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Mohammadi E, Smith L, Khan AF, Lee B, Spencer O, Muhammad F, Villeneuve LM, Dunn IF, Smith ZA. Post-pandemic paradigm shift toward telemedicine and tele-education; an updated survey of the impact of Covid-19 pandemic on neurosurgery residents in United States. World Neurosurg X 2024; 23:100326. [PMID: 38497059 PMCID: PMC10937949 DOI: 10.1016/j.wnsx.2024.100326] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 02/21/2024] [Indexed: 03/19/2024] Open
Abstract
Background Several strategies were implemented during the Covid-19 pandemic to enhance residency training and patient care. Objective This study aims to assess the post-pandemic landscape of neurosurgical training and practice. Method A survey consisting of 28 questions examining the challenges faced in neurosurgery and the adaptive measures was conducted among US neurosurgery residents from May 2022 to May 2023. Results This study encompassed 59 neurosurgical residents, predominantly male (72.9%) and in later years of training (66.1%) and were distributed across 25 states. Telemedicine and tele-education were pivotal during the pandemic, with virtual lecture series, standalone lectures, and virtual discussions highly favored. Remote didactic learning increased for nearly half of the residents, while 54.2% resumed in-person instruction. Telemedicine was deemed effective by 86.4% for evaluating neurosurgical patients. Access to teaching environments was restricted for 61.0% of residents, impacting their training. The pandemic significantly influenced elective surgeries, with complete cancellations reported by 42.4%. Reduced faculty engagement was noted by 35.6% of residents, while 47.5% reported a negative impact on the overall resident experience. The majority (76.3%) considered changes to their training reasonable given the global health situation. Conclusions Strategies implemented during the peak of the pandemic remain crucial in shaping neurosurgery training. Telemedicine has become indispensable, with widespread adoption. Tele-education has also expanded, providing additional learning opportunities. However, traditional didactic courses and hands-on experiences remain essential for comprehensive training. Balancing technology-driven methods with established approaches is crucial for optimizing neurosurgical education and maintaining high-quality patient care.
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Affiliation(s)
- Esmaeil Mohammadi
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Lonnie Smith
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Ali F. Khan
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Benjamin Lee
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Oslin Spencer
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Fauziyya Muhammad
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Lance M. Villeneuve
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Ian F. Dunn
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Zachary A. Smith
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
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Hailemariam RT, Nigatu AM, Melaku MS. Medical students' knowledge and attitude towards tele-education and associated factors at University of Gondar, Ethiopia, 2022: mixed method. BMC Med Educ 2023; 23:599. [PMID: 37608276 PMCID: PMC10463493 DOI: 10.1186/s12909-023-04579-5] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 08/08/2023] [Indexed: 08/24/2023]
Abstract
BACKGROUND Tele-education is the use of ICTs to conduct remote learning. It has been utilized to deliver ongoing training for many years. The world's modern culture is increasingly reliant on the use of information technology to enhance standards of education. However, in order to deploy successful e-learning systems in a developing nation, understanding of user characteristics is required in the creation and usage of e-learning systems. Thus, this study will enable us to understand the user's level of knowledge and attitude towards tele-education. METHODS An institution-based quantitative cross-sectional study supported by qualitative design was used 397 medical students at University of Gondar from May to June 2022. A pre-tested self-administered structured questionnaires and in-depth interview were used to collect quantitative and qualitative data respectively. Thematic-content analysis was conducted using open-code software for analyzing qualitative data. Quantitative data was entered to Epi-data version 4.6 and exported to SPSS version 25 software for further statistical analysis. Binary logistic regression was conducted. The adjusted odds ratio(AOR) was used to measure the association between the dependent and independent variables. RESULTS A total of 397 medical students were participated in this study with a response rate of 93.63%. In this study nearly six out of ten 230(57.9%) of study participants had good knowledge towards tele-education. More than half. 211(53.1%) of medical students participated on the study also had a favorable attitude towards tele-education. Factors associated with knowledge about tele-education is training related to ICT (AOR = 2.27 95% CI; (1.13,4.55)), knowledge of medical education digitization (AOR = 3.80 95% CI; (2.12,6.84)), high computer literacy (AOR = 2.82 95% CI; (1.68,4.72)) and favorable attitude towards tele-education (AOR = 3.52 95% CI; (2.12,5.84)). Factors associated with attitude towards tele-education is age group > 21 (AOR = 3.89, 95% CI; (1.33,11.39)) and good knowledge towards tele-education (AOR = 3.42,95%CI;(2.06,5.66)). CONCLUSION The study revealed that the knowledge of the medical students was good and nearly five out of ten of them had a favorable attitude towards tele-education. The study shows that training related to ICT, knowledge of medical education digitization, high computer literacy and favorable attitude towards tele-education were associated significantly with knowledge of tele-education. In this study age group > 21 and good knowledge towards tele-education of study participants were associated significantly with attitude towards tele-education.
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Affiliation(s)
- Rorisa Tadele Hailemariam
- Department of Health Informatics, School of Public Health, Arbaminch University, Arbaminch, Ethiopia.
| | - Araya Mesfin Nigatu
- Department of Health Informatics, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Mequannent Sharew Melaku
- Department of Health Informatics, Institute of Public Health, University of Gondar, Gondar, Ethiopia
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Lazari EC, Lazaris AC, Manou E, Agrogiannis G, Nastos C, Pikoulis E, Thomopoulou GE. "Starting from the Image": A Tele-pathology Pre-graduate Course Aimed at Motivating Medical Students. Med Sci Educ 2023; 33:589-593. [PMID: 37251207 PMCID: PMC10020748 DOI: 10.1007/s40670-023-01770-7] [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] [Figures] [Subscribe] [Scholar Register] [Accepted: 03/10/2023] [Indexed: 05/31/2023]
Abstract
In the tele-course entitled "Starting from the image", medical students are confronted with practical tasks in relevant professional contexts. Initially, a macroscopic or microscopic image of a patient case is presented to learners who then receive relevant information on the patient's history, clinical findings, and other laboratory tests. A pathologist actively discusses the pathological findings; then, a clinician explains their implications for the patient's individualized treatment and prognosis. In this way, pathology's interaction with other medical specialties is highlighted. Students declared that through these simulated professional practice experiences, they strengthened their decision-making skills. Educators should consider upgrading from information-based teaching to practice-focused instruction.
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Affiliation(s)
- Evgenia-Charikleia Lazari
- First Department of Pathology, School of Medicine, The National and Kapodistrian University of Athens, 75 Mikras Asias St., Goudi, Athens, 115 27 Greece
| | - Andreas C. Lazaris
- First Department of Pathology, School of Medicine, The National and Kapodistrian University of Athens, 75 Mikras Asias St., Goudi, Athens, 115 27 Greece
| | - Evangelia Manou
- First Department of Pathology, School of Medicine, The National and Kapodistrian University of Athens, 75 Mikras Asias St., Goudi, Athens, 115 27 Greece
| | - Georgios Agrogiannis
- First Department of Pathology, School of Medicine, The National and Kapodistrian University of Athens, 75 Mikras Asias St., Goudi, Athens, 115 27 Greece
| | - Constantinos Nastos
- Third Surgical Department, School of Medicine, “Attikon” University Hospital, The National and Kapodistrian University of Athens, Athens, Greece
| | - Emmanouil Pikoulis
- Third Surgical Department, School of Medicine, “Attikon” University Hospital, The National and Kapodistrian University of Athens, Athens, Greece
| | - Georgia-Eleni Thomopoulou
- Department of Cytology, School of Medicine, “Attikon” University Hospital, The National and Kapodistrian University of Athens, Athens, Greece
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Choi Y, Chodoff AC, Brown K, Murillo LA, Nesfeder J, Bugayong MT, Peairs KS. Preparing Future Medicine Physicians to Care for Cancer Survivors: Project ECHO® in a Novel Internal Medicine and Family Medicine Residency Curriculum. J Cancer Educ 2023; 38:608-617. [PMID: 35366218 PMCID: PMC8976217 DOI: 10.1007/s13187-022-02161-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 03/28/2022] [Indexed: 05/20/2023]
Abstract
Cancer survivorship education is limited in residency training. The goal of this pilot curriculum was to teach medicine residents a structured approach to cancer survivorship care. During the 2020-2021 academic year, we held eight 45-min sessions in an ambulatory noon conference series for a community family medicine (FM) and internal medicine (IM) residency program. The curriculum used Project ECHO®, an interactive model of tele-education through Zoom video conferencing, to connect trainees with specialists. Each session had a cancer-specific focus (e.g., breast cancer survivorship) and incorporated a range of core survivorship topics (e.g., surveillance, treatment effects). The session format included a resident case presentation and didactic lecture by an expert discussant. Residents completed pre- and post-curricular surveys to assess for changes in attitude, confidence, practice patterns, and/or knowledge in cancer survivorship care. Of 67 residents, 23/24 FM and 41/43 IM residents participated in the curriculum. Residents attended a mean of 3 sessions. By the end of the curriculum, resident confidence in survivorship topics (surveillance, treatment effects, genetic risk assessment) increased for breast, colorectal, and prostate cancers (p < 0.05), and there was a trend toward residents stating they ask patients more often about cancer treatment effects (p = 0.07). Over 90% of residents found various curricular components useful, and over 80% reported that the curriculum would improve their practice of cancer-related testing and treatment-related monitoring. On a 15-question post-curricular knowledge check, the mean correct score was 9.4 (63%). An eight-session curriculum improved resident confidence and perceived ability to provide cancer survivorship care.
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Affiliation(s)
- Youngjee Choi
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Alaina C Chodoff
- Greater Baltimore Medical Center Department of Medicine, Towson, MD, USA
| | - Krysta Brown
- Department of Medicine, TowerHealth/Reading Hospital, West Reading, PA, USA
| | - Luis A Murillo
- Department of Family Medicine, TowerHealth/Reading Hospital, West Reading, PA, USA
| | - Jonathan Nesfeder
- Department of Medicine, TowerHealth/Reading Hospital, West Reading, PA, USA
| | - Marielle T Bugayong
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kimberly S Peairs
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, USA
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Lewit EM, Figg LE, Addala A, Filipp SL, Lal R, Gurka MJ, Herndon JB, Haller MJ, Maahs DM, Walker AF. Project ECHO Diabetes Cost Modeling to Support the Replication and Expansion of Tele-mentoring Programs in Non-research Settings. Diabetes Ther 2023; 14:509-518. [PMID: 36680682 PMCID: PMC9981830 DOI: 10.1007/s13300-022-01364-3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 12/23/2022] [Indexed: 01/22/2023] Open
Abstract
INTRODUCTION Project ECHO Diabetes is a tele-education learning model for primary care providers (PCPs) seeking to improve care for patients with diabetes from marginalized communities. Project ECHO Diabetes utilized expert "hub" teams comprising endocrinologists, dieticians, nurses, psychologists, and social workers and "spokes" consisting of PCPs and their patients with diabetes. This Project ECHO Diabetes model provided diabetes support coaches to provide additional support to patients. We sought to estimate the costs of operating a Project ECHO Diabetes hub, inclusive of diabetes support coach costs. METHODS Data from Project ECHO Diabetes from June 2021 to June 2022 and wages from national databases were used to estimate hub and diabetes support coach costs to operate a 6-month, 24-session Project ECHO Diabetes program at hubs (University of Florida and Stanford University) and spokes (PCP clinic sites in Florida and California). RESULTS Hub costs for delivering a 6-month Project ECHO Diabetes program to five spoke clinics were $96,873. Personnel costs were the principal driver. Mean cost was $19,673 per spoke clinic and $11.37 per spoke clinic patient. Diabetes support coach costs were estimated per spoke clinic and considered scalable in that they would increase proportionately with the number of spoke clinics in a Project ECHO Diabetes cohort. Mean diabetes support coach costs were $6,506 per spoke clinic and $3.72 per patient. Total program costs per hub were $129,404. Mean cost per clinic was $25,881. Mean cost per patient was $15.03. CONCLUSION Herein, we document real-world costs to operate a Project ECHO Diabetes hub and diabetes support coaches. Future analysis of Project ECHO Diabetes will include estimates of spoke participation costs and changes in health care costs and savings. As state agencies, insurers, and philanthropies consider the replication of Project ECHO Diabetes, this analysis provides important initial information regarding primary operating costs.
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Affiliation(s)
- Eugene M Lewit
- Department of Health Policy, Stanford University, Stanford, CA, USA.
- , 2448 Emerson Street, Palo Alto, CA, 94301, USA.
| | - Lauren E Figg
- Department of Pediatrics, Division of Pediatric Endocrinology, Stanford University, Stanford, CA, USA
| | - Ananta Addala
- Department of Pediatrics, Division of Pediatric Endocrinology, Stanford University, Stanford, CA, USA
| | - Stephanie L Filipp
- Department of Pediatrics, Pediatric Endocrinology, University of Florida, PO Box 100296, Gainesville, FL, 32610, USA
| | - Rayhan Lal
- Department of Pediatrics, Division of Pediatric Endocrinology, Stanford University, Stanford, CA, USA
- Department of Medicine, Division of Endocrinology, Stanford University School of Medicine, Stanford, CA, USA
- Stanford Diabetes Research Center, Stanford University, Stanford, CA, USA
| | - Matthew J Gurka
- Department of Pediatrics, Pediatric Endocrinology, University of Florida, PO Box 100296, Gainesville, FL, 32610, USA
| | | | - Michael J Haller
- Department of Pediatrics, Pediatric Endocrinology, University of Florida, PO Box 100296, Gainesville, FL, 32610, USA.
| | - David M Maahs
- Department of Pediatrics, Division of Pediatric Endocrinology, Stanford University, Stanford, CA, USA
- Stanford Diabetes Research Center, Stanford University, Stanford, CA, USA
| | - Ashby F Walker
- Department of Health Services Research, Management and Policy, University of Florida, Gainesville, FL, USA
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Lalloo C, Mohabir V, Campbell F, Sun N, Klein S, Tyrrell J, Mesaroli G, Ataollahi-Eshqoor S, Osei-Twum J, Stinson J. Pediatric Project ECHO ® for Pain: implementation and mixed methods evaluation of a virtual medical education program to support interprofessional pain management in children and youth. BMC Med Educ 2023; 23:71. [PMID: 36709273 PMCID: PMC9883812 DOI: 10.1186/s12909-023-04023-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 01/11/2023] [Indexed: 05/22/2023]
Abstract
BACKGROUND Pediatric pain is a complex health challenge requiring a multi-modal management approach. It is critical that healthcare providers (HCPs) have access to ongoing, flexible education and mentorship specific to pediatric pain. However, there are significant gaps in available pain education and a need for more opportunities to support interprofessional training. Project Extension for Community Healthcare Outcomes (Project ECHO®) is a model for delivering online HCP education and cultivating a virtual community of practice. Within the pediatric pain setting, ECHO® has potential to improve local access to specialized pain knowledge, particularly among the physicians, nurses, and allied health providers who primarily manage these cases in community and hospital settings across rural and urban environments. The purpose of this study was three-fold. First, to evaluate the feasibility (participation levels, acceptability) of implementing Project ECHO® in the context of pediatric pain. Second, to measure preliminary program impacts on HCP knowledge, self-efficacy, and clinical practice. Third, to characterize HCP program engagement levels before and after onset of the COVID-19 pandemic. METHODS A needs assessment was conducted to identify interprofessional education gaps and inform the program curriculum. The no-cost Pediatric ECHO® for Pain program offered TeleECHO sessions (didactic and case-based learning) as well as foundational education. Surveys were distributed at baseline and 6 months to assess outcomes using 7-point Likert scales. Participant engagement was assessed for periods prior to and during the COVID-19 pandemic. Descriptive and inferential statistical analyses were conducted. RESULTS Eighty-five TeleECHO sessions were hosted, with a mean attendance of 34.1 ± 23.4 HCPs. Acceptability scores at 6 months (n = 33) ranged from 5.0 ± 1.4 to 6.5 ± 0.5. Participants reported statistically significant (p < 0.05) improvements in knowledge (7 out of 7 topics) and self-efficacy (8 out of 9 skills). Most participants reported positive practice impacts, including improved satisfaction with managing children with pain. Exploratory analyses showed a trend of greater engagement from ECHO® learners after onset of the COVID-19 pandemic. CONCLUSIONS Project ECHO® is a feasible and impactful model for virtual education of interprofessional HCPs in managing pediatric pain.
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Affiliation(s)
- C. Lalloo
- Child Health Evaluative Sciences, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, 686 Bay Street, Toronto, ON M5G 0A4 Canada
- Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, ON Canada
| | - V. Mohabir
- Child Health Evaluative Sciences, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, 686 Bay Street, Toronto, ON M5G 0A4 Canada
| | - F. Campbell
- Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, 555 University Avenue, Toronto, ON M5G 1X8 Canada
- Department of Anesthesiology and Pain Medicine, University of Toronto, 155 College Street, Toronto, ON M5T 1P8 Canada
| | - N. Sun
- Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, 555 University Avenue, Toronto, ON M5G 1X8 Canada
- Department of Anesthesiology and Pain Medicine, University of Toronto, 155 College Street, Toronto, ON M5T 1P8 Canada
| | - S. Klein
- Department of Rehabilitation, The Hospital for Sick Children, 555 University Avenue, Toronto, ON M5G 1X8 Canada
- Department of Physical Therapy, University of Toronto, 155 College Street, Toronto, ON M5T 1P8 Canada
| | - J. Tyrrell
- Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, 555 University Avenue, Toronto, ON M5G 1X8 Canada
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Toronto, ON M5T 1P8 Canada
| | - G. Mesaroli
- Child Health Evaluative Sciences, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, 686 Bay Street, Toronto, ON M5G 0A4 Canada
- Department of Rehabilitation, The Hospital for Sick Children, 555 University Avenue, Toronto, ON M5G 1X8 Canada
- Department of Physical Therapy, University of Toronto, 155 College Street, Toronto, ON M5T 1P8 Canada
| | - S. Ataollahi-Eshqoor
- Department of Rehabilitation, The Hospital for Sick Children, 555 University Avenue, Toronto, ON M5G 1X8 Canada
| | - J. Osei-Twum
- Child Health Evaluative Sciences, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, 686 Bay Street, Toronto, ON M5G 0A4 Canada
| | - J. Stinson
- Child Health Evaluative Sciences, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, 686 Bay Street, Toronto, ON M5G 0A4 Canada
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Toronto, ON M5T 1P8 Canada
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Khoddam S, Lotfi R, Kabir K, Merghati-Khoei E. The effect of a tele-educational intervention on modifying dysfunctional sexual beliefs of pregnant women: a randomized controlled trial. BMC Pregnancy Childbirth 2022; 22:495. [PMID: 35715786 PMCID: PMC9204371 DOI: 10.1186/s12884-022-04773-1] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 05/18/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND & AIM Some cultural scenarios in pregnancy and childbirth reinforce dysfunctional sexual beliefs that reverse changes in the couple's sexual life. The present study aimed to investigate the effect of education by sending text messages on modifying dysfunctional sexual beliefs in pregnant women. METHODS & MATERIALS This study is a randomized clinical trial, and 82 eligible pregnant women referred to educational-medical centers to receive prenatal care were randomly assigned to intervention or control group. The intervention group received 24 text messages during eight weeks (three text messages per week), and the control group received only routine care. Data was collected through a demographic questionnaire, reproductive profile, Spinner's Dyadic Adjustment Scale (DAS), and dysfunctional sexual beliefs questionnaire. Both groups completed the questionnaires before and one week after the intervention. Independent t-test, paired t-test, and analysis of covariance was used to analyze the data. RESULTS The findings revealed no statistically significant difference in the baseline Dyadic Adjustment mean scores of control (132.4 ± 11.01) and intervention (130.10 ± 10.66) groups. Paired t-test analysis showed that the mean score of dysfunctional sexual beliefs was significantly decreased from (29 ± 7.61) at baseline compared to one week after intervention (10.54 ± 6.97) (p < 0.001). Analysis of covariance test to compare the scores of dysfunctional sexual beliefs in the intervention group (10.54 ± 6.97) and control group (26.80 ± 7.80) showed a statistically significant difference (p < 0.01) with an effect size of 0.67. CONCLUSION This study showed that sending text messages to mobile phones of pregnant women has corrected their dysfunctional sexual beliefs. Therefore, this approach can be used in pregnancy care to promote women's sexual health. TRIAL REGISTRATION Clinical trial registry: IRCT20161230031662N9 .
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Affiliation(s)
- Shirin Khoddam
- Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran
| | - Razieh Lotfi
- Department of Midwifery, School of Nursing and Midwifery, Alborz University of Medical Sciences, 1st Golestan- Eshteraki Boulevard, Baghestan, Karaj, Iran. .,Social Determinants of Health Research Center, Alborz University of Medical Sciences, 1st Golestan- Eshteraki Boulevard, Baghestan, Karaj, Iran.
| | - Kourosh Kabir
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, 1st Golestan- Eshteraki Boulevard, Baghestan, Karaj, Iran.,Department of Community Medicine, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Effat Merghati-Khoei
- Spinal Cord Injury Research Center (BASIR), Neuroscience Institution, Tehran University of Medical Sciences, Tehran, Iran
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Molavynejad S, Miladinia M, Jahangiri M. A randomized trial of comparing video telecare education vs. in-person education on dietary regimen compliance in patients with type 2 diabetes mellitus: a support for clinical telehealth Providers. BMC Endocr Disord 2022; 22:116. [PMID: 35501846 PMCID: PMC9063130 DOI: 10.1186/s12902-022-01032-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 04/25/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Compliance to dietary recommendations by patients is the most difficult part of diabetes management. The nature of any educational method is to increase patients' awareness. But the question is, what is the effect of each method and for this purpose a comparative method should be considered. Therefore, this study was conducted to compare the effects of in-person education versus video tele-education on dietary regimen compliance in patients with T2DM. METHODS In this trial, 378 patients with type 2 diabetes mellitus (T2DM) were random allocated into video tele-education, in-person education and control groups. The patients' weight and biochemical parameters were measured before educational programs and three-month later. RESULTS The mean changes of patients' weight, glycemic parameters, and Lipid profiles decreased more in the two educational groups than the control group in a three-month period. There were no significant differences in the all study variables between the in-person and video education groups in post interventions except Total Cholesterol (TC). The pre- and post-intervention changes in the weight, TC, hemoglobin A1c, Triglyceride, and Very Low-density Lipoprotein Cholesterol were significant in both in-person group and video group. None of the educational programs had a significant impact on the Fasting blood sugar, Low-Density Lipoprotein Cholesterol, and High-Density Lipoprotein Cholesterol. DISCUSSION Video tele-education was just as effective as in-person educational method on dietary regimen compliance among patients with T2DM in a three-month period. Therefore, it is recommended to use video tele-education in combination with or as an alternative to the in-person education method. This study provides support for diabetes educator. TRIAL REGISTRATION This investigation was registered in the Iranian Registry of Clinical Trials Center ( IRCT20150302021307N4 ).
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Affiliation(s)
- Shahram Molavynejad
- Diabetes Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mojtaba Miladinia
- Diabetes Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Mina Jahangiri
- Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
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Dowling MJ, Molloy U, Payne C, McLean S, McQuillan R, Noonan C, Ryan DJ. Hospital transfer rates and advance care planning following a nursing home-targeted video-conference education series (Project ECHO): a prospective cohort study. Eur Geriatr Med 2022; 13:941-949. [PMID: 35438449 PMCID: PMC9016377 DOI: 10.1007/s41999-022-00624-6] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Accepted: 02/08/2022] [Indexed: 11/17/2022]
Abstract
Purpose Nursing home staff manage increasingly complex patients yet struggle to access education. This study measured the impact of a novel education programme on emergency transfers from nursing homes. Methods In this prospective experimental cohort study, ten interactive sessions were provided to 20 nursing homes, using teleconferencing technology through the “Project ECHO” (Extension for Community Healthcare Outcomes) model. Details of all emergency hospital transfers were submitted by participating nursing homes 6 months before and 6 months from commencement of ECHO. Results Of 20 nursing homes, 13 submitted sufficient data for inclusion. In these 13, there were 260 emergency transfers over a year. There was no significant difference in the number of transfers before and after ECHO (137/260 pre-ECHO vs 123/260 post-ECHO, p = 0.62). Post-ECHO, it was 50% more likely that transfer wishes were discussed in advance of transfer (62 of 137 (45%) transferred pre-ECHO vs 82 of 123 (67%) post-ECHO, p < 0.001). There was a significant increase in compliance with resident wishes post-ECHO in that transferred residents were less likely to have a documented “Not for Transfer” wish (29/137 pre-ECHO (21%) vs 10/123 post-ECHO (8%), p < 0.001). Point prevalence surveys of residents demonstrated significant increases in “Do Not Resuscitate” orders; 286/589 (49%) residents pre-ECHO vs 386/594 (65%) post-ECHO, p < 0.001. Post-ECHO, pain was less frequently the primary cause for transfer (11/137 (8%) pre-ECHO vs 1/123 (0.8%) post-ECHO, p = 0.006). Conclusion ECHO did not affect rates of emergency hospital transfers but did increase advance care planning discussions ahead of hospital transfer by 50% and compliance with the results of those discussions. Supplementary Information The online version contains supplementary material available at 10.1007/s41999-022-00624-6. Aim What effect does a novel education programme have on emergency hospital transfers of, and advance care planning decisions among, nursing home residents? Findings This education programme did not affect overall rates of emergency hospital transfer. It did increase advance care planning discussions, increase compliance with the results of these discussions and increase “DNR” orders among nursing home residents. Message Novel tele-education programmes have the potential to improve advance care planning discussions in nursing homes. Supplementary Information The online version contains supplementary material available at 10.1007/s41999-022-00624-6.
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Affiliation(s)
- Michael J Dowling
- Age-Related Healthcare Department, Tallaght University Hospital, Dublin 24, Ireland.
| | | | - Cathy Payne
- All-Ireland Institute of Hospice and Palliative Care, Dublin, Ireland
| | | | | | - Claire Noonan
- Age-Related Healthcare Department, Tallaght University Hospital, Dublin 24, Ireland
| | - Dan J Ryan
- Age-Related Healthcare Department, Tallaght University Hospital, Dublin 24, Ireland.,Department of Medical Gerontology, Trinity College Dublin, Dublin, Ireland
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Abstract
In order for us to understand our current situation of the oral health condition of those with special needs, we need to review the history of how education was presented and what has been done. The American Dental Association, Commission on Dental Accreditation (CODA) is recognized by the US Department of Education. CODA is responsible for the accreditation of predoctoral dental education programs (leading to the DDS or DMD degree), advanced dental education programs, and allied dental education programs that are fully operational or have attained "Initial Accreditation" status, including programs offered via distance education.
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Affiliation(s)
- Allen Wong
- University of the Pacific, Arthur A. Dugoni School of Dentistry, 155 Fifth Street, San Francisco, CA 94103, USA.
| | - Lisa Itaya
- University of the Pacific, Arthur A. Dugoni School of Dentistry, 155 Fifth Street, San Francisco, CA 94103, USA
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11
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Mounié M, Costa N, Gourdy P, Latorre C, Schirr-Bonnans S, Lagarrigue JM, Roussel H, Martini J, Buisson JC, Chauchard MC, Delaunay J, Taoui S, Poncet MF, Cosma V, Lablanche S, Coustols-Valat M, Chaillous L, Thivolet C, Sanz C, Penfornis A, Lepage B, Colineaux H, Hanaire H, Molinier L, Turnin MC. Cost-Effectiveness Evaluation of a Remote Monitoring Programme Including Lifestyle Education Software in Type 2 Diabetes: Results of the Educ@dom Study. Diabetes Ther 2022; 13:693-708. [PMID: 35133640 PMCID: PMC8991290 DOI: 10.1007/s13300-022-01207-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 01/18/2022] [Indexed: 01/02/2023] Open
Abstract
INTRODUCTION Telemedicine programs using health technological innovation to remotely monitor the lifestyles of patients with type 2 diabetes (T2D) can improve glycaemic control and thus reduce the incidence of complications as well as management costs. In this context, an assessment was made of the 1-year and 2-year cost-effectiveness of the EDUC@DOM telemonitoring and tele-education program. METHODS The EDUC@DOM study was a multicentre randomized controlled trial conducted between 2013 and 2017 that compared a telemonitoring group (TMG) to a control group (CG) merged with health insurance databases to extract economic data on resource consumption. Economic analysis was performed from the payer perspective, and direct costs and indirect costs were considered. The clinical outcome used was the intergroup change in glycated haemoglobin (HbA1c) levels from baseline. Missing economic data were imputed using multiple imputation, and fitted values from a generalized linear mixed model were used to calculate the incremental cost-effectiveness ratio (ICER). Bootstrapped 95% confidence ellipses were drawn in the cost-effectiveness plan. RESULTS The main analysis included data from 256 patients: 126 in the TMG and 130 in the CG. Incremental costs over 1 and 2 years were equal to €2129 and €5101, respectively, in favour of the TMG. Once imputed and adjusted for confounding factors, the TMG trends to a 21% cost decrease over 1 and 2 years of follow-up (0.79 [0.58; 1.08], p = 0.1452 and 0.79 [0.61; 1.03], p = 0.0879, respectively). The EDUC@DOM program led to a €1334 cost saving and a 0.17 decrease in HbA1c over 1 year and a €3144 cost saving and a 0.14 decrease in HbA1c over 2 years. According to the confidence ellipse, EDUC@DOM was a cost-effective strategy. CONCLUSION This study provides additional economic information on telemonitoring and tele-education programs to enhance their acceptance and promote their use. In the light of this work, the EDUC@DOM program is a cost-saving strategy in T2D management. TRIAL REGISTRATION This trial was registered in the Clinical Trials Database on 27 September 2013 under no. NCT01955031 and bears ID-RCB no. 2013-A00391-44.
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Affiliation(s)
- Michael Mounié
- Health-Economic Unit, Medical Information Department, University Hospital, Toulouse, France.
- CERPOP, INSERM - University Toulouse III Paul Sabatier, Toulouse, France.
| | - Nadège Costa
- Health-Economic Unit, Medical Information Department, University Hospital, Toulouse, France
- CERPOP, INSERM - University Toulouse III Paul Sabatier, Toulouse, France
| | - Pierre Gourdy
- Department of Diabetology, Metabolic Diseases and Nutrition, Toulouse University Hospital, Toulouse, France
- Institute of Metabolic and Cardiovascular Diseases, UMR1297 INSERM/UPS, Toulouse University, Toulouse, France
| | - Christelle Latorre
- Health-Economic Unit, Medical Information Department, University Hospital, Toulouse, France
| | - Solène Schirr-Bonnans
- Health-Economic Unit, Medical Information Department, University Hospital, Toulouse, France
| | | | - Henri Roussel
- CNAM, DRSM Occitanie, 2 rue Georges Vivent, 31082, Toulouse, France
| | - Jacques Martini
- Department of Diabetology, Metabolic Diseases and Nutrition, Toulouse University Hospital, Toulouse, France
- DIAMIP Network, Toulouse, France
| | | | - Marie-Christine Chauchard
- Department of Diabetology, Metabolic Diseases and Nutrition, Toulouse University Hospital, Toulouse, France
- DIAMIP Network, Toulouse, France
| | - Jacqueline Delaunay
- Department of Diabetology, Metabolic Diseases and Nutrition, Toulouse University Hospital, Toulouse, France
| | - Soumia Taoui
- Department of Diabetology, Metabolic Diseases and Nutrition, Toulouse University Hospital, Toulouse, France
| | | | | | | | | | | | | | | | - Alfred Penfornis
- Sud Francilien Hospital, Corbeil-Essonnes, and Paris-Saclay University, Corbeil-Essonnes, France
| | - Benoît Lepage
- Department of Epidemiology, University Hospital, Toulouse, France
- CERPOP, INSERM - University Toulouse III Paul Sabatier, Toulouse, France
| | - Hélène Colineaux
- Department of Epidemiology, University Hospital, Toulouse, France
- CERPOP, INSERM - University Toulouse III Paul Sabatier, Toulouse, France
| | - Hélène Hanaire
- Department of Diabetology, Metabolic Diseases and Nutrition, Toulouse University Hospital, Toulouse, France
- Institute of Metabolic and Cardiovascular Diseases, UMR1297 INSERM/UPS, Toulouse University, Toulouse, France
| | - Laurent Molinier
- Health-Economic Unit, Medical Information Department, University Hospital, Toulouse, France
- CERPOP, INSERM - University Toulouse III Paul Sabatier, Toulouse, France
| | - Marie-Christine Turnin
- Department of Diabetology, Metabolic Diseases and Nutrition, Toulouse University Hospital, Toulouse, France
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12
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Ratanarojanakul S, Pangkanon W. Comparison of Tele-Education and Conventional Cardiopulmonary Resuscitation Training During COVID-19 Pandemic. J Emerg Med 2022; 63:309-316. [PMID: 35562248 PMCID: PMC8894814 DOI: 10.1016/j.jemermed.2022.02.002] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 01/28/2022] [Accepted: 02/25/2022] [Indexed: 11/23/2022]
Abstract
Background Cardiopulmonary resuscitation (CPR) performed by lay rescuers can increase a person's chance of survival. The COVID-19 pandemic enforced prevention policies that encouraged social distancing, which disrupted conventional modes of health care education. Tele-education may benefit CPR training during the pandemic. Objective Our aim was to compare CPR knowledge and skills using tele-education vs. conventional classroom teaching methods. Methods A noninferiority trial was conducted as a Basic Life Support workshop. Participants were randomly assigned to a tele-education or conventional group. Primary outcomes assessed were CPR knowledge and skills and secondary outcomes assessed were individual skills, ventilation, and chest compression characteristics. Results Pretraining knowledge scores (mean ± standard deviation [SD] 3.50 ± 2.18 vs. 4.35 ± 1.70; p = 0.151) and post-training knowledge scores (7.91 ± 2.14 vs. 8.52 ± 0.90; p = 0.502) of the tele-education and conventional groups, respectively, had no statistically significant difference. Both groups’ training resulted in a significant and comparable gain in knowledge scores (p < 0.001). The tele-education and conventional groups skill scores (mean ± SD 78.30 ± 6.77 vs. 79.65 ± 9.93; p = 0.579) had no statistical difference. Skillset scores did not differ statistically except for the compression rate and ventilation ratio; the conventional group performed better (p = 0.042 vs. p = 0.017). The tele-education and conventional groups’ number of participants passed the skill test (95.5% and 91.3%, respectively; p = 1.000). Conclusions Tele-education offers a pragmatic and reasonably effective alternative to conventional CPR training during the COVID-19 pandemic.
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Serhal E, Pereira C, Armata R, Hardy J, Sockalingam S, Crawford A. Describing implementation outcomes for a virtual community of practice: The ECHO Ontario Mental Health experience. Health Res Policy Syst 2022; 20:17. [PMID: 35135565 PMCID: PMC8822668 DOI: 10.1186/s12961-022-00818-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 01/20/2022] [Indexed: 01/01/2023] Open
Abstract
Background Project ECHO is a virtual education model aimed at building capacity among healthcare providers to support optimal management for a range of health conditions. The expansion of the ECHO model, further amplified by the pandemic, has demonstrated an increased need to evaluate implementation success to ensure that interventions are implemented as planned. This study describes how Proctor et al.’s implementation outcomes (acceptability, adoption, appropriateness, costs, feasibility, fidelity, penetration, and sustainability) were adapted and used to assess the implementation of ECHO Ontario Mental Health (ECHO-ONMH), a mental health-focused capacity-building programme. Methods Using Proctor et al.’s implementation outcomes, the authors developed an implementation outcomes framework for ECHO-ONMH more generally. Using this, outcome measures and success thresholds were identified for each outcome for the ECHO-ONMH context, and then applied to evaluate the implementation of ECHO-ONMH using data from the first 4 years of the programme. Results An ECHO-ONMH implementation outcomes framework was developed using Proctor’s implementation outcomes. ECHO-ONMH adapted implementation outcomes suggest that ECHO-ONMH was implemented successfully in all domains except for penetration, which only had participation from 13/14 regions. Acceptability, appropriateness and adoption success thresholds were surpassed for all 4 years, showing strong signs of sustainability. The programme was deemed feasible all 4 years and was found to be more cost-effective. ECHO-ONMH also showed high rates of fidelity to the ECHO model, and high rates of penetration. Conclusions This is the first study to use Proctor et al.’s implementation outcomes to describe implementation success for a virtual capacity-building model. The proposed ECHO implementation outcomes framework provides a base for similar interventions to evaluate implementation success, which is an important precursor to understanding learning, service or health outcomes related to the model. Additionally, these findings can act as a benchmark for other international ECHOs and educational programmes.
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Affiliation(s)
- Eva Serhal
- Virtual Care, Outreach, and ECHO Department, Centre for Addiction and Mental Health, Toronto, ON, Canada.
| | - Cheryl Pereira
- Virtual Care, Outreach, and ECHO Department, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Rosaria Armata
- Virtual Care, Outreach, and ECHO Department, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Jenny Hardy
- Virtual Care, Outreach, and ECHO Department, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Sanjeev Sockalingam
- Department of Education, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Allison Crawford
- Virtual Care, Outreach, and ECHO Department, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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14
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Malik VS, Singal K, Singh M, Gupta V, Singh M. The perceived need for evidence-based COVID-19 management and Tele-education in the North-East region of India: a cross-sectional survey. J Community Health 2022; 47:943-8. [PMID: 35925434 DOI: 10.1007/s10900-022-01076-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2022] [Indexed: 01/08/2023]
Abstract
Due to the sudden rise in the cases of COVID-19 in the North-Eastern region of India, this study was conducted to survey the felt needs of the medical professionals with regards to education on the evidence-based management of COVID-19. A total of 25 North-East leaders were recruited and a baseline survey was conducted through the digital medium. Out of 25 North-East leaders, 52% were undergoing training in evidence-based medicine in the capacity-building program for evidence-based child health. Participants (48%) strongly agreed and 40% agreed on the possibility of enhanced care by capacity building in the areas of COVID-19 management through discussing cases. Out of 25 North East leaders, 48% agreed to join both as a speaker as well as a participant. Various priority topics on COVID-19 management e.g. childhood, adult, ocular manifestation, ICU management, telemedicine, vaccines, lab protocols, psychological distress, and treatment strategy have emerged. We have presented the findings of the survey which will help guide the mentoring program focusing on evidence-based management of COVID-19 in remote areas through Tele-education.
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15
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Turnin MC, Gourdy P, Martini J, Buisson JC, Chauchard MC, Delaunay J, Schirr-Bonnans S, Taoui S, Poncet MF, Cosma V, Lablanche S, Coustols-Valat M, Chaillous L, Thivolet C, Sanz C, Penfornis A, Lepage B, Colineaux H, Mounié M, Costa N, Molinier L, Hanaire H. Impact of a Remote Monitoring Programme Including Lifestyle Education Software in Type 2 Diabetes: Results of the Educ@dom Randomised Multicentre Study. Diabetes Ther 2021; 12:2059-2075. [PMID: 34160791 PMCID: PMC8266949 DOI: 10.1007/s13300-021-01095-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 06/05/2021] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Telemonitoring in type 2 diabetes (T2D) is mainly based on glucose monitoring. A new type of connected device which routinely gathers data on weight, physical activity and food intake could improve patients' diabetes control. The main aim of this study was to assess the efficacy of an at-home interventional programme incorporating such devices and lifestyle education software on diabetes control, i.e., change in HbA1c, compared to standard care. METHODS This multicentre study randomly assigned 282 people with T2D to either a telemonitoring group (TMG) or a control group (CG) for a 1-year intervention period. While routine follow-up was maintained in the CG, TMG subjects were provided with interactive lifestyle educational software (with artificial intelligence algorithms) and connected objects (blood glucose meters, scales and actimeters) for use in their own homes and were remotely monitored by their diabetologists. Changes in HbA1c were compared between groups using a mixed linear model. RESULTS The mean HbA1c dropped from 7.8 ± 0.8% (62 mmol/mol) to 7.4 ± 1.0% (57 mmol/mol) in the TMG and from 7.8 ± 0.8% (62 mmol/mol) to 7.6 ± 1.0% (60 mmol/mol) in the CG, resulting in an intergroup difference of - 0.16 (p = 0.06) in favour of TMG, after adjustment for confounding factors. Within TMG, the decrease in HbA1c was greater in frequent users: - 0.23% (p = 0.03) in the case of connections to telemonitoring synthesis above the median and - 0.21% (p = 0.05) in the case of connections to tele-education software above the median compared to the CG. Significant weight loss was observed in the TMG but only in women (p = 0.01). FINDINGS The EDUC@DOM telemonitoring and tele-education device did not highlight a significant decrease in HbA1c levels compared to routine management although a slight, albeit significant improvement in glycaemic control was observed in the frequent user subgroup as well as significant weight loss but only in women. A high level of satisfaction with the connected device was recorded amongst all participants. TRIAL REGISTRATION This trial was registered in the Clinical Trials Database on September 27, 2013, under no. NCT01955031 and bears ID-RCB number 2013-A00391-44.
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Affiliation(s)
- Marie-Christine Turnin
- Department of Diabetology, Metabolic Diseases and Nutrition, University Hospital of Toulouse, 1 Avenue Jean Poulhès, TSA 50032, Toulouse cedex 9, 31059, Toulouse, France.
| | - Pierre Gourdy
- Department of Diabetology, Metabolic Diseases and Nutrition, University Hospital of Toulouse, 1 Avenue Jean Poulhès, TSA 50032, Toulouse cedex 9, 31059, Toulouse, France
- Institute of Metabolic and Cardiovascular Diseases, UMR1297 INSERM/UPS, Toulouse University, Toulouse, France
| | - Jacques Martini
- Department of Diabetology, Metabolic Diseases and Nutrition, University Hospital of Toulouse, 1 Avenue Jean Poulhès, TSA 50032, Toulouse cedex 9, 31059, Toulouse, France
- DIAMIP Network, Toulouse, France
| | | | - Marie-Christine Chauchard
- Department of Diabetology, Metabolic Diseases and Nutrition, University Hospital of Toulouse, 1 Avenue Jean Poulhès, TSA 50032, Toulouse cedex 9, 31059, Toulouse, France
- DIAMIP Network, Toulouse, France
| | - Jacqueline Delaunay
- Department of Diabetology, Metabolic Diseases and Nutrition, University Hospital of Toulouse, 1 Avenue Jean Poulhès, TSA 50032, Toulouse cedex 9, 31059, Toulouse, France
| | - Solène Schirr-Bonnans
- Department of Diabetology, Metabolic Diseases and Nutrition, University Hospital of Toulouse, 1 Avenue Jean Poulhès, TSA 50032, Toulouse cedex 9, 31059, Toulouse, France
| | - Soumia Taoui
- Department of Diabetology, Metabolic Diseases and Nutrition, University Hospital of Toulouse, 1 Avenue Jean Poulhès, TSA 50032, Toulouse cedex 9, 31059, Toulouse, France
| | | | | | | | | | | | | | | | - Alfred Penfornis
- Sud Francilien Hospital, Corbeil-Essonnes and Paris-Saclay University, Paris, France
| | - Benoît Lepage
- University Department of Epidemiology, Health Economics and Public Health, University Hospital, Toulouse, France
| | - Hélène Colineaux
- University Department of Epidemiology, Health Economics and Public Health, University Hospital, Toulouse, France
| | - Michaël Mounié
- Medico-Economic Unit, Medical Information Department, University Hospital, Toulouse, France
| | - Nadège Costa
- Medico-Economic Unit, Medical Information Department, University Hospital, Toulouse, France
| | - Laurent Molinier
- Medico-Economic Unit, Medical Information Department, University Hospital, Toulouse, France
| | - Hélène Hanaire
- Department of Diabetology, Metabolic Diseases and Nutrition, University Hospital of Toulouse, 1 Avenue Jean Poulhès, TSA 50032, Toulouse cedex 9, 31059, Toulouse, France
- Institute of Metabolic and Cardiovascular Diseases, UMR1297 INSERM/UPS, Toulouse University, Toulouse, France
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Sarin-Gulian L, Espinoza J, Lee TC, Choe JYU, Fichera S. Development and Evaluation of a Tele-Education Program for Neonatal ICU Nurses in Armenia. J Pediatr Nurs 2021; 57:e9-e14. [PMID: 32981807 DOI: 10.1016/j.pedn.2020.08.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 08/23/2020] [Accepted: 08/31/2020] [Indexed: 11/16/2022]
Abstract
PURPOSE Neonatal mortality currently accounts for more than 60% of all infant mortality in Armenia. The majority of health professionals in Neonatal Intensive Care Units (NICU) however, have had no specialized training in neonatology. Local and global agencies have emphasized the need for improvement in the education and skills of NICU health professionals. The objective of this study was to design, implement, and evaluate an innovative tele-education program for NICU nurses in Armenia. DESIGN AND METHODS Seven online tele-education courses were designed on various neonatal nursing topics using Final Cut Pro and translated professionally to Armenian. The videos were uploaded to YouTube. All NICU nurses employed in two hospitals (n = 35) in Yerevan, Armenia, completed a diagnostic pretest, course viewing, a posttest, and a satisfaction survey for each topic. A difference in knowledge was defined as the number of correct test answers obtained before and after the course. Participant satisfaction was measured using a Likert scale. RESULTS The combined average for completed pre-tests for all courses was 45% and 71% for post-tests, which was statistically significant for each course (p < 0.05). A majority of the nurses either agreed or strongly agreed with all of the satisfaction parameters of the course. CONCLUSIONS These results support a tele-education model for effectively providing continuing education to NICU nurses in Armenia. A similar platform could be used to establish nationwide certification programs for neonatal nurses. PRACTICE IMPLICATIONS Tele-education technology can be used effectively by nursing educators working in global health as part of international learning collaboratives.
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Affiliation(s)
| | - Juan Espinoza
- Children's Hospital Los Angeles, Los Angeles, CA, United States.
| | - Thomas C Lee
- Children's Hospital Los Angeles, Los Angeles, CA, United States.
| | | | - Sharon Fichera
- Children's Hospital Los Angeles, Los Angeles, CA, United States.
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Aksoy Derya Y, Altiparmak S, AkÇa E, GÖkbulut N, Yilmaz AN. Pregnancy and birth planning during COVID-19: The effects of tele-education offered to pregnant women on prenatal distress and pregnancy-related anxiety. Midwifery 2021; 92:102877. [PMID: 33157497 PMCID: PMC7831526 DOI: 10.1016/j.midw.2020.102877] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 10/05/2020] [Accepted: 10/23/2020] [Indexed: 12/18/2022]
Abstract
AIM This study aims to examine pregnancy and birth planning during COVID-19 and the effects of a tele-education offered to pregnant women for this planning process on prenatal distress and pregnancy-related anxiety. METHOD The population of this quasi-experimental study was composed of pregnant women who applied for the antenatal education class of a public hospital in the east of Turkey during their past prenatal follow-ups and wrote their contact details in the registration book to participate in group trainings. The sample of the study consisted of a total of 96 pregnant women, including 48 in the experiment and 48 in the control groups, who were selected using power analysis and non-probability random sampling method. The data were collected between April 22 and May 13, 2020 using a "Personal Information Form", the "Revised Prenatal Distress Questionnaire (NuPDQ)" and the "Pregnancy Related Anxiety Questionnaire-Revised 2 (PRAQ-R2)". An individual tele-education (interactive education and consultancy provided by phone calls, text message and digital education booklet) was provided to the pregnant women in the experiment group for one week. No intervention was administered to those in the control group. The data were statistically analyzed using descriptive statistics (frequency, percentage, mean, standard deviation, min-max values) and t-test in dependent and independent groups. RESULTS The posttest NuPDQ total mean scores of pregnant women in the experiment and control groups were 8.75±5.10 and 11.50±4.91, respectively, whereby the difference between the groups was statistically significant (t=-2.689, p=0.008). Additionally, the difference between their mean scores on both PRAQ-R2 and its subscales of "fear of giving birth" and "worries of bearing a physically or mentally handicapped child" was statistically significant (p<0.05), where those in the experiment group had lower anxiety, fear of giving birth and worries of bearing a physically or mentally handicapped child. CONCLUSION The tele-education offered to the pregnant women for pregnancy and birth planning during COVID-19 decreased their prenatal distress and pregnancy-related anxiety.
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Affiliation(s)
- Yeşim Aksoy Derya
- Department of Midwifery, Faculty of Health Sciences, Inonu University, Malatya, Turkey.
| | - Sümeyye Altiparmak
- Department of Midwifery, Faculty of Health Sciences, Inonu University, Malatya, Turkey.
| | - Emine AkÇa
- Department of Midwifery, Faculty of Health Sciences, Inonu University, Malatya, Turkey.
| | - Nilay GÖkbulut
- Department of Midwifery, Faculty of Health Sciences, Çankırı Karatekin University, Çankırı, Turkey.
| | - Ayşe Nur Yilmaz
- Department of Midwifery, Faculty of Health Sciences, Fırat University, Elazığ, Turkey.
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Abstract
Tele-education is the use of communications technologies to distribute knowledge from one health care provider to another when distance separates providers. At the University of Arkansas for Medical Sciences, tele-education has been used for more than two decades to educate and support rural obstetrician/gynecologists throughout the state. Tele-education at University of Arkansas for Medical Sciences incorporates numerous interactive videoconferences and other digital portals and platforms. Continued provider education through tele-education increases access to quality care and evidenced-based practices for rural populations and is an effective strategy in the battle against health care disparities.
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Culmer N, Smith T, Stager C, Wright A, Burgess K, Johns S, Watt M, Desch M. Telemedical Asthma Education and Health Care Outcomes for School-Age Children: A Systematic Review. J Allergy Clin Immunol Pract 2020; 8:1908-1918. [PMID: 32084596 DOI: 10.1016/j.jaip.2020.02.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 02/05/2020] [Accepted: 02/06/2020] [Indexed: 10/25/2022]
Abstract
BACKGROUND Telemedicine in a school-based setting involving partnerships between a child with asthma and health care provider can provide patients and caregivers with opportunities to better manage chronic conditions, communicate among partners, and collaborate for solutions in convenient locations. OBJECTIVE This systematic review examined outcomes for school-age children with asthma involving asthma-based telemedical education. METHODS Guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, we searched 4 databases with terms related to asthma, education, and pediatrics. Included articles involved a school-based setting, children and adolescents, a telemedical mechanism for training, empirical study designs, and peer review. We extracted data regarding (a) participant background, (b) research methods and purpose, and (c) outcomes. RESULTS A total of 408 articles were identified. Five met inclusion criteria. Three studies were randomized and 2 were cohort studies. In addition to clinical and educational outcomes, studies reported on satisfaction, self-management, asthma knowledge gain, and quality of life (QOL). We found support for caregiver/parent QOL and participant self-management behaviors. We also found mixed results for participant QOL. Clinical outcomes showed mixed support regarding airway inflammation improvement, medication use improvement, improvements in symptom burden and symptom-free days, and spirometry improvements. CONCLUSIONS Results of real-time telemedically delivered asthma education to improve QOL, enhance symptom management ability, and reduce symptom burden were positive or nonsignificant. No study indicated negative effects due to telemedicine. Limited results indicate that patient education can, under certain circumstances, positively influence asthma burden. Further validation of intervention methods and tools as well as outcome measurement consistency is recommended.
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Affiliation(s)
- Nathan Culmer
- College of Community Health Sciences, The University of Alabama, Tuscaloosa, Ala.
| | - Todd Smith
- College of Community Health Sciences, The University of Alabama, Tuscaloosa, Ala
| | - Catanya Stager
- College of Community Health Sciences, The University of Alabama, Tuscaloosa, Ala
| | - Andrea Wright
- College of Community Health Sciences, The University of Alabama, Tuscaloosa, Ala
| | - Karen Burgess
- College of Community Health Sciences, The University of Alabama, Tuscaloosa, Ala
| | - Samantha Johns
- College of Community Health Sciences, The University of Alabama, Tuscaloosa, Ala
| | - Mykaela Watt
- College of Community Health Sciences, The University of Alabama, Tuscaloosa, Ala
| | - Madison Desch
- College of Community Health Sciences, The University of Alabama, Tuscaloosa, Ala
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Gleason LJ, Martinchek M, Long M, Rapier N, Hamlish T, Johnson D, Thompson K. An innovative model using telementoring to provide geriatrics education for nurses and social workers at skilled nursing facilities ✰. Geriatr Nurs 2019; 40:517-521. [PMID: 30987777 DOI: 10.1016/j.gerinurse.2019.03.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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: 11/28/2018] [Revised: 03/25/2019] [Accepted: 03/29/2019] [Indexed: 10/27/2022]
Abstract
Older adults with complex needs reside in skilled nursing facilities (SNFs) and are cared for by nurses and social workers with limited geriatrics education. We describe the pilot phase of an educational model using the Extension for Community Healthcare Outcomes (ECHO) platform to teach geriatrics principles to SNF staff. Twenty-five unique participants from 7 total facilities enrolled, with twenty-two participants completing both the pre/post surveys. Statistically significant improvement was seen in participants' self-efficacy to treat patients with dementia, educate patients about hospice and palliative medicine options, and assess and manage infections in older adults. The two largest barriers participants identified in making changes after the series were the time pressures of caring for complex geriatric patients and staff available to assist with social support needs of older adults. ECHO-Chicago's Geriatrics SNF pilot series is innovative and shows promise to provide geriatrics education for the SNF workforce.
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Affiliation(s)
- Lauren J Gleason
- Department of Medicine, Section of Geriatrics and Palliative Medicine, The University of Chicago Medicine, 5841 S. Maryland Ave MC6098, Chicago, IL, 60637, USA.
| | - Michelle Martinchek
- Department of Medicine, Section of Geriatrics and Palliative Medicine, The University of Chicago Medicine, 5841 S. Maryland Ave MC6098, Chicago, IL, 60637, USA
| | - Monica Long
- Department of Medicine, Section of Geriatrics and Palliative Medicine, The University of Chicago Medicine, 5841 S. Maryland Ave MC6098, Chicago, IL, 60637, USA
| | - Nicaya Rapier
- Department of Pediatrics, The University of Chicago Medicine, 5841 S. Maryland Avenue, Rm C-122, MC6082, Chicago, Illinois, 60637, USA
| | - Tamara Hamlish
- University of Illinois Cancer Center, 818 S. Wolcott Ave, Chicago, IL 60612, USA
| | - Daniel Johnson
- Department of Pediatrics, The University of Chicago Medicine, 5841 S. Maryland Avenue, Rm C-122, MC6082, Chicago, Illinois, 60637, USA
| | - Katherine Thompson
- Department of Medicine, Section of Geriatrics and Palliative Medicine, The University of Chicago Medicine, 5841 S. Maryland Ave MC6098, Chicago, IL, 60637, USA
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Kakisaka Y, Jin K, Fujikawa M, Kitazawa Y, Nakasato N. Teleconference-based education of epileptic seizure semiology. Epilepsy Res 2018; 145:73-76. [PMID: 29913406 DOI: 10.1016/j.eplepsyres.2018.06.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 03/05/2018] [Revised: 05/22/2018] [Accepted: 06/11/2018] [Indexed: 11/24/2022]
Abstract
BACKGROUND To evaluate whether a teleconference-based lecture provides similar understanding of seizure semiology to a face-to-face lecture for physicians. METHODS Subjects were 66 physicians consisting of adult and pediatric neurologists, neurosurgeons, psychiatrists, and general practitioners. All attended the 30-minute lecture to introduce various types of seizure semiology using video-clips by one of the authors (Yo.K.) and then joined the comprehensive case conference which discussed three cases in 1.5 h. Group A received the lecture and conference using a teleconference system (N = 43) and Group B attended in person (N = 23) for geographical reasons. After the conference, 32 subjects (23 in Group A and nine in Group B) scored their own post-lecture understanding of seizure semiology using the four-point Likert scale from 1 (not at all) to 4 (very well) as well as the estimated pre-lecture score. Data was analyzed to assess whether their understanding was improved after the lecture. RESULTS No significant difference was found in improvement of understanding after the lecture between Group A (43%) and Group B (22%; p = 0.42). Pre-lecture score of subjects with improved understanding was significantly lower (2.3 +/- 0.2) than those without improvement (3.7 +/- 0.1) (p < 0.05). SIGNIFICANCE Teleconference-based lectures can be a useful tool to educate seizure semiology for physicians, especially at the inexperienced level, by overcoming geographical limitations.
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Affiliation(s)
- Yosuke Kakisaka
- Department of Epileptology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.
| | - Kazutaka Jin
- Department of Epileptology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Mayu Fujikawa
- Department of Epileptology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Yu Kitazawa
- Department of Epileptology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Nobukazu Nakasato
- Department of Epileptology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
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Ben-Pazi H, Browne P, Chan P, Cubo E, Guttman M, Hassan A, Hatcher-Martin J, Mari Z, Moukheiber E, Okubadejo NU, Shalash A; International Parkinson and Movement Disorder Society Telemedicine Task Force. The Promise of Telemedicine for Movement Disorders: an Interdisciplinary Approach. Curr Neurol Neurosci Rep 2018; 18:26. [PMID: 29654523 DOI: 10.1007/s11910-018-0834-6] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
PURPOSE OF REVIEW Advances in technology have expanded telemedicine opportunities covering medical practice, research, and education. This is of particular importance in movement disorders (MDs), where the combination of disease progression, mobility limitations, and the sparse distribution of MD specialists increase the difficulty to access. In this review, we discuss the prospects, challenges, and strategies for telemedicine in MDs. RECENT FINDINGS Telemedicine for MDs has been mainly evaluated in Parkinson's disease (PD) and compared to in-office care is cost-effective with similar clinical care, despite the barriers to engagement. However, particular groups including pediatric patients, rare MDs, and the use of telemedicine in underserved areas need further research. Interdisciplinary telemedicine and tele-education for MDs are feasible, provide similar care, and reduce travel costs and travel time compared to in-person visits. These benefits have been mainly demonstrated for PD but serve as a model for further validation in other movement disorders.
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Martin P, Lizarondo L, Kumar S. A systematic review of the factors that influence the quality and effectiveness of telesupervision for health professionals. J Telemed Telecare 2017; 24:271-281. [PMID: 28387603 DOI: 10.1177/1357633x17698868] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction Whilst telesupervision (clinical supervision undertaken using communication technology) is being used more frequently, there is limited information on what factors influence its effectiveness and quality. We undertook this systematic review to address this gap. Methods Eligible telesupervision studies were identified following targeted search of electronic databases and the grey literature. Data were synthesised thematically, resulting in development of core themes. Results We identified 286 papers for initial relevancy screening by title and abstract. The full text of 36 papers were then retrieved and assessed for further relevance. A total of 11 papers were included in the final analysis. We identified eight themes that contribute to effective and high-quality telesupervision: supervisee characteristics, supervisor characteristics, supervision characteristics, supervisory relationship, communication strategies, prior face-to-face contact, environmental factors and technological considerations. Conclusion From the available evidence, telesupervision can be a feasible and acceptable form of clinical supervision if set up well. Further studies with robust designs are required to strengthen the existing evidence on what makes telesupervision effective, as well as to examine its cost-effectiveness.
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Affiliation(s)
- Priya Martin
- 1 International Centre for Allied Health Evidence (iCAHE), School of Health Sciences, University of South Australia, Australia.,2 Allied Health, Cunningham Centre, Darling Downs Hospital and Health Service, Australia
| | | | - Saravana Kumar
- 1 International Centre for Allied Health Evidence (iCAHE), School of Health Sciences, University of South Australia, Australia
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Kennedy CA, Warmington K, Flewelling C, Shupak R, Papachristos A, Jones C, Linton D, Beaton DE, Lineker S, Hogg-Johnson S. A prospective comparison of telemedicine versus in-person delivery of an interprofessional education program for adults with inflammatory arthritis. J Telemed Telecare 2016; 23:197-206. [PMID: 26957111 DOI: 10.1177/1357633x16635342] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction We evaluated two modes of delivery of an inflammatory arthritis education program ("Prescription for Education" (RxEd)) in improving arthritis self-efficacy and other secondary outcomes. Methods We used a non-randomized, pre-post design to compare videoconferencing (R, remote using telemedicine) versus local (I, in-person) delivery of the program. Data were collected at baseline (T1), immediately following RxEd (T2), and at six months (T3). Self-report questionnaires served as the data collection tool. Measures included demographics, disorder-related, Arthritis Self-Efficacy Scale (SE), previous knowledge (Arthritis Community Research and Evaluation Unit (ACREU) rheumatoid arthritis knowledge questionnaire), coping efficacy, Illness Intrusiveness, and Effective Consumer Scale. Analysis included: baseline comparisons and longitudinal trends (R vs I groups); direct between-group comparisons; and Generalized Estimating Equations (GEE) analysis. Results A total of 123 persons attended the program (I: n = 36; R: n = 87) and 111 completed the baseline questionnaire (T1), with follow-up completed by 95% ( n = 117) at T2 and 62% ( n = 76) at T3. No significant baseline differences were found across patient characteristics and outcome measures. Both groups (R and I) showed immediate effect (improved arthritis SE, mean change (95% confidence interval (CI)): R 1.07 (0.67, 1.48); I 1.48 (0.74, 2.23)) after the program that diminished over six months (mean change (95% CI): R 0.45 (-0.1, 0.1); I 0.73 (-0.25, 1.7)). For each of the secondary outcomes, both groups showed similar trends for improvement (mean change scores (95% CI)) over time. GEE analysis did not show any meaningful differences between groups (R vs I) over time. Discussion Improvements in arthritis self-efficacy and secondary outcomes displayed similar trends for I and R participant groups.
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Affiliation(s)
- Carol A Kennedy
- 1 Musculoskeletal Health and Outcomes Research, St. Michael's Hospital, Canada.,2 Institute for Work and Health, Canada.,3 Department of Physical Therapy, University of Toronto, Canada
| | - Kelly Warmington
- 4 Knowledge Translation, The Hospital for Sick Children, Canada.,5 Learning Institute, The Hospital for Sick Children, Canada
| | | | - Rachel Shupak
- 7 Martin Family Centre for Arthritis Care & Research, St. Michael's Hospital, Canada
| | - Angelo Papachristos
- 7 Martin Family Centre for Arthritis Care & Research, St. Michael's Hospital, Canada
| | - Caroline Jones
- 7 Martin Family Centre for Arthritis Care & Research, St. Michael's Hospital, Canada
| | - Denise Linton
- 1 Musculoskeletal Health and Outcomes Research, St. Michael's Hospital, Canada
| | - Dorcas E Beaton
- 1 Musculoskeletal Health and Outcomes Research, St. Michael's Hospital, Canada.,2 Institute for Work and Health, Canada.,8 Graduate Department of Health Policy, Management and Evaluation, University of Toronto, Canada.,9 Graduate Department of Rehabilitation Science, University of Toronto, Canada.,10 Department of Occupational Science and Occupational Therapy, University of Toronto, Canada
| | | | - Sheilah Hogg-Johnson
- 2 Institute for Work and Health, Canada.,12 Dalla Lana School of Public Health, University of Toronto, Canada
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Cubo E, Doumbe J, Njiengwe E, Onana P, Garoña R, Alcalde J, Seco J, Mariscal N, Epundugu BM, Cubo S, Coma MJ. A Parkinson's disease tele-education program for health care providers in Cameroon. J Neurol Sci 2015; 357:285-7. [PMID: 26190525 DOI: 10.1016/j.jns.2015.07.019] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Revised: 06/22/2015] [Accepted: 07/13/2015] [Indexed: 11/17/2022]
Abstract
BACKGROUND In Sub-Saharan countries, most patients with Parkinson's disease are underdiagnosed and untreated, with a marked shortage of qualified personnel. OBJECTIVES To develop a tele-education Parkison's disease program for health providers in Douala (Cameroon). METHODS Feasibility, satisfaction, pre-post course medical knowledge improvement and patients' access were analyzed. RESULTS Twenty lectures over the course of a year which connected participants with movement disorder experts using live, synchronous video conferences, and teaching materials were given. Thirty-three health professionals (52.4% women) including 16 doctors, and 17 allied health professionals and 18 speakers participated. Videoconferences were successfully completed in 80%, participation ranged from 20% to 70%, and satisfaction was at least above average in 70% of the participants. Whereas medical knowledge was dramatically improved, post-course patient access was not changed. CONCLUSION Tele-education for movement disorders in low-income countries is feasible. However, better access and patient care should be ensured as the final outcome for tele-health education. A sustainability plan is crucial to continue with this important need.
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Affiliation(s)
- Esther Cubo
- Neurology Department, Hospital Universitario Burgos, Burgos, Spain.
| | - Jacques Doumbe
- Neurology Department, Laquintinie Hospital, Burgos, Cameroon
| | - Erero Njiengwe
- Laboratory of Behavioral Sciences and Applied Psychology, University of Douala, Douala, Cameroon
| | - Paul Onana
- Recherche et Développement SkyVision Cameroon, Cameroon
| | | | | | | | | | | | - Sixto Cubo
- Department of Education Science, University of Extremadura, Spain
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Bansal M, Singh S, Maheshwari P, Adams D, McCulloch ML, Dada T, Sengupta SP, Kasliwal RR, Pellikka PA, Sengupta PP; VISION-in-Tele-Echo Study Investigators. Value of interactive scanning for improving the outcome of new-learners in transcontinental tele-echocardiography (VISION-in-Tele-Echo) study. J Am Soc Echocardiogr 2015; 28:75-87. [PMID: 25306222 DOI: 10.1016/j.echo.2014.09.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Indexed: 11/23/2022]
Abstract
BACKGROUND Point-of-care (POC) echocardiography may be helpful for mass triage, but such a strategy requires adequately trained sonographers at the remote site. The aim of this study was to test the feasibility of using a novel POC echocardiography training program for improving physicians' imaging skills during preanesthetic cardiac evaluations performed in a community camp organized for treating cataract blindness. METHODS Seventeen physicians were provided 6 hours of training in the use of POC echocardiography; nine were taught on site and eight were taught online through a transcontinental tele-echocardiography system. The trained physicians subsequently scanned elderly patients undergoing cataract surgery. The quality of images was graded, and agreement between local physicians' interpretations and Web-based interpretations by worldwide experts was compared. RESULTS A total of 968 studies were performed, with 660 used for validating physicians' competence. Major cardiac abnormalities were seen in 136 patients (14.2%), with 32 (3.3%) deemed prohibitive to surgery in unmonitored settings. Although good-quality images were obtained more frequently by physicians trained on site rather than online (P = .03), there were no differences between the two groups in agreement with expert interpretations. The majority of physicians (70.6%) expressed satisfaction with the training (average Likert-type scale score, 4.24 of 5), with no difference seen between the two groups. The training resulted in significant improvements in self-perceived competence in all components of POC echocardiography (P < .001 for all). CONCLUSIONS This study establishes the feasibility of using short-duration, one-on-one, personalized transcontinental tele-echocardiography education for wider dissemination of echocardiographic skills to local physicians in remote communities, essential for optimizing global cardiovascular health.
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Abstract
Telemedicine is rapidly developing telecommunication technology to provide medical information and services. The importance of telemedicine for neurosurgical emergencies was established with the fact that majority of the neurosurgical specialists are practicing in urban settings and in most of the rural areas, neurosurgical care is far off or non-existing. Countries with inadequate health care must incorporate telemedicine in their health care system. Telemedicine offers real benefits in a country as vast as India, where the majority of the population lives in remote areas with no access to even the most basic healthcare. Issues pertaining security, privacy, maintaining standards, and legal aspects are relevant. A recommended set of standards and guidelines for telemedicine needs to be set in place and constantly refined to promote the integrated growth of telemedicine in the country. The paper discusses various issues, shortcomings, and utility of telemedicine in India.
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Affiliation(s)
- Virendra Deo Sinha
- Department of Neurosurgery, SMS Medical College, Jaipur, Rajasthan, India
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