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Lamminmäki A, Hökkä M, Hirvonen O, Rahko E, Saarto T, T Lehto J. Post-graduate Course in Palliative Medicine: Experiences from an E-Learning-Based Pilot Program, a Mixed Methods Study. J Palliat Care 2024; 39:209-216. [PMID: 37133388 PMCID: PMC11097605 DOI: 10.1177/08258597231171823] [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: 05/04/2023]
Abstract
Objective: To study whether E-learning methods are feasible in the post-graduate education of palliative medicine. Methods: A mixed-methods study. Evaluations from pilot course attendees were analyzed numerically and answers to open-ended questions about E-learning were analyzed using inductive content analysis. A national pilot E-learning-based post-graduate course in palliative medicine with 24 participating physicians in Finland. The evaluation of teaching modules and different aspects of the course was achieved from the participants through numerical statements and open-ended questions. Results: The feedback on most aspects of the course was good. For example, issues of pain and symptom control, lectures, pre-exams, and group discussions were deemed suitable for E-learning, while studying communication and existential issues through E-learning was considered more challenging. The benefits of E-learning included efficacy, better accessibility, and the possibility to go back to the teaching material. Reduced networking and face-to-face interactions were stated as challenges of E-learning. Conclusions: E-learning is feasible in the post-graduate education of palliative medicine and can be 'surprisingly rewarding'. It allows easy access to learn many important topics, while social networking may fall short. Further studies are needed to assess the increase in competence by different learning methods.
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Affiliation(s)
- Annamarja Lamminmäki
- Department of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
- Cancer Center, KYS, Kuopio University Hospital, Kuopio, Finland
| | - Minna Hökkä
- Kajaani University of Applied Sciences, Kajaani, Finland
- Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Outi Hirvonen
- Department of Clinical Oncology, Turku University Hospital, Turku, Finland
- Department of Clinical Oncology, University of Turku, Turku, Finland
| | - Eeva Rahko
- Department of Oncology, Oulu University Hospital, Oulu, Finland
| | - Tiina Saarto
- Faculty of Medicine, Palliative Care Unit and University of Helsinki, Comprehensive Cancer Center, Helsinki University Hospital, Helsinki, Finland
| | - Juho T Lehto
- Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland
- Department of Oncology, Palliative Care Centre, Tampere University Hospital, Tampere, Finland
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Schwartz J, Schallenburger M, Tenge T, Batzler YN, Schlieper D, Kindgen-Milles D, Meier S, Niegisch G, Karger A, Roderburg C, Neukirchen M. Palliative Care e-Learning for Physicians Caring for Critically Ill and Dying Patients during the COVID-19 Pandemic: An Outcome Evaluation with Self-Assessed Knowledge and Attitude. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12377. [PMID: 36231676 PMCID: PMC9564513 DOI: 10.3390/ijerph191912377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 09/26/2022] [Accepted: 09/27/2022] [Indexed: 06/16/2023]
Abstract
During the COVID-19 pandemic, the care of critically ill and dying patients in isolation wards, intensive care units (ICUs), and regular wards was severely impaired. In order to support physicians in communicative and palliative care skills, an e-learning tool was developed as part of the joint project "Palliative Care in Pandemic Times" (PallPan). This study investigates the feasibility of this e-learning tool. Secondly, we aim to analyze changes in knowledge and attitude upon completion of the e-learning tool. A 38-item questionnaire-based evaluation study with assessment of global and specific outcomes including ICU and non-ICU physicians was performed. In total, 24 questionnaires were included in the anonymous analysis. Feasibility was confirmed by a very high rate of overall satisfaction (94% approval), with relevance reaching 99% approval. Overall, we detected high gains in knowledge and noticeably lower gains on the attitude plane, with the highest gain in naming reasons for incorporating palliative care. The lowest learning gain on the attitude plane was observed when the participants were confronted with their own mortality. This study shows that e-learning is a feasible tool for gaining knowledge and even changing the attitudes of physicians caring for critically ill and dying patients in a self-assessment evaluation.
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Affiliation(s)
- Jacqueline Schwartz
- Interdisciplinary Center for Palliative Medicine, University Hospital Duesseldorf, Medical Faculty, Heinrich Heine University Duesseldorf, 40225 Duesseldorf, Germany
| | - Manuela Schallenburger
- Interdisciplinary Center for Palliative Medicine, University Hospital Duesseldorf, Medical Faculty, Heinrich Heine University Duesseldorf, 40225 Duesseldorf, Germany
| | - Theresa Tenge
- Interdisciplinary Center for Palliative Medicine, University Hospital Duesseldorf, Medical Faculty, Heinrich Heine University Duesseldorf, 40225 Duesseldorf, Germany
- Department of Anesthesiology, University Hospital Duesseldorf, Medical Faculty, Heinrich Heine University Duesseldorf, 40225 Duesseldorf, Germany
| | - Yann-Nicolas Batzler
- Interdisciplinary Center for Palliative Medicine, University Hospital Duesseldorf, Medical Faculty, Heinrich Heine University Duesseldorf, 40225 Duesseldorf, Germany
| | - Daniel Schlieper
- Interdisciplinary Center for Palliative Medicine, University Hospital Duesseldorf, Medical Faculty, Heinrich Heine University Duesseldorf, 40225 Duesseldorf, Germany
| | - Detlef Kindgen-Milles
- Department of Anesthesiology, University Hospital Duesseldorf, Medical Faculty, Heinrich Heine University Duesseldorf, 40225 Duesseldorf, Germany
| | - Stefan Meier
- Department of Anesthesiology, University Hospital Duesseldorf, Medical Faculty, Heinrich Heine University Duesseldorf, 40225 Duesseldorf, Germany
| | - Günter Niegisch
- Department of Urology, University Hospital Duesseldorf, Medical Faculty, Heinrich Heine University Duesseldorf, 40225 Duesseldorf, Germany
| | - André Karger
- Institute for Psychosomatic Medicine and Psychotherapy, University Hospital Duesseldorf, Medical Faculty, Heinrich Heine University Duesseldorf, 40225 Duesseldorf, Germany
| | - Christoph Roderburg
- Department of Gastroenterology, University Hospital Duesseldorf, Medical Faculty, Heinrich Heine University Duesseldorf, 40225 Duesseldorf, Germany
| | - Martin Neukirchen
- Interdisciplinary Center for Palliative Medicine, University Hospital Duesseldorf, Medical Faculty, Heinrich Heine University Duesseldorf, 40225 Duesseldorf, Germany
- Department of Anesthesiology, University Hospital Duesseldorf, Medical Faculty, Heinrich Heine University Duesseldorf, 40225 Duesseldorf, Germany
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Finucane AM, O'Donnell H, Lugton J, Gibson-Watt T, Swenson C, Pagliari C. Digital health interventions in palliative care: a systematic meta-review. NPJ Digit Med 2021; 4:64. [PMID: 33824407 PMCID: PMC8024379 DOI: 10.1038/s41746-021-00430-7] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 02/25/2021] [Indexed: 02/07/2023] Open
Abstract
Digital health interventions (DHIs) have the potential to improve the accessibility and effectiveness of palliative care but heterogeneity amongst existing systematic reviews presents a challenge for evidence synthesis. This meta-review applied a structured search of ten databases from 2006 to 2020, revealing 21 relevant systematic reviews, encompassing 332 publications. Interventions delivered via videoconferencing (17%), electronic healthcare records (16%) and phone (13%) were most frequently described in studies within reviews. DHIs were typically used in palliative care for education (20%), symptom management (15%), decision-making (13%), information provision or management (13%) and communication (9%). Across all reviews, mostly positive impacts were reported on education, information sharing, decision-making, communication and costs. Impacts on quality of life and physical and psychological symptoms were inconclusive. Applying AMSTAR 2 criteria, most reviews were judged as low quality as they lacked a protocol or did not consider risk of bias, so findings need to be interpreted with caution.
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Affiliation(s)
- Anne M Finucane
- Clinical Psychology, School of Health in Social Science, University of Edinburgh, Edinburgh, Scotland, UK. .,Marie Curie Hospice Edinburgh, Edinburgh, Scotland, UK.
| | - Hannah O'Donnell
- The Usher Institute, University of Edinburgh, Edinburgh, Scotland, UK
| | - Jean Lugton
- Marie Curie Hospice Edinburgh, Edinburgh, Scotland, UK
| | - Tilly Gibson-Watt
- Edinburgh Medical School, University of Edinburgh, Edinburgh, Scotland, UK
| | | | - Claudia Pagliari
- The Usher Institute, University of Edinburgh, Edinburgh, Scotland, UK
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Abstract
BACKGROUND E-learning provides opportunities for flexible learning to those who cannot access palliative education in the traditional classroom setting, but it also presents learners with challenges. The study aims to identify the barriers and facilitators to accessing e-learning courses in palliative care. METHODS Cross-sectional surveys were developed, piloted and disseminated to healthcare professionals (HCPs) working in palliative care on the island of Ireland (Republic of Ireland and Northern Ireland). RESULTS Important factors that motivated HCPs to participate in e-learning are: dedicated time; quick technical and administrative support; computer training before completing an e-learning course; and regular contact with the tutor in online course work. Some 50% indicated face-to-face assistance and hands-on training sessions as the type of support that they would like to receive. CONCLUSIONS Healthcare professionals' prior experiences and attitudes towards e-learning will guide educators developing programmes. This study indicates the prerequisite for organisational supports and practical considerations to facilitate the uptake of e-learning.
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Affiliation(s)
- Joanne Callinan
- Library and Information Service, Milford Care Centre, Limerick, Republic of Ireland
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Rawlings D, Tieman J, Moores C. E-learning: who uses it and what difference does it make? Int J Palliat Nurs 2020; 25:482-493. [PMID: 31755839 DOI: 10.12968/ijpn.2019.25.10.482] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND CaseSearch 'My Learning' e-learning modules were designed to remind clinicians and practitioners about the role of evidence in practice and demonstrate how to find relevant evidence to make a difference in clinical care. This study aims to describe the role of the modules and their uptake, and determine whether the modules influenced the learners' palliative care practice and whether the modules were easy to use. METHOD Two sets of questions were designed to capture data to evaluate the modules. FINDINGS The modules supported the awareness and use of evidence by health professionals. The modules contribute to ongoing professional development for practitioners and can improve palliative care practice. CONCLUSION It is possible to collect meaningful data that contributes to understanding who uses e-learning resources and how useful healthcare professionals find them.
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Affiliation(s)
- Deb Rawlings
- Palliative and Supportive Services, College of Nursing and Health Sciences, Flinders University, CareSearch, Flinders University
| | - Jennifer Tieman
- Palliative and Supportive Services, College of Nursing and Health Sciences, Flinders University, CareSearch, Flinders University
| | - Carly Moores
- Nutrition and Dietetics, College of Nursing and Health Sciences, Flinders University, CareSearch, Flinders University, Adelaide, Australia
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de Leeuw RA, Westerman M, Walsh K, Scheele F. Development of an Instructional Design Evaluation Survey for Postgraduate Medical E-Learning: Content Validation Study. J Med Internet Res 2019; 21:e13921. [PMID: 31400102 PMCID: PMC6713039 DOI: 10.2196/13921] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 04/03/2019] [Accepted: 04/17/2019] [Indexed: 12/17/2022] Open
Abstract
Background E-Learning has taken a firm place in postgraduate medical education. Whereas 10 years ago it was promising, it now has a definite niche and is clearly here to stay. However, evaluating the effect of postgraduate medical e-learning (PGMeL) and improving upon it can be complicated. While the learning aims of e-learning are evaluated, there are no instruments to evaluate the instructional design of PGMeL. Such an evaluation instrument may be developed by following the Association for Medical Education in Europe (AMEE) 7-step process. The first 5 steps of this process were previously performed by literature reviews, focus group discussion, and an international Delphi study. Objective This study will continue with steps 6 and 7 and answer the research question: Is a content-validated PGMeL evaluation survey useful, understandable, and of added value for creators of e-learning? Methods There are five phases in this study: creating a survey from 37 items (phase A); testing readability and question interpretation (phase B); adjusting, rewriting, and translating surveys (phase C); gathering completed surveys from three PGMeL modules (phase D); and holding focus group discussions with the e-learning authors (phase E). Phase E was carried out by presenting the results of the evaluations from phase D, followed by a group discussion. There are four groups of participants in this study. Groups A and B are experienced end users of PGMeL and participated in phase B. Group C are users who undertook e-learning and were asked to complete the survey in phase D. Group D are the authors of the e-learning modules described above. Results From a list of 36 items, we developed a postgraduate Medical E-Learning Evaluation Survey (MEES). Seven residents participated in the phase B group discussion: 4 items were interpreted differently, 3 were not readable, and 2 items were double. The items from phase B were rewritten and, after adjustment, understood correctly. The MEES was translated into Dutch and again pilot-tested. All items were clear and were understood correctly. The MEES version used for the evaluation contained 3 positive domains (motivation, learning enhancers, and real-world translation) and 2 negative domains (barriers and learning discouragers), with 36 items in those domains, 5 Likert scale questions of 1 to 10, and 5 open questions asking participants to give their own comments in each domain. Three e-learning modules were evaluated from July to November 2018. There were a total of 158 responses from a Dutch module, a European OB/GYN (obstetrics and gynecology) module, and a surgical module offered worldwide. Finally, 3 focus group discussions took place with a total of 10 participants. Usefulness was much appreciated, understandability was good, and added value was high. Four items needed additional explanation by the authors, and a Creators’ Manual was written at their request. Conclusions The MEES is the first survey to evaluate the instructional design of PGMeL and was constructed following all 7 steps of the AMEE. This study completes the design of the survey and shows its usefulness and added value to the authors. It finishes with a final, publicly available survey that includes a Creators’ Manual. We briefly discuss the number of responses needed and conclude that more is better; in the end, however, one has to work with what is available. The next steps would be to see whether improvement can be measured by using the MEES and continue to work on the end understandability in different languages and cultural groups.
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Affiliation(s)
- Robert Adrianus de Leeuw
- Athena Institute for Trans-Disciplinary Research, VU University, Amsterdam, Netherlands.,Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Michiel Westerman
- Department of Internal Medicine, Franciscus Gasthuis en Vlietland Hospital, Rotterdam, Netherlands
| | - Kieran Walsh
- British Medical Journal Learning, British Medical Association House, London, United Kingdom
| | - Fedde Scheele
- Athena Institute for Trans-Disciplinary Research, VU University, Amsterdam, Netherlands
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Datta SS, Agrawal S. Can e-learning help you to connect compassionately? Commentary on a palliative care e-learning resource for India. Ecancermedicalscience 2017; 11:ed72. [PMID: 29104615 PMCID: PMC5659824 DOI: 10.3332/ecancer.2017.ed72] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Indexed: 11/23/2022] Open
Abstract
e-learning resources need to be customised to the audience and learners to make them culturally relevant. The ‘Palliative care e-learning resource for health care professionals in India’ has been developed by the Karunashraya Hospice, Bengaluru in collaboration with the Cardiff Palliative Care Education Team, Wales to address the training needs of professionals in India. The resource, comprising over 20 modules, integrates psychological, social and medical care for patients requiring palliative care for cancer and other diseases. With increased internet usage, it would help in training a large number of professionals and volunteers in India who want to work in the field of palliative care.
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Affiliation(s)
- Soumitra Shankar Datta
- Department of Palliative Care and Psycho-oncology, Tata Medical Centre, Kolkata, West Bengal, India 700160.,UCL EGA Institute for Women's Health (IfWH), UCL School of Life and Medical Sciences, University College London, UK
| | - Sanjit Agrawal
- Department of Breast Surgery, Tata Medical Centre, Kolkata, West Bengal, India 700160
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