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Abstract
BACKGROUND Case-Based Learning (CBL) in medical education is a teaching approach that engages students as learners through active learning in small, collaborative groups to solve cases from clinical patients. Due to the challenges afforded by the COVID-19 pandemic, small group learning such as CBL, transitioned quickly to include technology-enhanced learning to enable distance delivery, with little information on how to apply pedagogical frameworks and use learning theories to design and deliver online content. METHODS To extend understanding of online CBL a scoping review protocol following the PRISMA-ScR framework explored the literature that describes the use of online CBL application in medical education and the outcomes, perceptions, and learning theories. A literature search was conducted in January 2022 followed by a subsequent review in October 2022. After peer review using the PRESS guidelines, the CASP appraisal tool was used to assess the rigor of each study design. RESULTS The scoping review identified literature published between 2010 and 2022 (n = 13 articles), on online CBL in the field of medical education with 11 observational studies describing student and facilitator perceptions and two randomized controlled studies. Positive perceptions of online learning included a flexible work-life balance, connection with learners, and improved accessibility. Negative experiences of online CBL included poor internet access, a distracting learning environment, and loss of communication. In the studies that collected student performance data, results showed equivalent or improved outcomes compared to the control. The CASP appraisal tool highlighted the deficiencies in most study designs, lack of framework or learning theory, and poor reproducibility of the methods to answer the research questions. CONCLUSION This scoping review identified literature to describe the academic outcomes, and student and facilitator perceptions of online CBL in medical education. However, the CASP tool uncovered deficiencies in study descriptions and design leading to poor quality evidence in this area. The authors provide recommendations for frameworks and learning theories for the future implementation of online CBL.
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Affiliation(s)
- Rebecca Donkin
- School of Medicine and Dentistry, Griffith University, Sunshine Coast Health Institute, 6 Doherty St, Birtinya, Qld, 4575, Australia.
- School of Health, University of the Sunshine Coast, 90 Sippy Downs Drive, Sippy Downs, Qld, 4556, Australia.
| | - Heather Yule
- Department of Cellular and Physiological Sciences, Faculty of Medicine, University of British Columbia, 2350 Health Sciences Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Trina Fyfe
- Division of Medical Sciences, University of British Columbia, 3333 University Way, Prince George, BC, V2N 4Z9, Canada
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Bind RH, Sawyer K, Hazelgrove K, Rebecchini L, Miller C, Ahmed S, Dazzan P, Sevdalis N, Bakolis I, Davis R, Lopez MB, Woods A, Crane N, Manoharan M, Burton A, Dye H, Osborn T, Greenwood L, Perkins R, Fancourt D, Pariante CM, Estevao C. Feasibility, clinical efficacy, and well-being outcomes of an online singing intervention for postnatal depression in the UK: SHAPER-PNDO, a single-arm clinical trial. Pilot Feasibility Stud 2023; 9:131. [PMID: 37501172 PMCID: PMC10373337 DOI: 10.1186/s40814-023-01360-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 07/05/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND Postnatal depression (PND) affects over 12% of mothers, with numbers rising during COVID-19. Singing groups can support mothers with PND; however, online delivery has never been evaluated. SHAPER-PNDO, a single-arm clinical trial, evaluated the feasibility, clinical efficacy, and well-being outcomes of a 6-week online version of Breathe Melodies for Mums (M4M) singing intervention developed for mothers with PND during COVID-19 lockdowns. METHODS The primary objective of this study was to assess the feasibility of a group online singing intervention for new mothers with postnatal depression. This was ascertained through recruitment rates, study retention rates, attendance rates to the singing sessions, and study completion rates. The secondary objective of the study was to assess the clinical efficacy and well-being outcomes of the singing intervention. Specifically, we measured change in Edinburgh Postnatal Depression Scale (EPDS), State-Trait Anxiety Inventory (STAI), Perceived Stress Scale (PSS), and Office for National Statistics Wellbeing Scale (ONS) scores from baseline to end-of-intervention (week 6); follow-up assessments were completed at weeks 3, 16, and 32. Mothers were eligible if they scored ≥10 on the baseline EPDS. RESULTS Eighty-seven percent of the 37 recruited mothers completed the study, attending, on average, 5 of the 6 group singing sessions. With regard to secondary outcomes, at end-of-treatment, mothers experienced significant reductions in depression (EPDS, 16.6 ± 3.7 to 11.2 ± 5.3, 95% CI [0.79,1.65]), anxiety (STAI-S, 48.4 ± 27.1 to 41.7 ± 26.8, 95% CI [4.96, 17.65]) and stress (PSS, 29.0 ± 5.7 to 19.7 ± 5.3, 95% CI [1.33, 7.07]); and, furthermore, significant improvements in life satisfaction (ONS, 50.5 ± 23.0 to 72.8 ± 11.7, 95% CI [- 39.86, - 4.64]) and feelings of worthwhileness (ONS, 51.7 ± 30.4 to 78.6 ± 15.1, 95% CI [- 52.79, - 0.85]). Reduction on the EPDS correlated with a reduction on the BDI and the STAI-S and maternal childhood maltreatment was predictive of a smaller treatment response. CONCLUSIONS M4M online was feasible to mothers who partook in the programme. Furthermore, M4M online supports the mental health and well-being of new mothers experiencing PND, especially when barriers to in-person treatment are present. TRIAL REGISTRATION ClinicalTrials.gov NCT04857593 . Registered 22 April 2021, retrospectively registered.
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Affiliation(s)
- Rebecca H Bind
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 5 Cutcombe Rd, Brixton, London, SE5 9RT, UK.
| | - Kristi Sawyer
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 5 Cutcombe Rd, Brixton, London, SE5 9RT, UK
| | - Katie Hazelgrove
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 5 Cutcombe Rd, Brixton, London, SE5 9RT, UK
| | - Lavinia Rebecchini
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 5 Cutcombe Rd, Brixton, London, SE5 9RT, UK
| | - Celeste Miller
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 5 Cutcombe Rd, Brixton, London, SE5 9RT, UK
| | - Subeyda Ahmed
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 5 Cutcombe Rd, Brixton, London, SE5 9RT, UK
| | - Paola Dazzan
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 5 Cutcombe Rd, Brixton, London, SE5 9RT, UK
| | - Nick Sevdalis
- Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, 16 De Crespigny Park, London, SE5 8AB, UK
| | - Ioannis Bakolis
- Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, 16 De Crespigny Park, London, SE5 8AB, UK
| | - Rachel Davis
- Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, 16 De Crespigny Park, London, SE5 8AB, UK
| | - Maria Baldellou Lopez
- Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, 16 De Crespigny Park, London, SE5 8AB, UK
| | - Anthony Woods
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 5 Cutcombe Rd, Brixton, London, SE5 9RT, UK
| | - Nikki Crane
- Culture Team, King's College London, Somerset House East Wing, London, WC2R 2LS, Strand, UK
| | - Manonmani Manoharan
- South London and Maudsley NHS Foundation Trust, Denmark Hill, London, SE5 8AZ, UK
| | - Alexandra Burton
- Department of Behavioural Science and Health, University College London, Gower Street, London, WC1E 6BT, UK
| | - Hannah Dye
- Breathe Arts Health Research, The Clarence Centre, 6 St George's Circus, London, SE1 6FE, UK
| | - Tim Osborn
- Breathe Arts Health Research, The Clarence Centre, 6 St George's Circus, London, SE1 6FE, UK
| | - Lorna Greenwood
- Breathe Arts Health Research, The Clarence Centre, 6 St George's Circus, London, SE1 6FE, UK
| | - Rosie Perkins
- Centre for Performance Science, Royal College of Music, London, UK
- Faculty of Medicine, Imperial College London, London, UK
| | - Daisy Fancourt
- Department of Behavioural Science and Health, University College London, Gower Street, London, WC1E 6BT, UK
| | - Carmine M Pariante
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 5 Cutcombe Rd, Brixton, London, SE5 9RT, UK
| | - Carolina Estevao
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 5 Cutcombe Rd, Brixton, London, SE5 9RT, UK
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Eisele M, Pohl AJ, McDonough MH, McNeely ML, Ester M, Daun JT, Twomey R, Culos-Reed SN. The online delivery of exercise oncology classes supported with health coaching: a parallel pilot randomized controlled trial. Pilot Feasibility Stud 2023; 9:82. [PMID: 37173764 PMCID: PMC10175911 DOI: 10.1186/s40814-023-01316-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 05/02/2023] [Indexed: 05/15/2023] Open
Abstract
PURPOSE The primary objective was to investigate the feasibility of a synchronous, online-delivered, group-based, supervised, exercise oncology maintenance program supported with health coaching. METHODS Participants had previously completed a 12-week group-based exercise program. All participants received synchronous online delivered exercise maintenance classes, and half were block randomized to receive additional weekly health coaching calls. A class attendance rate of ≥ 70%, a health coaching completion rate of ≥ 80%, and an assessment completion rate of ≥ 70% were set as markers of feasibility. Additionally, recruitment rate, safety, and fidelity of the classes and health coaching calls were reported. Post-intervention interviews were performed to further understand the quantitative feasibility data. Two waves were conducted - as a result of initial COVID-19 delays, the first wave was 8 weeks long, and the second wave was 12 weeks long, as intended. RESULTS Forty participants (n8WK = 25; n12WK = 15) enrolled in the study with 19 randomized to the health coaching group and 21 to the exercise only group. The recruitment rate (42.6%), attrition (2.5%), safety (no adverse events), and feasibility were confirmed for health coaching attendance (97%), health coaching fidelity (96.7%), class attendance (91.2%), class fidelity (92.6%), and assessment completion (questionnaire = 98.8%; physical functioning = 97.5%; Garmin wear-time = 83.4%). Interviews highlighted that convenience contributed to participant attendance, while the diminished ability to connect with other participants was voiced as a drawback compared to in-person delivery. CONCLUSION The synchronous online delivery and assessment of an exercise oncology maintenance class with health coaching support was feasible for individuals living with and beyond cancer. Providing feasible, safe, and effective exercise online to individuals living with cancer may support increased accessibility. For example, online may provide an accessible alternative for those living in rural/remote locations as well as for those who may be immunocompromised and cannot attend in-person classes. Health coaching may additionally support individuals' behavior change to a healthier lifestyle. TRIAL REGISTRATION The trial was retrospectively registered (NCT04751305) due to the rapidly evolving COVID-19 situation that precipitated the rapid switch to online programming.
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Affiliation(s)
| | - Andrew J Pohl
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | | | - Margaret L McNeely
- Department of Physical Therapy & Oncology, University of Alberta, Edmonton, AB, Canada
| | - Manuel Ester
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - Julia T Daun
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - Rosie Twomey
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - S Nicole Culos-Reed
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
- Department of Oncology, Cummings School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Psychosocial Resources, Tom Baker Cancer Centre, Cancer Care, Alberta Health Services, Calgary, AB, Canada
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Bind RH, Estevao C, Fancourt D, Hazelgrove K, Sawyer K, Rebecchini L, Miller C, Dazzan P, Sevdalis N, Woods A, Crane N, Manoharan M, Burton A, Dye H, Osborn T, Greenwood L, Bakolis I, Lopez MB, Davis R, Perkins R, Pariante CM. Online singing interventions for postnatal depression in times of social isolation: a feasibility study protocol for the SHAPER-PNDO single-arm trial. Pilot Feasibility Stud 2022; 8:148. [PMID: 35851430 PMCID: PMC9289358 DOI: 10.1186/s40814-022-01112-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 07/07/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Postnatal depression (PND) affects 13% of new mothers, with numbers rising during the COVID-19 pandemic. Despite this prevalence, many women have difficulty with or hesitancy towards accessing pharmacological and/or psychological interventions. Group-based mother-baby activities, however, have a good uptake, with singing improving maternal mental health and the mother-infant relationship. The recent lockdowns highlight the importance of adapting activities to an online platform that is wide-reaching and accessible. AIMS The SHAPER-PNDO study will primarily analyse the feasibility of a 6-week online singing intervention, Melodies for Mums (M4M), for mothers with PND who are experiencing barriers to treatment. The secondary aim of the SHAPER-PNDO study will be to analyse the clinical efficacy of the 6-week M4M intervention for symptoms of postnatal depression. METHODS A total of 120 mothers and their babies will be recruited for this single-arm study. All dyads will attend 6 weekly online singing sessions, facilitated by Breathe Arts Health Research. Assessments will be conducted on Zoom at baseline and week 6, with follow-ups at weeks 16 and 32, and will contain interviews for demographics, mental health, and social circumstances, and biological samples will be taken for stress markers. Qualitative interviews will be undertaken to understand the experiences of women attending the sessions and the facilitators delivering them. Finally, data will be collected on recruitment, study uptake and attendance of the programme, participant retention, and acceptability of the intervention. DISCUSSION The SHAPER-PNDO study will focus on the feasibility, alongside the clinical efficacy, of an online delivery of M4M, available to all mothers with PND. We hope to provide a more accessible, effective treatment option for mothers with PND that can be available both during and outside of the pandemic for mothers who would otherwise struggle to attend in-person sessions, as well as to prepare for a subsequent hybrid RCT. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04857593 . Registered retrospectively on 22 April 2021. The first participants were recruited on 27 January 2021, and the trial is ongoing.
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Affiliation(s)
- Rebecca H Bind
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 5 Cutcombe Rd, London, SE5 9RT, UK.
| | - Carolina Estevao
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 5 Cutcombe Rd, London, SE5 9RT, UK
| | - Daisy Fancourt
- Department of Behavioural Science and Health, University College London, Gower Street, London, WC1E 6BT, UK
| | - Katie Hazelgrove
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 5 Cutcombe Rd, London, SE5 9RT, UK
| | - Kristi Sawyer
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 5 Cutcombe Rd, London, SE5 9RT, UK
| | - Lavinia Rebecchini
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 5 Cutcombe Rd, London, SE5 9RT, UK
| | - Celeste Miller
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 5 Cutcombe Rd, London, SE5 9RT, UK
| | - Paola Dazzan
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 5 Cutcombe Rd, London, SE5 9RT, UK
| | - Nick Sevdalis
- Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, 16 De Crespigny Park, London, SE5 8AB, UK
| | - Anthony Woods
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 5 Cutcombe Rd, London, SE5 9RT, UK
| | - Nikki Crane
- Culture Team, King's College London, Somerset House East Wing, Strand, WC2R 2LS, UK
| | - Manonmani Manoharan
- South London and Maudsley NHS Foundation Trust, Denmark Hill, London, SE5 8AZ, UK
| | - Alexandra Burton
- Department of Behavioural Science and Health, University College London, Gower Street, London, WC1E 6BT, UK
| | - Hannah Dye
- Breathe Arts Health Research, The Clarence Centre, 6 St George's Circus, London, SE1 6FE, UK
| | - Tim Osborn
- Breathe Arts Health Research, The Clarence Centre, 6 St George's Circus, London, SE1 6FE, UK
| | - Lorna Greenwood
- Breathe Arts Health Research, The Clarence Centre, 6 St George's Circus, London, SE1 6FE, UK
| | - Ioannis Bakolis
- Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, 16 De Crespigny Park, London, SE5 8AB, UK
| | - Maria Baldellou Lopez
- Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, 16 De Crespigny Park, London, SE5 8AB, UK
| | - Rachel Davis
- Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, 16 De Crespigny Park, London, SE5 8AB, UK
| | - Rosie Perkins
- Centre for Performance Science, Royal College of Music, London, UK
- Faculty of Medicine, Imperial College London, London, UK
| | - Carmine M Pariante
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 5 Cutcombe Rd, London, SE5 9RT, UK
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Fabusuyi T, Twumasi-Boakye R, Broaddus A, Fishelson J, Hampshire RC. Estimating small area demand for online package delivery. J Transp Geogr 2020; 88:102864. [PMID: 32982088 PMCID: PMC7505800 DOI: 10.1016/j.jtrangeo.2020.102864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 09/13/2020] [Accepted: 09/17/2020] [Indexed: 06/11/2023]
Abstract
Using publicly available microdata sets, we show how estimates for online delivery purchases can be generated for small geographic areas defined in our study as micro analysis zones (MAZ) and how these estimates vary across the MAZs that featured in our study. With a focus on Miami-Dade County, we use both the national household travel survey (NHTS) data and synthetic data obtained from Southeast Florida Regional Planning Model (SERPM) to generate demand estimates of online delivery purchases for more than 5300 distinct geographic units in Miami-Dade County. We assess the quality of the estimates using measures of predictive accuracy and by comparing the cumulative values obtained with the population estimates generated from the NHTS survey data for Miami-Dade County. Our approach fills a void in the area of purchases of online delivery items where rich observable data are typically unavailable and it also provides the added potential benefit of being easily replicated nationwide given the emphasis on the use of publicly available data.
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Affiliation(s)
- Tayo Fabusuyi
- Transportation Research Institute, University of Michigan, 2901 Baxter Rd, Ann Arbor, MI, United States of America
| | | | - Andrea Broaddus
- Robotics and Mobility Research, Ford Motor Company, United States of America
| | - James Fishelson
- tOS Studio, Robotics and Mobility Research, Ford Motor Company, United States of America
| | - Robert Cornelius Hampshire
- Gerald R. Ford School of Public Policy, Transportation Research Institute, University of Michigan, Ann Arbor, MI, United States of America
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