The effectiveness of web-based and face-to-face continuing education methods on nurses' knowledge about AIDS: a comparative study

Variations, effectiveness and its associated factors of a nationwide web-based hypertension management training project in China: insights from a government-led campaign for 1.2 million lay health workers

OBJECTIVES

To evaluate the effectiveness of a large-scale, web-based, in-service hypertension management training project among lay health workers (LHWs) at primary care health (PHC) settings in China, and to examine the factors contributing to the variations of effectiveness.

METHODS

We used data from a web-based national hypertension management training project implemented in 2018, it was designed to facilitate LHWs to learn, understand, and apply the relevant knowledge and skills in hypertension management through providing training courses by use of the web-based platform with unified standards. All LHWs were required to participate in the exams before and after training to acquire scores for the use of evaluating their performance of hypertension management knowledge. We first used descriptive analysis to present the variations of effectiveness in hypertension management knowledge among LHWs by important subgroups. Afterwards, we used multilevel logistic regression to examine the individual and regional factors contributing to the variations and quantify the magnitude of how these factors affected training effectiveness.

RESULTS

There were 1,208,610 LHWs who completed training and were certificated. Nationally, the scores of LHWs increased significantly from 62.87 ± 21.14 out of 100 in the pre-test to 88.30 ± 11.31 in the post-test by 25.43 (95% confidence interval [CI]: 25.40-25.47). Training contents involved in antihypertensive medication showed the lowest score (54.36) in the pre-test and soared the most after training, up to 84.22 by 54.94%. Individual factors associated with disparities in the knowledge of hypertension management decreased substantially after training, which included sex, age, education, practice type, professional level, and hierarchy of working institutions. Geographical variations were shown at the provincial level, with the majority of them being explained by factors at the regional level.

CONCLUSIONS

Accessible web-based training modality, government efforts, accompanied with experiences derived from the training, could be generalized to other low- and middle-income countries in facilitating the hypertension management capacity of LHWs. Localization and evaluation is warranted on the way to its further application.

The effect of web-based and face-to-face training given to office workers on health beliefs and physical activity levels regarding obesity

AIM

This study compared the effects of web-based and face-to-face education given to office workers on health beliefs and physical activity levels towards obesity.

METHODS

The research was conducted as a randomized controlled experimental study. The study population consisted of 768 office workers between February 2020 and April 2021, and the sample of the research consisted of 90 individuals selected from the population using the nonprobability sampling method. Clinical trial number of the study is NCT05591846.

RESULTS

A total of 90 people, including 30 people in each group, were included in the study. According to the obesity health belief model, a positive change was achieved in the beliefs of individuals about obesity; it was determined that there was a significant increase in the subdimensions of the importance of health, sensitivity, seriousness and perception of benefit and a decrease in the perception of obstacles (p < 0.05). After both education methods were given according to the health belief model, a positive change was achieved in the physical activity level of the individuals; it was determined that the physical activity level score increased significantly (p < 0.05).

CONCLUSION

It was determined that web-based and face-to-face education given to individuals had a positive effect on the obesity health belief model components and the levels of physical activity level.

The demand for skills training among Medicaid home-based caregivers

Medicaid spends nearly 100 billion dollars annually on home and community-based care for the disabled. Much of this care is provided by personal care aides, few of whom have received training related to the services they provide. We conducted a randomized controlled trial to estimate their demand for training. We find that 13 percent of these caregivers complete training without an incentive. Paying the caregivers four times their hourly wage increases training completion by roughly nine percentage points. Additional experimental variation suggests that among individuals confirmed to be aware of the training, the financial incentive increases completion from 35 to 58 percent. Demand curves based on these results suggest that while many caregivers value the opportunity to train, policies aimed at universal take up require large financial incentives.

Continuous training based on the needs of operating room nurses using web application: a new approach to improve their knowledge

INTRODUCTION

Since university education and intensive and limited pre-service training do not provide an acceptable level of performing the duties of operating room nurses, and considering the limitations of traditional training methods in the field of operating room; This study was conducted with the aim of determining the effect of using the electronic education approach based on web application, leveled, personalized and based on the needs of nurses on their level of knowledge and satisfaction.

MATERIALS AND METHODS

This research is a quasi-experimental type of single-group multi-center pre-test-post-test, which during that, four stages of educational needs assessment, educational content design, web application design for training and evaluation of operating room nurses and determining the effectiveness of this method are included. Based on their knowledge and satisfaction, during this period, 36 nurses from the operating rooms that met the study criteria were included in the study by stratified random sampling based on the determined sample size. The data collection includes a four-choice test to measure the knowledge of operating room nurses in heart anatomy (score range 0-20), the principles of movement, transferring and positioning of the patient in the operating room (score range 0-15), the principles of ergonomics in the operating room (score range score 0-10) and satisfaction questionnaire (score range 0-28). Data collected using descriptive statistical tests (percentage of frequency and frequency, mean and standard deviation) and analytical tests (paired sample t-test, independent samples t-test, ANOVA, Pearson correlation, chi-square) with the software SPSS version 16 was analyzed.

RESULTS

Generally, the average knowledge scores of operating room nurses before and after the intervention were 5.96 ± 3.96 vs. 13.6 ± 3.77, in the course of principles of moving, transferring and positioning the patient in the operating room were 6.3 ± 3.42 vs. 13.3 ± 1.32, respectively 8.7 ± 3.97 vs. 18.1 ± 1.07 (in heart anatomy), 1.57 ± 2.6 vs. 0.73 ± 9.1 (in the principles of ergonomics in the operating room) and the average Knowledge scores after the intervention were significantly higher than before the intervention (P<0.001). Also, the average satisfaction score of nurses was 21.3 ± 5.83 and 22 nurses (64.7%) were satisfied with the e-learning course.

CONCLUSION

The use of the electronic education approach based on the web application, leveled, personalized and based on the needs of the nurses, led to the improvement of the level of knowledge and satisfaction of the operating room nurses. E-learning can be used as a complementary educational tool and method for continuous training of operating room nurses in other specialized fields of operating room and surgery.

HIGHLIGHTS

• Educational content in the form of educational videos taught by professors of medical sciences universities on each of the topics of heart anatomy (28 episodes of 5-10 minutes), principles of ergonomics in the operating room (7 episodes of 5-25 minutes) and movement principles. The transfer and positioning of the patient in the operating room (16 episodes of 10-20 minutes) were designed in three primary, intermediate and advanced levels. • The results of this study showed that the use of an electronic education approach based on the web application, levelled, personalized and based on the needs of nurses, led to the improvement of the knowledge of operating room nurses. Also, operating room nurses were delighted with electronic training courses. E-learning can be used as a complementary educational tool and method for continuous training of operating room nurses in other specialized fields of operating room and surgery. • Based on the results of this study, the use of an electronic education approach based on the needs of operating room nurses can be used as a complementary tool to conventional continuous education. Since this method allows interactive, personalized education is levelled, and asynchronous. It can be used at any time and place on a laptop, tablet or mobile phone; a wide range of operating room nurses in the hospitals of the Islamic Republic of Iran can use it for educational justice to Many borders should be established in the country. However, there are studies to evaluate the generalizability and the effect of using the e-learning approach on the clinical skills of operating room nurses and to compare the effect of e-learning with other methods and educational tools on the knowledge and skills of the learners and the extent of consolidating the learned material in their memory.

Explaining the experiences of nurses regarding strategies to prevent missed nursing care: A Qualitative Study

AIM

To describe the experiences of nurses regarding strategies to prevent missed nursing care.

BACKGROUND

One of the global challenges is missed nursing care, which includes missed or delayed care. This problem puts patients' clinical outcome at risk, so understanding nurses' experiences of how to prevent or reduce it can help the healthcare policymakers.

METHOD

In this qualitative descriptive study, 14 nurses were selected by purposive sampling. In-depth semi-structured interviews were conducted to collect data. The Graneheim and Lundman's approach of qualitative content analysis was used for data analysis. MAXQDA (version 10) software was used for data management.

RESULTS

The extracted codes were summarized into seven categories and one theme. The categories included "empowering nurses", "manpower supply", "supervision", "specializing the activities", "providing resources and facilities", "encouraging teamwork", and "resolving dissatisfaction. " The main theme was " missed nursing care prevention strategies".

CONCLUSION

The frequency of missed nursing care can be reduced or prevented using management strategies such as paying attention to nurses 'empowerment, increasing nurses' job satisfaction, normalizing nurses' salaries, providing equipment and facilities, and monitoring nurses' performance. Experimental studies are recommended to evaluate the effectiveness of these strategies. Implications for nursing management Nursing managers can take steps such as workplace improvement, reducing nurses' workload, and empowering nurses to reduce or eliminate missed care.

Comparative study of virtual and face-to-face training methods on the quality of healthcare services provided by Kermanshah pre-hospital emergency staff (EMS): randomized educational Intervention trial

BACKGROUND

Emergency medical centers are globally one of the most important pillars of pre-hospital care. The most important purpose of this system is to provide satisfactory services in the shortest possible time and in accordance with the modern scientific standards of the world. The present study aimed to compare the effect of virtual and face-to-face training methods on the quality of service provided by Kermanshah pre-hospital emergency personnel, Iran.

METHODS

This was a randomized educational intervention trial performed among the staff of Kermanshah Emergency Medical Center. Individuals were randomly divided into two training groups of virtual and face-to-face. Participants in the face-to-face group received slides, lectures, and practical work with moulage for 6 h a day. Subjects were taught the four skills of intubation, laryngeal mask airway (LMA), cardiopulmonary resuscitation (CPR) and attenuated electrical device (AED). Participants in the virtual group received the same content in the form of a training video on CD with a full explanation of the project's objectives. Pre- and post-test scores of participants were compared within and between the groups by Stata 14.0 software.

RESULTS

Eighty-seven individuals were participated in the study, 43 of whom were assigned to the face-to-face training group and 44 to the virtual training group. There was no significant difference between the two groups in terms of work experience and educational level (P > 0.05). Post-training scores in both groups were significantly higher than pre-training in the four skills (P ≤ 0.005). After adjusting for educational level and work experience, however, the quality of CPR, intubation, and AED was higher in the face-to-face training group than in the virtual group. However, the increase in the mean score of LMA in the virtual training was not significantly different than that of the face-to-face training group.

CONCLUSION

The results of our study showed the same efficacy of both face-to-face and virtual methods in improving the performance of personnel in tracheal intubation, LMA, CPR and AED shock skills. E-learning methods can be used as a complement to face-to-face methods in education.

Comparison of Knowledge, Attitude, and Practice of Nursing and Medical Students in Kermanshah, Iran, about Toothbrush Maintenance and Use

Background

To promote oral health in society, medical and nursing students are required to have acceptable knowledge, attitude, and practice with respect to correct maintenance and use of a toothbrush. This study explored the knowledge, attitude, and practice of Iranian medical and nursing students about the correct maintenance and use of a toothbrush.

Methods

A total of 260 nursing students and 320 medical students were randomly recruited. Data were collected by a researcher-made questionnaire on the knowledge, attitude, and practice about toothbrush maintenance and use. Data were analyzed using descriptive and inferential statistics.

Results

The mean scores of knowledge, attitude, and practice were 54.53 ± 17.18, 49.67 ± 19.17, and 19 ± 51.50 in the nursing students and 54.17 ± 21.42, 51.18 ± 87.28, and 49.87 ± 17.52 out of 100 in the medical students, respectively. There was no significant difference between the medical and nursing students in the mean score of knowledge. The medical and nursing students had a similar attitude and practice in most items of toothbrush maintenance and use.

Conclusion

The medical and nursing students had average knowledge, attitude, and practice regarding toothbrush maintenance and use, which is not acceptable considering their job nature. Hence, interventional measures should be taken to enhance their knowledge, attitude, and practice.

Barriers to the success of cardiopulmonary resuscitation from the perspective of Iranian nurses: A qualitative content analysis

BACKGROUND

The survival rate following Cardiopulmonary Resuscitation (CPR) has been reported to be 7-26.7%. Various studies have shown that CPR failure is high in many countries. This study was aimed to explore the barriers to the success of CPR from the perspective of Iranian nurses.

METHODS

Participants were 14 Iranian nurses recruited through purposive sampling. In-depth semi-structured interviews were used to collect data. Data were analyzed using qualitative content analysis.

RESULTS

The barriers to successful CPR were developed in three main categories and nine subcategories. Some of the barriers to CPR success were: "delayed attendance of the CPR team and start of CPR", "inadequate experience and skill of the CPR team", "poor access to special units", "insufficient and deficient CPR equipment", "poor CPR location", "critical clinical conditions of the patient", and "interference of the patient's family members.

CONCLUSION

The results showed that human and environmental factors can result in CPR failure. These barriers can be minimized by measures such as empowerment of the CPR team, and providing the necessary facilities and equipment.

Market competition and demand for skills in a credence goods market: Evidence from face-to-face and web-based non-physician clinician training in rural China

Background

Non-physician clinicians (NPCs) providing services in functionally private markets account for a large share of the workforce in the primary care system in many low-income and middle-income countries. Although regular in-service training is believed to be crucial to updating NPCs’ professional knowledge, skills, and practices, participation rates are often low. Low participation may result from the “credence good” nature of the market for primary care: if patients are unable to observe quality improvements from training, NPCs have weaker incentives to participate. Empirical evidence is limited on the relationship between market competition and NPC participation in-service training as well as how participation varies with the type of training available.

Methods

The study uses a dataset of 301 NPCs from three prefectures in Yunnan, a province in southwest China, collected in July 2017. Logistic regression is used to estimate the relationship between competition and NPC’s participation in in-service training. We assess the relationship between participation and both the quantity of competition (number of competitors in the same village and surrounding villages) and the quality of competition (proxied using characteristics of competing clinicians).

Results

In 2016, nearly two thirds of NPCs participated in face-to-face or web-based in-service trainings at least once. Specifically, 58 percent of NPCs participated in face-to-face in-service trainings, and 24 percent of NPCs participated in web-based in-service trainings. The quantity of competitors is unrelated to participation in in-service training. The quality of competition is not related to face-to-face training but has a significant positive relationship with participation in web-based training.

Conclusions

Web-based trainings may be a better approach to increase NPC skills in developing country primary care markets.

Evaluation of a Web-Based Training Model for Family Peer Advocates in Children's Mental Health

OBJECTIVE

The aim of this study was to compare knowledge gains from a new online training program with gains from an existing in-person training program for family peer advocates.

METHODS

Data were used from a pre-post study of individuals who enrolled in the Web-based Parent Empowerment Program training; 144 participants completed the training and pre-post tests, and 140 were admitted to the analyses. Knowledge was assessed with 34 questions, 29 of which were common to the online and in-person trainings. Pre-post knowledge scores were available from the in-person training.

RESULTS

Statistically significant gains in knowledge were found with both the 34 questions and the 29 questions common to both trainings. Knowledge gains across the two training models did not differ.

CONCLUSIONS

Data on knowledge gains from this accessible, affordable online model show promise for training the growing and important workforce of family peer advocates.

The effect of a web-based training for improving primary health care providers' knowledge about diabetes mellitus management in rural China: A pre-post intervention study

Background

The performance of primary health care providers regarding DM management is poor in rural China, and effective training methods for providers are urgently needed. This study aimed to evaluate the effect of web-based training for improving knowledge about DM management among primary health care providers in rural China and to further compare the effects of the training effect between primary health care providers with different backgrounds.

Methods

A pre-post intervention study was conducted from April to August 2014. In this study, a total of 901 primary health care workers were recruited from six counties in Hubei province. To evaluate the effect of the web-based training, the knowledge achievement of participants was measured with multiple choice questions (MCQ) at baseline, at the end of two weeks of training and at three months after training. A mixed linear model (MLM) was used to measure group differences in the mean scores at baseline and follow-up.

Results

After the web-based training, the knowledge scores of the village doctors increased from 73.58 at baseline to 89.98 at posttest and to 84.57 three months after the training. For township health workers, we observed an upward trend in scores from 78.87 at the pre-test to 91.72 at the second test, and at the three months after the training, the scores increased to 94.91. For village doctors, greater knowledge achievement was observed between the scores at baseline and after two weeks of training(adjusted difference: 3.55, P = 0.03) compared to that observed for the township health workers, while decreased their knowledge achievement between baseline and the third-test compared with that of township health workers (adjusted difference: 5.05, P = 0.01).

Conclusions

This study suggested that web-based training was an effective method for improving the knowledge of primary health care providers about management of DM in remote areas. Compared with the effect of the training on village doctors, the training had a poor short-term effect on township health workers but a better long-term effect.

Evaluation of clinical competence and its related factors among ICU nurses in Kermanshah-Iran: A cross-sectional study

Objectives

The present study was conducted to evaluate the clinical competence and its related demographic factors among critical care nurses in Kermanshah, Iran.

Methods

In this cross-sectional study, 155 Iranian nurses were selected by stratified random sampling. The data collection tools included a personal information form and the “Nurse Competence Scale”. Data were analyzed using descriptive and analytical statistics.

Results

The mean score of nurses' clinical competence was equal to 76.14 ± 1.59 out of 100, which was at a “very good level”. The mean score of using clinical competence in practice was equal to 70.38 ± 15.25 out of 100, which was at a “good level”. Among the subscales of clinical competence, the highest mean score was related to “managing situation”. The mean score of “using clinical competence in practice” was related to the subscale of “therapeutic interventions”. There was no statistically significant difference among the score of clinical competence of nurses varying with different gender, age, academic degree, and work experience.

Conclusions

The clinical competence of critical care nurses in Kermanshah was at a “very good” level, and the use of clinical competence in practice was at a “good level.” Given the importance of clinical competencies in practice, nurses' clinical competence should be evaluated objectively and positive measures should be taken to promote the application of their clinical competence.

Knowledge and performance of nursing students of Kermanshah-Iran regarding the standards of nosocomial infections control: a cross-sectional study

Objectives

The aim of this study was to determine the level of knowledge and performance of nursing students in regard to the standards of nosocomial infections control.

Results

The average score of knowledge and performance of the subjects was 12.49 ± 2.3 from 18 and 43.07 ± 0.67 from 54, respectively. There was a direct and significant correlation between the knowledge and performance of students (r = 0.46, p < 0.0001). There was no statistically significant relationship between the knowledge of students and variables such as gender and academic year of the students, but there was a significant relationship between students’ performance, and gender (p = 0.014) and academic year (p = 0.015).

Challenges in a Technology-Based Cancer Pain Management Program Among Asian American Breast Cancer Survivors

This paper aims to discuss the challenges faced during a pilot study that tested a technology-based cancer pain management program among Asian American survivors of breast cancer and provide directions for future technology-based interventions for racial and ethnic minorities. Data consisting of research diaries and meeting minutes underwent content analysis to extract themes that reflected the challenges. The challenges included those related to (1) diversities within the population of Asian American survivors of breast cancer; (2) survivors' treatment and healing process; (3) Internet resources from the participants' countries of origin; (4) building trust between researchers and participants/gatekeepers; (5) fidelity of the intervention; and (6) cultural sensitivity. Future design and implementation of technology-based programs for racial and ethnic minorities must consider these challenges.

The Impact of a Web-Based Course Concerning Patient Education for Mental Health Care Professionals: Quasi-Experimental Study

BACKGROUND

Continuing education has an important role in supporting the competence of health care professionals. Although Web-based education is a growing business in various health sectors, few studies have been conducted in psychiatric settings to show its suitability in demanding work environments.

OBJECTIVE

We aimed to describe the impact of a Web-based educational course to increase self-efficacy, self-esteem, and team climate of health care professionals. Possible advantages and disadvantages of the Web-based course are also described.

METHODS

The study used nonrandomized, pre-post intervention design in 1 psychiatric hospital (3 wards). Health care professionals (n=33) were recruited. Self-efficacy, self-esteem, and team climate were measured at 3 assessment points (baseline, 8 weeks, and 6 months). Possible advantages and disadvantages were gathered with open-ended questions at the end of the course.

RESULTS

Our results of this nonrandomized, pre-post intervention study showed that health care professionals (n=33) had higher self-efficacy after the course, and the difference was statistically significant (mean 30.16, SD 3.31 vs mean 31.77, SD 3.35; P=.02). On the other hand, no differences were found in the self-esteem or team climate of the health care professionals before and after the course. Health care professionals found the Web-based course useful in supporting their work and relationships with patients. The tight schedule of the Web-based course and challenges in recruiting patients to use the patient education program with health care professionals were found to be the disadvantages.

CONCLUSIONS

Web-based education might be a useful tool to improve the self-efficacy of health care professionals even in demanding work environments such as psychiatric hospitals. However, more studies with robust and sufficiently powered data are still needed.

The Effect of Content Delivery Style on Student Performance in Anatomy

The development of new technologies and ensuing pedagogical research has led many tertiary institutions to integrate and adopt online learning strategies. The authors of this study have incorporated online learning strategies into existing educational practices of a second year anatomy course, resulting in half of the course content delivered via face-to-face lectures, and half delivered online via tailored video vignettes, with accompanying worksheets and activities. The effect of the content delivery mode on student learning was analyzed by tailoring questions to content presented either face-to-face or online. Four practical tests were conducted across the semester with each consisting of four questions. Within each test, two questions were based on content delivered face-to-face, and two questions were based on content delivered online. Examination multiple choice questions were similarly divided and assessed. Findings indicate that student learning is consistent regardless of the mode of content delivery. However, student viewing habits had a significant impact on learning, with students who viewed videos multiple times achieving higher marks than those less engaged with the online content. Student comments also indicated that content delivery mode was not an influence on learning. Therefore student engagement, rather than the mode of content delivery, is a determinant of student learning and performance in human anatomy. Anat Sci Educ. © 2018 American Association of Anatomists.

Awareness of professional rules among Iranian nurses: a cross-sectional study

Background

One of the main responsibilities of professional nurses is protecting themselves against legal complications. Hence, they have to be sufficiently aware of the professional rules. This study examines the Iranian nurses’ awareness of professional rules.

Methods

A total of 260 nurses were randomly selected from among the nurses working at various wards and included in this cross-sectional descriptive analytical study. Data were collected using a researcher-made questionnaire. The collected data were then analyzed using descriptive (mean and frequency percentage) and inferential (Kolmogorov-Smirnov, Mann-Whitney U, and Kruskal-Wallis) statistics.

Results

The nurses’ mean awareness of professional rules was 28.3 ± 4.0 out of 37. There was a significant relationship between the mean awareness of the nurses and ward (p = 0.001). However, this relationship was not significant regarding demographic variables age, sex, marital status, job title, working experience, education and history of participation in retraining courses on professional rules.

Conclusion

A significant number of nurses were not adequately aware of professional rules, which can put them and their working organization at serious risks. Some measures such as holding web-based or in-person training courses and providing educational booklets and pamphlets can be helpful in this regard.

Prevalence of self-medication practice among health sciences students in Kermanshah, Iran

Background

The possibility of self-medication is higher in health sciences students than other students because of easy access to drug information resources and relatively sufficient familiarity with various kinds of drugs. The current study was aimed to determine the prevalence of self-medication and its related factors among the health sciences students.

Methods

A total of 250 health sciences students were included in this cross-sectional study via random sampling. Data were collected by a researcher-made self-medication questionnaire. The collected data were analyzed by SPSS-20 software using descriptive and inferential statistics (chi-square test).

Results

The prevalence of self-medication was 89.6%. Prior experience about the illness, non-seriousness of the illness and availability of drugs were the most prevalent reasons for self-medication. The most commonly used medications included common cold drugs, analgesics and antibiotics. The most frequently used medications were cold pill, acetaminophen pill and amoxicillin capsule. Most students obtained their pharmaceutical information from the pharmacist physician and online sources. Self-medication did not show a significant difference in terms of variables such as age, gender, marital status, insurance status and residence.

Conclusion

Given the high prevalence of self-medication among the health sciences students, training courses about the self-medication risks, more supervision over prohibition of over-the-counter drugs and adequate facilities for students’ access to medical services are suggested to be provided.

Electronic supplementary material

The online version of this article (10.1186/s40360-018-0231-4) contains supplementary material, which is available to authorized users.

E-learning for health professionals

BACKGROUND

The use of e-learning, defined as any educational intervention mediated electronically via the Internet, has steadily increased among health professionals worldwide. Several studies have attempted to measure the effects of e-learning in medical practice, which has often been associated with large positive effects when compared to no intervention and with small positive effects when compared with traditional learning (without access to e-learning). However, results are not conclusive.

OBJECTIVES

To assess the effects of e-learning programmes versus traditional learning in licensed health professionals for improving patient outcomes or health professionals' behaviours, skills and knowledge.

SEARCH METHODS

We searched CENTRAL, MEDLINE, Embase, five other databases and three trial registers up to July 2016, without any restrictions based on language or status of publication. We examined the reference lists of the included studies and other relevant reviews. If necessary, we contacted the study authors to collect additional information on studies.

SELECTION CRITERIA

Randomised trials assessing the effectiveness of e-learning versus traditional learning for health professionals. We excluded non-randomised trials and trials involving undergraduate health professionals.

DATA COLLECTION AND ANALYSIS

Two authors independently selected studies, extracted data and assessed risk of bias. We graded the certainty of evidence for each outcome using the GRADE approach and standardised the outcome effects using relative risks (risk ratio (RR) or odds ratio (OR)) or standardised mean difference (SMD) when possible.

MAIN RESULTS

We included 16 randomised trials involving 5679 licensed health professionals (4759 mixed health professionals, 587 nurses, 300 doctors and 33 childcare health consultants).When compared with traditional learning at 12-month follow-up, low-certainty evidence suggests that e-learning may make little or no difference for the following patient outcomes: the proportion of patients with low-density lipoprotein (LDL) cholesterol of less than 100 mg/dL (adjusted difference 4.0%, 95% confidence interval (CI) -0.3 to 7.9, N = 6399 patients, 1 study) and the proportion with glycated haemoglobin level of less than 8% (adjusted difference 4.6%, 95% CI -1.5 to 9.8, 3114 patients, 1 study). At 3- to 12-month follow-up, low-certainty evidence indicates that e-learning may make little or no difference on the following behaviours in health professionals: screening for dyslipidaemia (OR 0.90, 95% CI 0.77 to 1.06, 6027 patients, 2 studies) and treatment for dyslipidaemia (OR 1.15, 95% CI 0.89 to 1.48, 5491 patients, 2 studies). It is uncertain whether e-learning improves or reduces health professionals' skills (2912 health professionals; 6 studies; very low-certainty evidence), and it may make little or no difference in health professionals' knowledge (3236 participants; 11 studies; low-certainty evidence).Due to the paucity of studies and data, we were unable to explore differences in effects across different subgroups. Owing to poor reporting, we were unable to collect sufficient information to complete a meaningful 'Risk of bias' assessment for most of the quality criteria. We evaluated the risk of bias as unclear for most studies, but we classified the largest trial as being at low risk of bias. Missing data represented a potential source of bias in several studies.

AUTHORS' CONCLUSIONS

When compared to traditional learning, e-learning may make little or no difference in patient outcomes or health professionals' behaviours, skills or knowledge. Even if e-learning could be more successful than traditional learning in particular medical education settings, general claims of it as inherently more effective than traditional learning may be misleading.

Internet or dvd for distance learning to isolated rural health professionals, what is the best approach?

BACKGROUND

Distance Learning (DL) is a means to overcome the barriers that prevent health workers access to medical education and training sessions to update their knowledge. The main objective of this study is to compare the knowledge acquisition among practitioners Heads of Health Based Center (HBC) for the management of hypertension in two training modalities, one interactive, via internet (by Visio conferencing and video Conferencing), and other non-interactive, via DVD in the three regions (Miarinarivo, Moramanga and Manjakandriana) of Madagascar.

METHODS

This is a quasi-experimental study comparing two distance learning methodologies, one via internet (VS or VD) and the other via DVD before and after training. Ninety-two (92) Heads of HBC participated in the training, including 56 via the Internet (24 doctors and 32 paramedics) and 36 via DVD (24 doctors and 12 paramedics).

RESULTS

According to the training mode: the mean score of knowledge of the participants was 7 (+ -2) for two terms before training. It is 14 (+ -2.5) in the internet group (VS or VD) and 15 (+ -2.7) in the DVD group after training. The difference between the two groups was not significant p = 0.076. For doctors, the score was 7 (+ -3.1) via internet and 8 (+ -2.3) via DVD in pre test and 14 (+ - 2.4) via internet and 16 (+ -. 2.7) via DVD in post test, the difference between the two training methods was significant (p = 0.008). Among the paramedics, the results are the same for both conditions, 7 (+ - 2.4 to + -3.2) in pre test and 14 (+ - 2.2 to + -2.7) in post test.

CONCLUSION

Both training methods have improved participants' knowledge and the DVD mode is the first choice for Heads HBC of Madagascar with the majority located in remote areas.

Effects of Improving Primary Health Care Workers' Knowledge About Public Health Services in Rural China: A Comparative Study of Blended Learning and Pure E-Learning

Background

Primary health care workers (PHCWs) are a major force in delivering basic public health services (BPHS) in rural China. It is necessary to take effective training approaches to improve PHCWs’ competency on BPHS. Both electronic learning (e-learning) and blended learning have been widely used in the health workers’ education. However, there is limited evidence on the effects of blended learning in comparison with pure e-learning.

Objective

The aim of this study was to evaluate the effects of a blended-learning approach for rural PHCWs in improving their knowledge about BPHS as well as training satisfaction in comparison with a pure e-learning approach.

Methods

The study was conducted among PHCWs in 6 rural counties of Hubei Province, China, between August 2013 and April 2014. Three counties were randomly allocated blended-learning courses (29 township centers or 612 PHCWs—the experimental group), and three counties were allocated pure e-learning courses (31 township centers or 625 PHCWs—the control group). Three course modules were administered for 5 weeks, with assessments at baseline and postcourse. Primary outcomes were score changes in courses’ knowledge. Secondary outcome was participant satisfaction (5-point Likert scale anchored between 1 [strongly agree] and 5 [strongly disagree]).

Results

The experimental group had higher mean scores than the control group in knowledge achievement in three course modules: (1) module 1: 93.21 (95% CI 92.49-93.93) in experimental group versus 88.29 (95% CI 87.19-89.40) in the control group; adjusted difference, 4.92 (95% CI 2.61-7.24; P<.001); (2) module 2: 94.05 (95% CI 93.37-94.73) in the experimental group vs 90.22 (95% CI 89.12-91.31) in the control group; adjusted difference, 3.67 (95% CI 1.17-6.18; P=.004); (3) module 3: 93.88 (95% CI 93.08-94.68) in the experimental group versus 89.09 (95% CI 87.89-90.30) in control group; adjusted difference, 4.63 (95% CI 2.12-7.14; P<.001). The participants in the experimental learning group gave more positive responses with the four issues than control group participants: (1) the increase of interest in learning, 1.85 (95% CI 1.22-2.80; P=.003); (2) the increase of interaction with others, 1.77 (95% CI 1.20-2.60; P=.004); (3) the satisfaction with learning experience, 1.78 (95% CI 1.11-2.88; P=.02); and (4) achievement of learning objectives, 1.63 (95% CI 1.08-2.48; P=.02).

Conclusions

Among PHCWs in rural China, a blended-learning approach to BPHS training could result in a higher knowledge achievement and satisfaction level compared with a pure e-learning approach. The findings of the study will contribute knowledge to improve the competency of PHCWs in similar settings.

A Multimedia E-Book-A Story of Health: Filling a Gap in Environmental Health Literacy for Health Professionals

Narrative approaches and storytelling are emerging as powerful health promotion tools that can spark interest, increase understanding of determinants of health, and translate complex science. A Story of Health, a multimedia e-book with continuing education credits was designed to harness the power of storytelling to increase environmental health literacy. Health professionals are a key audience. They recognize that patients may be suffering from preventable illnesses of environmental origin but often feel ill-equipped to educate individuals and families about risks associated with common exposures. A Story of Health seeks to fill this gap and help readers develop the competencies they need in order to help patients make informed choices, reduce health risks, improve quality of life, and protect the environment. Americans rate nurses and medical doctors as having the highest honesty and ethical standards of all professions. These medical professionals can play a key role in changing patterns of patient behavior and influencing public policies. The e-book provides an easily accessible method of developing environmental health competency. The multimedia format with graphical interpretations allows for quick reviews of topics or for more in-depth analysis via links to additional resources. The CE evaluations have been overwhelmingly positive.

Practical guidelines for development of web-based interventions

Despite a recent high funding priority on technological aspects of research and a high potential impact of Web-based interventions on health, few guidelines for the development of Web-based interventions are currently available. In this article, we propose practical guidelines for development of Web-based interventions based on an empirical study and an integrative literature review. The empirical study aimed at development of a Web-based physical activity promotion program that was specifically tailored to Korean American midlife women. The literature review included a total of 202 articles that were retrieved through multiple databases. On the basis of the findings of the study and the literature review, we propose directions for development of Web-based interventions in the following steps: (1) meaningfulness and effectiveness, (2) target population, (3) theoretical basis/program theory, (4) focus and objectives, (5) components, (6) technological aspects, and (7) logistics for users. The guidelines could help promote further development of Web-based interventions at this early stage of Web-based interventions in nursing.

Period Prevalence of Ketamine-Propofol Admixture "Ketofol" in the Operating Room among Anesthesia Providers at an Academic Medical Center

BACKGROUND

The primary aim of this study was to determine the period prevalence of the single-syringe ketamine-propofol admixture used for sedation and induction among anesthesia providers during a 5-year period before and after educational sessions addressing barriers to its use. Secondary aims were to determine barriers to its use and address the most prevalent concerns through educational sessions.

MATERIAL AND METHODS

Surveys were administered to certified and student registered nurse anesthetists, anesthesia residents, and anesthesiologists at Mayo Clinic Rochester, MN before and after educational sessions addressing common barriers. Identified barriers were addressed by oral and/or electronic presentations with identical content.

RESULTS

Pre-education period prevalence for sedation was 110 (43%) and 64 (25%) for induction. Identified barriers were uncertainty of benefit in 62 respondents (23%), mixed controlled substance disposal in 48 (18%), regulatory/institutional policies in 20 (7%), and compatibility in 9 (3%). Post-education period prevalence for sedation was 102 (44%), and induction 63 (27%). No concerns were noted in 72% of the post-education group verses 42% in the pre-education group (p<0.01). No concerns were reported in 51% of the electronic only education group verses 64% in the oral education group (p<0.01).

CONCLUSIONS

The period prevalence of "ketofol" was greater for sedation than induction. The period prevalence following education showed a slight increase in both sedation and induction use. There was a significant reduction in barriers following education, with oral presentations being more effective than electronic only. Period prevalence was increasing following education; however, allowing more time may have shown a significant practice change.

Web-based training for primary healthcare workers in rural China: a qualitative exploration of stakeholders' perceptions

Background

Equitable access to basic public health services is a priority in China. However, primary healthcare workers’ competence to deliver public health services is relatively poor because they lack professional training. Since the availability of web-based training has increased in China, the current study explored stakeholders’ perceptions of a web-based training program on basic public health services to understand their thoughts, experiences, and attitudes about it.

Methods

Six focus group discussions with primary healthcare workers and three with directors of township hospitals, county-level Health Bureaus, and county-level Centers for Disease Control and Prevention were conducted in Yichang City during 2013. Semi-structured topic guides were used to facilitate qualitative data collection. Audio recordings of the sessions were transcribed verbatim and theme analysis was performed.

Results

Most of the study’s participants, especially the village doctors, had insufficient knowledge of basic public health services. The existing training program for primary healthcare workers consisted of ineffective traditional face-to-face sessions and often posed accessibility problems for the trainees. Most of the study’s participants had a positive attitude about web-based learning and expressed a strong desire to receive this novel training approach because of its flexibility and convenience. The perceived barriers to utilizing the web-based training method included poor computer literacy, lack of personal interaction, inadequate infrastructure, and lack of time and motivation. The facilitators of this approach included the training content applicability, the user-friendly and interactive learning format, and policy support.

Conclusions

Web-based training on basic public health services is a promising option in rural China. The findings of the study will contribute knowledge to implementation of web-based training in similar settings.

An education initiative modifies opinions of hemodialysis nurses towards home dialysis

Background

It has been shown that in-center hemodialysis (HD) nurses prefer in-center HD for patients with certain characteristics; however it is not known if their opinions can be changed.

Objective

To determine if an education initiative modified the perceptions of in-center HD nurses towards home dialysis.

Design

Cross-sectional survey of in-center HD nurses before and after a three hour continuing nursing education (CNE) initiative. Content of the CNE initiative included a didactic review of benefits of home dialysis, common misconceptions about patient eligibility, cost comparisons of different modalities and a home dialysis patient testimonial video.

Setting

All in-center HD nurses (including those working in satellite dialysis units) affiliated with a single academic institution

Measurements

Survey themes included perceived barriers to home dialysis, preferred modality (home versus in-center HD), ideal modality distribution in the local program, awareness of home dialysis and patient education about home modalities.

Methods

Paired comparisons of responses before and after the CNE initiative.

Results

Of the 115 in-center HD nurses, 100 registered for the CNE initiative and 89 completed pre and post surveys (89% response rate). At baseline, in-center HD nurses perceived that impaired cognition, poor motor strength and poor visual acuity were barriers to peritoneal dialysis and home HD. In-center HD was preferred for availability of multidisciplinary care and medical personnel in case of catastrophic events. After the initiative, perceptions were more in favor of home dialysis for all patient characteristics, and most patient/system factors. Home dialysis was perceived to be underutilized both at baseline and after the initiative. Finally, in-center HD nurses were more aware of home dialysis, felt better informed about its benefits and were more comfortable teaching in-center HD patients about home modalities after the CNE session.

Limitations

Single-center study

Conclusions

CNE initiatives can modify the opinions of in-center HD nurses towards home modalities and should complement the multitude of strategies aimed at promoting home dialysis.

Electronic supplementary material

The online version of this article (doi:10.1186/s40697-015-0051-z) contains supplementary material, which is available to authorized users.

Home Nurses’ Opinions Toward e-Learning in Continuing Education

There is an increased focus on the introduction of e-learning in the continuing education of home nurses. The aim of this study was to explore the opinions of home nurses toward continuing education via e-learning. The majority of the participants (87.9%) were willing to be educated via e-learning. The five main criteria in the success of an e-learning module were the user friendliness (79.7%), a thorough explanation about the use of the platform (63.7%), a thorough development of the subject (34.7%), the possibility to exchange ideas with colleagues or teachers (30.9%), and the availability of online illustrations (30.8%). The home nurses are willing to be educated via e-learning, but they were not conclusive on their preference toward classical education or education via e-learning.

Developing blended online and classroom strategies to deliver an occupational health nursing overview course in a multi-state region in the United States

This article describes how hybrid online and classroom learning approaches were used to design and offer an occupational health nursing review course throughout a multi-state region of the northwest United States. In response to demand from practicing occupational health nurses for board certification preparation, a series of asynchronous and synchronous continuing education modules was created covering a range of occupational health nursing topics. This review course illustrates how innovative educational delivery models can serve the needs of occupational health nurses challenged by geographic and time constraints.

Effectiveness Comparison of Mothers' In-person Versus Written Nutritional Education Intervention on Infant Growth in Iran

BACKGROUND

In 1990, the Iranian Ministry of Health implemented a health plan to increase mothers' knowledge of infant feeding using health workers and health volunteers. This study evaluates the effects of nutrition education on mothers' knowledge and whether increase in mothers' knowledge was associated with increase in growth of their children in Ardabil, Iran.

METHODS

A quasi-experimental study of the impact of written nutritional education and in-person nutritional education given to the participants (mothers) from urban health centers by health workers and health volunteers. Sixteen urban health centers located in Ardabil, Iran, were selected randomly for nutritional education. A group of 303 mothers with infants younger than 6 months of age from 16 health centers participated in this study. Height-for-age Z scores and weight-for age Z scores were calculated based on the National Center for Health Statistics reference values.

RESULTS

There were signifi cant differences between maternal nutritional knowledge before and after the intervention in all groups. However, the in-person method of instruction given by health workers was more effective in increasing mothers' knowledge than those in non-health worker volunteers intervention group. There were also significant differences between the growth rates of infants' heights and weights before and after the intervention.

CONCLUSIONS AND GLOBAL HEALTH IMPLICATIONS

In line with the aims of the government's plan, the education given by health volunteers from non-governmental organizations was effective. However, it was less effective than the one given by professional health workers.

A 3-armed randomized controlled trial of nurses' continuing education meetings on adverse drug reactions

INTRODUCTION

Nurses' insufficient knowledge of adverse drug reactions is reported as a barrier to spontaneous reporting. Therefore, CE meetings could be utilized to enhance nurses' competencies.

METHODS

In a 3-armed randomized controlled trial, 496 nurses, working in a tertiary medical center, were randomly allocated to a didactic lecture, brainstorming workshop, or the control group (delayed education). Similar instructors (2 clinical pharmacists) prepared and delivered the educational content to all 3 groups. Outcomes were declarative/procedural knowledge (primary outcome), participation rate, and satisfaction. Knowledge was evaluated using a validated researcher-made questionnaire in 3 time points: immediately before, immediately after, and 3 months after each session. Participants' satisfaction was assessed immediately after each meeting via a standard tool. Data were analyzed using appropriate parametric and nonparametric tests.

RESULTS

Rate of participation was 37.7% for the lecture group and 47.5% for the workshop group. The workshop participants were significantly more satisfied in comparison with the lecture group (p < .05). Mean knowledge scores were similar at baseline in the 3 study groups (43-47). Immediately after the meeting, knowledge was significantly higher in the lecture group (79.1 ± 11.9 vs 73.7 ± 11.3; p = .01). At the follow-up, knowledge scores of the lecture and workshop groups were similar, while significantly higher than the control group. However, the reduction of knowledge score was significantly higher in the lecture group (-13.0 ± 15.9% vs -5.7 ± 15.1%, p = .02).

DISCUSSION

Educational interventions can improve nurses' knowledge of adverse drug reactions. Short-term learning could be achieved with lecture, but the retention of knowledge will be enhanced by simple interactive techniques.

Telehealth distance education course in Latin America: analysis of an experience involving 15 countries

BACKGROUND

Telehealth activities are already going on in many Latin American countries. This article aims to present and evaluate a distance learning telehealth training course in the region.

MATERIALS AND METHODS

This was a cross-sectional descriptive study. A coordinating committee was formed, composed of medical school faculty from 15 countries, which defined the course's syllabus, teaching model, and mentoring structure. A questionnaire was prepared, using a Likert scale, in order to verify if the parameters of gender, age, professional category, postgraduate degree, and experience in distance education indicated any difference in relation to the course evaluation. The responses were analyzed by chi-squared test, considering as significant a value of p<0.05.

RESULTS

Of the 353 enrolled participants, 251 (71.10%) did the basic modules, and 96 (43.91%) completed the full training. In relation to the overall course assessment, it was considered excellent or good by 80.92% of participants, the mentors received positive evaluations by 72.83% of students, the course content was evaluated as excellent or good by 87.4% of students, and 94.40% of participants would recommend it. As for the parameters assessed, only experience in distance education was statistically significant for the evaluation of the tutors.

CONCLUSIONS

The results presented indicate an important concern on the part of the Latin American countries participating on the course in relation to telehealth training activities. Regarding course assessment, high approval rates in relation to tutoring, educational model, course content, and goals were noted, corroborating literature data. The experience of conducting a Latin American shared telehealth training course was indeed positive, contributing to the development of telehealth actions.

Sexual behavioral abstine HIV/AIDS questionnaire: Validation study of an Iranian questionnaire

BACKGROUND

This study was designed to assess the validity and reliability of the designed sexual, behavioral abstinence, and avoidance of high-risk situation questionnaire (SBAHAQ), with an aim to construct an appropriate development tool in the Iranian population.

MATERIALS AND METHODS

A descriptive-analytic study was conducted among female undergraduate students of Tehran University, who were selected through cluster random sampling. After reviewing the questionnaires and investigating face and content validity, internal consistency of the questionnaire was assessed by Cronbach's alpha. Explanatory and confirmatory factor analysis was conducted using SPSS and AMOS 16 Software, respectively.

RESULTS

The sample consisted of 348 female university students with a mean age of 20.69 ± 1.63 years. The content validity ratio (CVR) coefficient was 0.85 and the reliability of each section of the questionnaire was as follows: Perceived benefit (PB; 0.87), behavioral intention (BI; 0.77), and self-efficacy (SE; 0.85) (Cronbach's alpha totally was 0.83). Explanatory factor analysis showed three factors, including SE, PB, and BI, with the total variance of 61% and Kaiser-Meyer-Olkin (KMO) index of 88%. These factors were also confirmed by confirmatory factor analysis [adjusted goodness of fitness index (AGFI) = 0.939, root mean square error of approximation (RMSEA) = 0.039].

CONCLUSION

This study showed the designed questionnaire provided adequate construct validity and reliability, and could be adequately used to measure sexual abstinence and avoidance of high-risk situations among female students.

Web-based interventions in nursing

With recent advances in computer and Internet technologies and high funding priority on technological aspects of nursing research, researchers at the field level began to develop, use, and test various types of Web-based interventions. Despite high potential impacts of Web-based interventions, little is still known about Web-based interventions in nursing. In this article, to identify strengths and weaknesses of Web-based nursing interventions, a literature review was conducted using multiple databases with combined keywords of "online," "Internet" or "Web," "intervention," and "nursing." A total of 95 articles were retrieved through the databases and sorted by research topics. These articles were then analyzed to identify strengths and weaknesses of Web-based interventions in nursing. A strength of the Web-based interventions was their coverage of various content areas. In addition, many of them were theory-driven. They had advantages in their flexibility and comfort. They could provide consistency in interventions and require less cost in the intervention implementation. However, Web-based intervention studies had selected participants. They lacked controllability and had high dropouts. They required technical expertise and high development costs. Based on these findings, directions for future Web-based intervention research were provided.

Investigating the efficacy of practical skill teaching: a pilot-study comparing three educational methods

Effective education of practical skills can alter clinician behaviour, positively influence patient outcomes, and reduce the risk of patient harm. This study compares the efficacy of two innovative practical skill teaching methods, against a traditional teaching method. Year three pre-clinical physiotherapy students consented to participate in a randomised controlled trial, with concealed allocation and blinded participants and outcome assessment. Each of the three randomly allocated groups were exposed to a different practical skills teaching method (traditional, pre-recorded video tutorial or student self-video) for two specific practical skills during the semester. Clinical performance was assessed using an objective structured clinical examination (OSCE). The students were also administered a questionnaire to gain the participants level of satisfaction with the teaching method, and their perceptions of the teaching methods educational value. There were no significant differences in clinical performance between the three practical skill teaching methods as measured in the OSCE, or for student ratings of satisfaction. A significant difference existed between the methods for the student ratings of perceived educational value, with the teaching approaches of pre-recorded video tutorial and student self-video being rated higher than 'traditional' live tutoring. Alternative teaching methods to traditional live tutoring can produce equivalent learning outcomes when applied to the practical skill development of undergraduate health professional students. The use of alternative practical skill teaching methods may allow for greater flexibility for both staff and infrastructure resource allocation.

Developing a blended learning program for nursing and midwifery students in Iran: Process and preliminary outcomes

BACKGROUND

We aimed to develop and evaluate outcomes of a blended learning (BL) program for educating nursing and midwifery students of Tehran university of medical sciences (Tehran, Iran).

MATERIALS AND METHODS

This was a participatory action research project. After designing BL website, providing technological infrastructures, and holding preparatory workshops, 22 blended courses were designed. BL method was implemented for one semester. Students' grade point average, participation with courses, and opinion about educational methods, and instructors' attitude and opinion about educational methods were assessed.

RESULTS

Most students (n = 181; 72.1%) and 17 instructors (28.3%) consented to participate in the study. Students' grade point average and participation was significantly higher in BL rather than in face-to-face method (P < 0.0001). Most instructors (n = 11, 65%) had positive attitude toward BL method. Textual analysis of participants' opinion showed that most students preferred BL method and felt more independent in this method. However, they complained about lack of easy access to Internet and weakness in computer skills. Instructors admired the flexibility and incentives that had been provided in the program. However, some of them complained about the time-consuming nature of BL course design.

CONCLUSION

The program showed positive effect on students' learning outcomes and participation. The strengths and weaknesses of the program should be considered for development of next phase of the project. Lessons learned in this phase might be helpful for decision makers who tend to develop similar programs in Iran. Motivational and communicational issues and users' IT skills should be addressed in every BL program.

Effectiveness of Web-based versus face-to-face delivery of education in prescription of falls-prevention exercise to health professionals: randomized trial

Background

Exercise is an effective intervention for the prevention of falls; however, some forms of exercises have been shown to be more effective than others. There is a need to identify effective and efficient methods for training health professionals in exercise prescription for falls prevention.

Objective

The objective of our study was to compare two approaches for training clinicians in prescribing exercise to prevent falls.

Methods

This study was a head-to-head randomized trial design. Participants were physiotherapists, occupational therapists, nurses, and exercise physiologists working in Victoria, Australia. Participants randomly assigned to one group received face-to-face traditional education using a 1-day seminar format with additional video and written support material. The other participants received Web-based delivery of the equivalent educational material over a 4-week period with remote tutor facilitation. Outcomes were measured across levels 1 to 3 of Kirkpatrick’s hierarchy of educational outcomes, including attendance, adherence, satisfaction, knowledge, and self-reported change in practice.

Results

Of the 166 participants initially recruited, there was gradual attrition from randomization to participation in the trial (n = 67 Web-based, n = 68 face-to-face), to completion of the educational content (n = 44 Web-based, n = 50 face-to-face), to completion of the posteducation examinations (n = 43 Web-based, n = 49 face-to-face). Participant satisfaction was not significantly different between the intervention groups: mean (SD) satisfaction with content and relevance of course material was 25.73 (5.14) in the Web-based and 26.11 (5.41) in the face-to-face group; linear regression P = .75; and mean (SD) satisfaction with course facilitation and support was 11.61 (2.00) in the Web-based and 12.08 (1.54) in the face-to-face group; linear regression P = .25. Knowledge test results were comparable between the Web-based and face-to-face groups: median (interquartile range [IQR]) for the Web-based group was 90.00 (70.89–90.67) and for the face-to-face group was 80.56 (70.67–90.00); rank sum P = .07. The median (IQR) scores for the exercise assignment were also comparable: Web-based, 78.6 (68.5–85.1), and face-to-face, 78.6 (70.8–86.9); rank sum P = .61. No significant difference was identified in Kirkpatrick’s hierarchy domain change in practice: mean (SD) Web-based, 21.75 (4.40), and face-to-face, 21.88 (3.24); linear regression P = .89.

Conclusion

Web-based and face-to-face approaches to the delivery of education to clinicians on the subject of exercise prescription for falls prevention produced equivalent results in all of the outcome domains. Practical considerations should arguably drive choice of delivery method, which may favor Web-based provision for its ability to overcome access issues for health professionals in regional and remote settings.

Trial Registration

Australian New Zealand Clinical Trials Registry number: ACTRN12610000135011; http://www.anzctr.org.au/ACTRN12610000135011.aspx (Archived by WebCite at http://www.webcitation.org/63MicDjPV)

Overview and experience of a nursing e-mentorship program

Little is known regarding the feasibility and efficacy of an online continuing education program for oncology nurses. The Multiple Myeloma Mentorship Program, a quality improvement project for the Institute for Medical Education and Research, was designed to meet the educational needs of oncology nurses caring for patients with multiple myeloma. Twenty-five expert nurses with expertise in multiple myeloma from 23 cancer centers in the United States partnered with 50 oncology nurses in an electronic format from July 2009 to January 2010. The purpose of the program was to educate oncology nurses about the latest treatments and strategies for optimal side-effect management for patients with multiple myeloma. Nurse mentees selected their preferred form of learning--webcast, in-person speaker, or monograph. Two live webcasts allowed for didactic discussion between mentors and mentees. During and after the program, mentors conducted informal, unscripted interviews with nurse participants to determine preferred learning format, challenges, and implications for practice. Twelve nurses preferred Web-based learning to in-person presentations, citing flexibility and convenience as reasons for that choice. Time constraints with Web-based and in-person learning were a barrier to nurse mentees completing assigned modules. Several nurses implemented practice changes as a result of the program. Nurses who participated in the mentorship program were satisfied with the content. Learning styles and format should be considered in future mentorship programs.

A Comparison of Student Performance between Two Instructional Delivery Methods for a Healthcare Ethics Course

Healthcare ethics has become part of the standard curriculum of students in the health professions. The goals of healthcare ethics education are to give students the skills they need to identify, assess, and address ethical issues in clinical practice and to develop virtuous practitioners. Incorporating the medical humanities into medical school, for example, is intended to foster empathy and professionalism among students and to provide mechanisms for enhanced physician well-being. Yet, despite the long-standing inclusion of the humanities in nursing curricula, increases in the amount and kinds of scientific knowledge essential for clinical practice has resulted in the erosion of the “humanistic arts” from nursing education. One potential solution to this challenge comes with the increase in interprofessional education, where students in a variety of healthcare professions programs come together to learn about issues common to all healthcare fields.

Increasing health worker capacity through distance learning: a comprehensive review of programmes in Tanzania

BACKGROUND

Tanzania, like many developing countries, faces a crisis in human resources for health. The government has looked for ways to increase the number and skills of health workers, including using distance learning in their training. In 2008, the authors reviewed and assessed the country's current distance learning programmes for health care workers, as well as those in countries with similar human resource challenges, to determine the feasibility of distance learning to meet the need of an increased and more skilled health workforce.

METHODS

Data were collected from 25 distance learning programmes at health training institutions, universities, and non-governmental organizations throughout the country from May to August 2008. Methods included internet research; desk review; telephone, email and mail-in surveys; on-site observations; interviews with programme managers, instructors, students, information technology specialists, preceptors, health care workers and Ministry of Health and Social Welfare representatives; and a focus group with national HIV/AIDS care and treatment organizations.

RESULTS

Challenges include lack of guidelines for administrators, instructors and preceptors of distance learning programmes regarding roles and responsibilities; absence of competencies for clinical components of curricula; and technological constraints such as lack of access to computers and to the internet. Insufficient funding resulted in personnel shortages, lack of appropriate training for personnel, and lack of materials for students.Nonetheless, current and prospective students expressed overwhelming enthusiasm for scale-up of distance learning because of the unique financial and social benefits offered by these programs. Participants were retained as employees in their health care facilities, and remained in their communities and supported their families while advancing their careers. Space in health training institutions was freed up for new students entering in-residence pre-service training.

CONCLUSIONS

A blended print-based distance learning model is most feasible at the national level due to current resource and infrastructure constraints. With an increase in staffing; improvement of infrastructure, coordination and curricula; and decentralization to the zonal or district level, distance learning can be an effective method to increase both the skills and the numbers of qualified health care workers capable of meeting the health care needs of the Tanzanian population.