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Cline RJ, Haynes KM. Consumer health information seeking on the Internet: the state of the art. HEALTH EDUCATION RESEARCH 2001; 16:671-692. [PMID: 11780707 DOI: 10.1093/her/16.6.671] [Citation(s) in RCA: 860] [Impact Index Per Article: 35.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Increasingly, consumers engage in health information seeking via the Internet. Taking a communication perspective, this review argues why public health professionals should be concerned about the topic, considers potential benefits, synthesizes quality concerns, identifies criteria for evaluating online health information and critiques the literature. More than 70 000 websites disseminate health information; in excess of 50 million people seek health information online, with likely consequences for the health care system. The Internet offers widespread access to health information, and the advantages of interactivity, information tailoring and anonymity. However, access is inequitable and use is hindered further by navigational challenges due to numerous design features (e.g. disorganization, technical language and lack of permanence). Increasingly, critics question the quality of online health information; limited research indicates that much is inaccurate. Meager information-evaluation skills add to consumers' vulnerability, and reinforce the need for quality standards and widespread criteria for evaluating health information. Extant literature can be characterized as speculative, comprised of basic 'how to' presentations, with little empirical research. Future research needs to address the Internet as part of the larger health communication system and take advantage of incorporating extant communication concepts. Not only should research focus on the 'net-gap' and information quality, it also should address the inherently communicative and transactional quality of Internet use. Both interpersonal and mass communication concepts open avenues for investigation and understanding the influence of the Internet on health beliefs and behaviors, health care, medical outcomes, and the health care system.
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Review |
24 |
860 |
2
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Chumley-Jones HS, Dobbie A, Alford CL. Web-based learning: sound educational method or hype? A review of the evaluation literature. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2002; 77:S86-93. [PMID: 12377715 DOI: 10.1097/00001888-200210001-00028] [Citation(s) in RCA: 283] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
MESH Headings
- Attitude of Health Personnel
- Computer-Assisted Instruction/economics
- Computer-Assisted Instruction/standards
- Costs and Cost Analysis
- Education, Dental/economics
- Education, Dental/methods
- Education, Medical/economics
- Education, Medical/methods
- Education, Nursing/economics
- Education, Nursing/methods
- Educational Measurement
- Evaluation Studies as Topic
- Humans
- Internet/economics
- Internet/standards
- Models, Educational
- Program Evaluation/economics
- Program Evaluation/methods
- Program Evaluation/standards
- Students, Dental/psychology
- Students, Medical/psychology
- Students, Nursing/psychology
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Review |
23 |
283 |
3
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Bosseler A, Massaro DW. Development and Evaluation of a Computer-Animated Tutor for Vocabulary and Language Learning in Children with Autism. J Autism Dev Disord 2003; 33:653-72. [PMID: 14714934 DOI: 10.1023/b:jadd.0000006002.82367.4f] [Citation(s) in RCA: 208] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Using our theoretical framework of multimodal processing, we developed and evaluated a computer-animated tutor, Baldi, to teach vocabulary and grammar for children with autism. Baldi was implemented in a Language Wizard/Player, which allows easy creation and presentation of a language lesson involving the association of pictures and spoken words. The lesson plan includes both the identification of pictures and the production of spoken words. In Experiment 1, eight children were given initial assessment tests, tutorials, and reassessment tests 30 days following mastery of the vocabulary items. All of the students learned a significant number of new words and grammar. A second within-subject design with six children followed a multiple baseline design and documented that the program was responsible for the learning and generalization of new words. The research indicates that children with autism are capable of learning new language within an automated program centered around a computer-animated agent, multimedia, and active participation and can transfer and use the language in a natural, untrained environment.
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22 |
208 |
4
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Downs M, Turner S, Bryans M, Wilcock J, Keady J, Levin E, O'Carroll R, Howie K, Iliffe S. Effectiveness of educational interventions in improving detection and management of dementia in primary care: cluster randomised controlled study. BMJ 2006; 332:692-6. [PMID: 16565124 PMCID: PMC1410839 DOI: 10.1136/bmj.332.7543.692] [Citation(s) in RCA: 148] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/23/2006] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To test the effectiveness of educational interventions in improving detection rates and management of dementia in primary care. DESIGN Unblinded, cluster randomised, before and after controlled study. SETTING General practices in the United Kingdom (central Scotland and London) between 1999 and 2002. INTERVENTIONS Three educational interventions: an electronic tutorial carried on a CD Rom; decision support software built into the electronic medical record; and practice based workshops. PARTICIPANTS 36 practices participated in the study. Eight practices were randomly assigned to the electronic tutorial; eight to decision support software; 10 to practice based workshops; and 10 to control. Electronic and manual searches yielded 450 valid and usable medical records. MAIN OUTCOME MEASURES Rates of detection of dementia and the extent to which medical records showed evidence of improved concordance with guidelines regarding diagnosis and management. RESULTS Decision support software (P = 0.01) and practice based workshops (P = 0.01) both significantly improved rates of detection compared with control. There were no significant differences by intervention in the measures of concordance with guidelines. CONCLUSIONS Decision support systems and practice based workshops are effective educational approaches in improving detection rates in dementia.
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Multicenter Study |
19 |
148 |
5
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Glasgow RE, La Chance PA, Toobert DJ, Brown J, Hampson SE, Riddle MC. Long-term effects and costs of brief behavioural dietary intervention for patients with diabetes delivered from the medical office. PATIENT EDUCATION AND COUNSELING 1997; 32:175-184. [PMID: 9423499 DOI: 10.1016/s0738-3991(97)00039-6] [Citation(s) in RCA: 132] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
This study evaluated the 12-month follow-up results and costs of a personalized, medical office-based intervention focused on behavioral issues related to dietary self-management. Two hundred and six adults having diabetes attending an internal medicine outpatient clinic visit were randomized to either Usual Care or to Brief Intervention. The single session intervention involved touchscreen computer-assisted assessment that provided immediate feedback on key barriers to dietary self-management, goal setting and problem-solving counselling. Follow-up components included phone calls and videotape intervention relevant to each participant. Brief Intervention produced significantly greater improvement than Usual Care on multiple measures of change in dietary behaviour (e.g., covariate adjusted difference of 2.2% of calories from fat; p = 0.023) and on serum cholesterol levels (covariate adjusted difference of 15 mg/dl; p = 0.002) at 12-month follow-up. There were also significant differences favouring intervention on patient satisfaction (p < 0.02) but not on HbA1c levels. The costs of intervention ($137 per patient) were modest relative to many commonly used practices.
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Clinical Trial |
28 |
132 |
6
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Mahmood T, Darzi A. The learning curve for a colonoscopy simulator in the absence of any feedback: no feedback, no learning. Surg Endosc 2004; 18:1224-30. [PMID: 15457382 DOI: 10.1007/s00464-003-9143-4] [Citation(s) in RCA: 129] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2003] [Accepted: 03/04/2004] [Indexed: 12/12/2022]
Abstract
BACKGROUND The hypothesis of this study is that working on the simulator without a structured feedback does not change performance; hence, any effects shown after structured feedback would amount to useful learning of the procedure. The aim was to investigate the learning curve for the HT Immersion Medical Colonoscopy Simulator without any structured feedback. This could then be potentially applied to validate the learning curve on the simulator when structured feedback is provided. There are no previous studies on this matter. METHODS Candidates were asked to perform colonoscopy on the HT Immersion Medical Colonoscopy Simulator. Modules 3 and 4 were used at random. In total, each candidate was asked to perform five consecutive virtual colonoscopies on the same module. These five episodes were collectively referred to as one trial. A time result of 3,600 sec (1 h) was used to denote perforation. No guidance or feedback was given to candidates before, during, or after each procedure. A total of 26 postgraduate doctors were recruited, including nine research fellows, five preregistration house officers, six specialist registrars, and six consultants. Fourteen candidates recorded five attempts each (i.e., one trial each) on the same module of the colonoscopy simulator (14 trials over 70 episodes). Another 12 candidates recorded five attempts (i.e., one trial each) on two modules of the colonoscopy simulator (24 trials over 120 episodes). Hence, 190 episodes were recorded in total, representing 38 trials. RESULTS There was no improvement in performance on the simulator from first attempt to the fifth in the absence of feedback. If there was any initial gain in any measurable outcome, this was lost in subsequent attempts indicating lack of learning. The outcomes measured included time taken to complete the test, percentage of the mucosa visualized, depth of the instrument inserted, and the path length used. The results were statistically significant for all outcomes. CONCLUSIONS This study demonstrates that in the absence of feedback, it is not possible to improve performance on the HT Immersion Medical Colonoscopy Simulator. Thus, there is no learning curve for the machine. The information from this study is vital for using the simulators in training and assessment because any improvement in learning curves shown after training on simulators can be presumed to be due to learning the procedure and not the simulator.
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Randomized Controlled Trial |
21 |
129 |
7
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Abstract
AIMS To describe the experiences of registered nurses (RNs) who enrolled in a web-based course from either their home or the workplace. RATIONALE In order to maintain competency in rapidly changing health care systems, and meet the challenge of overcoming traditional barriers to continuing education, RNs need access to innovative educational delivery methods. As yet, little is known about the web-based learners' experience, particularly when courses are accessed from the nursing practice setting. METHODS The article focuses on the results from questionnaires conducted with 57 RNs enrolled in a web-based, postdiploma course. These findings emanate from a larger study using survey method and focus group interviews. Nurses' experiences were measured using the Online Learner Support Instrument which was developed and tested for use in the study. RESULTS Most nurses found the course highly satisfactory. Not all experiences were positive however, and a number of challenges were faced. Access to the course from home was reported as very satisfactory for the majority, while work users encountered a number of serious barriers such as insufficient time and limited computer access. The RNs made significant gains in their learning with e-mail, Internet, keyboarding and word processing skills during the 16-week course. Lack of computer skills, erroneous perceptions of course workload and inadequate preparation for web learning were largely responsible for the majority of withdrawals. CONCLUSION Web-based learning can be an effective mode of delivery for nursing education. Advance preparation by educational institutions, employers and prospective students is essential. Teachers, peers, technology, course design and the learning environment are key variables that influence the learners' experience and success.
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Evaluation Study |
23 |
117 |
8
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Garg AX, Norman GR, Eva KW, Spero L, Sharan S. Is there any real virtue of virtual reality?: the minor role of multiple orientations in learning anatomy from computers. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2002; 77:S97-S99. [PMID: 12377717 DOI: 10.1097/00001888-200210001-00030] [Citation(s) in RCA: 116] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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Evaluation Study |
23 |
116 |
9
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Levinson AJ, Weaver B, Garside S, McGinn H, Norman GR. Virtual reality and brain anatomy: a randomised trial of e-learning instructional designs. MEDICAL EDUCATION 2007; 41:495-501. [PMID: 17470079 DOI: 10.1111/j.1365-2929.2006.02694.x] [Citation(s) in RCA: 112] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
CONTEXT Computer-aided instruction is used increasingly in medical education and anatomy instruction with limited research evidence to guide its design and deployment. OBJECTIVES To determine the effects of (a) learner control over the e-learning environment and (b) key views of the brain versus multiple views in the learning of brain surface anatomy. DESIGN Randomised trial with 2 phases of study. Participants Volunteer sample of 1st-year psychology students (phase 1, n = 120; phase 2, n = 120). Interventions Phase 1: computer-based instruction in brain surface anatomy with 4 conditions: (1) learner control/multiple views (LMV); (2) learner control/key views (LKV); (3) programme control/multiple views (PMV); (4) programme control/key views (PKV). Phase 2: 2 conditions: low learner control/key views (PKV) versus no learner control/key views (SKV). All participants performed a pre-test, post-test and test of visuospatial ability. MAIN OUTCOME MEASURES A 30-item post-test of brain surface anatomy structure identification. RESULTS The PKV group attained the best post-test score (57.7%) and the PMV group received the worst (42.2%), with the 2 high learner control groups performing in between. For students with low spatial ability, estimated scores are 20% lower for those who saw multiple views during learning. In phase 2, students with the most static condition and no learner control (SKV) performed similarly to those students in the PKV group. CONCLUSIONS Multiple views may impede learning, particularly for those with relatively poor spatial ability. High degrees of learner control may reduce effectiveness of learning.
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Randomized Controlled Trial |
18 |
112 |
10
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Bartholomew LK, Gold RS, Parcel GS, Czyzewski DI, Sockrider MM, Fernandez M, Shegog R, Swank P. Watch, Discover, Think, and Act: evaluation of computer-assisted instruction to improve asthma self-management in inner-city children. PATIENT EDUCATION AND COUNSELING 2000; 39:269-280. [PMID: 11040726 DOI: 10.1016/s0738-3991(99)00046-4] [Citation(s) in RCA: 100] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
An interactive multimedia computer game to enhance self-management skills and thereby improve asthma outcomes in inner city children with asthma was evaluated. Subjects aged 6-17 were recruited from four pediatric practices and randomly assigned to the computer intervention condition or to the usual-care comparison. The main character in the game could match the subject on gender and ethnicity. Characteristics of the protagonist's asthma were tailored to be like those of the subject. Subjects played the computer game as part of regular asthma visits. Time between pre- and post-test varied from 4 to 15.6 months (mean, 7.6 months). Analysis of covariance, with pre-test scores, age, and asthma severity as covariates, found that the intervention was associated with fewer hospitalizations, better symptom scores, increased functional status, greater knowledge of asthma management, and better child self-management behavior for those in the intervention condition. Interactions with covariates were found and discussed in terms of variable efficacy of the intervention.
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Clinical Trial |
25 |
100 |
11
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Abstract
AIMS The purpose of the study was to describe Registered Nurses' experiences when taking a web-based course from either the workplace or home, and the impact of their learning on clinical practice. RATIONALE Little is known about the web-based learners' experience, particularly when courses are accessed from the nursing practice setting. Even less is known about whether nurses transfer their web-based learning to clinical practice. METHODS A qualitative design employing focus group interviews was used. Participants included hospital and community nurses from three Canadian provinces and one territory. Data were collected at three points over a 6-month period and analysed using a thematic analysis process. These findings emanate from a larger study using survey method and focus group interviews. RESULTS The focus group interviews captured the hurdles nurses faced during the first weeks when they struggled with technology, re-framed their views of teaching and adjusted to web-based learning from home and work. These first stressful weeks were followed by a period during which nurses developed relationships with the teacher and peers that enabled them to focus on learning and prevented attrition. Most nurses reported the web course was convenient and that they would be interested and comfortable using technology for learning and work purposes in the future. Six weeks after the course was completed, nurses articulated a number of ways the course had improved their practice. CONCLUSION Initial weeks in a web-based course can be very challenging for novice Internet users, however, most nurses who completed the course reported a positive learning experience. Nurses, employers and educators should evaluate computer skills, computer access and the learning environment when preparing for web-based learning.
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Research Support, Non-U.S. Gov't |
21 |
95 |
12
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Reilly A, Spratt C. The perceptions of undergraduate student nurses of high-fidelity simulation-based learning: a case report from the University of Tasmania. NURSE EDUCATION TODAY 2007; 27:542-50. [PMID: 17069935 DOI: 10.1016/j.nedt.2006.08.015] [Citation(s) in RCA: 94] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2006] [Revised: 06/05/2006] [Accepted: 08/29/2006] [Indexed: 05/12/2023]
Abstract
This paper reports a qualitatively informed curriculum research project in the three-year Bachelor of Nursing (BN) at the School of Nursing and Midwifery (SNM) at the University of Tasmania. The project investigated the perceptions of second year undergraduate nurses and their academic teachers of their experiences of high-fidelity simulation using the Laerdal Vital Sim Nursing Kelly and Nursing Anne technology(2) as part of their preparation for clinical practice. An associated curriculum benchmarking audit was also undertaken. A voluntary purposeful sample of students enrolled in a clinically-based practise unit(3) participated in the research, along with a small cohort of academic teachers. The results indicated that undergraduate nursing students value the opportunity to practice nursing activities in a safe environment prior to clinical placement. Students believed that simulation is an innovative strategy that promotes active learning and has great potential for developing clinical competence and increasing confidence prior to practise. The academic staff reported a similar belief about the potential of high-fidelity simulation in a case-based curriculum. The associated curriculum benchmarking audit provided evidence to support further integration of high-fidelity simulation in the undergraduate nursing program.
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18 |
94 |
13
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Zary N, Johnson G, Boberg J, Fors UGH. Development, implementation and pilot evaluation of a Web-based Virtual Patient Case Simulation environment--Web-SP. BMC MEDICAL EDUCATION 2006; 6:10. [PMID: 16504041 PMCID: PMC1397827 DOI: 10.1186/1472-6920-6-10] [Citation(s) in RCA: 91] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2005] [Accepted: 02/21/2006] [Indexed: 05/04/2023]
Abstract
BACKGROUND The Web-based Simulation of Patients (Web-SP) project was initiated in order to facilitate the use of realistic and interactive virtual patients (VP) in medicine and healthcare education. Web-SP focuses on moving beyond the technology savvy teachers, when integrating simulation-based education into health sciences curricula, by making the creation and use of virtual patients easier. The project strives to provide a common generic platform for design/creation, management, evaluation and sharing of web-based virtual patients. The aim of this study was to evaluate if it was possible to develop a web-based virtual patient case simulation environment where the entire case authoring process might be handled by teachers and which would be flexible enough to be used in different healthcare disciplines. RESULTS The Web-SP system was constructed to support easy authoring, management and presentation of virtual patient cases. The case authoring environment was found to facilitate for teachers to create full-fledged patient cases without the assistance of computer specialists. Web-SP was successfully implemented at several universities by taking into account key factors such as cost, access, security, scalability and flexibility. Pilot evaluations in medical, dentistry and pharmacy courses shows that students regarded Web-SP as easy to use, engaging and to be of educational value. Cases adapted for all three disciplines were judged to be of significant educational value by the course leaders. CONCLUSION The Web-SP system seems to fulfil the aim of providing a common generic platform for creation, management and evaluation of web-based virtual patient cases. The responses regarding the authoring environment indicated that the system might be user-friendly enough to appeal to a majority of the academic staff. In terms of implementation strengths, Web-SP seems to fulfil most needs from course directors and teachers from various educational institutions and disciplines. The system is currently in use or under implementation in several healthcare disciplines at more than ten universities worldwide. Future aims include structuring the exchange of cases between teachers and academic institutions by building a VP library function. We intend to follow up the positive results presented in this paper with other studies looking at the learning outcomes, critical thinking and patient management. Studying the potential of Web-SP as an assessment tool will also be performed. More information about Web-SP: http://websp.lime.ki.se.
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product-review |
19 |
91 |
14
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Campbell FA, Goldman BD, Boccia ML, Skinner M. The effect of format modifications and reading comprehension on recall of informed consent information by low-income parents: a comparison of print, video, and computer-based presentations. PATIENT EDUCATION AND COUNSELING 2004; 53:205-216. [PMID: 15140461 DOI: 10.1016/s0738-3991(03)00162-9] [Citation(s) in RCA: 85] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2002] [Revised: 04/10/2003] [Accepted: 04/24/2003] [Indexed: 05/24/2023]
Abstract
A randomized trial comparing the amount of knowledge orally recalled from four different presentations of the same consent information was conducted in a non-clinic sample of 233 low-income parents who displayed a range of reading comprehension skill. The study simulated recruitment of children into one of two actual studies underway at another location: one involved high risk to participants, the other did not. Use of a non-clinic sample controlled for prior knowledge of the conditions, and avoiding discussion of the information further assured that differences in recalled information could be attributed more confidently to the format itself. The formats included the original written forms, enhanced print (simpler language, topic headings, pictures), narrated videotapes, and self-paced PowerPoint presentations via laptop computer with bulleted print information, pictures, and narration. No format-related differences in recalled information were found in the full sample but for the 124 individuals with reading comprehension scores at or below the 8th grade level, the enhanced print version tended to be more effective than either the original form or the video. Across all formats, more information was recalled about the low-risk study. The findings emphasize the necessity for clinicians and researchers to verify understanding of consent information, especially when there is risk of reduced literacy skill. Reliance on video to convey information in preference to well-done print media appeared questionable.
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Clinical Trial |
21 |
85 |
15
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Abstract
Using the Internet to deliver nursing courses via distance education can facilitate learning on demand and promote learner-centered instruction. The authors describe 20 graduate nursing students' experiences with online learning. Students learn through reflection, exploration, use of critical thinking, interacting with others, sharing of information, and using resources. Key points of students' experiences with online learning were consistent with the Constructivism Theory. Implications for improving teaching are based upon the Constructivism Theory and include strategies for identifying learning goals and conditions for learning, as well as planning and implementing various methods of instruction.
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21 |
82 |
16
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Abstract
BACKGROUND The need to integrate information technology into nursing education has been recognized and well documented. In spite of this, information technology remains a neglected subject in many nursing programmes. Strategies have been considered for increasing the integration of information technology in nursing education. One of the key issues identified is the need for research into the factors that contribute to optimal learning with information technology, specifically the need to explore issues that contribute to student frustration and satisfaction with learning. Within Australia, the incorporation of information technology as a core subject in nursing education is still relatively new. This article describes how one university used 'online' learning to expose students to conceptual and experiential opportunities that enabled them to develop skills in the management of information technology. METHODS Twenty-one students participated in this qualitative study. Individual interviews were used to develop insights into student perceptions. Thematic analysis enabled refined themes to emerge. These themes formed the basis of focus group discussions. Focus groups were used to enhance and validate the information from one-to-one interviews by using group dynamics to add experiential richness to the data. FINDINGS Four major themes emerged: computer confidence, flexibility, active learning and practicalities of teaching. CONCLUSIONS The integration of information technology into nursing education requires a dramatic change in thinking. The 'learning curve' is steep for both student and educator and there are many issues that need to be considered. This research does not aim to provide solutions to the issues highlighted but rather offers recommendations for enhancing the teaching and learning experience.
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23 |
82 |
17
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Wofford JL, Smith ED, Miller DP. The multimedia computer for office-based patient education: a systematic review. PATIENT EDUCATION AND COUNSELING 2005; 59:148-57. [PMID: 16257619 DOI: 10.1016/j.pec.2004.10.011] [Citation(s) in RCA: 80] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2004] [Revised: 10/06/2004] [Accepted: 10/16/2004] [Indexed: 05/05/2023]
Abstract
Use of the multimedia computer for education is widespread in schools and businesses, and yet computer-assisted patient education is rare. In order to explore the potential use of computer-assisted patient education in the office setting, we performed a systematic review of randomized controlled trials (search date April 2004 using MEDLINE and Cochrane databases). Of the 26 trials identified, outcome measures included clinical indicators (12/26, 46.1%), knowledge retention (12/26, 46.1%), health attitudes (15/26, 57.7%), level of shared decision-making (5/26, 19.2%), health services utilization (4/26, 17.6%), and costs (5/26, 19.2%), respectively. Four trials targeted patients with breast cancer, but the clinical issues were otherwise diverse. Reporting of the testing of randomization (76.9%) and appropriate analysis of main effect variables (70.6%) were more common than reporting of a reliable randomization process (35.3%), blinding of outcomes assessment (17.6%), or sample size definition (29.4%). We concluded that the potential for improving the efficiency of the office through computer-assisted patient education has been demonstrated, but better proof of the impact on clinical outcomes is warranted before this strategy is accepted in the office setting.
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Review |
20 |
80 |
18
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Patten CA, Croghan IT, Meis TM, Decker PA, Pingree S, Colligan RC, Dornelas EA, Offord KP, Boberg EW, Baumberger RK, Hurt RD, Gustafson DH. Randomized clinical trial of an Internet-based versus brief office intervention for adolescent smoking cessation. PATIENT EDUCATION AND COUNSELING 2006; 64:249-58. [PMID: 16616449 DOI: 10.1016/j.pec.2006.03.001] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2005] [Revised: 01/31/2006] [Accepted: 03/01/2006] [Indexed: 05/06/2023]
Abstract
OBJECTIVE Evaluation of novel treatment delivery methods, such as the Internet are notably absent from the adolescent smoking treatment literature. METHODS Adolescent smokers ages 11-18 years were randomized to a clinic-based, brief office intervention (BOI; N=69) consisting of four individual counseling sessions; or to Stomp Out Smokes (SOS), an Internet, home-based intervention (N=70). Adolescents in SOS had access to the SOS site for 24 weeks. RESULTS The 30-day, point-prevalence smoking abstinence rates for BOI and SOS were 12% versus 6% at week 24 and 13% versus 6% at week 36, with no significant treatment differences. Among participants who continued to smoke, SOS was associated with a significantly greater reduction in average number of days smoked than BOI (P=0.006). The BOI was found to be feasible with high session attendance rates. SOS participants accessed the site a mean+/-S.D. of 6.8+/-7.1 days. SOS use dropped to less than one-third of participants by week 3. CONCLUSION Additional research is needed to tap the potential capabilities of the Internet for adolescent smoking cessation using proactive, personalized, patient-education components. PRACTICE IMPLICATIONS Augmenting the SOS type of intervention with more structured, personal and proactive patient-education components delivered in-person or by telephone or electronic mail is recommended.
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Comparative Study |
19 |
78 |
19
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Cook DA, Ellaway RH. Evaluating technology-enhanced learning: A comprehensive framework. MEDICAL TEACHER 2015; 37:961-70. [PMID: 25782599 DOI: 10.3109/0142159x.2015.1009024] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
BACKGROUND The absence of a standard, comprehensive approach to evaluating technology-enhanced learning (TEL) limits the utility of individual evaluations, and impedes the integration and synthesis of results across studies. PURPOSE To outline a comprehensive framework for approaching TEL evaluation in medical education, and to develop instruments for measuring the perceptions of TEL learners and instructors. METHODS AND RESULTS Using both theoretical constructs of inquiry in education and a synthesis of existing models and instruments, we outlined a general model for evaluation that links utility, principles, and practices. From this we derived a framework for TEL evaluation that identifies seven data collection activities: needs analysis; documentation of processes, decisions, and final product; usability testing; observation of implementation; assessment of participant experience; assessment of learning outcomes; and evaluation of cost, reusability, and sustainability. We then used existing quality standards and approaches to develop instruments for assessing the experiences of learners and instructors using TEL. CONCLUSIONS No single evaluation is likely to collect all of this information, nor would any single audience likely find all information elements equally useful. However, consistent use of a common evaluation framework across different courses and institutions would avoid duplication of effort and allow cross-course comparisons.
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10 |
76 |
20
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Abstract
OBJECTIVES To evaluate the outcome of training both urological novices and experts, using the recently developed UroMentor (Simbionix Ltd, Israel) trainer, that provides a realistic simulation of rigid and flexible ureterorenoscopy (URS). SUBJECTS AND METHODS Twenty experienced urologists (total number of previous flexible URSs 21-153) were monitored during simulated flexible URS for treating a lower calyceal stone, and the outcome was correlated with individual experience. A score was compiled based on the variables recorded, including total operation time, stone contact time, complications such as bleeding or perforation, and treatment success. A further five urological residents with no endourological experience were trained on the UroMentor in rigid URS for ureteric stone treatment. Their acquired clinical skills were subsequently compared to those of five urological residents who received no simulator training. RESULTS All 20 experienced urologists disintegrated the stone on the simulator, and the score achieved was related to their personal experience; there was a significant difference in performance in those with < 40 and > 80 previous flexible URSs. For the five urological residents with no endourological experience, simulator training improved their skills, and comparison with urological residents who had received no simulator training showed advantages for the trained residents. After being trained on the simulator, the group performed better in the first four URSs on patients. CONCLUSIONS Individual experience correlates with individual performance on the simulator. Simulator training was helpful in improving clinical skills. Although the distribution of computer-based simulators is limited by high prices, virtual reality-based training has the potential to become an important tool for clinical education.
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Raikos A, Waidyasekara P. How useful is YouTube in learning heart anatomy? ANATOMICAL SCIENCES EDUCATION 2014; 7:12-8. [PMID: 23564745 DOI: 10.1002/ase.1361] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Revised: 01/17/2012] [Accepted: 02/15/2013] [Indexed: 05/06/2023]
Abstract
Nowadays more and more modern medical degree programs focus on self-directed and problem-based learning. That requires students to search for high quality and easy to retrieve online resources. YouTube is an emerging platform for learning human anatomy due to easy access and being a free service. The purpose of this study is to make a quantitative and qualitative analysis of the available human heart anatomy videos on YouTube. Using the search engine of the platform we searched for relevant videos using various keywords. Videos with irrelevant content, animal tissue, non-English language, no sound, duplicates, and physiology focused were excluded from further elaboration. The initial search retrieved 55,525 videos, whereas only 294 qualified for further analysis. A unique scoring system was used to assess the anatomical quality and details, general quality, and the general data for each video. Our results indicate that the human heart anatomy videos available on YouTube conveyed our anatomical criteria poorly, whereas the general quality scoring found borderline. Students should be selective when looking up on public video databases as it can prove challenging, time consuming, and the anatomical information may be misleading due to absence of content review. Anatomists and institutions are encouraged to prepare and endorse good quality material and make them available online for the students. The scoring rubric used in the study comprises a valuable tool to faculty members for quality evaluation of heart anatomy videos available on social media platforms.
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Chen BY, Kern DE, Kearns RM, Thomas PA, Hughes MT, Tackett S. From Modules to MOOCs: Application of the Six-Step Approach to Online Curriculum Development for Medical Education. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2019; 94:678-685. [PMID: 30681454 DOI: 10.1097/acm.0000000000002580] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Online curricula can make high-quality health professions education accessible in virtually any setting. They can enhance teaching and learning by both standardizing curricular resources and individualizing curricular experiences. Despite growing demand for and institutional interest in online curricula for medical education, many medical educators lack a framework for online curriculum development. Without rigorous and thoughtful development, online curricula can waste opportunity and resources by leading to education that is inferior to traditional methods. In this article, the authors describe a systematic approach to online curriculum development based on the Six-Step Approach for Curriculum Development for Medical Education, a widely used method that has led to successful implementation of a variety of traditional and online curricula. In each step, special considerations for curricula with larger and more diverse learner audiences-characteristic of many online curricula-are highlighted. Four common online curricular formats are also discussed: blended curricula, instructor-led fully online curricula, self-paced modules, and massive open online courses (MOOCs). The authors emphasize factors that differentiate one online format from another, including the budgetary, technical, and human resource requirements for each. The article concludes by urging medical educators to pursue opportunities to study and disseminate online curricular work.
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Abstract
The purpose of this study was to review quantitative studies related to computer-based simulation and healthcare education and determine the effect of simulation on education and learning. A total of 513 references were retrieved, but only 9 quantitative studies met the inclusion criteria. To synthesize the data, the mean scores and standard deviations of the studies were used to determine the effect size, the index, and the direction of the effect. This review indicates that 75% of the studies showed positive effects of simulation on skill and/or knowledge acquisition. The potential of computer-based simulation as an education augmentation is enormous, but research is needed to determine effective and successful uses of high-fidelity simulations for nursing education.
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Review |
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Abstract
PURPOSE To test the effects of a classroom and World Wide Web (WWW) educational intervention on self-efficacy (SE) for healthy eating (HE) and to examine the relationship of the theoretical concepts in a hypothesized model of eating behavior in adolescents. DESIGN A quasiexperimental pretest, posttest design was used in a random sample of students in two junior high schools. METHODS The intervention consisted of a combination of 5 hours of Web-based instruction and 10 hours of classroom curriculum, compared to nutrition education embedded in the standard school curriculum during a 1-month period. Participants completed six questionnaires. Data were analyzed using descriptive statistics, t tests, and Pearson's r correlation coefficient. FINDINGS AND CONCLUSIONS The intervention group had significantly higher scores for SE for fruits and vegetables, SE for lower fat, usual food choices, and dietary knowledge of fat compared to the control group. No difference was found between groups in food consumption. Self-efficacy was significantly associated with dietary knowledge of lower fat, usual food choices, and was inversely associated with lower-fat consumption in the hypothesized model of eating behavior. The intervention was tailored to the social and developmental preferences of adolescents and effectively increased SE for HE. The mediating role of SE in the hypothesized model of adolescent eating behavior warrants further investigation.
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Randomized Controlled Trial |
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Letterie GS. Medical education as a science: the quality of evidence for computer-assisted instruction. Am J Obstet Gynecol 2003; 188:849-53. [PMID: 12634669 DOI: 10.1067/mob.2003.168] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE A marked increase in the number of computer programs for computer-assisted instruction in the medical sciences has occurred over the past 10 years. The quality of both the programs and the literature that describe these programs has varied considerably. The purposes of this study were to evaluate the published literature that described computer-assisted instruction in medical education and to assess the quality of evidence for its implementation, with particular emphasis on obstetrics and gynecology. STUDY DESIGN Reports published between 1988 and 2000 on computer-assisted instruction in medical education were identified through a search of MEDLINE and Educational Resource Identification Center and a review of the bibliographies of the articles that were identified. Studies were selected if they included a description of computer-assisted instruction in medical education, regardless of the type of computer program. Data were extracted with a content analysis of 210 reports. The reports were categorized according to study design (comparative, prospective, descriptive, review, or editorial), type of computer-assisted instruction, medical specialty, and measures of effectiveness. RESULTS Computer-assisted instruction programs included online technologies, CD-ROMs, video laser disks, multimedia work stations, virtual reality, and simulation testing. Studies were identified in all medical specialties, with a preponderance in internal medicine, general surgery, radiology, obstetrics and gynecology, pediatrics, and pathology. Ninety-six percent of the articles described a favorable impact of computer-assisted instruction in medical education, regardless of the quality of the evidence. Of the 210 reports that were identified, 60% were noncomparative, descriptive reports of new techniques in computer-assisted instruction, and 15% and 14% were reviews and editorials, respectively, of existing technology. Eleven percent of studies were comparative and included some form of assessment of the effectiveness of the computer program. These assessments included pre- and posttesting and questionnaires to score program quality, perceptions of the medical students and/or residents regarding the program, and impact on learning. In one half of these comparative studies, computer-assisted instruction was compared with traditional modes of teaching, such as text and lectures. Six studies compared performance before and after the computer-assisted instruction. Improvements were shown in 5 of the studies. In the remainder of the studies, computer-assisted instruction appeared to result in similar test performance. Despite study design or outcome, most articles described enthusiastic endorsement of the programs by the participants, including medical students, residents, and practicing physicians. Only 1 study included cost analysis. Thirteen of the articles were in obstetrics and gynecology. CONCLUSION Computer-assisted instruction has assumed to have an increasing role in medical education. In spite of enthusiastic endorsement and continued improvements in software, few studies of good design clearly demonstrate improvement in medical education over traditional modalities. There are no comparative studies in obstetrics and gynecology that demonstrate a clear-cut advantage. Future studies of computer-assisted instruction that include comparisons and cost assessments to gauge their effectiveness over traditional methods may better define their precise role.
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Evaluation Study |
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60 |