Continuing medical education in pediatric anesthesia--a theoretical overview

Type 2 diabetes continuing medical education for general practitioners: what works? A systematic review

AIMS

To perform a systematic review of studies that have assessed the effectiveness of interventions designed to improve healthcare professionals' care of patients with diabetes and to assess the effects of educational interventions targeted at general practitioners' diabetes management.

METHODS

A computer search was conducted using the Cochrane Library, PubMed, Ovid MEDLINE, Scopus, EMBASE, Informit, Google scholar and ERIC from the earliest date of each database up until 2013. A supplementary review of reference lists from each article obtained was also carried out. Measured changes in general practitioners' satisfaction, knowledge, practice behaviours and patient outcomes were recorded.

RESULTS

Thirteen out of 1255 studies met the eligibility criteria, but none was specifically conducted in rural or remote areas. Ten studies were randomized trials. Fewer than half of the studies (5/13, 38.5%) reported a significant improvement in at least one of the following outcome categories: satisfaction with the programme, knowledge and practice behaviour. There was little evidence of the impact of general practitioner educational interventions on patient outcomes. Of the five studies that examined patient outcomes, only one reported a positive impact: a reduction in patient HbA1c levels.

CONCLUSIONS

Few studies examined the effectiveness of general practitioner Type 2 diabetes education in improving general practitioner satisfaction, knowledge, practices and/or patient outcomes. Evidence to support the effectiveness of education is partial and weak. To determine effective strategies for general practitioner education related to Type 2 diabetes, further well designed studies, accompanied by valid and reliable evaluation methods, are needed.

Public health grand rounds at the Centers for Disease Control and Prevention: evaluation feedback from a broad community of learners

OBJECTIVE

To evaluate the relevance and educational benefit of monthly Public Health Grand Rounds (GR), an hour-long interactive lecture series featuring 1 current, relevant public health topic.

DESIGN

Quantitative and qualitative analysis of data evaluating GR format and content submitted by 2063 continuing education (CE) participants.

SETTING

Survey data submitted electronically to the Centers for Disease Control and Prevention online CE system from January 2010 through December 2011.

PARTICIPANTS

Physicians, nurses, pharmacists, health education specialists, and other health care professionals seeking CE credits for Public Health GR.

MAIN OUTCOME MEASURES

Proportion of respondents agreeing or strongly agreeing that GR is using educational strategies that enhance user learning and is meeting preidentified learning objectives.

RESULTS

On questions involving instructional strategies and delivery methods, 95.0% and 95.6% of respondents, respectively, agreed or strongly agreed that the GR was conducive to learning. More than 90% of respondents agreed or strongly agreed that they could describe the burden of the disease/condition in question and identify key preventive interventions, knowledge gaps, and measures of public health progress.

CONCLUSIONS

These evaluation results indicate that the GR is meeting content-specific and educational needs of diverse health care professionals. The GR models organized scientific discussions on evidence and translation into real-world impacts of decreased morbidity, mortality, and health care costs, and links public health to clinical practice. This promotes a greater understanding of the interplay of different health fields and may lead to greater and cross-disciplinary collaborations.

Pain management in intellectually disabled children: a survey of perceptions and current practices among Dutch anesthesiologists

BACKGROUND

  Intellectually disabled children are more likely to undergo surgical interventions and almost all have comorbidities that need to be managed. Compared with controls, intellectually disabled children tend to receive less intraoperative analgesia and fewer of them are assessed for postoperative pain.

AIM

  To evaluate perceptions and practices of anesthesiologists in the Netherlands concerning pain management in intellectually disabled children.

METHODS/MATERIALS

  We surveyed members of the Section on Pediatric Anesthesiology of the Netherlands Society of Anesthesiology in 2005 and 2009, using a self-designed questionnaire.

RESULTS

  The response rate was 47% in both years. In 2005, 32% of the anesthesiologists rated intellectually disabled children as 'more sensitive to pain' than nonintellectually disabled children--vs 25% in 2009. But no more than 7% in 2005 vs 6% in 2009 agreed with the statement 'children with intellectually disabled children need more analgesia'. Most anesthesiologists gave similar doses of intraoperative opioids for intellectually disabled and nonintellectually disabled children, 92% in 2005 vs 89% in 2009. In 2005, only 3% applied a pain assessment tool validated for intellectually disabled children, vs 4% in 2009.

CONCLUSIONS

Anesthesiologists in the Netherlands take a different approach when caring for intellectually disabled children and they were not aware of pain observation scales for these children. However, the majority think that intellectually disabled children are not more sensitive to pain or require more analgesia. These opinions did not change over the 4-year period. One way to proceed is to implement validated pain assessment tools and to invest in education.

Survey of pediatric continuing professional development undertaken by consultant anesthetists

BACKGROUND

Whilst not all anesthetists have a regular pediatric commitment there is a need for out of hours cover of pediatric anesthesia. We have attempted to determine who covers pediatric anesthetic services in the District General Hospital setting.

METHODS

A postal survey of 170 consultant anesthetists in nine District General Hospitals was conducted looking at who is responsible for pediatric anesthetics and emergencies out of hours as well as pediatric anesthetic experience, resuscitation training and continuing professional development (CPD).

RESULTS

There was a 62% response rate with 98% of the consultants with on call duties also covering pediatric anesthetic emergencies. Fifty percent of consultants who responded were within 4 years of a pediatric-specific resuscitation course, of which 93% had found it useful. However, 40% had never completed a pediatric resuscitation course or it could be considered out of date. Sixty-three percent of consultants had had some sort of pediatric anesthetic update in the last 4 years.

CONCLUSIONS

General anesthetists are responsible for elective and emergency anesthetics as well as the care of critically ill children outside of specialist centers. This is despite a proportion of these consultants not having regular pediatric experience, not having completed a recent pediatric resuscitation course and without pediatric anesthetic CPD.