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Price O, Papastavrou Brooks C, Johnston I, McPherson P, Goodman H, Grundy A, Cree L, Motala Z, Robinson J, Doyle M, Stokes N, Armitage CJ, Barley E, Brooks H, Callaghan P, Carter LA, Davies LM, Drake RJ, Lovell K, Bee P. Development and evaluation of a de-escalation training intervention in adult acute and forensic units: the EDITION systematic review and feasibility trial. Health Technol Assess 2024; 28:1-120. [PMID: 38343036 PMCID: PMC11017147 DOI: 10.3310/fggw6874] [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] [Indexed: 02/15/2024] Open
Abstract
Background Containment (e.g. physical restraint and seclusion) is used frequently in mental health inpatient settings. Containment is associated with serious psychological and physical harms. De-escalation (psychosocial techniques to manage distress without containment) is recommended to manage aggression and other unsafe behaviours, for example self-harm. All National Health Service staff are trained in de-escalation but there is little to no evidence supporting training's effectiveness. Objectives Objectives were to: (1) qualitatively investigate de-escalation and identify barriers and facilitators to use across the range of adult acute and forensic mental health inpatient settings; (2) co-produce with relevant stakeholders an intervention to enhance de-escalation across these settings; (3) evaluate the intervention's preliminary effect on rates of conflict (e.g. violence, self-harm) and containment (e.g. seclusion and physical restraint) and understand barriers and facilitators to intervention effects. Design Intervention development informed by Experience-based Co-design and uncontrolled pre and post feasibility evaluation. Systematic reviews and qualitative interviews investigated contextual variation in use and effects of de-escalation. Synthesis of this evidence informed co-design of an intervention to enhance de-escalation. An uncontrolled feasibility trial of the intervention followed. Clinical outcome data were collected over 24 weeks including an 8-week pre-intervention phase, an 8-week embedding and an 8-week post-intervention phase. Setting Ten inpatient wards (including acute, psychiatric intensive care, low, medium and high secure forensic) in two United Kingdom mental health trusts. Participants In-patients, clinical staff, managers, carers/relatives and training staff in the target settings. Interventions Enhancing de-escalation techniques in adult acute and forensic units: Development and evaluation of an evidence-based training intervention (EDITION) interventions included de-escalation training, two novel models of reflective practice, post-incident debriefing and feedback on clinical practice, collaborative prescribing and ward rounds, practice changes around admission, shift handovers and the social and physical environment, and sensory modulation and support planning to reduce patient distress. Main outcome measures Outcomes measured related to feasibility (recruitment and retention, completion of outcome measures), training outcomes and clinical and safety outcomes. Conflict and containment rates were measured via the Patient-Staff Conflict Checklist. Clinical outcomes were measured using the Attitudes to Containment Measures Questionnaire, Attitudes to Personality Disorder Questionnaire, Violence Prevention Climate Scale, Capabilities, Opportunities, and Motivation Scale, Coercion Experience Scale and Perceived Expressed Emotion in Staff Scale. Results Completion rates of the proposed primary outcome were very good at 68% overall (excluding remote data collection), which increased to 76% (excluding remote data collection) in the post-intervention period. Secondary outcomes had high completion rates for both staff and patient respondents. Regression analyses indicated that reductions in conflict and containment were both predicted by study phase (pre, embedding, post intervention). There were no adverse events or serious adverse events related to the intervention. Conclusions Intervention and data-collection procedures were feasible, and there was a signal of an effect on the proposed primary outcome. Limitations Uncontrolled design and self-selecting sample. Future work Definitive trial determining intervention effects. Trial registration This trial is registered as ISRCTN12826685 (closed to recruitment). Funding This award was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme (NIHR award ref: 16/101/02) and is published in full in Health Technology Assessment; Vol. 28, No. 3. See the NIHR Funding and Awards website for further award information. Context Conflict (a term used to describe a range of potentially unsafe events including violence, self-harm, rule-breaking, medication refusal, illicit drug and alcohol use and absconding) in mental health settings causes serious physical and psychological harm. Containment interventions which are intended to minimise harm from violence (and other conflict behaviours) such as restraint, seclusion and rapid tranquilisation can result in serious injuries to patients and, occasionally, death. Involvement in physical restraint is the most common cause of serious physical injury to National Health Service mental health staff in the United Kingdom. Violence to staff results in substantial costs to the health service in sickness and litigation payments. Containment interventions are also expensive (e.g. physical restraint costs mental health services £6.1 million and enhanced observations £88 million per annum). Despite these harms, recent findings indicate containment interventions such as seclusion and physical restraint continue to be used frequently in mental health settings. Clinical trials have demonstrated that interventions can reduce containment without increasing violence and other conflict behaviours (e.g. verbal aggression, self-harm). Substantial cost-savings result from reducing containment use. De-escalation, as an intervention to manage aggression and potential violence without restrictive practices, is a core intervention. 'De-escalation' is a collective term for a range of psychosocial techniques designed to reduce distress and anger without the need to use 'containment' interventions (measures to prevent harm through restricting a person's ability to act independently, such as physical restraint and seclusion). Evidence indicates that de-escalation involves ensuring conditions for safe intervention and effective communication are established, clarifying and attempting to resolve the patient's concern, conveyance of respect and empathy and regulating unhelpful emotions such as anxiety and anger. Despite featuring prominently in clinical guidelines and training policy domestically and internationally and being a component of mandatory National Health Service training, there is no evidence-based model on which to base training. A systematic review of de-escalation training effectiveness and acceptability conducted in 2015 concluded: (1) no model of training has demonstrated effectiveness in a sufficiently rigorous evaluation, (2) the theoretical underpinning of evaluated models was often unclear and (3) there has been inadequate investigation of the characteristics of training likely to enhance acceptability and uptake. Despite all National Health Service staff being trained in de-escalation there have been no high-quality trials evaluating the effectiveness and cost-effectiveness of training. Feasibility studies are needed to establish whether it is possible to conduct a definitive trial that can determine the clinical, safety and cost-effectiveness of this intervention.
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Affiliation(s)
- Owen Price
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, University of Manchester, Manchester, UK
| | | | - Isobel Johnston
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Peter McPherson
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK
| | - Helena Goodman
- School of Health Sciences, University of Surrey, Guildford, UK
| | - Andrew Grundy
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, University of Manchester, Manchester, UK
| | - Lindsey Cree
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, University of Manchester, Manchester, UK
| | - Zahra Motala
- Atherleigh Park Hospital, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Jade Robinson
- School of Health Sciences, University of Surrey, Guildford, UK
| | - Michael Doyle
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK
| | - Nicholas Stokes
- West London Forensic Service, St Bernard's Hospital, West London Mental Health NHS Trust, Southall, UK
| | - Christopher J Armitage
- Manchester Centre for Health Psychology, School of Health Sciences, University of Manchester, Manchester, UK
| | | | - Helen Brooks
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, University of Manchester, Manchester, UK
| | - Patrick Callaghan
- School of Applied Sciences, London South Bank University, London, UK
| | | | - Linda M Davies
- Division of Population Health, Health Services Research and Primary Care, Work, School of Health Sciences, University of Manchester, Manchester, UK
| | - Richard J Drake
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, UK
| | - Karina Lovell
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, University of Manchester, Manchester, UK
| | - Penny Bee
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, University of Manchester, Manchester, UK
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Totten AM, Womack DM, Griffin JC, McDonagh MS, Davis-O'Reilly C, Blazina I, Grusing S, Elder N. Telehealth-guided provider-to-provider communication to improve rural health: A systematic review. J Telemed Telecare 2022:1357633X221139892. [PMID: 36567431 DOI: 10.1177/1357633x221139892] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Telehealth may address healthcare disparities for rural populations. This systematic review assesses the use, effectiveness, and implementation of telehealth-supported provider-to-provider collaboration to improve rural healthcare. METHODS We searched Ovid MEDLINE®, CINAHL®, EMBASE, and Cochrane CENTRAL from 1 January 2010 to 12 October 2021 for trials and observational studies of rural provider-to-provider telehealth. Abstracts and full text were dual-reviewed. We assessed the risk of bias for individual studies and strength of evidence for studies with similar outcomes. RESULTS Seven studies of rural uptake of provider-to-provider telehealth documented increases over time but variability across geographic regions. In 97 effectiveness studies, outcomes were similar with rural provider-to-provider telehealth versus without for inpatient consultations, neonatal care, outpatient depression and diabetes, and emergency care. Better or similar results were reported for changes in rural clinician behavior, knowledge, confidence, and self-efficacy. Evidence was insufficient for other clinical uses and outcomes. Sixty-seven (67) evaluation and qualitative studies identified barriers and facilitators to implementing rural provider-to-provider telehealth. Success was linked to well-functioning technology, sufficient resources, and adequate payment. Barriers included lack of understanding of rural context and resources. Methodologic weaknesses of studies included less rigorous study designs and small samples. DISCUSSION Rural provider-to-provider telehealth produces similar or better results versus care without telehealth. Barriers to rural provider-to-provider telehealth implementation are common to practice change but include some specific to rural adaptation and adoption. Evidence gaps are partially due to studies that do not address differences in the groups compared or do not include sufficient sample sizes.
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Affiliation(s)
| | - Dana M Womack
- Oregon Health & Science University, Portland, OR, USA
| | | | | | | | - Ian Blazina
- Oregon Health & Science University, Portland, OR, USA
| | - Sara Grusing
- Oregon Health & Science University, Portland, OR, USA
| | - Nancy Elder
- Oregon Health & Science University, Portland, OR, USA
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Al-Mohawes H, Amante M, Hannon B, Zimmermann C, Kaya E, Al-Awamer A. Online Bridging Program for new international palliative medicine fellows: development and evaluation. BMJ Support Palliat Care 2021:bmjspcare-2020-002797. [PMID: 33737288 DOI: 10.1136/bmjspcare-2020-002797] [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: 11/11/2020] [Revised: 02/11/2021] [Accepted: 03/01/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVES International medical graduates (IMGs) who pursue additional training in another country may encounter unique challenges that compromise their learning experience. This paper describes the development of an Online Bridging Program in the Division of Palliative Care at the University Health Network Toronto and examines its effectiveness in improving IMGs' readiness for Canadian fellowship training. METHODS The annual Online Bridging Program was developed to help new IMGs transitioning to Canadian palliative fellowship using Kern's framework for curriculum development. Following a needs assessment, eight online modules with weekly live sessions were developed and underwent external content validation and usability tests. After each iteration, the programme was improved based on participant feedback. Evaluation was conducted first through an online survey immediately on completion of the programme and then through qualitative interviews 6 months into the fellowship. The interviews were analysed using Braun and Clarke's model for thematic analysis. RESULTS Nine IMGs participated in the Online Bridging Program from 2018 to 2020. All nine participated in the survey and eight in the interviews. Responses to the online survey were almost unanimously positive, suggesting its effectiveness in assisting the IMGs' transitions into fellowship. The interviews revealed four major themes: the importance of combining online modules and live sessions, reducing the fellows' anxiety and easing the transition into their new role, an improved overall learning experience and recognising online format limitations. CONCLUSION The Online Bridging Program effectively eased IMG palliative medicine fellows' transition into training and enhanced their learning experience.
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Affiliation(s)
- Hanan Al-Mohawes
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Madelaine Amante
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
- Division of Palliative Medicine, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Breffni Hannon
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
- Division of Medical Oncology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Camilla Zimmermann
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
- Division of Palliative Medicine, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Division of Medical Oncology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Ebru Kaya
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
- Division of Palliative Medicine, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Ahmed Al-Awamer
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
- Division of Palliative Medicine, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
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The role of digital technology in providing education, training, continuing professional development and support to the rural health workforce. HEALTH EDUCATION 2021. [DOI: 10.1108/he-11-2020-0109] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
PurposeEducation, training and continuing professional development are amongst the evidence-based initiatives for attracting and retaining rural and remote health professionals. With rapidly increasing access to and use of digital technology worldwide, there are new opportunities to leverage training and support for those who are working in rural and remote areas. In this paper we determine the key elements associated with the utility of digital technologies to provide education, training, professional learning and support for rural health workforce outside the University and tertiary sector.Design/methodology/approachA scoping review of peer-reviewed literature from Australia, Canada, US and New Zealand was conducted in four bibliographic databases – Medline complete, CINAHL, Academic Search complete and Education Complete. Relevant studies published between January 2010 and September 2020 were identified. The Levac et al. (2010) enhanced methodology of the Arksey and O'Malley (2005) framework was used to analyse the literature.FindingsThe literature suggests there is mounting evidence demonstrating the potential for online platforms to address the challenges of rural health professional practice and the tyranny of distance. After analysing 22 publications, seven main themes were found – Knowledge and skills (n = 13), access (n = 10), information technology (n = 7), translation of knowledge into practice (n = 6), empowerment and confidence (n = 5), engagement (n = 5) and the need for support (n = 5). Ongoing evaluation will be critical to explore new opportunities for digital technology to demonstrate enhanced capability and retention of rural health professionals.Originality/valueTo date there has been limited examination of research that addresses the value of digital platforms on continuing professional development, education and support for rural health professionals outside the university and tertiary training sectors.
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Robinson T, Janssen A, Kirk J, DeFazio A, Goodwin A, Tucker K, Shaw T. New Approaches to Continuing Medical Education: a QStream (spaced education) Program for Research Translation in Ovarian Cancer. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2017; 32:476-482. [PMID: 26574041 PMCID: PMC5543185 DOI: 10.1007/s13187-015-0944-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Continuing medical education (CME) is challenging and often has limited impact on clinician behavior or patient outcomes. This study examined the impact of an online Qstream education program on senior clinicians to determine its utility for increasing clinician knowledge about the latest guidelines regarding genetic assessment and consideration of genetic testing for women with particular types of ovarian, fallopian tube and primary peritoneal cancer. Participants were recruited into a pilot study that involved responding to case-based scenarios at spaced and repeated intervals. At the completion of the program, semi-structured interviews were conducted to ascertain the impact on their knowledge and referral behavior. Findings from interviews were subject to thematic analysis that involved the identification of categories and themes. Twenty-one participants commenced the program, seventeen completed and twelve participated in semi-structured interviews. Thematic analysis yielded several themes including knowledge change, curriculum and format and changes in referral patterns. A majority of participants (n = 10) agreed the program had helped update their knowledge about referring women, and eight agreed they would now change their referral patterns. The use of QStream as an approach to CME has significant advantages when working with busy clinicians. QStream has a well accepted format and most participants indicated it is very appropriate for disseminating updates to clinical guidelines and protocols. It is important to supplement CME programs with other implementation techniques, such as audit and feedback as multifaceted approaches are more likely to result in behavior change.
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Affiliation(s)
- Tracy Robinson
- Faculty of Nursing and Midwifery, University of Canberra, Sydney, Australia.
- Sydney West Translational Cancer Research Centre, Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, Australia.
| | - Anna Janssen
- Sydney West Translational Cancer Research Centre, Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, Australia
- Research in Implementation Science and eHealth, Faculty of Health Sciences, University of Sydney, Sydney, Australia
| | - Judy Kirk
- Sydney West Translational Cancer Research Centre, Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, Australia
- Familial Cancer Services, Westmead Hospital, Sydney, Australia
| | - Anna DeFazio
- Sydney West Translational Cancer Research Centre, Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, Australia
| | - Annabel Goodwin
- Royal Prince Alfred Hospital, Sydney, Australia
- Sydney Catalyst Translational Cancer Research Centre, Chris O'Brien Life House, Royal Prince Alfred Hospital, Sydney, Australia
| | - Kathy Tucker
- Hereditary Cancer Clinic, Prince of Wales Hospital, Sydney, Australia
| | - Timothy Shaw
- Sydney West Translational Cancer Research Centre, Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, Australia
- Research in Implementation Science and eHealth, Faculty of Health Sciences, University of Sydney, Sydney, Australia
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Reeves S, Fletcher S, McLoughlin C, Yim A, Patel KD. Interprofessional online learning for primary healthcare: findings from a scoping review. BMJ Open 2017; 7:e016872. [PMID: 28780560 PMCID: PMC5623444 DOI: 10.1136/bmjopen-2017-016872] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES This article presents the findings from a scoping review which explored the nature of interprofessional online learning in primary healthcare. The review was informed by the following questions: What is the nature of evidence on online postgraduate education for primary healthcare interprofessional teams? What learning approaches and study methods are used in this context? What is the range of reported outcomes for primary healthcare learners, their organisations and the care they deliver to patients/clients? SETTING The review explored the global literature on interprofessional online learning in primary healthcare settings. RESULTS The review found that the 23 included studies employed a range of different e-learning methods with contrasting course durations, use of theory, participant mix, approaches to accreditation and assessment of learning. Most of the included studies reported outcomes associated with learner reactions and positive changes in participant attitudes/perceptions and improvement in knowledge/skills as a result of engagement in an e-learning course. In contrast, fewer studies reported changes in participant behaviours, changes in organisational practice and improvements to patients/clients. CONCLUSIONS A number of educational, methodological and outcome implications are be offered. E-learning can enhance an education experience, support development, ease time constraints, overcome geographic limitations and can offer greater flexibility. However, it can also contribute to the isolation of learners and its benefits can be negated by technical problems.
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Affiliation(s)
- Scott Reeves
- Faculty of Health, Social Care and Education, Kingston University and St Georges, University London, London, UK
| | - Simon Fletcher
- Faculty of Health, Social Care and Education, Kingston University and St Georges, University London, London, UK
| | | | - Alastair Yim
- Department of Paediatrics, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Kunal D Patel
- Faculty of Health, Social Care and Education, Kingston University and St Georges, University London, London, UK
- Research & Advocacy, Iheed, Dublin, Ireland
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Price O, Baker J, Bee P, Lovell K. Learning and performance outcomes of mental health staff training in de-escalation techniques for the management of violence and aggression. Br J Psychiatry 2015; 206:447-55. [PMID: 26034178 DOI: 10.1192/bjp.bp.114.144576] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND De-escalation techniques are a recommended non-physical intervention for the management of violence and aggression in mental health. Although taught as part of mandatory training for all National Health Service (NHS) mental health staff, there remains a lack of clarity around training effectiveness. AIMS To conduct a systematic review of the learning, performance and clinical safety outcomes of de-escalation techniques training. METHOD The review process involved a systematic literature search of 20 electronic databases, eligibility screening of results, data extraction, quality appraisal and data synthesis. RESULTS A total of 38 relevant studies were identified. The strongest impact of training appears to be on de-escalation-related knowledge, confidence to manage aggression and deescalation performance (although limited to artificial training scenarios). No strong conclusions could be drawn about the impact of training on assaults, injuries, containment and organisational outcomes owing to the low quality of evidence and conflicting results. CONCLUSIONS It is assumed that de-escalation techniques training will improve staff's ability to de-escalate violent and aggressive behaviour and improve safety in practice. There is currently limited evidence that this training has these effects.
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Affiliation(s)
- Owen Price
- Owen Price, MSc, RMN, NIHR Trainees Coordinating Centre, London; John Baker, PhD, Penny Bee, PhD, Karina Lovell, PhD, The University of Manchester, School of Nursing, Midwifery and Social Work, Manchester M13 9PL, UK
| | - John Baker
- Owen Price, MSc, RMN, NIHR Trainees Coordinating Centre, London; John Baker, PhD, Penny Bee, PhD, Karina Lovell, PhD, The University of Manchester, School of Nursing, Midwifery and Social Work, Manchester M13 9PL, UK
| | - Penny Bee
- Owen Price, MSc, RMN, NIHR Trainees Coordinating Centre, London; John Baker, PhD, Penny Bee, PhD, Karina Lovell, PhD, The University of Manchester, School of Nursing, Midwifery and Social Work, Manchester M13 9PL, UK
| | - Karina Lovell
- Owen Price, MSc, RMN, NIHR Trainees Coordinating Centre, London; John Baker, PhD, Penny Bee, PhD, Karina Lovell, PhD, The University of Manchester, School of Nursing, Midwifery and Social Work, Manchester M13 9PL, UK
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Curran V, Reid A, Reis P, Doucet S, Price S, Alcock L, Fitzgerald S. The use of information and communications technologies in the delivery of interprofessional education: A review of evaluation outcome levels. J Interprof Care 2015; 29:541-50. [PMID: 25955607 DOI: 10.3109/13561820.2015.1021002] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Interprofessional education (IPE) in health and human services educational and clinical settings has proliferated internationally. The use of information and communication technologies (ICTs) in the facilitation of interprofessional learning is also growing, yet reviews of the effectiveness of ICTs in the delivery of pre- and/or post-licensure IPE have been limited. The current study's purpose was to review the evaluation outcomes of IPE initiatives delivered using ICTs. Relevant electronic databases and journals from 1996 to 2013 were searched. Studies which evaluated the effectiveness of an IPE intervention using ICTs were included and analyzed using the Barr et al. modified Kirkpatrick educational outcomes typology. Fifty-five studies were identified and a majority reported evaluation findings at the level 1 (reaction/satisfaction). Analysis revealed that learners react favorably to the use of ICTs in the delivery of IPE, and ICT-mediated IPE can lead to positive attitudinal and knowledge change. A majority of the studies reported positive evaluation outcomes at the learner satisfaction level, with the use of web-based learning modalities. The limited number of studies at other levels of the outcomes typology and deficiencies in study designs indicate the need for more rigorous evaluation of outcomes in ICT-mediated IPE.
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Affiliation(s)
- Vernon Curran
- a Faculty of Medicine , Centre for Collaborative Health Professional Education, Memorial University , St. John's , Newfoundland , Canada
| | - Adam Reid
- a Faculty of Medicine , Centre for Collaborative Health Professional Education, Memorial University , St. John's , Newfoundland , Canada
| | - Pamela Reis
- b College of Nursing, East Carolina University , Greensville , VA , USA
| | - Shelley Doucet
- c Department of Nursing and Health Sciences , University of New Brunswick , Saint John , New Brunswick , Canada
| | - Sheri Price
- d School of Nursing, Dalhousie University , Halifax , Nova Scotia , Canada
| | - Lindsay Alcock
- e Health Sciences Library, Memorial University , St. John's , Newfoundland , Canada , and
| | - Shari Fitzgerald
- f Discipline of Family Medicine, Faculty of Medicine, Memorial University, St. John's , Newfoundland , Canada
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