019 to 2020 was +15.8 (p < 0.00001). When categorizing by the total number of questions completed, high users demonstrated a mean percentile difference of +15.3 (p = 0.00002), average users had a difference of +19.1 (p = 0.00029), and low users showed a percentile difference of +1.2 (p = 0.45244). When categorizing by daily engagement level, high users demonstrated a mean percentile difference of +17.9 (p < 0.00001), low users had a mean percentile difference of +15.3 (p = 0.00124), and minimal users showed a mean percentile change of -5.7. CONCLUSIONS The use of the spaced education method with ABSITE Quest, especially in users with a greater number of questions completed and high levels of daily engagement, correlated with a significant improvement on ABSITE performance.
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Affiliation(s)
| | - Michael Gerges
- University of Texas Health Science Center San Antonio, Department of Surgery, San Antonio, Texas
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Timmer MCJ, Steendijk P, Arend SM, Versteeg M. Making a Lecture Stick: the Effect of Spaced Instruction on Knowledge Retention in Medical Education. MEDICAL SCIENCE EDUCATOR 2020; 30:1211-1219. [PMID: 34457784 PMCID: PMC8368805 DOI: 10.1007/s40670-020-00995-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Poor knowledge retention is a persistent problem among medical students. This challenging issue may be addressed by optimizing frequently used instructional designs, such as lectures. Guided by neuroscientific literature, we designed a spaced learning lecture in which the educator repeats the to-be-learned information using short temporal intervals. We investigated if this modified instructional design could enhance students' retention. MATERIALS AND METHODS Second-year medical students (n = 148) were randomly allocated to either the spaced lecture or the traditional lecture. The spaced lecture consisted of three 15-min instructional periods, separated by 5-min intervals. A short summary of the preceding information was provided after each interval. The traditional lecture encompassed the same information including the summary in the massed format, thus without the intervals. All students performed a baseline knowledge test 2 weeks prior to the lectures and students' knowledge retention was assessed 8 days after the lectures. RESULTS The average score on the retention test (α = 0.74) was not significantly different between the spaced lecture group (33.8% ± 13.6%) and the traditional lecture group (31.8% ± 12.9%) after controlling for students' baseline-test performance (F(1,104) = 0.566, p = 0.458). Students' narrative comments showed that the spaced lecture format was well-received and subjectively benefitted their attention-span and cognitive engagement. DISCUSSION AND CONCLUSION We were unable to show increased knowledge retention after the spaced lecture compared with the traditional lecture. Based on these findings, we provide recommendations for further research. Ultimately, we aim for optimized spaced learning designs to facilitate learning in the medical curriculum and to help educate health professionals with a solid knowledge base.
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Affiliation(s)
- Marnix C. J. Timmer
- Center for Innovation in Medical Education, Leiden University Medical Center, Leiden, The Netherlands
| | - Paul Steendijk
- Center for Innovation in Medical Education, Leiden University Medical Center, Leiden, The Netherlands
- Department of Cardiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Sandra M. Arend
- Department of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands
| | - Marjolein Versteeg
- Center for Innovation in Medical Education, Leiden University Medical Center, Leiden, The Netherlands
- Department of Cardiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
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Mobile Spaced Education in Surgical Education Settings and Specialties: A Scoping Review. CURRENT SURGERY REPORTS 2020. [DOI: 10.1007/s40137-020-00250-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Versteeg M, Hendriks RA, Thomas A, Ommering BWC, Steendijk P. Conceptualising spaced learning in health professions education: A scoping review. MEDICAL EDUCATION 2020; 54:205-216. [PMID: 31860936 PMCID: PMC7064953 DOI: 10.1111/medu.14025] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 09/05/2019] [Accepted: 10/21/2019] [Indexed: 05/10/2023]
Abstract
OBJECTIVES To investigate the definitions and applications of 'spaced learning' and to propose future directions for advancing its study and practice in health professions education. METHOD The authors searched five online databases for articles published on spaced learning in health professions education prior to February 2018. Two researchers independently screened articles for eligibility with set inclusion criteria. They extracted and analysed key data using both quantitative and qualitative methods. RESULTS Of the 2972 records retrieved, 120 articles were included in the review. More than 90% of these articles were published in the last 10 years. The definition of spaced learning varied widely and was often not theoretically grounded. Spaced learning was applied in distinct contexts, including online learning, simulation training and classroom settings. There was a large variety of spacing formats, ranging from dispersion of information or practice on a single day, to intervals lasting several months. Generally, spaced learning was implemented in practice or testing phases and rarely during teaching. CONCLUSIONS Spaced learning is infrequently and poorly defined in the health professions education literature. We propose a comprehensive definition of spaced learning and emphasise that detailed descriptions of spacing formats are needed in future research to facilitate the operationalisation of spaced learning research and practice in health professions education.
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Affiliation(s)
- Marjolein Versteeg
- Department of CardiologyLeiden University Medical CenterLeidenthe Netherlands
- Center for Innovation In Medical EducationLeiden University Medical CenterLeidenthe Netherlands
| | - Renée A. Hendriks
- Center for Innovation In Medical EducationLeiden University Medical CenterLeidenthe Netherlands
| | - Aliki Thomas
- School of Physical and Occupational TherapyMontrealQuébecCanada
- Faculty of MedicineInstitute for Health Sciences EducationMcGill UniversityMontrealQuébecCanada
- Centre for Interdisciplinary Research in RehabilitationMontrealQuébecCanada
| | - Belinda W. C. Ommering
- Center for Innovation In Medical EducationLeiden University Medical CenterLeidenthe Netherlands
| | - Paul Steendijk
- Department of CardiologyLeiden University Medical CenterLeidenthe Netherlands
- Center for Innovation In Medical EducationLeiden University Medical CenterLeidenthe Netherlands
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Menon V, Chubaty A, Clezy K, Su Y, Post JJ, Janssen A, Shaw T, Konecny P. Infectious diseases and antimicrobial prescribing: Online spaced education for junior doctors. J Glob Antimicrob Resist 2020; 22:226-230. [PMID: 32087310 DOI: 10.1016/j.jgar.2020.02.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 02/01/2020] [Accepted: 02/10/2020] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Inappropriate antimicrobial prescribing may harm patients and drive antimicrobial resistance. Junior doctors' knowledge of infectious diseases and antimicrobial prescribing is inadequate. Online spaced case-based learning can improve knowledge. OBJECTIVE To develop infectious diseases and antimicrobial prescribing course content for online spaced education and assess its effectiveness and feasibility for junior doctors. METHODS Infectious diseases and antimicrobial course content was developed for an online spaced education platform (Qstream Inc., Burlington, MA). Junior doctors (postgraduate years 1-3) at two tertiary teaching hospitals in Sydney participated in the study. Course content was provided with Qstream at one hospital and at the other hospital via two face-to-face (FTF) tutorials from August to October 2017. Knowledge and self-confidence were compared before and after training within and between both cohorts. RESULTS Participation in the course was higher in the Qstream cohort with 48/127 (37.8%) completing the course compared with 44/110 (40%) attending one or both FTF sessions, of whom 22/110 (20%) attended both. Improvement in mean knowledge score from 69.7% to 81.5% in the Qstream cohort was significantly greater than the FTF cohort's minimal improvement from 67.6% to 67.9% (95% CI 2.79-20.33; P=0.01). In the Qstream cohort mean confidence rating (0-10) improvement from 5.14 to 6.55 was greater than the FTF group improvement from 5.37 to 5.85 (95% CI 0.132-1.171; P=0.02). Qstream feedback was very positive. CONCLUSIONS Online spaced education in infectious diseases and antimicrobial prescribing was feasible, acceptable and effective for junior doctors. It has potential to reduce inappropriate antimicrobial prescribing and warrants further investigation.
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Affiliation(s)
- V Menon
- Department of Infectious Diseases, Prince of Wales Hospital, Sydney, Australia; Prince of Wales Clinical School, University of New South Wales, Sydney, Australia
| | - A Chubaty
- Pharmacy Department, Prince of Wales Hospital, Sydney, Australia
| | - K Clezy
- Department of Infectious Diseases, Prince of Wales Hospital, Sydney, Australia; Prince of Wales Clinical School, University of New South Wales, Sydney, Australia
| | - Y Su
- Department of Infectious Diseases, Prince of Wales Hospital, Sydney, Australia
| | - J J Post
- Department of Infectious Diseases, Prince of Wales Hospital, Sydney, Australia; Prince of Wales Clinical School, University of New South Wales, Sydney, Australia
| | - A Janssen
- Research in Implementation Science and eHealth Group, The University of Sydney, Sydney, Australia
| | - T Shaw
- Research in Implementation Science and eHealth Group, The University of Sydney, Sydney, Australia
| | - P Konecny
- Department of Infectious Diseases, Immunology & Sexual Health, St George Hospital, Sydney, Australia; St George and Sutherland Clinical School, University of New South Wales, Sydney, Australia.
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Phillips JL, Heneka N, Bhattarai P, Fraser C, Shaw T. Effectiveness of the spaced education pedagogy for clinicians' continuing professional development: a systematic review. MEDICAL EDUCATION 2019; 53:886-902. [PMID: 31144348 DOI: 10.1111/medu.13895] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 12/11/2019] [Accepted: 03/27/2019] [Indexed: 06/09/2023]
Abstract
CONTEXT Ensuring clinical practice reflects current evidence is challenging given the rapid proliferation of new knowledge. Changing entrenched clinical behaviours and facilitating the adoption of best practice evidence requires a range of strategies, including affordable, scalable and effective continuing professional development (CPD). Yet, identifying the CPD delivery method most likely to effectively change and improve patient outcomes is difficult given the variability in the evidence for different learning approaches. Although there is moderate level evidence for outreach education, audit and feedback, and face-to-face or online learning, little is known about the capacity of spaced education to change ineffective clinical practice(s). Spaced education harnesses the power of spacing, repetition and testing learning content to increase topic-specific knowledge. Although spaced education is widely used in undergraduate and postgraduate medical programmes, its effectiveness as a CPD delivery method that improves patient outcomes is less certain. AIM To determine the effectiveness of the spaced education CPD programmes to change targeted clinical knowledge and practice(s) to improve patient outcomes. METHOD A systematic review, appraising the spaced education CPD evidence generated from searching six specialist medical and psychosocial databases. Studies published in English peer-reviewed journals from 1 January, 2000 to 31 August, 2018 were eligible for inclusion. A modified Kirkpatrick four levels of evaluation framework assisted with appraising the effect of spaced education CPD interventions on clinicians and patients. RESULTS Of the 2396 studies identified, 17 met the inclusion criteria, involving 2701 practising clinicians from multiple disciplines and specialties. Five randomised controlled trials generated level II evidence, with the remaining 12 studies generating lower levels of evidence. The majority of studies (n = 14) involved the delivery of online spaced education. All studies were evaluated using the modified Kirkpatrick four levels of evaluation framework with: 10 studies demonstrating significant increases in participants' knowledge; seven studies reporting significant changes in clinician behaviour; four studies showing significant increases in clinician confidence; and three studies identifying significant and sustained increases in participants' clinical skills. Only two studies reported positive improvements in patient outcomes. CONCLUSION Spaced education via an online platform offers a scalable CPD format that can increase clinical knowledge and change practice. However, further adequately powered randomised controlled trials are required to confirm that spaced education CPD can impact positively on patients' reported outcomes.
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Affiliation(s)
- Jane L Phillips
- Centre for Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Nicole Heneka
- Centre for Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
- School of Nursing, University of Notre Dame Australia, Sydney, New South Wales, Australia
| | - Priyanka Bhattarai
- School of Nursing, University of Notre Dame Australia, Sydney, New South Wales, Australia
| | - Claire Fraser
- School of Nursing, University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - Tim Shaw
- Implementation Science and eHealth (RISe), Charles Perkins Centre, Faculty of Health Sciences, University of Sydney, Sydney, New South Wales, Australia
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George PP, Zhabenko O, Kyaw BM, Antoniou P, Posadzki P, Saxena N, Semwal M, Tudor Car L, Zary N, Lockwood C, Car J. Online Digital Education for Postregistration Training of Medical Doctors: Systematic Review by the Digital Health Education Collaboration. J Med Internet Res 2019; 21:e13269. [PMID: 30801252 PMCID: PMC6410118 DOI: 10.2196/13269] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 01/29/2019] [Accepted: 01/30/2019] [Indexed: 12/19/2022] Open
Abstract
Background Globally, online and local area network–based (LAN) digital education (ODE) has grown in popularity. Blended learning is used by ODE along with traditional learning. Studies have shown the increasing potential of these technologies in training medical doctors; however, the evidence for its effectiveness and cost-effectiveness is unclear. Objective This systematic review evaluated the effectiveness of online and LAN-based ODE in improving practicing medical doctors’ knowledge, skills, attitude, satisfaction (primary outcomes), practice or behavior change, patient outcomes, and cost-effectiveness (secondary outcomes). Methods We searched seven electronic databased for randomized controlled trials, cluster-randomized trials, and quasi-randomized trials from January 1990 to March 2017. Two review authors independently extracted data and assessed the risk of bias. We have presented the findings narratively. We mainly compared ODE with self-directed/face-to-face learning and blended learning with self-directed/face-to-face learning. Results A total of 93 studies (N=16,895) were included, of which 76 compared ODE (including blended) and self-directed/face-to-face learning. Overall, the effect of ODE (including blended) on postintervention knowledge, skills, attitude, satisfaction, practice or behavior change, and patient outcomes was inconsistent and ranged mostly from no difference between the groups to higher postintervention score in the intervention group (small to large effect size, very low to low quality evidence). Twenty-one studies reported higher knowledge scores (small to large effect size and very low quality) for the intervention, while 20 studies reported no difference in knowledge between the groups. Seven studies reported higher skill score in the intervention (large effect size and low quality), while 13 studies reported no difference in the skill scores between the groups. One study reported a higher attitude score for the intervention (very low quality), while four studies reported no difference in the attitude score between the groups. Four studies reported higher postintervention physician satisfaction with the intervention (large effect size and low quality), while six studies reported no difference in satisfaction between the groups. Eight studies reported higher postintervention practice or behavior change for the ODE group (small to moderate effect size and low quality), while five studies reported no difference in practice or behavior change between the groups. One study reported higher improvement in patient outcome, while three others reported no difference in patient outcome between the groups. None of the included studies reported any unintended/adverse effects or cost-effectiveness of the interventions. Conclusions Empiric evidence showed that ODE and blended learning may be equivalent to self-directed/face-to-face learning for training practicing physicians. Few other studies demonstrated that ODE and blended learning may significantly improve learning outcomes compared to self-directed/face-to-face learning. The quality of the evidence in these studies was found to be very low for knowledge. Further high-quality randomized controlled trials are required to confirm these findings.
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Affiliation(s)
- Pradeep Paul George
- Health Services and Outcomes Research, National Healthcare Group, Singapore, Singapore.,Joanna Briggs Institute, University of Adelaide, Adelaide, Australia.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Olena Zhabenko
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Bhone Myint Kyaw
- Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Panagiotis Antoniou
- Laboratory of Medical Physics, Aristotle University of Thessaloniki, Thessaloníki, Greece
| | - Pawel Posadzki
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Nakul Saxena
- Ophthalmology Team, Novartis, Singapore, Singapore
| | - Monika Semwal
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Lorainne Tudor Car
- Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Nabil Zary
- Medical Education Research and Scholarship Unit, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.,Department of Learning, Informative, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.,10I Emerging Technologies Lab, Mohammed VI University of Health Sciences, Casablanca, Morocco
| | - Craig Lockwood
- Joanna Briggs Institute, University of Adelaide, Adelaide, Australia
| | - Josip Car
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.,Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
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Vaona A, Banzi R, Kwag KH, Rigon G, Cereda D, Pecoraro V, Tramacere I, Moja L. E-learning for health professionals. Cochrane Database Syst Rev 2018; 1:CD011736. [PMID: 29355907 PMCID: PMC6491176 DOI: 10.1002/14651858.cd011736.pub2] [Citation(s) in RCA: 134] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND The use of e-learning, defined as any educational intervention mediated electronically via the Internet, has steadily increased among health professionals worldwide. Several studies have attempted to measure the effects of e-learning in medical practice, which has often been associated with large positive effects when compared to no intervention and with small positive effects when compared with traditional learning (without access to e-learning). However, results are not conclusive. OBJECTIVES To assess the effects of e-learning programmes versus traditional learning in licensed health professionals for improving patient outcomes or health professionals' behaviours, skills and knowledge. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, five other databases and three trial registers up to July 2016, without any restrictions based on language or status of publication. We examined the reference lists of the included studies and other relevant reviews. If necessary, we contacted the study authors to collect additional information on studies. SELECTION CRITERIA Randomised trials assessing the effectiveness of e-learning versus traditional learning for health professionals. We excluded non-randomised trials and trials involving undergraduate health professionals. DATA COLLECTION AND ANALYSIS Two authors independently selected studies, extracted data and assessed risk of bias. We graded the certainty of evidence for each outcome using the GRADE approach and standardised the outcome effects using relative risks (risk ratio (RR) or odds ratio (OR)) or standardised mean difference (SMD) when possible. MAIN RESULTS We included 16 randomised trials involving 5679 licensed health professionals (4759 mixed health professionals, 587 nurses, 300 doctors and 33 childcare health consultants).When compared with traditional learning at 12-month follow-up, low-certainty evidence suggests that e-learning may make little or no difference for the following patient outcomes: the proportion of patients with low-density lipoprotein (LDL) cholesterol of less than 100 mg/dL (adjusted difference 4.0%, 95% confidence interval (CI) -0.3 to 7.9, N = 6399 patients, 1 study) and the proportion with glycated haemoglobin level of less than 8% (adjusted difference 4.6%, 95% CI -1.5 to 9.8, 3114 patients, 1 study). At 3- to 12-month follow-up, low-certainty evidence indicates that e-learning may make little or no difference on the following behaviours in health professionals: screening for dyslipidaemia (OR 0.90, 95% CI 0.77 to 1.06, 6027 patients, 2 studies) and treatment for dyslipidaemia (OR 1.15, 95% CI 0.89 to 1.48, 5491 patients, 2 studies). It is uncertain whether e-learning improves or reduces health professionals' skills (2912 health professionals; 6 studies; very low-certainty evidence), and it may make little or no difference in health professionals' knowledge (3236 participants; 11 studies; low-certainty evidence).Due to the paucity of studies and data, we were unable to explore differences in effects across different subgroups. Owing to poor reporting, we were unable to collect sufficient information to complete a meaningful 'Risk of bias' assessment for most of the quality criteria. We evaluated the risk of bias as unclear for most studies, but we classified the largest trial as being at low risk of bias. Missing data represented a potential source of bias in several studies. AUTHORS' CONCLUSIONS When compared to traditional learning, e-learning may make little or no difference in patient outcomes or health professionals' behaviours, skills or knowledge. Even if e-learning could be more successful than traditional learning in particular medical education settings, general claims of it as inherently more effective than traditional learning may be misleading.
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Affiliation(s)
- Alberto Vaona
- Azienda ULSS 20 ‐ VeronaPrimary CareOspedale di MarzanaPiazzale Ruggero Lambranzi 1VeronaItaly37142
| | - Rita Banzi
- IRCCS ‐ Mario Negri Institute for Pharmacological ResearchLaboratory of Regulatory Policiesvia G La Masa 19MilanItaly20156
| | - Koren H Kwag
- IRCCS Galeazzi Orthopaedic InstituteClinical Epidemiology UnitVia R. Galeazzi, 4MilanItaly20161
| | - Giulio Rigon
- Azienda ULSS 20 ‐ VeronaPrimary CareOspedale di MarzanaPiazzale Ruggero Lambranzi 1VeronaItaly37142
| | | | - Valentina Pecoraro
- IRCCS ‐ Mario Negri Institute for Pharmacological ResearchLaboratory of Regulatory Policiesvia G La Masa 19MilanItaly20156
| | - Irene Tramacere
- Fondazione IRCCS Istituto Neurologico Carlo BestaDepartment of Research and Clinical Development, Scientific DirectorateVia Giovanni Celoria, 11MilanItaly20133
| | - Lorenzo Moja
- University of MilanDepartment of Biomedical Sciences for HealthVia Pascal 36MilanSwitzerland20133
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Spaced education in medical residents: An electronic intervention to improve competency and retention of medical knowledge. PLoS One 2017; 12:e0181418. [PMID: 28759606 PMCID: PMC5536283 DOI: 10.1371/journal.pone.0181418] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 06/30/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Spaced education is a novel method that improves medical education through online repetition of core principles often paired with multiple-choice questions. This model is a proven teaching tool for medical students, but its effect on resident learning is less established. We hypothesized that repetition of key clinical concepts in a "Clinical Pearls" format would improve knowledge retention in medical residents. METHODS This study investigated spaced education with particular emphasis on using a novel, email-based reinforcement program, and a randomized, self-matched design, in which residents were quizzed on medical knowledge that was either reinforced or not with electronically-administered spaced education. Both reinforced and non-reinforced knowledge was later tested with four quizzes. RESULTS Overall, respondents incorrectly answered 395 of 1008 questions (0.39; 95% CI, 0.36-0.42). Incorrect response rates varied by quiz (range 0.34-0.49; p = 0.02), but not significantly by post-graduate year (PGY1 0.44, PGY2 0.33, PGY3 0.38; p = 0.08). Although there was no evidence of benefit among residents (RR = 1.01; 95% CI, 0.83-1.22; p = 0.95), we observed a significantly lower risk of incorrect responses to reinforced material among interns (RR = 0.83, 95% CI, 0.70-0.99, p = 0.04). CONCLUSIONS Overall, repetition of Clinical Pearls did not statistically improve test scores amongst junior and senior residents. However, among interns, repetition of the Clinical Pearls was associated with significantly higher test scores, perhaps reflecting their greater attendance at didactic sessions and engagement with Clinical Pearls. Although the study was limited by a low response rate, we employed test and control questions within the same quiz, limiting the potential for selection bias. Further work is needed to determine the optimal spacing and content load of Clinical Pearls to maximize retention amongst medical residents. This particular protocol of spaced education, however, was unique and readily reproducible suggesting its potential efficacy for intern education within a large residency program.
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Tshibwabwa E, Mallin R, Fraser M, Tshibwabwa M, Sanii R, Rice J, Cannon J. An Integrated Interactive-Spaced Education Radiology Curriculum for Preclinical Students. J Clin Imaging Sci 2017; 7:22. [PMID: 28584689 PMCID: PMC5450459 DOI: 10.4103/jcis.jcis_1_17] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Accepted: 03/20/2017] [Indexed: 01/02/2023] Open
Abstract
Introduction: The objective of this study is to determine whether a radiology module, together with online spaced education, helps students of an integrated problem-based learning (PBL) curriculum increase their radiology knowledge and long-term retention. Materials and Methods: Second-year students at the American University of Antigua College of Medicine participated in small groups of ten students each into two 2 h of radiology laboratories. The study comprised two cohorts: winter and fall 2013 students (control group) and 2014 students (experimental group). Both groups used face-to-face PBL. The students of the experimental group received additional online-spaced education. The skills were assessed for both groups before the beginning of laboratories and 4 weeks and 7 months after laboratories. Results: There was no significant difference on pretest between the control and experimental groups. On completion of the radiology laboratories, comparison of test results before and after training showed net improvement for both groups. The corresponding difference for the experimental group was higher compared to the one for the control group (7.83 vs. 6.21, P < 0.001). The difference between the scores on delayed test and pretest showed that the students of both groups demonstrated average knowledge improvement even though their level of performance was slightly below the posttest. The corresponding difference for the experimental group did not differ much from the posttest (P > 0.05), and no significant difference of scores was observed 7 months later for either group. Further, a higher percentage of the students in the experimental group strongly agreed that their learning objectives were met (92% vs. 71%, P > 0.001), and this trend persisted throughout the study. Conclusion: Online spaced education combined to a face-to-face PBL enhances not only the student's knowledge of basic radiology along with his/her self-assessment skills but also the long-term retention of radiology material and satisfaction with the integrated interactive system-based module. Future research is needed to see if medical students in need of additional education support may benefit from spaced education in the field of remediation.
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Affiliation(s)
- Eli Tshibwabwa
- Department of Clinical Medicine, American University of Antigua College of Medicine, University Park, P. O. Box W1451, Coolidge, Antigua and Barbuda.,Department of Radiology, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Robert Mallin
- Department of Clinical Medicine, American University of Antigua College of Medicine, University Park, P. O. Box W1451, Coolidge, Antigua and Barbuda
| | - Madeleine Fraser
- Department of Clinical Medicine, American University of Antigua College of Medicine, University Park, P. O. Box W1451, Coolidge, Antigua and Barbuda
| | - Martin Tshibwabwa
- Notre-Dame Secondary Catholic School, Student Success Centre, Providence Catholic School Board, 700 Bristol Street, Woodstock, ON, Canada
| | - Reza Sanii
- Department of Physiology, American University of Antigua College of Medicine, University Park, P. O. Box W1451, Coolidge, Antigua and Barbuda
| | - James Rice
- Behavior and Neuroscience, American University of Antigua College of Medicine, University Park, P. O. Box W1451, Coolidge, Antigua and Barbuda
| | - Jenifer Cannon
- Department of Clinical Medicine, American University of Antigua College of Medicine, University Park, P. O. Box W1451, Coolidge, Antigua and Barbuda
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Phillips JL, Heneka N, Hickman L, Lam L, Shaw T. Can A Complex Online Intervention Improve Cancer Nurses’ Pain Screening and Assessment Practices? Results from a Multicenter, Pre-post Test Pilot Study. Pain Manag Nurs 2017; 18:75-89. [DOI: 10.1016/j.pmn.2017.01.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Revised: 01/24/2017] [Accepted: 01/26/2017] [Indexed: 11/15/2022]
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Watkins AA, Gondek SP, Lagisetty KH, Castillo-Angeles M, Gangadharan SP, Cahalane MJ, Kent TS. Weekly e-mailed teaching tips and reading material influence teaching among general surgery residents. Am J Surg 2017; 213:195-201.e3. [DOI: 10.1016/j.amjsurg.2016.05.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 03/19/2016] [Accepted: 05/05/2016] [Indexed: 10/21/2022]
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Blankstein U, Lantz AG, D'A Honey RJ, Pace KT, Ordon M, Lee JY. Simulation-based flexible ureteroscopy training using a novel ureteroscopy part-task trainer. Can Urol Assoc J 2015; 9:331-5. [PMID: 26644806 DOI: 10.5489/cuaj.2811] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Simulation-based training (SBT) is being increasingly used for novice trainees as a means of overcoming the early learning curve associated with new surgical skills. We designed a SBT flexible ureteroscopy (fURS) course using a novel inanimate training model (Cook Medical, Bloomington, IN; URS model). We evaluated the course and validated this Cook URS model. METHODS A 2-week SBT fURS course was designed for junior level urology trainees at 2 Canadian universities. The curriculum included didactic lectures, hands-on training, independent training sessions with expert feedback, and use of the Cook URS part-task model. Baseline and post-course assessments of trainee fURS skills were conducted using a standardized test task (fURS with basket manipulation of a calyceal stone). Performances were video-recorded and reviewed by 2 blinded experts using a validated assessment device. RESULTS Fifteen residents (postgraduate years [PGY] 0-3) participated in the course. Of the participants, 80% rated the Cook URS model as realistic (mean = 4.2/5) and 5 endourology experts rated it as useful as a training device (mean = 4.9/5), providing both face and content validity. The mean overall performance scores, task completion times, and passing ratings correlated with trainee clinical fURS experience - demonstrating construct validity for the Cook URS model. The mean post-course task completion times (15.76 vs. 9.37 minutes, p = 0.001) and overall performance scores (19.20 vs. 25.25, p = 0.007) were significantly better than at baseline. Post-course performance was better in all domains assessed by the validated assessment device. CONCLUSIONS This study demonstrates that a SBT curriculum for fURS can lead to improved short-term technical skills among junior level urology residents. The Cook URS model demonstrated good face, content and construct validity.
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Affiliation(s)
- Udi Blankstein
- Division of Urology, St Michael's Hospital, University of Toronto, Toronto, ON
| | - Andrea G Lantz
- Department of Urology, Dalhousie University, Halifax, NS
| | - R John D'A Honey
- Division of Urology, St Michael's Hospital, University of Toronto, Toronto, ON
| | - Kenneth T Pace
- Division of Urology, St Michael's Hospital, University of Toronto, Toronto, ON
| | - Michael Ordon
- Division of Urology, St Michael's Hospital, University of Toronto, Toronto, ON
| | - Jason Young Lee
- Division of Urology, St Michael's Hospital, University of Toronto, Toronto, ON
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