Effective continuing education: the CRISIS criteria

A phenomenological exploration of experience of Syrian dentists with online Course "Traumatic dental injuries"

Background

Several learning modalities have been implemented to improve learning about Traumatic Dental Injuries (TDIs) worldwide. Free online courses about TDIs might be an effective and convenient approach for equipping Syrian dentists with essential competencies during the Syrian crisis. Therefore, this qualitative study with a descriptive phenomenological method was undertaken to explore the lived experience of Syrian dentists enrolled in an online course about TDIs and investigate areas requiring improvement.

Methods

Ethical approval was obtained from the Faculty of Dentistry, Damascus University, and the University of Dundee. Educational contents of the TDI course were developed. About 10 dentists who completed the TDI course, were interviewed. The interviews were recorded, transcribed, and analyzed to identify emerging themes. Inductive thematic analysis was performed to extract all data.

Results

About 10 clustered categories were first developed and this has led to the emergence of 3 themes that represent the lived experience including usefulness, challenges, and recommendations. Participants were so motivated and keen to take advantage of the course despite the personal, technical problems, and crisis-related challenges. TDIs course was effective for general and specialists despite the challenges they experienced. Factors that lead to effective TDIs courses as reported by participants were flexibility in time and location, interactivity with colleagues, other commitments, quantity and quality of content, easiness, and variety of virtual environment tools. Conversely, negative attitudes were linked to factors like lack of interest, unfamiliarity with the learning environment and tools, late participation, lack of confidence, anxiety about independent learning and insufficient interactivity and engagement tools.

Conclusion

Syrian dentists can benefit from online courses if constraints and various learning needs are addressed during the design and delivery of online courses. Future work is still required to identify other effective instructional modalities that equip Syrian dentists to overcome challenges and enhance their learning.

Needs assessment of a pythiosis continuing professional development program

BACKGROUND

Pythiosis is a rare disease with high mortality, with over 94% of cases reported from Thailand and India. Prompt diagnosis and surgery improves patient outcomes. Therefore, continuing professional development (CPD) is essential for early recognition. However, a needs assessment related to a pythiosis CPD program has not been performed.

OBJECTIVES

We conducted a needs assessment to develop a pythiosis CPD program.

PATIENTS/METHODS

We conducted a survey study with 267 King Chulalongkorn Memorial Hospital residents (141 internal medicine (IM) residents and 126 surgery residents). A 30-item survey consisting of a knowledge assessment, demographic section, and an attitudes portion was distributed both electronically and via paper. The data was analyzed with descriptive and inferential statistics.

RESULTS

Sixty-seven percent completed the survey (110/141 IM residents, 70/126 surgery residents). The mean score [95% confidence interval] on the knowledge assessment was 41.67% [39.64%-43.69%] across all objectives. The three domains with the highest scores were pythiosis risk factors (67.22% correct), microbiologic characteristics (50.83%), and radiographic interpretation (50.56%). The three domains with the lowest scores were laboratory investigation (15.00%), epidemiology (29.17%), and symptomatology (30.83%). Most participants noted that the program should be online with both synchronous and asynchronous sessions, with a preferred length of 60-90 minutes per session.

CONCLUSION

The pythiosis CPD program should emphasize education regarding symptomatology, laboratory investigation, and epidemiology, all of which are critical for the early detection of pythiosis to decrease mortality from this devastating disease. Most respondents felt this program was necessary and should be implemented in a virtual blended format.

Perceptions of Community Pharmacists Towards Patient Counseling and Continuing Pharmacy Education Programs in Sudan

Background

Community pharmacists are uniquely positioned at the heart of communities, and their patient counseling role is the cornerstone for achieving the required therapeutic goals. Therefore, the main objective of this study is to explore the perceptions of community pharmacists regarding patient counseling, and their perception towards continuing pharmacy education programs.

Methods

A descriptive, cross-sectional design was performed among randomly selected 238 community pharmacies in Khartoum locality (Sudan) from September 2022 to December 2022. The data were collected using a self-administered questionnaire adopted from a previous study with few minor modifications, which was adding three sociodemographic questions. Descriptive statistics were carried out according to the study objective to analyze the pharmacists' responses.

Results

The majority of the community pharmacists gave counseling and understood its importance to the patients, most of them (70.6%) took 1-5 minutes during the dispensing process. The dose was the most provided information by community pharmacists (26.7%) followed by administration (23.7%) and duration (22.4%). Few (28.2%) of the patients ask the pharmacists about the cost of the medication. Lack of patients' interest (55%) was the major barrier to effective counseling followed by lack of time (47.9%). Almost all (96.2%) pharmacists in this study were interested in continuing pharmacy education programs, and they preferred programs focusing on common diseases (36.6%), and common drugs (30.3%).

Conclusion

This study showed that the majority of community pharmacists in the Khartoum locality had positive perceptions toward patient counseling and they were interested in continuing pharmacy education programs.

Application of the electronic book to promote self-directed learning in medical technologist continuing education: a cross-sectional study

BACKGROUND

Continuing education (CE) is essential for health professionals to improve competence in clinical practice, yet many medical technologists still experience barriers to learning in complex clinical settings. To better manage CE and address medical technologists' learning needs, we developed a learner-centred electronic book (e-book) to promote self-directed learning for medical technologists.

METHODS

A cross-sectional study was conducted to explore the acceptability and learning impacts of the e-book as CE material for medical technologists in two medical centres in Taiwan. We designed the learner-centred context in the e-book based on medical technologists' practice requirements and learning needs. Moreover, we adopted The New World Kirkpatrick Model with four levels (reactions, learning, behaviours and results) to evaluate the e-book's learning impacts on medical technologists. A total of 280 medical technologists were invited to complete a questionnaire and a post-test, providing learning patterns as well as their satisfaction with the e-book and their learning outcomes after using it.

RESULTS

Most readers had positive learning experiences and better learning outcomes, including knowledge acquisition and behavioural change, after reading the e-book. The e-book became a new CE activity and reached medical technologists in various types of laboratories.

CONCLUSIONS

The low-cost and learner-centred e-book effectively overcame CE learning barriers for medical technologists. The interactivity and flexibility of e-learning particularly helped learners to engage in clinical scenarios in laboratory medicine. This study could pave the way for medical educators to build a high-quality e-learning model in CE.

Design, Implementation, and Evaluation of a Distance Learning Framework to Adapt to the Changing Landscape of Anatomy Instruction in Medical Education During COVID-19 Pandemic: A Proof-of-Concept Study

This study presents the design of a DL-framework to deliver anatomy teaching that provides a microfiche of the onsite anatomy learning experience during the mandated COVID-19 lockdown. First, using nominal-group technique, we identified the DL learning theories to be employed in blueprinting the DL-framework. Effectiveness of the designed DL-framework in anatomy teaching was demonstrated using the exemplar of the Head and Neck (H&N) course during COVID-19 lockdown, in the pre-clerkship curriculum at our medical school. The dissemination of the DL-framework in the anatomy course was informed by the Analyse, Design, Develop, Implement, and Evaluate (ADDIE) model. The efficiency of the DL-framework was evaluated using the first two levels of Kirkpatrick's model. Versatility of the DL-framework was demonstrated by aligning its precepts with individual domains of key learning outcomes framework. The framework's blueprint was designed amalgamating principles of: Garrison's community inquiry, Siemens' connectivism and Harasim's online-collaborative-learning; and improved using Anderson's DL-model. Following the implementation of the DL-framework in the H&N course informed by ADDIE, the framework's efficiency was evaluated. In total, 70% students responded to the survey assessing perception toward DL (Kirkpatrick's Level: 1). Descriptive analysis of the survey results showed that the DL-framework was positively received by students and attested that students had an enriched learning experience, which promoted collaborative-learning and student-autonomy. For, Kirkpatrick's Level: 2 i.e., cognitive development, we compared the summative assessment performance in the H&N course across three cohort of students. The results show that the scores of the cohort, which experienced the course entirely through DL modality was statistically higher (P < 0.01) than both the other cohorts, indicating that shift to DL did not have an adverse effect on students' learning. Using Bourdieu's Theory of Practice, we showed that the DL-framework is an efficient pedagogical approach, pertinent for medical schools to adopt; and is versatile as it attests to the key domains of students' learning outcomes in the different learning outcomes framework. To our knowledge this is the first-study of its kind where a rationale and theory-guided approach has been availed not only to blueprint a DL framework, but also to implement it in the MBBS curriculum.

How We Evaluate Postgraduate Medical E-Learning: Systematic Review

BACKGROUND

Electronic learning (e-learning) in postgraduate medical education has seen a rapid evolution; however, we tend to evaluate it only on its primary outcome or learning aim, whereas its effectiveness also depends on its instructional design. We believe it is important to have an overview of all the methods currently used to evaluate e-learning design so that the preferred method may be identified and the next steps needed to continue to evaluate postgraduate medical e-learning may be outlined.

OBJECTIVE

This study aimed to identify and compare the outcomes and methods used to evaluate postgraduate medical e-learning.

METHODS

We performed a systematic literature review using the Web of Science, PubMed, Education Resources Information Center, and Cumulative Index of Nursing and Allied Health Literature databases. Studies that used postgraduates as participants and evaluated any form of e-learning were included. Studies without any evaluation outcome (eg, just a description of e-learning) were excluded.

RESULTS

The initial search identified 5973 articles, of which we used 418 for our analysis. The types of studies were trials, prospective cohorts, case reports, and reviews. The primary outcomes of the included studies were knowledge, skills, and attitude. A total of 12 instruments were used to evaluate a specific primary outcome, such as laparoscopic skills or stress related to training. The secondary outcomes mainly evaluated satisfaction, motivation, efficiency, and usefulness. We found 13 e-learning design methods across 19 studies (4% 19/418). The methods evaluated usability, motivational characteristics, and the use of learning styles or were based on instructional design theories, such as Gagne's instructional design, the Heidelberg inventory, Kern's curriculum development steps, and a scale based on the cognitive load theory. Finally, 2 instruments attempted to evaluate several aspects of a design, based on the experience of creating e-learning.

CONCLUSIONS

Evaluating the effect of e-learning design is complicated. Given the diversity of e-learning methods, there are many ways to carry out such an evaluation, and probably, many ways to do so correctly. However, the current literature shows us that we have yet to reach any form of consensus about which indicators to evaluate. There is a great need for an evaluation tool that is properly constructed, validated, and tested. This could be a more homogeneous way to compare the effects of e-learning and for the authors of e-learning to continue to improve their product.

Introducing continuing professional development

Most professions have recently realised that basic undergraduate and postgraduate training is not enough to maintain high standards of practice throughout a long career. Continuing professional development (CPD) has become a feature therefore of the working life of these professions, and medicine, which was in the forefront for undergraduate and postgraduate education, has somewhat lagged behind in this. The failure of consultants to keep up to date in their professional knowledge and attitudes is clearly detrimental to patients, to the doctors themselves, and to the Health Service.

Dementia Diagnosis and Management in Primary Care

Dementia presents a challenge for primary care and the advent of new therapeutic options has highlighted the need to improve its detection so that early decisions about medication use can be made. Efforts at earlier diagnosis should be targeted at primary care as the gateway to specialist health and social services. There is, however, evidence that dementia remains under-detected and sub-optimally managed in general practice throughout the world. This article reviews the obstacles to early recognition of dementia and the factors causing sub-optimal management in the community, and discusses educational approaches to enhancing professional skills in the recognition of and response to dementia. Three educational interventions with different characteristics and methods of delivery are described.

Evaluating educational initiatives to improve palliative care for people with dementia: a narrative review

Dementia accounts for one in three deaths among people aged 65 and over, but end-of-life care for people with dementia is often sub-optimal. Palliative care for people with dementia poses particular challenges to those providing services, and current policy initiatives recommend education and training in palliative care for those working with patients with dementia. However, there are few evaluations of the effectiveness of dementia education and training. This paper presents a narrative review undertaken in 2011-2012 of evaluations of palliative care education for those working with people with dementia at the end of life. A total of eight papers were identified that described and evaluated such palliative care education; none reported benefits for people with dementia. There is a clear need to develop and evaluate educational interventions designed to improve palliative and end-of-life care for people with dementia. Some suggestions for educationally sound approaches are discussed.

Be FAIR to students: four principles that lead to more effective learning

A teacher is a professional not a technician. An understanding of some basic principles about learning can inform the teacher or trainer in their day-to-day practice as a teacher or a trainer. The FAIR principles are: provide feedback to the student, engage the student in active learning, individualise the learning to the personal needs of the student and make the learning relevant. Application of the principles can lead to more effective learning - the poor teacher can become a good teacher and the good teacher an excellent teacher.

Looking back to the future: a message for a new generation of medical educators

OBJECTIVE

Many changes in medical education have occurred during the author's 50-year career in the field. The aim of this paper is to describe 10 lessons worth recording for others engaged in the training of health care professionals.

THREE CAREER PHASES

The first phase in the author's career occurred during 1960-1972 in Glasgow, where an interest in medical education developed alongside an engagement in clinical medicine and research into iodine metabolism. The second phase took place during 1972-2002 in Dundee, where, after working for a period as a clinician, the author made a full-time commitment to medical education. The third phase, from 2002 to the present, has provided the opportunity to explore new horizons in medical education.

CONCLUSIONS

The following lessons have been learned. (i) People are important as role models and collaborators. (ii) Innovation in medical education is a complex process and research findings can easily be misinterpreted. (iii) Nudges, interventions that encourage rather than mandate change, are valuable. (iv) Students are important players in planning, delivering and evaluating a curriculum. Each student has different needs and aspirations. They are the 'digital natives'. (v) Offer stakeholders practical solutions to problems that can be implemented. (vi) There is always something to learn outside one's own practice. Go to a conference or read a journal in a related field. (vii) Time spent recording one's work and publishing reports based on it is rewarding. (viii) Learn from history. We don't need to keep reinventing the wheel. (ix) Obtain independent funding. (x) Finally, and most importantly, have fun. Working in medical education can be exciting, fulfilling and hugely enjoyable.

What if continuing education became mandatory? Opinions of Belgian community pharmacists

Objective In July 2003, a survey (n = 1032) was conducted on issues related to continuing education for community pharmacists. This study aims to explore specific results of this survey in-depth. The objectives were to examine how current continuing education courses can be optimised, how much interest pharmacists have in distance learning, and how pharmacists think about mandatory continuing education.

Setting Community pharmacy in the Dutch-speaking part of Belgium.

Method Six focus group discussions were held: two with attenders (n = 14), two with non-attenders (n = 13), and two with the management of the Institute for Permanent Study for Pharmacists (n = 12). A theme plan was used to moderate discussions. Framework analysis was applied to analyse data.

Key findings To optimise live courses, continuing education providers should select good speakers, provide extensive course notes, and focus on issues that are relevant to day-to-day pharmacy practice. The interest in distance learning as a continuing education format was limited. Non-attenders are likely to need a formal obligation to engage in continuing education, with the preferred format being live courses. By increasing patients' awareness and appreciation of pharmacists' capabilities, pharmacists could be more motivated to counsel patients, to engage in continuing education, and to accept a system of mandatory continuing education.

Conclusion Implementation of mandatory continuing education in Belgium might encourage more pharmacists to take part in live continuing education courses than in distance learning. The arguments for and against mandatory continuing education as well as the suggestions for improvement of live continuing education courses should be taken into account when implementing a system of mandatory continuing education.

Teaching trainers to incorporate evidence-based medicine (EBM) teaching in clinical practice: the EU-EBM project

BACKGROUND

Evidence based medicine (EBM) is considered an integral part of medical training, but integration of teaching various EBM steps in everyday clinical practice is uncommon. Currently EBM is predominantly taught through theoretical courses, workshops and e-learning. However, clinical teachers lack confidence in teaching EBM in workplace and are often unsure of the existing opportunities for teaching EBM in the clinical setting. There is a need for continuing professional development (CPD) courses that train clinical trainers to teach EBM through on-the-job training by demonstration of applied EBM real time in clinical practice. We developed such a course to encourage clinically relevant teaching of EBM in post-graduate education in various clinical environments.

METHODS

We devised an e-learning course targeting trainers with EBM knowledge to impart educational methods needed to teach application of EBM teaching in commonly used clinical settings. The curriculum development group comprised experienced EBM teachers, clinical epidemiologists, clinicians and educationalists from institutions in seven European countries. The e-learning sessions were designed to allow participants (teachers) to undertake the course in the workplace during short breaks within clinical activities. An independent European steering committee provided input into the process.

RESULTS

The curriculum defined specific learning objectives for teaching EBM by exploiting educational opportunities in six different clinical settings. The e-modules incorporated video clips that demonstrate practical and effective methods of EBM teaching in everyday clinical practice. The course encouraged focussed teaching activities embedded within a trainer's personal learning plan and documentation in a CPD portfolio for reflection.

CONCLUSION

This curriculum will help senior clinicians to identify and make the best use of available opportunities in everyday practice in clinical situations to teach various steps of EBM and demonstrate their applicability to clinical practice. Once fully implemented, the ultimate outcome of this pilot project will be a European qualification in teaching EBM, which will be used by doctors, hospitals, professional bodies responsible for postgraduate qualifications and continuing medical education.

Integrating Practice Guidelines Into Professional Training

The authors present the findings of a special task group (STG) organized to explore effective training strategies for the practice guidelines focused on diverse populations. They provide a brief literature review and summarize survey data from academic training directors regarding current use of practice guidelines. The authors then describe the Integrative Training Model (ITM), developed by the STG, as a framework for students and professionals to incorporate the complex array of information contained in each set of guidelines. Unique challenges associated with incorporating the ITM are described, as well as pedagogical considerations for both students and current professionals. The authors believe the ITM may help students and professionals increase their diversity competence by developing a more holistic understanding of the various dimensions and social group experiences that affect their clients and themselves.

Continuing medical education in pediatric anesthesia--a theoretical overview

The importance of continuing medical education (CME) as a method of improving the quality of care of children undergoing anesthesia is universally recognized. This article, which is based on a presentation at the FEAPA European Conference on Paediatric Anaesthesia in September 2007 in Amsterdam, gives a theoretical overview of continuing education and introduces some generic educational concepts, such as the CRISIS-criteria and Kirkpatrick's evaluation model, which are as relevant to pediatric anesthesia as to other areas of medical practice. The terms CME and continuing professional develop are described. Some consideration is given to how anesthesiologists can assess the potential worth of an educational activity for their practice. No attempt will be made to judge particular educational activities, as the choice of the most appropriate activity rests primarily with the individual.

Continuing medical education: AMEE Education Guide No 35

This guide is designed to provide a foundation for developing effective continuing medical education (CME) for practicing physicians. For the purposes of this work, continuing medical education is defined as any activity which serves to maintain, develop, or increase the knowledge, skills and professional performance and relationships that a physician uses to provide services for patients, the public, or the profession (American Medical Association 2007; Accreditation Council for CME 2007). The term continuing professional development (CPD) is broader and has become more popular in many areas of the world. As defined by Stanton and Grant, CPD includes educational methods beyond the didactic, embodies concepts of self-directed learning and personal development and considers organizational and systemic factors (Stanton & Grant 1997). In fact, this guide describes many modalities that may be defined as CME or CPD. In the interest of simplicity, we will use the term continuing medical education (CME) throughout, with the understanding that the same strategies may be applied to non-clinical continuing professional education. For those who do not work exclusively in CME, many terms and processes may be unfamiliar. This guide is intended to provide a broad overview of the discipline of CME as well as a pragmatic approach to the practice of CME. The format provides an overview of CME including history and rationale for the discipline, followed by a practical approach to developing CME activities, the management of the overall CME programme and finally, future trends. At the end of the guide you will find resources including readings, websites and professional associations to assist in the development and management of CME programmes.

A clinically integrated curriculum in evidence-based medicine for just-in-time learning through on-the-job training: the EU-EBM project

BACKGROUND

Over the last years key stake holders in the healthcare sector have increasingly recognised evidence based medicine (EBM) as a means to improving the quality of healthcare. However, there is considerable uncertainty about the best way to disseminate basic knowledge of EBM. As a result, huge variation in EBM educational provision, setting, duration, intensity, content, and teaching methodology exists across Europe and worldwide. Most courses for health care professionals are delivered outside the work context ('stand alone') and lack adaptation to the specific needs for EBM at the learners' workplace. Courses with modern 'adaptive' EBM teaching that employ principles of effective continuing education might fill that gap. We aimed to develop a course for post-graduate education which is clinically integrated and allows maximum flexibility for teachers and learners.

METHODS

A group of experienced EBM teachers, clinical epidemiologists, clinicians and educationalists from institutions from eight European countries participated. We used an established methodology of curriculum development to design a clinically integrated EBM course with substantial components of e-learning. An independent European steering committee provided input into the process.

RESULTS

We defined explicit learning objectives about knowledge, skills, attitudes and behaviour for the five steps of EBM. A handbook guides facilitator and learner through five modules with clinical and e-learning components. Focussed activities and targeted assignments round off the learning process, after which each module is formally assessed.

CONCLUSION

The course is learner-centred, problem-based, integrated with activities in the workplace and flexible. When successfully implemented, the course is designed to provide just-in-time learning through on-the-job-training, with the potential for teaching and learning to directly impact on practice.

A hierarchy of effective teaching and learning to acquire competence in evidenced-based medicine

BACKGROUND

A variety of methods exists for teaching and learning evidence-based medicine (EBM). However, there is much debate about the effectiveness of various EBM teaching and learning activities, resulting in a lack of consensus as to what methods constitute the best educational practice. There is a need for a clear hierarchy of educational activities to effectively impart and acquire competence in EBM skills. This paper develops such a hierarchy based on current empirical and theoretical evidence.

DISCUSSION

EBM requires that health care decisions be based on the best available valid and relevant evidence. To achieve this, teachers delivering EBM curricula need to inculcate amongst learners the skills to gain, assess, apply, integrate and communicate new knowledge in clinical decision-making. Empirical and theoretical evidence suggests that there is a hierarchy of teaching and learning activities in terms of their educational effectiveness: Level 1, interactive and clinically integrated activities; Level 2(a), interactive but classroom based activities; Level 2(b), didactic but clinically integrated activities; and Level 3, didactic, classroom or standalone teaching.

SUMMARY

All health care professionals need to understand and implement the principles of EBM to improve care of their patients. Interactive and clinically integrated teaching and learning activities provide the basis for the best educational practice in this field.

Training health professions instructors for the twenty-first century: the Dundee experience

This article describes the award-bearing program of courses for instructors and trainers of health care professionals in medical education that is available through the Centre for Medical Education, University of Dundee, Scotland, UK. The program is designed for those who wish to enhance their teaching skills and acknowledges the different roles that a instructor must undertake. The program is open to health care professionals throughout the world. Participation from across the world has increased on a yearly basis; currently we have upwards of 1,000 health professionals studying with us. This article describes the educational philosophy underpinning the course structure. It looks at the special features of the course, such as the outcome-based approach and the linking of theory to practice. The course design, delivery, content, and assessment are explained, as well as some new developments and collaborative work. It is hoped that this article will be of interest to journal readers wishing to undertake a qualification in health professions education.

A new vision for distance learning and continuing medical education

Increasing demands on continuing medical education (CME) are taking place at a time of significant developments in educational thinking and new learning technologies. Such developments allow today's CME providers to better meet the CRISIS criteria for effective continuing education: convenience, relevance, individualization, self-assessment, independent learning, and a systematic approach. The International Virtual Medical School (IVIMEDS) provides a case study that illustrates how rapid growth of the Internet and e-learning can alter undergraduate education and has the potential to alter the nature of CME. Key components are a bank of reusable learning objects, a virtual practice with virtual patients, a learning-outcomes framework, and self-assessment instruments. Learning is facilitated by a curriculum map, guided-learning resources, "ask-the-expert" opportunities, and collaborative or peer-to-peer learning. The educational philosophy is "just-for-you" learning (learning customized to the content, educational strategy, and distribution needs of the individual physician) and "just-in-time" learning (learning resources available to physicians when they are required). Implications of the new learning technologies are profound. E-learning provides a bridge between the cutting edge of education and training and outdated procedures embedded in institutions and professional organizations. There are important implications, too, for globalization in medical education, for multiprofessional education, and for the continuum of education from undergraduate to postgraduate and continuing education.

Use of geriatrics at your fingertips, a pocket guide, to educate physiatrists in geriatric care11No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors(s) or upon any organization with which the author(s) is/are associated

OBJECTIVE

To determine whether a geriatric pocket guide, Geriatrics At Your Fingertips, may be a useful tool in educating physiatrists about the care of their older patients.

DESIGN

Geriatrics At Your Fingertips was distributed through the American Academy of Physical Medicine and Rehabilitation (AAPM&R) to physical medicine and rehabilitation (PM&R) residents and practicing physiatrists. Two questionnaires evaluated guide use.

SETTING

Two academic PM&R departments and physiatrists in the United States.

PARTICIPANTS

Two PM&R residency programs, members of AAPM&R's Geriatric Rehabilitation Special Interest Group (GR-SIG), and AAPM&R's membership.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

Identification of clinically useful information by residents and GR-SIG members and frequency of guide use among AAPM&R membership.

RESULTS

Forty-five PM&R residents and 17 GR-SIG members reported examples of useful information. Geriatrics At Your Fingertips was requested by 483 AAPM&R members. Forty-six percent returned questionnaires (N=223). Seventy percent had used the guide at least once and 49% 4 or more times.

CONCLUSIONS

Geriatrics At Your Fingertips is a useful tool with which to educate PM&R residents and physiatrists about geriatric care.

PACT: An ESICM Multidisciplinary Distance Learning Programme for Intensive Care Training

Intensive Care Medicine (ICM) is a medical specialty where doctors from a variety of disciplinary backgrounds manage the medical care of critically ill patients. Training and continuing education for these doctors involves the acquisition and maintenance of the knowledge, skills and attitudes which allow them to manage the most severely ill. In order to improve and harmonise the quality of intensive care medicine, the European Society of Intensive Care Medicine (ESICM) is producing a distance learning programme: Patient-Centred Acute Care Training (PACT) for the training of doctors working in intensive care and acute medicine.

Evaluation of distance interactive learning in obstetrics and gynaecology (DIALOG)

OBJECTIVES

1. To determine whether DIALOG, a multimedia interactive CD-ROM designed for postgraduate education, was achieving its educational aim; 2. to assess DIALOG as a computer-assisted learning tool by evaluating its design, presentation, usability, effective use of multimedia and interactions and availability; 3. to measure end user satisfaction and the impact of DIALOG in achieving an improvement in clinical practice as an index of educational value.

METHODS

Postal questionnaires were sent out to 150 users of DIALOG. A combination of the CIPP model, the CRISIS criteria and Kirkpatrick's model was used to design the evaluation questionnaire.

RESULTS

There was a 61.3% response rate to the questionnaire. Overall, 86.9% of respondents were happy with the use of DIALOG, 60.8% had a positive comment on the concept of distance learning using DIALOG and computer-assisted learning, 50% agreed that it had helped sharpen their analytic skills and 45.6% reported an improvement in clinical practice after using DIALOG.

CONCLUSION

This assessment proved to be a useful formative assessment of DIALOG. It has provided feedback on the availability and use of DIALOG and has highlighted the potential areas of improvement for future issues.

Bioscience in the pre-registration curriculum: finding the right teaching strategy

With the transition of pre-registration nursing programmes into higher education, a disproportionate number of problems have arisen in relation to the bioscience component of the curriculum. Therefore, a survey was undertaken to obtain the views of students (n = 294) and staff (n = 57) to identify effective teaching strategies to facilitate students' learning and understanding of this difficult area of the curriculum. In contrast to the staff, the majority of students found all three teaching strategies (lectures, tutorials and laboratory sessions) of approximately equal value to their learning and practice. Our findings suggest that students' problems with the biosciences could be ameliorated by adjustments in curriculum apportionment. Our data would support the continuation of lead lectures and laboratory work in bioscience. However, a tutorial system, specifically designed to overcome the particular difficulties experienced by nursing students in this area, is needed. This should augment, not replace, lectures and teaching laboratories. There was little indication that such a redistribution of resources would be favoured by the majority of the staff.

Problem-based learning as an alternative to lecture-based continuing medical education

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Continuing medical education case study series. An innovative programme for general practitioners on malignant melanoma

Increasing interest in continuing medical education is reflected in greater demand for educational programmes. Content and educational strategies should be appropriate to the needs of the target audience. Proper matching of content and strategies to target needs of users requires the instructional design to be carefully planned and based on a needs-assessment study. We illustrate the influence of educational needs on content and learning strategies through an educational programme for general practitioners on the subject of malignant melanoma. Its design includes: i. a trigger leaflet; ii. a core text; iii. a set of interactive case studies; iv. a job-aid card; v. a follow-up leaflet; and vi. recorded messages available by telephone. It addressed, in particular, the key decision to be taken by the general practitioner: 'When should I refer a patient with a suspected early melanoma: when should I merely reassure the patient?' Doctors were invited, in the programme, to make decisions about referral of patients. They received immediate feedback on their decisions. Various strategies reinforced this feedback.

Continuing medical education in marital and family therapy: a survey of South Australian psychiatrists

OBJECTIVE

South Australian psychiatrists were surveyed to determine their impressions of the usefulness of marital and family therapy (MFT) in the management of serious psychiatric conditions and to ascertain their previous experience with Continuing Medical Education (CME) about family therapy. It was expected that psychiatrists' preferences regarding CME would be related to their clinical experience of the usefulness of MFT.

METHOD

One hundred and twenty psychiatrists returned a questionnaire about their training, clinical and research interests, with ratings of the usefulness of MFT and CME preferences. This represented 65% of those eligible for the CME programme.

RESULTS

Thirteen percent of the respondents found MFT to be extremely useful and a further 47% found it moderately useful in their current practice. There was evidence of a possible training effect: respondents who had previous CME rated MFT as more useful, especially for mood disorders. Furthermore, the treatment of mood disorders seemed to have a particular relevance in family psychiatry, making a statistically unique contribution to ratings of MFT usefulness in the respondents' total practice. Sixty-nine percent of the respondents requested further CME in family therapy. This represented 45% of all South Australian psychiatrists. Respondents who rated MFT as more useful in practice were significantly more likely to be interested in CME.

CONCLUSIONS

There seems to be sufficient interest and clinical experience among psychiatrists for MFT to be included in CME courses. It is recommended that further training focus on major mental disorders, especially mood disorders and schizophrenia.

Progress in medical education

Progress in implementing the World Federation for Medical Education Edinburgh Recommendations in all three phases of education--undergraduate, postgraduate and continuing--is dependent upon recognition of the need to manage dissatisfaction with the present, to have appropriate visions for the future, to have a management strategy for implementing change and to be cost-effective. The extent to which progress can be anticipated is reflected in the formula: Change = (Dissatisfaction x Vision x Process) > Cost We have to aim for a curriculum that will be more convenient, relevant, individualized to the need of each student or trainee, diagnostic--emphasizing self-assessment, interesting--taking account of motivation of students and doctors, systematic or planned and allowing for speculation and a consideration of the grey areas or uncertainties of medicine as well as the certainties.