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Hill J, Gratton N, Kulkarni A, Hamer O, Harrison J, Harris C, Chesters J, Duddy E, Collins L, Clegg A. The effectiveness of evidence-based healthcare educational interventions on healthcare professionals' knowledge, skills, attitudes, professional practice and healthcare outcomes: Systematic review and meta-analysis. J Eval Clin Pract 2024. [PMID: 38817022 DOI: 10.1111/jep.14001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 03/25/2024] [Accepted: 04/07/2024] [Indexed: 06/01/2024]
Abstract
OBJECTIVE The primary aim of this systematic review is to assess the effectiveness of evidence-based healthcare (EBHC) educational interventions on healthcare professionals' knowledge, skills, attitudes, behaviour of EBHC, clinical process and care outcomes. A secondary aim of the review is to assess the effects of important pedagogical moderating factors for EBHC educational interventions. METHOD This systematic review used a forward and backward citation search strategy on the Web of Science platform (date of inception to 28 April 2023). Only randomised controlled trials (RCTs) and cluster RCTs which compared EBHC educational interventions for healthcare professionals were included. A random effects meta-analysis was undertaken for EBHC compared with an active and nonactive control for all outcomes. RESULTS Sixty-one RCTs were identified which included a total of 5208 healthcare professionals. There was a large effect for EBHC educational interventions compared with waiting list/no treatment/sham control on knowledge (SMD, 2.69; 95% CI, 1.26-4.14, GRADE Low), skills (SMD, 0.88; 95% CI, 0.25-1.73, Very Low Certainty), attitude (SMD, 0.81; 95% CI, 0.16-1.47, Very Low Certainty) and behaviour of EBHC (SMD, 0.82; 95% CI, 0.25-1.40, Very Low Certainty). Over time the effect of EBHC educational interventions substantially decreased with no evidence of effect at 6 months for any outcome except behaviour (SMD,1.72; 95% CI, 0.74-2.71, Low Certainty). There was some evidence that blended learning, active learning and consistency in the individual delivering the intervention may be important positive moderating factors. CONCLUSION These findings suggest that EBHC educational interventions may have a large short-term effect on improving healthcare professionals' knowledge, skills, attitude and behaviour of EBHC. These effects may be longer-lasting regarding EBHC behaviour. In terms of pedagogy, blended learning, active learning, and consistency of the individual delivering the intervention may be important positive moderating factors.
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Affiliation(s)
- James Hill
- University of Central Lancashire, Preston, UK
| | - Nikki Gratton
- Royal College of Speech & Language Therapists, London, UK
| | - Amit Kulkarni
- University of Central Lancashire, Preston, UK
- Royal College of Speech & Language Therapists, London, UK
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Hermus M, van der Wilk BJ, Dekker JWT, Nieuwenhuijzen GAP, Rosman C, Timmermans L, Wijnhoven BPL, van der Zijden CJ, van Lanschot JJB, Busschbach JJ, Lagarde SM, Kranenburg LW. Developing an e-learning tool for clinicians to take patient preferences into account in esophageal cancer treatment decision-making. Health Sci Rep 2023; 6:e1725. [PMID: 38111742 PMCID: PMC10726811 DOI: 10.1002/hsr2.1725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 06/24/2023] [Accepted: 11/02/2023] [Indexed: 12/20/2023] Open
Affiliation(s)
- Merel Hermus
- Section of Medical Psychology and Psychotherapy, Department of PsychiatryErasmus University Medical CenterRotterdamThe Netherlands
| | - Berend J. van der Wilk
- Department of Surgery, Erasmus Cancer InstituteErasmus University Medical CenterRotterdamThe Netherlands
| | | | | | - Camiel Rosman
- Department of SurgeryRadboud University Medical CenterNijmegenThe Netherlands
| | - Liesbeth Timmermans
- Department of Primary and Community CareRadboud University Medical CenterNijmegenThe Netherlands
| | - Bas P. L. Wijnhoven
- Department of Surgery, Erasmus Cancer InstituteErasmus University Medical CenterRotterdamThe Netherlands
| | - Charlène J. van der Zijden
- Department of Surgery, Erasmus Cancer InstituteErasmus University Medical CenterRotterdamThe Netherlands
| | - J. Jan B. van Lanschot
- Department of Surgery, Erasmus Cancer InstituteErasmus University Medical CenterRotterdamThe Netherlands
| | - Jan J. Busschbach
- Section of Medical Psychology and Psychotherapy, Department of PsychiatryErasmus University Medical CenterRotterdamThe Netherlands
| | - Sjoerd M. Lagarde
- Department of Surgery, Erasmus Cancer InstituteErasmus University Medical CenterRotterdamThe Netherlands
| | - Leonieke W. Kranenburg
- Section of Medical Psychology and Psychotherapy, Department of PsychiatryErasmus University Medical CenterRotterdamThe Netherlands
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Ban JW, Perera R, Williams V. Influence of research evidence on the use of cardiovascular clinical prediction rules in primary care: an exploratory qualitative interview study. BMC PRIMARY CARE 2023; 24:194. [PMID: 37730553 PMCID: PMC10512575 DOI: 10.1186/s12875-023-02155-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 09/06/2023] [Indexed: 09/22/2023]
Abstract
BACKGROUND Cardiovascular clinical prediction rules (CPRs) are widely used in primary care. They accumulate research evidence through derivation, external validation, and impact studies. However, existing knowledge about the influence of research evidence on the use of CPRs is limited. Therefore, we explored how primary care clinicians' perceptions of and experiences with research influence their use of cardiovascular CPRs. METHODS We conducted an exploratory qualitative interview study with thematic analysis. Primary care clinicians were recruited from the WWAMI (Washington, Wyoming, Alaska, Montana and Idaho) region Practice and Research Network (WPRN). We used purposeful sampling to ensure maximum variation within the participant group. Data were collected by conducting semi-structured online interviews. We analyzed data using inductive thematic analysis to identify commonalities and differences within themes. RESULTS Of 29 primary care clinicians who completed the questionnaire, 15 participated in the interview. We identified two main themes relating to the influence of clinicians' perceptions of and experiences with cardiovascular CPR research on their decisions about using cardiovascular CPRs: "Seek and judge" and "be acquainted and assume." When clinicians are familiar with, trust, and feel confident in using research evidence, they might actively search and assess the evidence, which may then influence their decisions about using cardiovascular CPRs. However, clinicians, who are unfamiliar with, distrust, or find it challenging to use research evidence, might be passively acquainted with evidence but do not make their own judgment on the trustworthiness of such evidence. Therefore, these clinicians might not rely on research evidence when making decisions about using cardiovascular CPRs. CONCLUSIONS Clinicians' perceptions and experiences could influence how they use research evidence in decisions about using cardiovascular CPRs. This implies, when promoting evidence-based decisions, it might be useful to target clinicians' unfamiliarity, distrust, and challenges regarding the use of research evidence rather than focusing only on their knowledge and skills. Further, because clinicians often rely on evidence-unrelated factors, guideline developers and policymakers should recommend cardiovascular CPRs supported by high-quality evidence.
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Affiliation(s)
- Jong- Wook Ban
- Centre for Evidence-Based Medicine, University of Oxford, Oxford, UK.
- Department for Continuing Education, University of Oxford, Oxford, UK.
| | - Rafael Perera
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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Wilson SN, Noble H, Ordoñez WJN, Wong GZ, Rodríguez MJ, Checa DO, Warne M, Senturia K, LaGrone LN. Implementing point-of-care medical information systems into trauma and general surgeon practice in a middle-income country: a qualitative study utilizing the Consolidated Framework for Implementation Research. Implement Sci Commun 2023; 4:38. [PMID: 37024984 PMCID: PMC10078056 DOI: 10.1186/s43058-023-00397-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 02/04/2023] [Indexed: 04/08/2023] Open
Abstract
BACKGROUND Point-of-care medical information systems (POCMIS) can provide an efficient and effective means of strengthening health systems globally through their encouragement of continued medical education. Using the Consolidated Framework for Implementation Research (CFIR) as a guide, this research provides suggestions for improved implementation of POCMIS in low- and middle-income countries informed by an intervention implemented across public and military hospitals in Lima, Peru. METHODS Analysis is based on qualitative interviews conducted with 12 Peruvian surgeons across eight public hospitals and one military hospital who received an intervention that provided free access to UpToDate and introduced Google Translate. The post-intervention interviews were transcribed, translated, and analyzed for themes overlapping with CFIR constructs to expose barriers to implementation and suggestions for improved implementation of future interventions. RESULTS Barriers included a lack of seniority buy-in and engaged leadership, an overabundance of personal preferences for multiple POCMIS, and a culture of assumption that inhibited open communication regarding access to and use of POCMIS. Suggestions for improved implementation focused on the adaptation of the intervention. Namely, surgeons discussed regionally-specific adaptations as well as adaptations specific to their surgical specialty including visual, rather than written, representation of the information available via POCMIS. CONCLUSIONS Results indicate necessary adaptations for implementing interventions including POCMIS in LMICs, mimicking much of the implementation science literature on intervention adaptation. In addition to explicit suggestions provided by surgeons, we also suggest actionable steps to adapt to barriers identified in our data. Rapid assessment procedures (RAP) are one established methodological technique useful for assessing organization culture prior to implementation, allowing for necessary cultural adaptations. Dynamic adaption process (DAP) is another useful and established method that breaks implementation into four phases allowing for adaptations based on the initial assessment of the intervention site.
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Affiliation(s)
| | - Helen Noble
- Northern Pacific Global Health Fogarty International Program, University of Washington, Seattle, WA, USA
| | | | | | | | | | - Maria Warne
- University of Colorado Health, Denver, CO, USA
| | | | - Lacey Nicole LaGrone
- Department of Surgery, Medical Center of the Rockies, University of Colorado Health, Loveland, CO, USA.
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Shin J, Le J, Hessol NA, Miller SM. Development of a curriculum integrating biostatistics and study design with core sciences in an organ system block. CURRENTS IN PHARMACY TEACHING & LEARNING 2022; 14:1091-1097. [PMID: 36154953 DOI: 10.1016/j.cptl.2022.07.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 06/23/2022] [Accepted: 07/20/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION The objectives of this study were to develop and evaluate a curriculum that integrated biostatistics and research design content with core sciences content within a pharmacy course. METHODS An inquiry curriculum was developed in 2019 and included lectures on biostatistics and research design with small group discussions of clinical research papers directly related to the core sciences content. Students' perceptions and pass rates between students who did (2019 cohort) and did not (2018 cohort) undergo the curriculum were compared. Test scores taken approximately one year after completion of each cohort's course were also compared. RESULTS Of 127 students in the 2019 cohort, 120 (94%) responded. Over 90% agreed or strongly agreed that inquiry and core sciences contents were integrated well. The 2019 cohort had a significantly higher pass rate than the 2018 cohort on two of three assessment questions evaluated: one multiple choice question (P = .037) and one short answer question (P = .013). After adjustments for baseline characteristics, retention study volunteers from the 2019 cohort had a significantly higher percent test score than those from the 2018 cohort (parameter estimate = 8.48%; P = .026). CONCLUSIONS An inquiry curriculum consisting of select biostatistics and research design topics can be integrated with a core sciences curriculum in a large integrated pharmacy course. Inclusion of this content increased student academic performance and retention of knowledge and skills.
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Affiliation(s)
- Jaekyu Shin
- Clinical Pharmacy, Department of Clinical Pharmacy, School of Pharmacy, University of California, San Francisco, 521 Parnassus Avenue, Floor 3, San Francisco, CA 94143-0622, United States.
| | - Jennifer Le
- Huntington Memorial Hospital, Department of Pharmacy, 100 W California Blvd, Pasadena, CA 91105, United States.
| | - Nancy A Hessol
- Department of Clinical Pharmacy, School of Pharmacy, University of California, San Francisco, 521 Parnassus Avenue, Floor 3, San Francisco, CA 94143-0622, United States.
| | - Susan M Miller
- Department of Pharmaceutical Chemistry, School of Pharmacy, University of California, San Francisco, 600 16th St, Rm S512B, San Francisco, CA 94158-2280, United States.
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Umphrey L, Lenhard N, Lam SK, Hayward NE, Hecht S, Agrawal P, Chambliss A, Evert J, Haq H, Lauden SM, Paasi G, Schleicher M, McHenry MS. Virtual global health in graduate medical education: a systematic review. INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2022; 13:230-248. [PMID: 36057978 PMCID: PMC9911141 DOI: 10.5116/ijme.62eb.94fa] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 08/04/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES To synthesize recent virtual global health education activities for graduate medical trainees, document gaps in the literature, suggest future study, and inform best practice recommendations for global health educators. METHODS We systematically reviewed articles published on virtual global health education activities from 2012-2021 by searching MEDLINE, EMBASE, Cochrane Library, ERIC, Scopus, Web of Science, and ProQuest Dissertations & Theses A&I. We performed bibliography review and search of conference and organization websites. We included articles about primarily virtual activities targeting for health professional trainees. We collected and qualitatively analyzed descriptive data about activity type, evaluation, audience, and drivers or barriers. Heterogeneity of included articles did not lend to formal quality evaluation. RESULTS Forty articles describing 69 virtual activities met inclusion criteria. 55% of countries hosting activities were high-income countries. Most activities targeted students (57%), with the majority (53%) targeting trainees in both low- to middle- and high-income settings. Common activity drivers were course content, organization, peer interactions, and online flexibility. Common challenges included student engagement, technology, the internet, time zones, and scheduling. Articles reported unanticipated benefits of activities, including wide reach; real-world impact; improved partnerships; and identification of global health practice gaps. CONCLUSIONS This is the first review to synthesize virtual global health education activities for graduate medical trainees. Our review identified important drivers and challenges to these activities, the need for future study on activity preferences, and considerations for learners and educators in low- to middle-income countries. These findings may guide global health educators in their planning and implementation of virtual activities.
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Affiliation(s)
- Lisa Umphrey
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Nora Lenhard
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Suet Kam Lam
- Cleveland Clinic Lerner College of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | | | - Shaina Hecht
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Priya Agrawal
- Mid-Atlantic Permanente Medical Group, Washington, DC, USA
| | - Amy Chambliss
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Jessica Evert
- Child Family Health International, El Cerrito, California, USA
| | - Heather Haq
- Department of Pediatrics, Baylor College of Medicine, Texas, USA
| | - Stephanie M. Lauden
- Nationwide Children's Hospital, The Ohio State University, Columbus, OH, USA
| | - George Paasi
- Mbale Clinical Research Institute, Mbale, Uganda
| | - Mary Schleicher
- Cleveland Clinic Floyd D. Loop Alumni Library, Cleveland, OH, USA
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Patient satisfaction and its health provider-related determinants in primary health facilities in rural China. BMC Health Serv Res 2022; 22:946. [PMID: 35883080 PMCID: PMC9316702 DOI: 10.1186/s12913-022-08349-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 07/18/2022] [Indexed: 12/17/2022] Open
Abstract
Background Patient satisfaction is an important outcome measure of health service and is one of the main reasons for the gradual deterioration of doctor–patient relationships in China. This study used the standardized patient (SP) method to explore patient satisfaction and its health provider-related determinants among primary health facilities in rural China. Methods The dataset comprised 1138 clinic cases in 728 rural primary health facilities in 31 counties, spread across four provinces. Information regarding the consultation interaction between the unannounced SPs and primary physicians was recorded. Patient satisfaction was gathered from the feedback of SPs after the visit. Results The overall average score of SP satisfaction with rural primary health facilities was only 13.65 (SD = 3.22) out of 20. The SP scores were found to be consistent with those of real patients. After controlling variances in patient population via the SP method, the regression analysis demonstrated that health provider-related factors, such as physician-level characteristics, consultation process, affordability, and convenience, have a significant correlation with patient satisfaction among primary physicians. Among factors relating to physician-level characteristics, affordability, convenience and the consultation process of the visit, the quality of the consultation process (e.g., consultation time, proactively providing necessary instructions and other crucial information) were found to be the prominent determinants. Conclusions This study revealed the need to improve patient satisfaction in primary health facilities in rural China. To solve this issue, we recommend that policies to increase medical service quality be implemented in rural primary healthcare systems. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-08349-9.
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Schneider A, Böhmer G, Petzel A, Schneider V, Stolte C, Weger V, Ludwig J, Killinger J, Welcker T. Kolposkopie: Können Online-Fortbildungen die Ausbildung sinnvoll unterstützen? Geburtshilfe Frauenheilkd 2022. [DOI: 10.1055/a-1750-7464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Achim Schneider
- Institut für Zytologie und Dysplasie, MVZ Fürstenbergkarree, Berlin, Deutschland
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Kenjrawi Y, Dashash M. The First Asynchronous Online Evidence-Based Medicine Course To Target Syrian Health Workers: A Pilot Study (Preprint). JMIR Form Res 2022; 6:e36782. [DOI: 10.2196/36782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 08/13/2022] [Accepted: 08/22/2022] [Indexed: 11/13/2022] Open
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Avinash B, Ali I, Sahoo R, Hegde V, Nagpal D, Mohammed C, Jain A, Kukkamalla A, Rai S. Mentor-learner web-based interprofessional collaborative distance learning: An innovation in teaching-learning method. INTERNATIONAL JOURNAL OF ACADEMIC MEDICINE 2022. [DOI: 10.4103/ijam.ijam_52_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Kelly F, Uys M, Bezuidenhout D, Mullane SL, Bristol C. Improving Healthcare Worker Resilience and Well-Being During COVID-19 Using a Self-Directed E-Learning Intervention. Front Psychol 2021; 12:748133. [PMID: 34925152 PMCID: PMC8675897 DOI: 10.3389/fpsyg.2021.748133] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 11/03/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: High rates of burnout, depression, anxiety, and insomnia in healthcare workers responding to the COVID-19 pandemic have been reported globally. Methods: Responding to the crisis, the Foundation for Professional Development (FPD) developed an e-learning course to support healthcare worker well-being and resilience. A self-paced, asynchronous learning model was used as the training intervention. Each module included practical, skill-building activities. An outcome evaluation was conducted to determine if completing the course improved healthcare worker knowledge of and confidence in the learning outcomes of the course, their use of resilience-building behaviours, their resilience, and their well-being. A secondary objective was to explore if there were any associations between behaviours, resilience, and well-being. Participants completed pre- and post-course questionnaires to measure knowledge of and confidence in the learning outcomes, y, frequency of self-reported resilience-building behaviours, and levels of resilience (CD-RISC) and well-being (WHO-5). Results were analysed in STATA using paired T-tests, univariate and multivariate linear regression models. Results: Participants (n = 474; 77.6% female; 55.7% primary care) exhibited significant increases in knowledge, confidence, resilience-building behaviour, resilience, and well-being scores. Statistically significant improvements in the frequency of resilience-building behaviours led to significant improvements in resilience (0.25 points; 95% CI: 0.06, 0.43) and well-being (0.21 points; 95% CI: 0.05, 0.36). Increasing changes in well-being scores had a positive effect on change in resilience scores (β = 0.20; 95% CI: 0.11, 0.29), and vice versa (β = 0.28; 95% CI: 0.14, 0.41). Conclusion: A healthcare worker e-learning course can build knowledge and skills that may prompt changes in resilience-building behaviours and improvements in well-being and resilience scores. The findings suggest that e-learning courses may improve more than competency-based outcomes alone but further research is warranted to further explore these relationships.
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Affiliation(s)
- Frances Kelly
- Foundation for Professional Development, Pretoria, South Africa
| | - Margot Uys
- Foundation for Professional Development, Pretoria, South Africa
| | | | - Sarah L Mullane
- Johnson and Johnson Health and Wellness Solutions Inc., New Brunswick, NJ, United States
| | - Caitlin Bristol
- Johnson and Johnson Global Community Impact, London, United Kingdom
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Silva PGDB, Dias CC, Machado LC, Carlos ACAM, Dantas TS, Ximenes J, Sousa RMRB, Sousa FB. Distance education in dentistry in Brazil: a critical STROBE-based analysis. Braz Oral Res 2021; 35:e109. [PMID: 34816897 DOI: 10.1590/1807-3107bor-2021.vol35.0109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 03/01/2021] [Indexed: 11/22/2022] Open
Abstract
The COVID-19 pandemic has forced dentistry schools (DSs) to adapt their teaching techniques to digital platforms. Therefore, we aimed to evaluate distance classes in the Brazilian DS curriculum. After an online search of higher education institutions (HEIs) with DS on the e-Ministry of Education (MEC) platform, we included institutions with at least one graduated class to extract the age/localization of the DS, funding, number of authorized seats, MEC-grade, ENADE-score, and workload. HEIs' webpages were consulted to identify the curriculum, subjects offered in the distance education (DE) format, extracurricular programs, scientific events, postgraduate programs, and institutional YouTube channels. Chi-square/Fisher's tests plus binary logistic regression were performed (SPSS 20.0, p < 0.05). Of the 241 DSs evaluated, 82 (34.0%) offered distance classes, and a high prevalence was observed in the southeast region (p <0.001) and private HEIs (p = 0.001). HEIs with distance classes had lower ENADE scores (p = 0.004), lower workload (p = 0.007), and higher workload for optional subjects (p = 0.016), doctoral programs (p = 0.041), specialization courses (p = 0.017), and institutional YouTube channels (p < 0.001). Southern dental schools (p < 0.001), lower workload (p = 0.022), optional subjects (p = 0.033), and institutional YouTube channels (p = 0.005) were independently associated with distance classes. In one-third of the Brazilian DSs, distance classes and institutional YouTube channels were strongly associated variables. The association of distance learning with lower workload and low academic performance draws attention to the need for regulatory bodies for controlling the quality of DE.
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Affiliation(s)
| | - Camila Costa Dias
- Centro Universitário Christus, Department of Odontology, Fortaleza, CE, Brazil
| | | | | | | | - Juliana Ximenes
- Centro Universitário Christus, Department of Odontology, Fortaleza, CE, Brazil
| | | | - Fabrício Bitu Sousa
- Centro Universitário Christus, Department of Odontology, Fortaleza, CE, Brazil
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Rahimi-Ardabili H, Spooner C, Harris MF, Magin P, Tam CWM, Liaw ST, Zwar N. Online training in evidence-based medicine and research methods for GP registrars: a mixed-methods evaluation of engagement and impact. BMC MEDICAL EDUCATION 2021; 21:492. [PMID: 34521409 PMCID: PMC8439372 DOI: 10.1186/s12909-021-02916-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 08/28/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Evidence-based medicine (EBM) is a core skillset for enhancing the quality and safety of patients' care. Online EBM education could improve clinicians' skills in EBM, particularly when it is conducted during vocational training. There are limited studies on the impact of online EBM training on clinical practice among general practitioner (GP) registrars (trainees in specialist general practice). We aimed to describe and evaluate the acceptability, utility, satisfaction and applicability of the GP registrars experience with the online course. The course was developed by content-matter experts with educational designers to encompass effective teaching methods (e.g. it was interactive and used multiple teaching methods). METHODS Mixed-method data collection was conducted after individual registrars' completion of the course. The course comprised six modules that aimed to increase knowledge of research methods and application of EBM skills to everyday practice. GP registrars who completed the online course during 2016-2020 were invited to complete an online survey about their experience and satisfaction with the course. Those who completed the course within the six months prior to data collection were invited to participate in semi-structured phone interviews about their experience with the course and the impact of the course on clinical practice. A thematic analysis approach was used to analyse the data from qualitative interviews. RESULTS The data showed the registrars were generally positive towards the course and the concept of EBM. They stated that the course improved their confidence, knowledge, and skills and consequently impacted their practice. The students perceived the course increased their understanding of EBM with a Cohen's d of 1.6. Registrars identified factors that influenced the impact of the course. Of those, some were GP-related including their perception of EBM, and being comfortable with what they already learnt; some were work-place related such as time, the influence of supervisors, access to resources; and one was related to patient preferences. CONCLUSIONS This study showed that GP registrars who attended the online course reported that it improved their knowledge, confidence, skill and practice of EBM over the period of three months. The study highlights the supervisor's role on GP registrars' ability in translating the EBM skills learnt in to practice and suggests exploring the effect of EBM training for supervisors.
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Affiliation(s)
| | - Catherine Spooner
- Centre for Primary Health Care and Equity, UNSW Sydney, Sydney, NSW 2052 Australia
| | - Mark F. Harris
- Centre for Primary Health Care and Equity, UNSW Sydney, Sydney, NSW 2052 Australia
| | - Parker Magin
- Research and Evaluation Unit, GP Synergy, Sydney, NSW 2304 Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2304 Australia
| | - Chun Wah Michael Tam
- Primary and Integrated Care Unit, South Western Sydney Local Health District, Liverpool, NSW 2170 Australia
| | - Siaw-Teng Liaw
- WHO Collaborating Centre (eHealth), School of Population Health, UNSW Sydney, Sydney, NSW 2052 Australia
| | - Nicholas Zwar
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, 4229 Australia
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Rostamnia L, Ghanbari V, Shabani F, Farahani A, Dehghan-Nayeri N. Evidence-Based Practice for Cardiac Intensive Care Unit Nurses: An Educational Intervention Study. J Contin Educ Nurs 2021; 51:167-173. [PMID: 32232492 DOI: 10.3928/00220124-20200317-06] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 09/23/2019] [Indexed: 11/20/2022]
Abstract
BACKGROUND This study examined the effectiveness of two educational methods on nurses' skills and commitment to implementing evidence-based practice (EBP). METHOD Ninety nurses were randomly assigned to three groups. Participants in the workshop group took part in a 2-day training course, participants in the multimedia group received educational content through video, and participants in the control group did not receive any training content. The nurses' skills and commitment to implement EBP were assessed at baseline and 1 month after the teaching sessions. RESULTS The EBP skills of nurses in the intervention groups were significantly enhanced compared with nurses in the control group (p < .05). Mean scores in the multimedia group were slightly better than in the workshop group; however, this difference was not statistically significant. Commitment to EBP implementation did not change significantly over time among the groups (p > .05). CONCLUSION Different methods of training can be useful in improving nurses' EBP skills; however, the participants' commitment to implement EBP did not change considerably. Because of its cost effectiveness, the multimedia method should be considered for use in nurse training. [J Contin Educ Nurs. 2020;51(4):167-173.].
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Borakati A. Evaluation of an international medical E-learning course with natural language processing and machine learning. BMC MEDICAL EDUCATION 2021; 21:181. [PMID: 33766037 PMCID: PMC7992837 DOI: 10.1186/s12909-021-02609-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 02/16/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND In the context of the ongoing pandemic, e-learning has become essential to maintain existing medical educational programmes. Evaluation of such courses has thus far been on a small scale at single institutions. Further, systematic appraisal of the large volume of qualitative feedback generated by massive online e-learning courses manually is time consuming. This study aimed to evaluate the impact of an e-learning course targeting medical students collaborating in an international cohort study, with semi-automated analysis of feedback using text mining and machine learning methods. METHOD This study was based on a multi-centre cohort study exploring gastrointestinal recovery following elective colorectal surgery. Collaborators were invited to complete a series of e-learning modules on key aspects of the study and complete a feedback questionnaire on the modules. Quantitative data were analysed using simple descriptive statistics. Qualitative data were analysed using text mining with most frequent words, sentiment analysis with the AFINN-111 and syuzhet lexicons and topic modelling using the Latent Dirichlet Allocation (LDA). RESULTS One thousand six hundred and eleventh collaborators from 24 countries completed the e-learning course; 1396 (86.7%) were medical students; 1067 (66.2%) entered feedback. 1031 (96.6%) rated the quality of the course a 4/5 or higher (mean 4.56; SD 0.58). The mean sentiment score using the AFINN was + 1.54/5 (5: most positive; SD 1.19) and + 0.287/1 (1: most positive; SD 0.390) using syuzhet. LDA generated topics consolidated into the themes: (1) ease of use, (2) conciseness and (3) interactivity. CONCLUSIONS E-learning can have high user satisfaction for training investigators of clinical studies and medical students. Natural language processing may be beneficial in analysis of large scale educational courses.
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Affiliation(s)
- Aditya Borakati
- University Department of Surgery, Royal Free Hospital, Pond Street, London, NW3 2QG, UK.
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Bock A, Kniha K, Goloborodko E, Lemos M, Rittich AB, Möhlhenrich SC, Rafai N, Hölzle F, Modabber A. Effectiveness of face-to-face, blended and e-learning in teaching the application of local anaesthesia: a randomised study. BMC MEDICAL EDUCATION 2021; 21:137. [PMID: 33639906 PMCID: PMC7913455 DOI: 10.1186/s12909-021-02569-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 02/15/2021] [Indexed: 05/28/2023]
Abstract
BACKGROUND Local anaesthesia plays a key role in many aspects of a dentist's work. The required skills to perform anaesthesia successfully are acquired at university. To take advantage of the possibilities for new teaching formats, a blended learning concept for the local anaesthesia course was developed. The aim of the study was to compare the effectiveness of face-to-face, blended and e-learning in teaching in local anaesthesia by assessing students' knowledge gain, performance of practical skills and satisfaction with the course. METHODS All participants (n = 37) were randomly allocated into three groups. After acquiring the theoretical background in the blended learning, e-learning or lecture groups, a test to assess knowledge gain was performed. The performance of the practical skills was assessed in a small-group seminar. Student attitudes were evaluated with a questionnaire. RESULTS The blended group showed significantly better results (mean = 17, SD =1.5) in theoretical knowledge gain than the other two groups (e-learning group: mean = 14.7, SD = 2.2; lecture group: mean = 14.8, SD =2.3). When comparing the results of the clinical skills assessment, there was no significant difference among all three groups (p > 0.017). The participants confirmed a high overall satisfaction with the course, in particular with the blended learning approach. CONCLUSION This study indicates that blended learning improves the learning outcome for theoretical knowledge in teaching local anaesthesia more than either face-to-face learning or e-learning alone. Furthermore, the blended learning approach is highly appreciated by the students. For acquiring practical skills, this study shows that blended learning is as effective as other teaching methods.
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Affiliation(s)
- Anna Bock
- Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelsstrasse 30, D-52074, Aachen, Germany.
| | - Kristian Kniha
- Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelsstrasse 30, D-52074, Aachen, Germany
| | - Evgeny Goloborodko
- Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelsstrasse 30, D-52074, Aachen, Germany
| | - Martin Lemos
- Audiovisual Media Center, Medical Faculty, RWTH Aachen University, Pauwelsstraße 30, D-52074, Aachen, Germany
| | - Anne Barbara Rittich
- Department of Prosthodontics and Biomaterials, University Hospital RWTH Aachen, Pauwelsstrasse 30, D-52074, Aachen, Germany
| | | | - Nicole Rafai
- Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelsstrasse 30, D-52074, Aachen, Germany
| | - Frank Hölzle
- Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelsstrasse 30, D-52074, Aachen, Germany
| | - Ali Modabber
- Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelsstrasse 30, D-52074, Aachen, Germany
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Effect of training on evidence-based practice to undergraduate dental students: pre and postexperimental study. INT J EVID-BASED HEA 2020; 18:101-107. [PMID: 31335664 DOI: 10.1097/xeb.0000000000000199] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Evidence-based practice (EBP) training is essential for undergraduate students in making sound clinical decisions during patient care. However, EBP training is not included in the curriculum of undergraduate dental students in India and there is a dearth of research that assessed the effectiveness of EBP training in India. Hence, this study aimed to assess the effectiveness of EBP training to dental undergraduate students. METHODS Final year undergraduate students and interns of a dental institution participated in this pre and postexperimental study. All the participants received a 2-day workshop (didactic lectures, hands-on and group activities) in a classroom setting. A validated 35 item instrument titled EBP Knowledge, Attitudes, Access and Confidence questionnaire was used for the outcome assessment of EBP training. RESULTS Fifty undergraduate students (33 interns and 17 final year) participated in the study. Statistically significant improvement was observed in six out of 10 items related to EBP knowledge. All the items related to attitude showed a significant positive change in scores. Only four out of nine items related to accessing evidence showed a statistically significant change. Participants reported moderate confidence gain in critical appraisal skills. CONCLUSION The current study demonstrated moderate improvement in the effectiveness of EBP training in improving EBP knowledge, accessing evidence and critical appraisal skills.
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Afnan MAM, Khan KS, Mol BW. Generating translatable evidence to improve patient care: the contribution of human factors. Reprod Biomed Online 2020; 41:353-356. [PMID: 32553553 PMCID: PMC7207140 DOI: 10.1016/j.rbmo.2020.04.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 04/15/2020] [Accepted: 04/25/2020] [Indexed: 12/27/2022]
Abstract
Generating translatable evidence to improve patient care has proved challenging in reproductive medicine, with many 'add-on' treatments in routine assisted conception clinical practice that have not been reliably tested. This has consequences for patient care; specifically, IVF pregnancy rates have not improved. A change of culture is required in our profession, from indiscriminately applying the latest 'add-on' to large-scale participation in generating reliable translatable evidence.
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Affiliation(s)
- Masoud A M Afnan
- Department of Obstetrics and Gynaecology, Qingdao United Family Hospital, Qingdao, People's Republic of China.
| | - Khalid Saeed Khan
- Distinguished Investigator in Preventive Medicine and Public Health at the University of Granada funded by the Beatriz Galindo Program (Senior Modality) of the Spanish Ministry of Science, Innovation and Universities, Universidad de Granada, Granada, Spain
| | - Ben Willem Mol
- Department of Obstetrics and Gynaecology, Monash University, Clayton, Victoria, Australia
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Vallée A, Blacher J, Cariou A, Sorbets E. Blended Learning Compared to Traditional Learning in Medical Education: Systematic Review and Meta-Analysis. J Med Internet Res 2020; 22:e16504. [PMID: 32773378 PMCID: PMC7445617 DOI: 10.2196/16504] [Citation(s) in RCA: 175] [Impact Index Per Article: 43.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 11/07/2019] [Accepted: 11/13/2019] [Indexed: 02/06/2023] Open
Abstract
Background Blended learning, which combines face-to-face learning and e-learning, has grown rapidly to be commonly used in education. Nevertheless, the effectiveness of this learning approach has not been completely quantitatively synthesized and evaluated using knowledge outcomes in health education. Objective The aim of this study was to assess the effectiveness of blended learning compared to that of traditional learning in health education. Methods We performed a systematic review of blended learning in health education in MEDLINE from January 1990 to July 2019. We independently selected studies, extracted data, assessed risk of bias, and compared overall blended learning versus traditional learning, offline blended learning versus traditional learning, online blended learning versus traditional learning, digital blended learning versus traditional learning, computer-aided instruction blended learning versus traditional learning, and virtual patient blended learning versus traditional learning. All pooled analyses were based on random-effect models, and the I2 statistic was used to quantify heterogeneity across studies. Results A total of 56 studies (N=9943 participants) assessing several types of learning support in blended learning met our inclusion criteria; 3 studies investigated offline support, 7 studies investigated digital support, 34 studies investigated online support, 8 studies investigated computer-assisted instruction support, and 5 studies used virtual patient support for blended learning. The pooled analysis comparing all blended learning to traditional learning showed significantly better knowledge outcomes for blended learning (standardized mean difference 1.07, 95% CI 0.85 to 1.28, I2=94.3%). Similar results were observed for online (standardized mean difference 0.73, 95% CI 0.60 to 0.86, I2=94.9%), computer-assisted instruction (standardized mean difference 1.13, 95% CI 0.47 to 1.79, I2=78.0%), and virtual patient (standardized mean difference 0.62, 95% CI 0.18 to 1.06, I2=78.4%) learning support, but results for offline learning support (standardized mean difference 0.08, 95% CI –0.63 to 0.79, I2=87.9%) and digital learning support (standardized mean difference 0.04, 95% CI –0.45 to 0.52, I2=93.4%) were not significant. Conclusions From this review, blended learning demonstrated consistently better effects on knowledge outcomes when compared with traditional learning in health education. Further studies are needed to confirm these results and to explore the utility of different design variants of blended learning.
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Affiliation(s)
- Alexandre Vallée
- Diagnosis and Therapeutic Center, Hypertension and Cardiovascular Prevention Unit, Hôtel-Dieu Hospital, Assistance Publique-Hôpitaux de Paris, Paris-Descartes University, Paris, France
| | - Jacques Blacher
- Diagnosis and Therapeutic Center, Hypertension and Cardiovascular Prevention Unit, Hôtel-Dieu Hospital, Assistance Publique-Hôpitaux de Paris, Paris-Descartes University, Paris, France
| | | | - Emmanuel Sorbets
- Diagnosis and Therapeutic Center, Hypertension and Cardiovascular Prevention Unit, Hôtel-Dieu Hospital, Assistance Publique-Hôpitaux de Paris, Paris-Descartes University, Paris, France
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van Woezik TE, Oosterman JP, Reuzel RP, van der Wilt GJ, Koksma JJ. Practice-based learning: an appropriate means to acquire the attitude and skills for evidence-based medicine. INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2020; 11:140-145. [PMID: 32710724 PMCID: PMC7874920 DOI: 10.5116/ijme.5ee0.ab48] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 06/10/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES To evaluate a practice-based, self-directed EBM-course in an undergraduate medical curriculum in terms of EBM attitude and motivation beliefs. METHODS This study was conducted in a 4-week course of the first-year undergraduate medical curriculum, which takes place twice in an academic year. One group of students (n=210) received a normal EBM-module in November. A practice-based EBM-module was implemented in January for another group of students (n=130). We approached all students following the courses for participation in our research project. In a quasi-experimental design, a validated survey was used to assess students' EBM task value and self-efficacy on a 7-point Likert-scale. In the experimental group, complementary qualitative data were gathered on attitude and motivation by open evaluative questions. RESULTS Overall response rate was 93,5%, resulting in 191 students in the control group and 127 students in the experimental group. We did not find differences between the groups in terms of EBM task value and self-efficacy. However, the experimental group showed a higher increased perception of the importance of EBM in decision making in clinical practice (60.0% vs 77.2%; χ2(1, N=318) = 8.432, p=0.004). These students obtained a better understanding of the complexities and time-consuming nature of EBM in medical practice. CONCLUSIONS The practice-based EBM-course helps students to reflect on practice and knowledge critically. Our findings indicate that integrating clinical practice in the undergraduate learning environment fosters attitude and motivation, suggesting that practice-based learning in EBM education may advance student development as a critically reflective practitioner.
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Affiliation(s)
| | | | - Rob P.B. Reuzel
- Radboud University Medical Centre, Nijmegen, the Netherlands
| | | | - Jur J. Koksma
- Radboud University Medical Centre, Nijmegen, the Netherlands
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Lautrette A, Boyer A, Gruson D, Argaud L, Schwebel C, Tardy B, Vignon P, Megarbane B, Schoeffler P, Chabrot P, Schmidt J, Boirie Y, Guerin C, Darmon M, Klouche K, Souweine B, Dellamonica J, Pereira B. Impact of take-home messages written into slide presentations delivered during lectures on the retention of messages and the residents' knowledge: a randomized controlled study. BMC MEDICAL EDUCATION 2020; 20:180. [PMID: 32493318 PMCID: PMC7271544 DOI: 10.1186/s12909-020-02092-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 05/28/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Lectures with slide presentations are widely used to teach evidence-based medicine to large groups. Take-home messages (THMs) are poorly identified and recollected by students. We investigated whether an instruction to list THMs in written form on slides would improve the retention thereof by residents, and the residents' level of knowledge, 1 month after lectures. METHODS Prospective blinded randomized controlled study was conducted. Twelve lectures (6 control and 6 intervention lectures) were delivered to 73 residents. For the intervention lectures, the lecturers were instructed to incorporate clear written THMs into their slide presentations. The outcomes were ability of resident to recollect THMs delivered during a lecture (as assessed by accordance rate between the lecturers' and residents' THMs) and knowledge (as assessed by multiple choice questions (MCQs)). RESULTS Data for 3738 residents' THMs and 3410 MCQs were analyzed. The intervention did not significantly increase the number of THMs written on slides (77% (n = 20/26), 95% CI 56-91 vs 64% (n = 18/28), 95% CI 44-81, p = 0.31) nor THMs retention (13% (n = 238/1791), 95% CI 12-15 vs 17% (n = 326/1947), 95% 15-18, p = 0.40) nor knowledge (63.8 ± 26.2 vs 61.1 ± 31.4 /100 points, p = 0.75). In multivariable analyses performed with all THMs written on slides from the two groups, a superior knowledge was associated with notetaking during lectures (OR 1.88, 95% CI 1.41-2.51) and THMs retention (OR 2.17, 95% CI 1.54-3.04); and THMs retention was associated with written THMs (OR 2.94, 95% CI 2.20-3.93). CONCLUSIONS In lectures delivered to residents, a third of the THMs were not in written form. An intervention based on an explicit instruction to lecturers to provide THMs in written form in their slide presentations did not result in increased use of written THMs into the slide presentation or improvement of the THMs retention or level of knowledge. However, we showed that there was a strong positive association between writing THMs on a slide, retention of THMs and residents' knowledge. Further researches are needed to assess interventions to increase written THMs in lectures by faculty. TRIAL REGISTRATION ClinicalTrials.gov NCT01795651 (Fev 21, 2013).
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Affiliation(s)
- Alexandre Lautrette
- Intensive Care Medicine, Gabriel Montpied Hospital, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France.
- Intensive Care Unit, Centre Jean Perrin, Clermont-Ferrand, France.
- LMGE «Laboratoire Micro-organismes: Génome et Environnement», UMR CNRS 6023, Clermont-Auvergne University, Clermont-Ferrand, France.
| | - Alexandre Boyer
- Intensive Care Unit, Pellegrin-Tripode Hospital, University Hospital of Bordeaux, Bordeaux, France
| | - Didier Gruson
- Intensive Care Unit, Pellegrin-Tripode Hospital, University Hospital of Bordeaux, Bordeaux, France
| | - Laurent Argaud
- Intensive Care Unit, Edouard Herriot Hospital, University Hospital of Lyon, Lyon, France
| | - Carole Schwebel
- Intensive Care Unit, Albert Michallon Hospital, University Hospital of Grenoble, Grenoble, France
| | - Bernard Tardy
- Clinical Investigation Center-CIC 1408, Nord Teaching Hospital, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Philippe Vignon
- Medical-Surgical Intensive Care Unit, Dupuytren Hospital, University Hospital of Limoges, Limoges, France
| | - Bruno Megarbane
- Department of Medical and Toxicological Critical Care, Lariboisière Hospital, Assistance Publique - Hopitaux de Paris, INSERM UMRS-1144, Paris-Diderot University, Paris, France
| | - Pierre Schoeffler
- Intensive Care Unit, Department of Anaesthesiology, Gabriel Montpied Hospital, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
| | - Pascal Chabrot
- Department of Radiology, Gabriel Montpied Hospital, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
| | - Jeannot Schmidt
- Adult Emergency Department, Gabriel Montpied Hospital, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
| | - Yves Boirie
- Nutrition Unit, Gabriel Montpied Hospital, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
| | - Claude Guerin
- Intensive Care Unit, Croix Rousse Hospital, University Hospital of Lyon, Lyon, France
| | - Michaël Darmon
- Intensive Care Unit, Nord Teaching Hospital, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Kada Klouche
- Intensive Care Unit, Lapeyronie Hospital, University Hospital of Montpellier, Montpellier, France
| | - Bertrand Souweine
- LMGE «Laboratoire Micro-organismes: Génome et Environnement», UMR CNRS 6023, Clermont-Auvergne University, Clermont-Ferrand, France
- Medical Intensive Care Unit, Gabriel Montpied Hospital, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
| | - Jean Dellamonica
- Intensive Care Unit, l'Archet Hospital, Cote d'Azur University, Nice, France
| | - Bruno Pereira
- Biostatistics unit, Delegation à la Recherche Clinique (DRCI), University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
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Barteit S, Guzek D, Jahn A, Bärnighausen T, Jorge MM, Neuhann F. Evaluation of e-learning for medical education in low- and middle-income countries: A systematic review. COMPUTERS & EDUCATION 2020; 145:103726. [PMID: 32565611 PMCID: PMC7291921 DOI: 10.1016/j.compedu.2019.103726] [Citation(s) in RCA: 81] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 10/03/2019] [Accepted: 10/05/2019] [Indexed: 05/23/2023]
Abstract
In low- and middle-income countries (LMICs), e-learning for medical education may alleviate the burden of severe health worker shortages and deliver affordable access to high quality medical education. However, diverse challenges in infrastructure and adoption are encountered when implementing e-learning within medical education in particular. Understanding what constitutes successful e-learning is an important first step for determining its effectiveness. The objective of this study was to systematically review e-learning interventions for medical education in LMICs, focusing on their evaluation and assessment methods. Nine databases were searched for publications from January 2007 to June 2017. We included 52 studies with a total of 12,294 participants. Most e-learning interventions were pilot studies (73%), which mainly employed summative assessments of study participants (83%) and evaluated the e-learning intervention with questionnaires (45%). Study designs, evaluation and assessment methods showed considerable variation, as did the study quality, evaluation periods, outcome and effectiveness measures. Included studies mainly utilized subjective measures and custom-built evaluation frameworks, which resulted in both low comparability and poor validity. The majority of studies self-concluded that they had had an effective e-learning intervention, thus indicating potential benefits of e-learning for LMICs. However, MERSQI and NOS ratings revealed the low quality of the studies' evidence for comparability, evaluation instrument validity, study outcomes and participant blinding. Many e-learning interventions were small-scale and conducted as short-termed pilots. More rigorous evaluation methods for e-learning implementations in LMICs are needed to understand the strengths and shortcomings of e-learning for medical education in low-resource contexts. Valid and reliable evaluations are the foundation to guide and improve e-learning interventions, increase their sustainability, alleviate shortages in health care workers and improve the quality of medical care in LMICs.
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Affiliation(s)
- Sandra Barteit
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg University, Germany
| | - Dorota Guzek
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg University, Germany
| | - Albrecht Jahn
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg University, Germany
| | - Till Bärnighausen
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg University, Germany
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, USA
- Africa Health Research Institute (AHRI), KwaZulu-Natal, South Africa
| | - Margarida Mendes Jorge
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg University, Germany
| | - Florian Neuhann
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg University, Germany
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Laks M, Guerra CM, Miraglia JL, Medeiros EA. Distance learning in antimicrobial stewardship: innovation in medical education. BMC MEDICAL EDUCATION 2019; 19:191. [PMID: 31174524 PMCID: PMC6555969 DOI: 10.1186/s12909-019-1623-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2018] [Accepted: 05/22/2019] [Indexed: 06/01/2023]
Abstract
BACKGROUND This study aimed to analyse the impact that web-based distance learning has on knowledge gain in medical students, as well as student perceptions of the methodology. METHODS This was an educational intervention study conducted at a tertiary teaching hospital in the city of São Paulo, Brazil. From 2008 to 2014, we offered a free web-based distance learning course, covering antimicrobial use and microbial resistance, to fifth-year medical students. The course encompassed 100 h of activities, with five theoretical modules, exercises and simulations, within a virtual learning environment. The students were tutored in their online activities, and some classes were conducted in real time for live discussions. In addition, students underwent face-to-face assessments of their knowledge of the topic before and after the course. Statistical analysis was performed and the means of the overall scores were obtained, as were the respective 95% confidence intervals (CIs). The means were compared by two-tailed paired t-tests and by the paired Wilcoxon test. RESULTS Of 814 eligible medical students, 606 (74.45%) completed the entire course during the study period. The mean score for knowledge of the topic was significantly higher on the final assessment than on the initial assessment (p < 0.001). We found that dedication (in hours) was directly proportional to the level of participation, as reflected in the mean final score (p = 0.009) and in the proportion of students who passed (p = 0.028). All of the participants considered their knowledge adequate or insufficient before the course, stating that it is quite important or important to address the topic during medical education. Although dedication levels were low, 70.5% stated that they had learned "quite a lot" or "more than expected" about the topic and would dedicate more time to it if they could. CONCLUSIONS The use of a virtual learning environment can promote teaching and learning in the infectious diseases field, specifically for antimicrobial stewardship, increasing knowledge significantly, and should be considered for inclusion in the final stages of medical education.
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Affiliation(s)
- Michel Laks
- Infectious Diseases Division, Department of Internal Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, Napoleão de Barros, 690, second floor, São Paulo, Brazil
| | - Carla Morales Guerra
- Infectious Diseases Division, Department of Internal Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, Napoleão de Barros, 690, second floor, São Paulo, Brazil
| | - João Luiz Miraglia
- Infectious Diseases Division, Department of Internal Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, Napoleão de Barros, 690, second floor, São Paulo, Brazil
| | - Eduardo Alexandrino Medeiros
- Infectious Diseases Division, Department of Internal Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, Napoleão de Barros, 690, second floor, São Paulo, Brazil
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Sarid O, Berger R, Guez J. Reduced HbA1c levels in type 2 diabetes patients: An interaction between a pedagogical format for students and psycho-educational intervention for patients. Diabetes Metab Syndr 2019; 13:2280-2284. [PMID: 31235169 DOI: 10.1016/j.dsx.2019.05.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Accepted: 05/22/2019] [Indexed: 11/15/2022]
Abstract
In this prospective study we compared Hemoglobin A1c (HbA1c) levels in T2DM (Type 2 diabetes) patients who received psycho-educational intervention vs. usual care. Intervention was provided by pharmaceutics students, and accompanied by an academic course. We further examined the effect of the pedagogical format by which students were taught on HbA1c levels of the patients. The format of the academic course varied: the simultaneous format included theoretical, clinical, and practical themes taught within each lesson; whereas in the non-simultaneous format, theoretical themes were taught during the first several lessons, followed by practical skills taught in the following ones. T2DM patients (n = 171) were recruited through 10 primary care clinics. The inclusion criterion was patients with uncontrolled type 2 diabetes (HbA1c > 7%). Patients were randomly allocated to a training or control group. Pharmaceutics students (n = 85) in their fourth year participated in an academic course and were randomly allocated to a simultaneous vs. non-simultaneous pedagogical format. The interaction effect between intervention type and pedagogical format was significant. Only patients who participated in the training group consisting of students who participated in the simultaneous course format showed improvement on their HbA1c levels. Implications on patients' outcome and suggestions for future studies are discussed.
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Affiliation(s)
- Orly Sarid
- Department of Social Work, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
| | - Rivka Berger
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
| | - Jonathan Guez
- Department of Psychiatry, Beer-Sheva Mental Health Center, Beer-Sheva, Israel.
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George PP, Zhabenko O, Kyaw BM, Antoniou P, Posadzki P, Saxena N, Semwal M, Tudor Car L, Zary N, Lockwood C, Car J. Online Digital Education for Postregistration Training of Medical Doctors: Systematic Review by the Digital Health Education Collaboration. J Med Internet Res 2019; 21:e13269. [PMID: 30801252 PMCID: PMC6410118 DOI: 10.2196/13269] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 01/29/2019] [Accepted: 01/30/2019] [Indexed: 12/19/2022] Open
Abstract
Background Globally, online and local area network–based (LAN) digital education (ODE) has grown in popularity. Blended learning is used by ODE along with traditional learning. Studies have shown the increasing potential of these technologies in training medical doctors; however, the evidence for its effectiveness and cost-effectiveness is unclear. Objective This systematic review evaluated the effectiveness of online and LAN-based ODE in improving practicing medical doctors’ knowledge, skills, attitude, satisfaction (primary outcomes), practice or behavior change, patient outcomes, and cost-effectiveness (secondary outcomes). Methods We searched seven electronic databased for randomized controlled trials, cluster-randomized trials, and quasi-randomized trials from January 1990 to March 2017. Two review authors independently extracted data and assessed the risk of bias. We have presented the findings narratively. We mainly compared ODE with self-directed/face-to-face learning and blended learning with self-directed/face-to-face learning. Results A total of 93 studies (N=16,895) were included, of which 76 compared ODE (including blended) and self-directed/face-to-face learning. Overall, the effect of ODE (including blended) on postintervention knowledge, skills, attitude, satisfaction, practice or behavior change, and patient outcomes was inconsistent and ranged mostly from no difference between the groups to higher postintervention score in the intervention group (small to large effect size, very low to low quality evidence). Twenty-one studies reported higher knowledge scores (small to large effect size and very low quality) for the intervention, while 20 studies reported no difference in knowledge between the groups. Seven studies reported higher skill score in the intervention (large effect size and low quality), while 13 studies reported no difference in the skill scores between the groups. One study reported a higher attitude score for the intervention (very low quality), while four studies reported no difference in the attitude score between the groups. Four studies reported higher postintervention physician satisfaction with the intervention (large effect size and low quality), while six studies reported no difference in satisfaction between the groups. Eight studies reported higher postintervention practice or behavior change for the ODE group (small to moderate effect size and low quality), while five studies reported no difference in practice or behavior change between the groups. One study reported higher improvement in patient outcome, while three others reported no difference in patient outcome between the groups. None of the included studies reported any unintended/adverse effects or cost-effectiveness of the interventions. Conclusions Empiric evidence showed that ODE and blended learning may be equivalent to self-directed/face-to-face learning for training practicing physicians. Few other studies demonstrated that ODE and blended learning may significantly improve learning outcomes compared to self-directed/face-to-face learning. The quality of the evidence in these studies was found to be very low for knowledge. Further high-quality randomized controlled trials are required to confirm these findings.
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Affiliation(s)
- Pradeep Paul George
- Health Services and Outcomes Research, National Healthcare Group, Singapore, Singapore.,Joanna Briggs Institute, University of Adelaide, Adelaide, Australia.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Olena Zhabenko
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Bhone Myint Kyaw
- Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Panagiotis Antoniou
- Laboratory of Medical Physics, Aristotle University of Thessaloniki, Thessaloníki, Greece
| | - Pawel Posadzki
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Nakul Saxena
- Ophthalmology Team, Novartis, Singapore, Singapore
| | - Monika Semwal
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Lorainne Tudor Car
- Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Nabil Zary
- Medical Education Research and Scholarship Unit, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.,Department of Learning, Informative, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.,10I Emerging Technologies Lab, Mohammed VI University of Health Sciences, Casablanca, Morocco
| | - Craig Lockwood
- Joanna Briggs Institute, University of Adelaide, Adelaide, Australia
| | - Josip Car
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.,Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
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26
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Gaupp R, Dinius J, Drazic I, Körner M. Long-term effects of an e-learning course on patient safety: A controlled longitudinal study with medical students. PLoS One 2019; 14:e0210947. [PMID: 30657782 PMCID: PMC6338364 DOI: 10.1371/journal.pone.0210947] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 01/06/2019] [Indexed: 12/02/2022] Open
Abstract
Background To improve patient safety, educational interventions on all system levels, including medical school are necessary. Sound theoretical knowledge on elements influencing patient safety (such as error management or team work) is the basis for behavioral changes of health care professionals. Methods A controlled, quasi-experimental study with repeated measures was deployed. The intervention group participated in a mandatory e-learning course on patient safety (ELPAS) between October 2016 and December 2016. The control group did not receive any didactic session on patient safety. In both groups we measured technical knowledge and attitudes towards patient safety before the intervention (T0), directly after the intervention (T1) and one year after the intervention (T2). Participants were 309 third-year medical students in the intervention group and 154 first- and second-year medical students in the control group. Results Technical knowledge in the intervention group (but not the control group) improved significantly after the intervention and remained high after one year (F(2, 84) = 13.506, p < .001, η2 = .243). Students of the intervention group felt better prepared for safe patient practice, even one year after the intervention F(2, 85) = 6.743, p < .002, η2 = .137). There was no sustainable significant effect on attitudes towards patient safety. Conclusion This study shows, that eLearning interventions can produce significant long-term effects on patient safety knowledge, however, the study did not show long-term effects on attitudes towards patient safety. Our study implies two potential developments for future research: e-learning might be used in combination with face-to-face sessions, or more intensive (in terms of frequency and duration) e-learning sessions may be needed to achieve lasting changes in attitude.
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Affiliation(s)
- Rainer Gaupp
- Freiburg University, Medical Faculty, Medical Psychology and Medical Sociology, Hebelstrasse, Freiburg, Germany
- * E-mail:
| | - Julia Dinius
- Freiburg University, Medical Faculty, Medical Psychology and Medical Sociology, Hebelstrasse, Freiburg, Germany
| | - Ivana Drazic
- SRH University Berlin, Ernst-Reuter-Platz, Berlin, Germany
| | - Mirjam Körner
- Freiburg University, Medical Faculty, Medical Psychology and Medical Sociology, Hebelstrasse, Freiburg, Germany
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Fei J, Li Y, Gao W, Li J. Efficacy of evidence-based medicine training for primary healthcare professionals: a non-randomized controlled trial. BMC MEDICAL EDUCATION 2018; 18:299. [PMID: 30526573 PMCID: PMC6286505 DOI: 10.1186/s12909-018-1404-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Accepted: 11/26/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND The impact of evidence-based medicine (EBM) training techniques in primary healthcare professionals remains to be determined. METHODS A non-randomized controlled trial (NRCT) was performed aiming to assess the two methods of evidence-based medicine training for primary healthcare professionals by assessing evidence based practice (EBP) related knowledge (EBP-K), attitude (EBP-A), personal application (EBP-P), anticipated future use (EBP-F), and community management of hypertension. Participants were recruited and assigned to either an EBM training group that receiving a weekly face-to-face EBM training course, or an EBM self-instruction course for eight weeks. A validated instrument was applied to evaluate the four aspects of EBP. Additionally, community management of hypertension was assessed by comparing the the rate of detection, blood pressure control, standard management, grading management and patient satisfaction between 2015 and 2016 to measure training efficacy. The difference between the impact of these two interventions was assessed statistically. RESULTS One hundred fifty-one participants (69 in the face-to-face EBM training group and 82 in the self-instruction group) were included. Compared to self-instruction, the face-to-face EBM training was associated with significantly improved EBP-Knowledge (26.14 ± 4.22 vs. 22.44 ± 4.47, P < 0.05), EBP-Personal application (22.52 ± 6.18 vs. 16.89 ± 5.99, P < 0.05), and EBP-Future use (44.04 ± 8.97 vs. 37.71 ± 8.39, P < 0.05). EBP-Attitude scores (10.89 ± 4.52 vs.14.93 ± 5.92, P < 0.000) were lower in the EBM training group. Stratified analyses showed that the results were consistent regardless of the participants' gender, professional role (doctors & apothecaries or nurses), rank (junior or senior doctors & apothecaries), or specialty (Traditional Chinese or Western Medicine). Assessment of community hypertension management revealed that the rate of blood pressure control, standardized hypertension management and patient satisfaction was significantly better in group A than group B (1.14% vs.0.69, 2.85% vs.1.68 and 2.41% vs.0.84%). CONCLUSIONS A face-to-face EBM training course improved primary healthcare professionals' EBP knowledge, attitudes, personal application, and anticipated future use. Effective EBM training may improve the efficacy of primary health care services. TRIAL REGISTRATION Non-Randomized Controlled Trial ChiCTR1800017498 , August 1, 2018.
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Affiliation(s)
- Jiaojiao Fei
- General Practice Department at the Second Hospital affiliated to Zhejiang Chinese Medical University, No. 318 Chaowang Road, Hangzhou, 310000 Zhejiang China
| | - Yanhua Li
- General Practice Department at the Second Hospital affiliated to Zhejiang Chinese Medical University, No. 318 Chaowang Road, Hangzhou, 310000 Zhejiang China
| | - Weifei Gao
- General Practice Department at the Second Hospital affiliated to Zhejiang Chinese Medical University, No. 318 Chaowang Road, Hangzhou, 310000 Zhejiang China
| | - Junwei Li
- Zhejiang Chinese Medical University, No. 548 Binwen Road, Hangzhou, Zhejiang, Hangzhou, 310000 Zhejiang China
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28
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Buchberger B, Mattivi J, Schwenke C, Katzer C, Huppertz H, Wasem J. Critical appraisal of RCTs by 3rd year undergraduates after short courses in EBM compared to expert appraisal. GMS JOURNAL FOR MEDICAL EDUCATION 2018; 35:Doc24. [PMID: 29963614 PMCID: PMC6022580 DOI: 10.3205/zma001171] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 11/25/2017] [Accepted: 01/31/2018] [Indexed: 06/08/2023]
Abstract
Introduction: An essential aim of courses in evidence-based medicine (EBM) is to improve the skills for reading and interpreting medical literature adequately. Regarding the conceptual framework, it is important to consider different educational levels. Aim: Our primary aim was to investigate the applicability of different instruments for the assessment of methodological study quality by 3rd grade students after short courses in EBM. Our secondary outcomes were agreement with expert assessments and student's knowledge and competences. Methods: We conducted four short courses in EBM of 90 minutes each for health care management and medical students focused on critical appraisal of the literature. At the end, the students assessed five publications about randomized controlled trials (RCTs) using five different instruments; the results were compared to expert assessments. Results: In total, 167 students participated in our EBM courses. Students' assessments showed a non-systematic over- and underestimation of risk of bias compared to expert assessments with no clear direction. Agreement with expert assessments ranged between 66% to over 80%. Across RCTs, evidence was found that the choice of instrument had an impact on agreement rates between expert and student assessments (p=0.0158). Three RCTs showed an influence of the instrument on the agreement rate (p<0.05 each). Discussion: Our results contrast sharply with those of many other comparable evaluations. Reasons may be a lack of students' motivation due to the compulsory courses, and the comparison to a reference standard in addition to self-ratings causing objectivity. Conclusion: Undergraduates should become familiar with the principles of EBM, including research methods, and the reading of scientific papers as soon as possible. For a deeper understanding, clinical experience seems to be an indispensable precondition. Based on our results, we would recommend an integration of lectures about EBM and critical appraisal at least twice during studies and with greater intensity shortly before graduation.
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Affiliation(s)
- B. Buchberger
- University of Duisburg-Essen, Faculty of Economics and Business Administration, Institute for Health Care Management and Research, Essen, Germany
| | - J.T. Mattivi
- University of Duisburg-Essen, Faculty of Economics and Business Administration, Institute for Health Care Management and Research, Essen, Germany
| | - C. Schwenke
- SCO:SSiS, Schwenke Consulting: Strategies and Solutions in Statistics, Berlin, Germany
| | - C. Katzer
- University of Duisburg-Essen, Faculty of Economics and Business Administration, Institute for Health Care Management and Research, Essen, Germany
| | - H. Huppertz
- University of Duisburg-Essen, Faculty of Economics and Business Administration, Institute for Health Care Management and Research, Essen, Germany
| | - J. Wasem
- University of Duisburg-Essen, Faculty of Economics and Business Administration, Institute for Health Care Management and Research, Essen, Germany
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29
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Mason R, Turner L. Serious gaming: A tool to educate health care providers about domestic violence. Health Care Women Int 2018; 39:859-871. [PMID: 29652562 DOI: 10.1080/07399332.2018.1464572] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Due to many adverse health effects, victims of domestic violence are frequently seen in the health care system. Yet, health care providers may lack the training to assist them. Online curricula can be an effective instructional tool. Our competency-based, serious video game, Responding to Domestic Violence in Clinical Settings, was designed to address health care providers' knowledge gaps through 17 modules, each a half hour in length. Nearly 9,000 participants completed at least one module; nursing students completed the most modules, approximately five hours of instruction. This serious video game-based curriculum is useful in helping health providers and students learn about Domestic Violence.
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Affiliation(s)
- Robin Mason
- Women's College Research Institute, Women's College Hospital; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
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30
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Modi RN, Chapman L, Gajria C, Tang EYH. ‘The best laid schemes o’ mice an’ men’: a workshop to teach the application of evidence based medicine in low- and middle-income countries. EDUCATION FOR PRIMARY CARE 2018; 29:107-112. [DOI: 10.1080/14739879.2017.1413597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Rakesh Narendra Modi
- Institute for Global Health, University College London, London, UK
- Department of Primary Care and Population Health, University College London, London, UK
- Junior International Committee, Royal College of General Practitioners, London, UK
| | | | - Camille Gajria
- Junior International Committee, Royal College of General Practitioners, London, UK
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31
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Cecatti JG, Silveira C, Souza RT, Fernandes KG, Surita FG. EXPERIENCE WITH THE BRAZILIAN NETWORK FOR STUDIES IN REPRODUCTIVE AND PERINATAL HEALTH: THE POWER OF COLLABORATION IN POSTGRADUATE PROGRAMS. Rev Col Bras Cir 2017; 42 Suppl 1:89-93. [PMID: 27437983 DOI: 10.1590/0100-69912015s01027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Accepted: 09/12/2015] [Indexed: 12/11/2022] Open
Abstract
The scientific collaboration in networks may be developed among countries, academic institutions and among peer researchers. Once established, they contribute for knowledge dissemination and a strong structure for research in health. Several advantages are attributed to working in networks: the inclusion of a higher number of subjects in the studies; generation of stronger evidence with a higher representativeness of the population (secondary generalization and external validity); higher likelihood of articles derived from these studies to be accepted in high impact journals with a wide coverage; a higher likelihood of obtaining budgets for sponsorship; easier data collection on rare conditions; inclusions of subjects from different ethnic groups and cultures, among others. In Brazil, the Brazilian Network for Studies on Reproductive and Perinatal Health was created in 2008 with the initial purpose of developing a national network of scientific cooperation for the surveillance of severe maternal morbidity. Since the establishment of this Network, five studies were developed, some of them already finished and others almost being completed, and two new ones being implemented. Results of the activities in this Network have been very productive and with a positive impact on not only the Postgraduate Program of Obstetrics and Gynecology from the University of Campinas, its coordinating center, but also on other participating centers. A considerable number of scientific articles was published, master´s dissertations and PhD theses were presented, and post-doctorate programs were performed, including students from several areas of health, from distinct regions and from several institutions of the whole country. This represents a high social impact taking into account the relevance of the studied topics for the country. As colaborações científicas em rede podem ocorrer entre países, instituições acadêmicas e entre pares de pesquisadores e, uma vez estabelecidas, contribuem para a disseminação do conhecimento e estruturação da pesquisa em saúde. Diversas vantagens são atribuídas ao trabalho em rede como: a inclusão de maior número de participantes nos estudos; gerar evidências mais fortes e com maior representatividade da população (generalização secundária e validade externa); maior facilidade das publicações oriundas dos estudos serem aceitas em periódicos de impacto e abrangência; maior probabilidade de obtenção de verbas para financiamento; maior facilidade na coleta de dados sobre condições raras; inclusão de participantes de diferentes grupos étnicos e culturas, entre outras. No Brasil a Rede Brasileira de Estudos em Saúde Reprodutiva e Perinatal foi criada em 2008 com o objetivo inicial de desenvolver rede nacional de cooperação científica para vigilância da morbidade materna grave. Desde sua formação, cinco estudos foram desenvolvidos, alguns já encerrados e outros em fase de finalização, com outros dois em fase final de implantação. Os resultados das atividades desta Rede têm sido bastante produtivos e impactaram positivamente não apenas no Programa de Pós-Graduação em Tocoginecologia da Universidade Estadual de Campinas, seu centro coordenador, mas também o de outros centros participantes, uma vez que expressivo número de artigos científicos foi publicado, mestrados e doutorados foram defendidos e pós-doutorados finalizados, de alunos de diversas áreas da saúde, de diferentes regiões e de várias instituições de todo o país, com alto impacto social dada a relevância dos temas estudados para o país.
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Affiliation(s)
- José G Cecatti
- Postgraduate Program in Obstetrics and Gynecology, Department of Obstetrics and Gynecology, School of Medical Sciences, Campinas State University, Campinas, SP, Brazil
| | - Carla Silveira
- Postgraduate Program in Obstetrics and Gynecology, Department of Obstetrics and Gynecology, School of Medical Sciences, Campinas State University, Campinas, SP, Brazil
| | - Renato T Souza
- Postgraduate Program in Obstetrics and Gynecology, Department of Obstetrics and Gynecology, School of Medical Sciences, Campinas State University, Campinas, SP, Brazil
| | - Karayna G Fernandes
- Postgraduate Program in Obstetrics and Gynecology, Department of Obstetrics and Gynecology, School of Medical Sciences, Campinas State University, Campinas, SP, Brazil
| | - Fernanda G Surita
- Postgraduate Program in Obstetrics and Gynecology, Department of Obstetrics and Gynecology, School of Medical Sciences, Campinas State University, Campinas, SP, Brazil
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Aoshima S, Kuwabara H, Yamamoto M. Behavioral change of pharmacists by online evidence-based medicine-style education programs. J Gen Fam Med 2017; 18:393-397. [PMID: 29264070 PMCID: PMC5729380 DOI: 10.1002/jgf2.110] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Accepted: 02/20/2017] [Indexed: 11/07/2022] Open
Abstract
Background Although e‐learning evidence‐based medicine (EBM) courses have proven useful in improving the knowledge and skills of residents, it was still unclear for pharmacists in non‐English‐speaking countries. Thus, we investigated the behavioral change of Japanese pharmacists who participated in an EBM‐style e‐learning educational program available online. Methods This EBM‐style e‐learning program, the Japanese Journal Club for Clinical Pharmacists, was operated by three pharmacists through Skype. It comprised an online questionnaire administered to the program viewers. Two frequencies, the opportunity to be aware of EBM practices and that of reading an article, were compared before and after viewing the broadcast. Frequencies were classified into five categories: “almost every day,” “1–2 times a week,” “1–2 times a month,” “1–2 times a year,” and “not at all.” The changes before and after viewing the broadcast were evaluated using a Wilcoxon signed‐rank test. Results The announcement of the questionnaire survey on the web was conducted during the journal club on August 24 and September 7, 2014. The maximum number of simultaneous audiences at the time was 113 persons. Among them, we analyzed data from 36 people who answered the questionnaire. Among these, “1–2 times a week” and “almost every day” were increased, whereas “not at all” was greatly reduced. Indeed, a significant difference was observed in overall change of each frequency before and after viewing the broadcast (P<.001). Conclusion EBM‐style learning programs may play an important role in the postgraduate clinical education of pharmacists.
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Affiliation(s)
- Syuichi Aoshima
- Nakano Hospital Tochigishi Tochigiken Japan.,Association for Appropriate Healthcare Decision-making and Practice Higashihiroshima-shi Hiroshima Japan
| | - Hidenori Kuwabara
- Association for Appropriate Healthcare Decision-making and Practice Higashihiroshima-shi Hiroshima Japan.,Senogawa Hospital Hiroshima-shi Hiroshima Japan
| | - Masahiro Yamamoto
- Association for Appropriate Healthcare Decision-making and Practice Higashihiroshima-shi Hiroshima Japan.,Yanase pharmacy Co., Ltd.Toyota-shi Aichi Japan
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da Costa Vieira RA, Lopes AH, Sarri AJ, Benedetti ZC, de Oliveira CZ. Oncology E-Learning for Undergraduate. A Prospective Randomized Controlled Trial. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2017; 32:344-351. [PMID: 26768003 DOI: 10.1007/s13187-015-0979-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
UNLABELLED The e-learning education is a promising method, but there are few prospective randomized publications in oncology. The purpose of this study was to assess the level of retention of information in oncology from undergraduate students of physiotherapy. A prospective, controlled, randomized, crossover study, 72 undergraduate students of physiotherapy, from the second to fourth years, were randomized to perform a course of physiotherapy in oncology (PHO) using traditional classroom or e-learning. Students were offered the same content of the subject. The teacher in the traditional classroom model and the e-learning students used the Articulate® software. The course tackled the main issues related to PHO, and it was divided into six modules, 18 lessons, evaluated by 126 questions. A diagnosis evaluation was performed previous to the course and after every module. The sample consisted of 67 students, allocated in groups A (n = 35) and B (n = 32), and the distribution was homogeneous between the groups. Evaluating the correct answers, we observed a limited score in the pre-test (average grade 44.6 %), which has significant (p < 0.001) improvement in post-test evaluation (average grade 73.9 %). The correct pre-test (p = 0.556) and post-test (p = 0.729) evaluation and the retention of information (p = 0.408) were not different between the two groups. The course in PHO allowed significant acquisition of knowledge to undergraduate students, but the level of information retention was statistically similar between the traditional classroom form and the e-learning, a fact that encourages the use of e-learning in oncology. CLINICAL TRIAL REGISTRATION NUMBER REBECU1111-1142-1963.
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Affiliation(s)
- René Aloisio da Costa Vieira
- Posgraduate Oncology Program, Barretos Cancer Hospital, Rua Antenor Duarte Villela, 1331, Bairro Dr Paulo Prata, Barretos, SP, CEP: 14.784.400, Brazil.
| | - Ana Helena Lopes
- Posgraduate Oncology Program, Barretos Cancer Hospital, Rua Antenor Duarte Villela, 1331, Bairro Dr Paulo Prata, Barretos, SP, CEP: 14.784.400, Brazil
- UNIFAFIBE Universitary Center, Barretos, Brazil
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Zhan X, Zhang Z, Sun F, Liu Q, Peng W, Zhang H, Yan W. Effects of Improving Primary Health Care Workers' Knowledge About Public Health Services in Rural China: A Comparative Study of Blended Learning and Pure E-Learning. J Med Internet Res 2017; 19:e116. [PMID: 28461286 PMCID: PMC5432664 DOI: 10.2196/jmir.6453] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2016] [Revised: 10/02/2016] [Accepted: 03/02/2017] [Indexed: 02/06/2023] Open
Abstract
Background Primary health care workers (PHCWs) are a major force in delivering basic public health services (BPHS) in rural China. It is necessary to take effective training approaches to improve PHCWs’ competency on BPHS. Both electronic learning (e-learning) and blended learning have been widely used in the health workers’ education. However, there is limited evidence on the effects of blended learning in comparison with pure e-learning. Objective The aim of this study was to evaluate the effects of a blended-learning approach for rural PHCWs in improving their knowledge about BPHS as well as training satisfaction in comparison with a pure e-learning approach. Methods The study was conducted among PHCWs in 6 rural counties of Hubei Province, China, between August 2013 and April 2014. Three counties were randomly allocated blended-learning courses (29 township centers or 612 PHCWs—the experimental group), and three counties were allocated pure e-learning courses (31 township centers or 625 PHCWs—the control group). Three course modules were administered for 5 weeks, with assessments at baseline and postcourse. Primary outcomes were score changes in courses’ knowledge. Secondary outcome was participant satisfaction (5-point Likert scale anchored between 1 [strongly agree] and 5 [strongly disagree]). Results The experimental group had higher mean scores than the control group in knowledge achievement in three course modules: (1) module 1: 93.21 (95% CI 92.49-93.93) in experimental group versus 88.29 (95% CI 87.19-89.40) in the control group; adjusted difference, 4.92 (95% CI 2.61-7.24; P<.001); (2) module 2: 94.05 (95% CI 93.37-94.73) in the experimental group vs 90.22 (95% CI 89.12-91.31) in the control group; adjusted difference, 3.67 (95% CI 1.17-6.18; P=.004); (3) module 3: 93.88 (95% CI 93.08-94.68) in the experimental group versus 89.09 (95% CI 87.89-90.30) in control group; adjusted difference, 4.63 (95% CI 2.12-7.14; P<.001). The participants in the experimental learning group gave more positive responses with the four issues than control group participants: (1) the increase of interest in learning, 1.85 (95% CI 1.22-2.80; P=.003); (2) the increase of interaction with others, 1.77 (95% CI 1.20-2.60; P=.004); (3) the satisfaction with learning experience, 1.78 (95% CI 1.11-2.88; P=.02); and (4) achievement of learning objectives, 1.63 (95% CI 1.08-2.48; P=.02). Conclusions Among PHCWs in rural China, a blended-learning approach to BPHS training could result in a higher knowledge achievement and satisfaction level compared with a pure e-learning approach. The findings of the study will contribute knowledge to improve the competency of PHCWs in similar settings.
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Affiliation(s)
- Xingxin Zhan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Zhixia Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Fang Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Qian Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Weijun Peng
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Heng Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Weirong Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
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Huntley SJ, Dean RS, Brennan ML. The Awareness of the International Veterinary Profession of Evidence-Based Veterinary Medicine and Preferred Methods of Training. Vet Sci 2017; 4:vetsci4010015. [PMID: 29056674 PMCID: PMC5606622 DOI: 10.3390/vetsci4010015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 02/21/2017] [Accepted: 03/01/2017] [Indexed: 11/16/2022] Open
Abstract
Evidence-based veterinary medicine (EVM) is an evolving discipline in veterinary medicine so it is important to periodically “benchmark” opinion about EVM across the profession. An international survey to assess veterinarians’ awareness of EVM was conducted. Veterinarians were surveyed via an online questionnaire (all countries) or a postal questionnaire (UK only). Participants were asked whether they had heard of EVM, where they had first heard the term, and their preferences of method for receiving continuing professional development (CPD). There were 6310 respondents, of which 4579 (72.5%) worked in the UK and 5384 (85.3%) were clinicians. Veterinarians that had heard of EVM (n = 5420, 85.9%) were most likely to be clinicians (OR = 4.00; 95% CI: 3.37, 4.75), respondents working in the UK (OR = 1.32; CI: 1.13, 1.54), or respondents with a postgraduate degree or qualification (OR = 1.77; CI: 1.51, 2.08). The most common sources from which respondents had heard of EVM were at vet school or university (n = 1207, 29.8%), via literature (peer-reviewed papers or other publications) (n = 1074, 26.5%), and via CPD courses (n = 564, 13.9%). Most respondents were interested in finding out more about EVM (n = 4256 of 6173, 69%). The preferred methods of CPD were day or evening seminars (n = 2992 of 6017, 49.7%), conferences (n = 1409, 23.4%), and online courses (n = 524, 8.7%), although the order of preference differed slightly between groups. There appears to be substantial awareness of EVM amongst veterinarians internationally. However, it appears that further training in EVM would be welcomed. Preferences on how CPD in general is received differs between groups, so this should be borne in mind by training providers when formulating a strategy for the dissemination of EVM training across the global profession.
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Affiliation(s)
- Selene J Huntley
- Centre for Evidence-based Veterinary Medicine (CEVM), School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington Campus, Leicestershire LE12 5RD, UK.
| | - Rachel S Dean
- Centre for Evidence-based Veterinary Medicine (CEVM), School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington Campus, Leicestershire LE12 5RD, UK.
| | - Marnie L Brennan
- Centre for Evidence-based Veterinary Medicine (CEVM), School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington Campus, Leicestershire LE12 5RD, UK.
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Internet Training Resulted in Improved Trainee Performance in a Simulated Opioid-Poisoned Patient as Measured by Checklist. J Med Toxicol 2016; 12:289-94. [PMID: 27037564 DOI: 10.1007/s13181-016-0544-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 02/15/2016] [Accepted: 03/02/2016] [Indexed: 10/22/2022] Open
Abstract
INTRODUCTION Opioid overdose is a leading cause of death in the USA. Internet-based teaching can improve medical knowledge among trainees, but there are limited data to show the effect of Internet-based teaching on clinical competence in medical training, including management of opioid poisoning. METHODS We used an ecological design to assess the effect of an Internet-based teaching module on the management of a simulated opioid-poisoned patient. We enrolled two consecutive classes of post-graduate year-1 residents from a single emergency medicine program. The first group (RA) was instructed to read a toxicology textbook chapter and the second group (IT) took a brief Internet training module. All participants subsequently managed a simulated opioid-poisoned patient. The participants' performance was evaluated with two types of checklist (simple and time-weighted), along with global assessment scores. RESULTS Internet-trained participants performed better on both checklist scales. The difference between mean simple checklist scores by the IT and RA groups was 0.23 (95 % CI, 0.016-0.44). The difference between mean time-weighted checklist scores was 0.27 (95 % CI, 0.048-0.49). When measured by global assessment, there was no statistically significant difference between RA and IT participants. CONCLUSION These data suggest that the Internet module taught basic principles of management of the opioid-poisoned patient. In this scenario, global assessment and checklist assessment may not measure the same proficiencies. These encouraging results are not sufficient to show that this Internet tool improves clinical performance. We should assess the impact of the Internet module on performance in a true clinical environment.
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Thor J, Olsson D, Nordenström J. The design, fate and impact of a hospital-wide training program in evidence-based medicine for physicians - an observational study. BMC MEDICAL EDUCATION 2016; 16:86. [PMID: 26956890 PMCID: PMC4784409 DOI: 10.1186/s12909-016-0601-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 02/23/2016] [Indexed: 05/26/2023]
Abstract
BACKGROUND Many doctors fail to practice Evidence-Based Medicine (EBM) effectively, in part due to insufficient training. We report on the design, fate and impact of a short learner-centered EBM train-the-trainer program aimed at all 2400 doctors at the Karolinska University Hospital in Sweden on the heels of a tumultuous merger, focusing particularly on whether it affected the doctors' knowledge, attitudes and skills regarding EBM. METHODS We used a validated EBM instrument in a before-and-after design to assess the impact of the training. Changes in responses were analyzed at the individual level using the Wilcoxon matched pairs test. We also reviewed documentation from the program - including the modular EBM training schedule and the template for participants' Critically Appraised Topic reports - to describe the training's content, design, conduct, and fate. RESULTS The training, designed to be delivered in modules of 45 min totaling 1.5 days, failed to reach most doctors at the hospital, due to cost cutting pressures and competing demands. Among study participants (n = 174), many reported suboptimal EBM knowledge and skills before the training. Respondents' strategies for solving clinical problems changed after the training: the proportion of respondents reporting to use (or intend to use) secondary sources "Often/very often" changed from 5 % before the training to 76 % after the training; in parallel, reliance on textbooks and on colleagues fell (48 to 23 % and 79 to 65 %, respectively). Participants' confidence in assessing scientific articles increased and their attitudes toward EBM became more positive. The proportion of correct answers in the EBM knowledge test increased from 52 to 71 %. All these changes were statistically significant at p < 0.05. CONCLUSIONS Many study participants, despite working at a university hospital, lacked basic EBM knowledge and skills and used the scientific literature suboptimally. The kind of short learner-centered EBM training evaluated here brought significant improvements among the minority of hospital doctors who were able to participate and, if applied widely, could contribute to better, safer and more cost-effective care.
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Affiliation(s)
- Johan Thor
- />The Jönköping Academy for Improvement of Health and Welfare, Jönköping University, P O Box 1026, SE-551 11 Jönköping, Sweden
- />The Medical Management Centre, Department for Learning, Informatics, Management and Ethics, Karolinska Institutet, Tomtebodavägen 18A, 5th floor, SE-171 77 Stockholm, Sweden
| | - Daniel Olsson
- />Unit of Biostatistics, Department of Epidemiology, Institute for Environmental Medicine (IMM), Karolinska Institutet, Nobels väg 13, SE-171 77 Stockholm, Sweden
| | - Jörgen Nordenström
- />Department of Molecular Medicine and Surgery (MMK), Karolinska Institutet, K1 Karolinska University Hospital, Solna (L1:00), SE-171 76 Stockholm, Sweden
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Liu Q, Peng W, Zhang F, Hu R, Li Y, Yan W. The Effectiveness of Blended Learning in Health Professions: Systematic Review and Meta-Analysis. J Med Internet Res 2016; 18:e2. [PMID: 26729058 PMCID: PMC4717286 DOI: 10.2196/jmir.4807] [Citation(s) in RCA: 272] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Revised: 08/28/2015] [Accepted: 10/07/2015] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Blended learning, defined as the combination of traditional face-to-face learning and asynchronous or synchronous e-learning, has grown rapidly and is now widely used in education. Concerns about the effectiveness of blended learning have led to an increasing number of studies on this topic. However, there has yet to be a quantitative synthesis evaluating the effectiveness of blended learning on knowledge acquisition in health professions. OBJECTIVE We aimed to assess the effectiveness of blended learning for health professional learners compared with no intervention and with nonblended learning. We also aimed to explore factors that could explain differences in learning effects across study designs, participants, country socioeconomic status, intervention durations, randomization, and quality score for each of these questions. METHODS We conducted a search of citations in Medline, CINAHL, Science Direct, Ovid Embase, Web of Science, CENTRAL, and ERIC through September 2014. Studies in any language that compared blended learning with no intervention or nonblended learning among health professional learners and assessed knowledge acquisition were included. Two reviewers independently evaluated study quality and abstracted information including characteristics of learners and intervention (study design, exercises, interactivity, peer discussion, and outcome assessment). RESULTS We identified 56 eligible articles. Heterogeneity across studies was large (I(2) ≥93.3) in all analyses. For studies comparing knowledge gained from blended learning versus no intervention, the pooled effect size was 1.40 (95% CI 1.04-1.77; P<.001; n=20 interventions) with no significant publication bias, and exclusion of any single study did not change the overall result. For studies comparing blended learning with nonblended learning (pure e-learning or pure traditional face-to-face learning), the pooled effect size was 0.81 (95% CI 0.57-1.05; P<.001; n=56 interventions), and exclusion of any single study did not change the overall result. Although significant publication bias was found, the trim and fill method showed that the effect size changed to 0.26 (95% CI -0.01 to 0.54) after adjustment. In the subgroup analyses, pre-posttest study design, presence of exercises, and objective outcome assessment yielded larger effect sizes. CONCLUSIONS Blended learning appears to have a consistent positive effect in comparison with no intervention, and to be more effective than or at least as effective as nonblended instruction for knowledge acquisition in health professions. Due to the large heterogeneity, the conclusion should be treated with caution.
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Affiliation(s)
- Qian Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College of Huazhong University of Science &Technology, Wuhan, China
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Nicastro E, Lo Vecchio A, Liguoro I, Chmielewska A, De Bruyn C, Dolinsek J, Doroshina E, Fessatou S, Pop TL, Prell C, Tabbers MM, Tavares M, Urenden-Elicin P, Bruzzese D, Zakharova I, Sandhu B, Guarino A. The Impact of E-Learning on Adherence to Guidelines for Acute Gastroenteritis: A Single-Arm Intervention Study. PLoS One 2015; 10:e0132213. [PMID: 26148301 PMCID: PMC4493016 DOI: 10.1371/journal.pone.0132213] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Accepted: 06/12/2015] [Indexed: 02/05/2023] Open
Abstract
Objective E-learning is a candidate tool for clinical practice guidelines (CPG) implementation due to its versatility, universal access and low costs. We aimed to assess the impact of a five-module e-learning course about CPG for acute gastroenteritis (AGE) on physicians’ knowledge and clinical practice. Study design This work was conceived as a pre/post single-arm intervention study. Physicians from 11 European countries registered for the online course. Personal data, pre- and post-course questionnaires and clinical data about 3 to 5 children with AGE managed by each physician before and after the course were collected. Primary outcome measures included the proportion of participants fully adherent to CPG and number of patients managed with full adherence. Results Among the 149 physicians who signed up for the e-learning course, 59 took the course and reported on their case management of 519 children <5 years of age who were referred to their practice because of AGE (281 and 264 children seen before and after the course, respectively). The course improved knowledge scores (pre-course 8.6 ± 2.7 versus post-course 12.8 ± 2.1, P < 0.001), average adherence (from 87.0 ± 7.7% to 90.6 ± 7.1%, P = 0.001) and the number of patients managed in full adherence with the guidelines (from 33.6 ± 31.7% to 43.9 ± 36.1%, P = 0.037). Conclusions E-learning is effective in increasing knowledge and improving clinical practice in paediatric AGE and is an effective tool for implementing clinical practice guidelines.
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Affiliation(s)
- Emanuele Nicastro
- Department of Translational Medical Science, Sector of Pediatrics. University Federico II, Naples, Italy
- Paediatric Hepatology Gastroenterology and Transplantation Unit, Hospital Papa Giovanni XXIII, Bergamo, Italy
| | - Andrea Lo Vecchio
- Department of Translational Medical Science, Sector of Pediatrics. University Federico II, Naples, Italy
| | - Ilaria Liguoro
- Department of Translational Medical Science, Sector of Pediatrics. University Federico II, Naples, Italy
| | - Anna Chmielewska
- Department of Pediatrics, The Medical University of Warsaw, Warsaw, Poland
| | - Caroline De Bruyn
- Universitair Ziekenhuis Brussel Kinderen, Vrije Universiteit Brussel, Brussels, Belgium
| | | | - Elena Doroshina
- Russian Medical Postgraduate Academy, Moscow, Russian Federation
| | | | - Tudor Lucian Pop
- 2nd Pediatric Clinic, Iuliu Haţieganu, University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Christine Prell
- Dr. von Hauner Children’s Hospital, University of Munich Medical Center, Munich, Germany
| | | | - Marta Tavares
- Department of Pediatrics, Hospital Sao Joao, Porto, Portugal
| | | | - Dario Bruzzese
- Department of Public Health, University of Naples “Federico II,” Italy
| | - Irina Zakharova
- Russian Medical Postgraduate Academy, Moscow, Russian Federation
| | - Bhupinder Sandhu
- Department of Paediatric Gastroenterology, Bristol Royal Hospital for Children, Bristol, United Kingdom
| | - Alfredo Guarino
- Department of Translational Medical Science, Sector of Pediatrics. University Federico II, Naples, Italy
- * E-mail:
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Zhang Z, Zhan X, Li Y, Hu R, Yan W. Web-based training for primary healthcare workers in rural China: a qualitative exploration of stakeholders' perceptions. PLoS One 2015; 10:e0125975. [PMID: 25961727 PMCID: PMC4427271 DOI: 10.1371/journal.pone.0125975] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Accepted: 03/27/2015] [Indexed: 11/29/2022] Open
Abstract
Background Equitable access to basic public health services is a priority in China. However, primary healthcare workers’ competence to deliver public health services is relatively poor because they lack professional training. Since the availability of web-based training has increased in China, the current study explored stakeholders’ perceptions of a web-based training program on basic public health services to understand their thoughts, experiences, and attitudes about it. Methods Six focus group discussions with primary healthcare workers and three with directors of township hospitals, county-level Health Bureaus, and county-level Centers for Disease Control and Prevention were conducted in Yichang City during 2013. Semi-structured topic guides were used to facilitate qualitative data collection. Audio recordings of the sessions were transcribed verbatim and theme analysis was performed. Results Most of the study’s participants, especially the village doctors, had insufficient knowledge of basic public health services. The existing training program for primary healthcare workers consisted of ineffective traditional face-to-face sessions and often posed accessibility problems for the trainees. Most of the study’s participants had a positive attitude about web-based learning and expressed a strong desire to receive this novel training approach because of its flexibility and convenience. The perceived barriers to utilizing the web-based training method included poor computer literacy, lack of personal interaction, inadequate infrastructure, and lack of time and motivation. The facilitators of this approach included the training content applicability, the user-friendly and interactive learning format, and policy support. Conclusions Web-based training on basic public health services is a promising option in rural China. The findings of the study will contribute knowledge to implementation of web-based training in similar settings.
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Affiliation(s)
- Zhixia Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, P.R. China
| | - Xingxin Zhan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, P.R. China
| | - Yingxue Li
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, P.R. China
| | - Rong Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, P.R. China
| | - Weirong Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, P.R. China
- * E-mail:
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Cross-sectional study to examine evidence-based practice skills and behaviors of physical therapy graduates: is there a knowledge-to-practice gap? Phys Ther 2015; 95:568-78. [PMID: 24810862 DOI: 10.2522/ptj.20130450] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Accepted: 04/22/2014] [Indexed: 02/09/2023]
Abstract
BACKGROUND Curricula changes in physical therapist education programs in Canada emphasize evidence-based practice skills, including literature retrieval and evaluation. Do graduates use these skills in practice? OBJECTIVES The aim of this study was to evaluate the use of research information in the clinical decision making of therapists with different years of experience and evidence-based practice preparation. Perceptions about evidence-based practice were explored qualitatively. DESIGN A cross-sectional study with 4 graduating cohorts was conducted. METHODS Eighty physical therapists representing 4 different graduating cohorts participated in interviews focused on 2 clinical scenarios. Participants had varying years of clinical experience (range=1-15 years) and academic knowledge of evidence-based practice skills. Therapists discussed the effectiveness of interventions related to the scenarios and identified the sources of information used to reach decisions. Participants also answered general questions related to evidence-based practice knowledge. RESULTS Recent graduates demonstrated better knowledge of evidence-based practice skills compared with therapists with 6 to 15 years of clinical experience. However, all groups used clinical experience most frequently as their source of information for clinical decisions. Research evidence was infrequently included in decision making. LIMITATIONS This study used a convenience sample of therapists who agreed to volunteer for the study. CONCLUSIONS The results suggest a knowledge-to-practice gap; graduates are not using the new skills to inform their practice. Tailoring academic evidence-based activities more to the time constraints of clinical practice may help students to be more successful in applying evidence in practice. Academic programs need to do more to create and nurture environments in both academic and clinical settings to ensure students practice using evidence-based practice skills across settings.
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Thorne CJ, Lockey AS, Bullock I, Hampshire S, Begum-Ali S, Perkins GD. E-learning in advanced life support--an evaluation by the Resuscitation Council (UK). Resuscitation 2015; 90:79-84. [PMID: 25766092 DOI: 10.1016/j.resuscitation.2015.02.026] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Revised: 02/01/2015] [Accepted: 02/15/2015] [Indexed: 11/26/2022]
Abstract
AIM To descriptively analyse the outcomes following the national roll out of an e-Learning advanced life support course (e-ALS) compared to a conventional 2-day ALS course (c-ALS). METHOD Between 1st January 2013 and 30th June 2014, 27,170 candidates attended one of the 1350 Resuscitation Council (UK) ALS courses across the UK. 18,952 candidates were enrolled on a c-ALS course and 8218 on an e-ALS course. Candidates participating in the e-ALS course completed 6-8h of online e-Learning prior to attending the 1 day modified face-to-face course. Candidates participating in the c-ALS course undertook the Resuscitation Council (UK) 2-day face-to-face course. All candidates were assessed by a pre- and post-course MCQ and a practical cardiac arrest simulation (CAS-test). Demographic data were collected in addition to assessment outcomes. RESULTS Candidates on the e-ALS course had higher scores on the pre-course MCQ (83.7%, SD 7.3) compared to those on the c-ALS course (81.3%, SD 8.2, P<0.001). Similarly, they had slightly higher scores on the post-course MCQ (e-ALS 87.9%, SD 6.4 vs. c-ALS 87.4%, SD 6.5; P<0.001). The first attempt CAS-test pass rate on the e-ALS course was higher than the pass rate on the c-ALS course (84.6% vs. 83.6%; P=0.035). The overall pass rate was 96.6% on both the e-ALS and c-ALS courses (P=0.776). CONCLUSION The e-ALS course demonstrates equivalence to traditional face-to-face learning in equipping candidates with ALS skills when compared to the c-ALS course. Value is added when considering benefits such as increased candidate autonomy, cost-effectiveness, decreased instructor burden and improved standardisation of course material. Further dissemination of the e-ALS course should be encouraged.
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Affiliation(s)
- C J Thorne
- Department of Critical Care Medicine, Heart of England NHS Foundation Trust, Birmingham B9 5SS, UK; Resuscitation Council (UK), Tavistock House North, Tavistock Square, London WC1H 9HR, UK.
| | - A S Lockey
- Resuscitation Council (UK), Tavistock House North, Tavistock Square, London WC1H 9HR, UK; Calderdale & Huddersfield NHS Foundation Trust, Halifax HX3 0PW, UK
| | - I Bullock
- Resuscitation Council (UK), Tavistock House North, Tavistock Square, London WC1H 9HR, UK; Royal College of Physicians, London NW1 4LE, UK
| | - S Hampshire
- Resuscitation Council (UK), Tavistock House North, Tavistock Square, London WC1H 9HR, UK
| | - S Begum-Ali
- Resuscitation Council (UK), Tavistock House North, Tavistock Square, London WC1H 9HR, UK
| | - G D Perkins
- Department of Critical Care Medicine, Heart of England NHS Foundation Trust, Birmingham B9 5SS, UK; Resuscitation Council (UK), Tavistock House North, Tavistock Square, London WC1H 9HR, UK; University of Warwick, Warwick Medical School, Warwick CV4 7AL, UK
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Barteit S, Hoepffner P, Huwendiek S, Karamagi A, Munthali C, Theurer A, Neuhann F. Self-directed e-learning at a tertiary hospital in Malawi--a qualitative evaluation and lessons learnt. GMS ZEITSCHRIFT FUR MEDIZINISCHE AUSBILDUNG 2015; 32:Doc7. [PMID: 25699110 PMCID: PMC4330637 DOI: 10.3205/zma000949] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Revised: 09/22/2014] [Accepted: 12/01/2014] [Indexed: 11/30/2022]
Abstract
Background: Malawi faces a severe lack of health workers. Despite initiatives to address this problem, a critical shortage of health care staff remains. This lack challenges the education and training of junior medical staff, especially medical interns in their final and crucial training year before they independently work as medical doctors. Project description: We have introduced an e-learning platform in the medical department of the Kamuzu Central Hospital (KCH) in Malawi. With the support of computer-assisted instruction, we aimed to improve the quality of medical training and education, as well as access to current medical materials, in particular for interns. Method: From March to April 2012, we conducted a qualitative evaluation to assess relevance and appropriateness of the e-learning platform. Data was collected via face-to-face interviews, a guided group discussion and a checklist based observation log. Evaluation data was recorded and coded using content analysis, interviewees were chosen via purposive sampling. Results: E-learning proved to be technically feasible in this setting. Users considered the e-learning platform to be relevant and appropriate. Concerns were raised about sustainability, accessibility and technical infrastructure, as well as limited involvement and responsibilities of Malawian partners. Interest in e-learning was high, yet, awareness of and knowledge about the e-learning platform among potential users was low. Evaluation results indicated that further adaptions to local needs are necessary to increase usage and accessibility. Conclusions: Interview results and our project experiences showed that, in the given setting, e-learning requires commitment from local stakeholders, adequate technical infrastructure, identification and assignation of responsibilities, as well as specific adaption to local needs.
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Affiliation(s)
- Sandra Barteit
- Heidelberg University, Institute of Public Health, Heidelberg, Germany
| | - Philip Hoepffner
- University Hospital of Würzburg, Clinic and Polyclinic for Psychiatry and Psychotherapy, Würzburg, Germany
| | - Sören Huwendiek
- University of Bern, Institute of Medical Education, Department of Assessment and Evaluation, Bern, Switzerland
| | - Angela Karamagi
- ESTHER Germany, Malawi German Networking for Capacity Building in Treatment, Training and Research at Kamuzu Central Hospital (MAGNET), Germany
| | | | - Antje Theurer
- ESTHER Germany, Malawi German Networking for Capacity Building in Treatment, Training and Research at Kamuzu Central Hospital (MAGNET), Germany
| | - Florian Neuhann
- Heidelberg University, Institute of Public Health, Heidelberg, Germany
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Foster MJ, Shurtz S, Pepper C. Evaluation of best practices in the design of online evidence-based practice instructional modules. J Med Libr Assoc 2014; 102:31-40. [PMID: 24415917 DOI: 10.3163/1536-5050.102.1.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES The research determined to what extent best practices are being followed by freely available online modules aimed at teaching critical thinking and evidence-based practices (EBPs) in health sciences fields. METHODS In phase I, an evaluation rubric was created after reviewing the literature. Individual rubric questions were assigned point values and grouped into sections, and the sections weighted. Phase II involved searching Internet platforms to locate online EBP modules, which were screened to determine if they met predetermined criteria for inclusion. Phase III comprised a first evaluation, in which two authors assessed each module, followed by a second evaluation of the top-scoring modules by five representatives from different health sciences units. RESULTS The rubric's 28 questions were categorized into 4 sections: content, design, interactivity, and usability. After retrieving 170 online modules and closely screening 91, 42 were in the first evaluation and 8 modules were in the second evaluation. Modules in the first evaluation earned, on average, 59% of available points; modules in the second earned an average of 68%. Both evaluations had a moderate level of inter-rater reliability. CONCLUSIONS The rubric was effective and reliable in evaluating the modules. Most modules followed best practices for content and usability but not for design and interactivity. IMPLICATIONS By systematically collecting and evaluating instructional modules, the authors found many potentially useful elements for module creation. Also, by reviewing the limitations of the evaluated modules, the authors were able to anticipate and plan ways to overcome potential issues in module design.
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Affiliation(s)
- Margaret J Foster
- , Systematic Reviews and Research Coordinator, Medical Sciences Library, Texas A&M University, 4462 TAMU, College Station, TX 77843-4462; , Instructional Services Librarian, Medical Sciences Library, Texas A&M University, 4462 TAMU, College Station, TX 77843-4462; , Field Services Coordinator, Medical Sciences Library, Texas A&M University, 3950 North A. W. Grimes, Room N405G, Round Rock, TX 78665
| | - Suzanne Shurtz
- , Systematic Reviews and Research Coordinator, Medical Sciences Library, Texas A&M University, 4462 TAMU, College Station, TX 77843-4462; , Instructional Services Librarian, Medical Sciences Library, Texas A&M University, 4462 TAMU, College Station, TX 77843-4462; , Field Services Coordinator, Medical Sciences Library, Texas A&M University, 3950 North A. W. Grimes, Room N405G, Round Rock, TX 78665
| | - Catherine Pepper
- , Systematic Reviews and Research Coordinator, Medical Sciences Library, Texas A&M University, 4462 TAMU, College Station, TX 77843-4462; , Instructional Services Librarian, Medical Sciences Library, Texas A&M University, 4462 TAMU, College Station, TX 77843-4462; , Field Services Coordinator, Medical Sciences Library, Texas A&M University, 3950 North A. W. Grimes, Room N405G, Round Rock, TX 78665
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Li T, Saldanha IJ, Vedula SS, Yu T, Rosman L, Twose C, N Goodman S, Dickersin K. Learning by doing-teaching systematic review methods in 8 weeks. Res Synth Methods 2014; 5:254-63. [PMID: 26052850 DOI: 10.1002/jrsm.1111] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Revised: 12/30/2013] [Accepted: 01/06/2014] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The objective of this paper is to describe the course "Systematic Reviews and Meta-analysis" at the Johns Hopkins Bloomberg School of Public Health. METHODS A distinct feature of our course is a group project in which students, assigned to multi-disciplinary groups, conduct a systematic review. In-class sessions comprise didactic lectures, hands-on exercises, demonstrations, discussion, and group work. Students also work outside of class to complete the systematic review. Students evaluated the course at the end of the term. We also surveyed students from 2004 to 2012 to learn more about the long-term impact of the course. RESULTS The course has been offered to more than 800 students since 1995. In our view, aspects that worked well include the hands-on approach, students working in a multidisciplinary group, intensive interaction with the teaching team, moving to an online approach, and continuous updates of the course content. A persistent issue is the constraint of time. 193 of 211 (91%) survey participants reported that the course is currently useful or as having an impact on their work. CONCLUSIONS Our experiences have led us to remain committed to a hands-on approach. Our course serves as a bridge between classroom learning and real-world practice, and provides an example of teaching systematic review.
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Affiliation(s)
- Tianjing Li
- Center for Clinical Trials, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Ian J Saldanha
- Center for Clinical Trials, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - S Swaroop Vedula
- Center for Clinical Trials, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Tsung Yu
- Center for Clinical Trials, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Lori Rosman
- Center for Clinical Trials, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Claire Twose
- Center for Clinical Trials, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Steven N Goodman
- Center for Clinical Trials, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Kay Dickersin
- Center for Clinical Trials, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
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Ma X, Xu B, Liu Q, Zhang Y, Xiong H, Li Y. Effectiveness of evidence-based medicine training for undergraduate students at a Chinese Military Medical University: a self-controlled trial. BMC MEDICAL EDUCATION 2014; 14:133. [PMID: 24996537 PMCID: PMC4091652 DOI: 10.1186/1472-6920-14-133] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2014] [Accepted: 06/30/2014] [Indexed: 06/02/2023]
Abstract
BACKGROUND To evaluate the effect of the integration of evidence-based medicine (EBM) into medical curriculum by measuring undergraduate medical students' EBM knowledge, attitudes, personal application, and anticipated future use. METHODS A self-controlled trial was conducted with 251 undergraduate students at a Chinese Military Medical University, using a validated questionnaire regarding the students' evidence-based practice (EBP) about knowledge (EBP-K), attitude (EBP-A), personal application (EBP-P), and future anticipated use (EBP-F). The educational intervention was a 20-hour EBM course formally included in the university's medical curriculum, combining lectures with small group discussion and student-teacher exchange sessions. Data were analyzed using paired t-tests to test the significance of the difference between a before and after comparison. RESULTS The difference between the pre- and post-training scores were statistically significant for EBP-K, EBP-A, EBP-P, and EBP-F. The scores for EBP-P showed the most pronounced percentage change after EBM training (48.97 ± 8.6%), followed by EBP-A (20.83 ± 2.1%), EBP-K (19.21 ± 3.2%), and EBP-F (17.82 ± 5.7%). Stratified analyses by gender, and program subtypes did not result in any significant changes to the results. CONCLUSIONS The integration of EBM into the medical curriculum improved undergraduate medical students' EBM knowledge, attitudes, personal application, and anticipated future use. A well-designed EBM training course and objective outcome measurements are necessary to ensure the optimum learning opportunity for students.
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Affiliation(s)
- Xiangyu Ma
- Department of Epidemiology, College of Preventive Medicine, Third Military Medical University, Chongqing 400038, People’s Republic of China
- Center for Clinical Epidemiology and Evidence-based Medicine, Third Military Medical University, Chongqing People’s Republic of China
| | - Bin Xu
- Department of Epidemiology, College of Preventive Medicine, Third Military Medical University, Chongqing 400038, People’s Republic of China
- Center for Clinical Epidemiology and Evidence-based Medicine, Third Military Medical University, Chongqing People’s Republic of China
| | - Qingyun Liu
- Department of Epidemiology, College of Preventive Medicine, Third Military Medical University, Chongqing 400038, People’s Republic of China
- Center for Clinical Epidemiology and Evidence-based Medicine, Third Military Medical University, Chongqing People’s Republic of China
| | - Yao Zhang
- Department of Epidemiology, College of Preventive Medicine, Third Military Medical University, Chongqing 400038, People’s Republic of China
- Center for Clinical Epidemiology and Evidence-based Medicine, Third Military Medical University, Chongqing People’s Republic of China
| | - Hongyan Xiong
- Department of Epidemiology, College of Preventive Medicine, Third Military Medical University, Chongqing 400038, People’s Republic of China
- Center for Clinical Epidemiology and Evidence-based Medicine, Third Military Medical University, Chongqing People’s Republic of China
| | - Yafei Li
- Department of Epidemiology, College of Preventive Medicine, Third Military Medical University, Chongqing 400038, People’s Republic of China
- Center for Clinical Epidemiology and Evidence-based Medicine, Third Military Medical University, Chongqing People’s Republic of China
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Aryal KR, Pereira J. E learning in surgery. Indian J Surg 2014; 76:487-93. [PMID: 25614725 DOI: 10.1007/s12262-014-1092-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Accepted: 04/23/2014] [Indexed: 11/27/2022] Open
Abstract
E learning means use of electronic media and information technologies in education. Virtual learning environment (VLE) provides learning platforms consisting of online tools, databases and managed resources. This article is a review of use of E learning in medical and surgical education including available evidence favouring this approach. E learning has been shown to be more effective, less costly and more satisfying to the students than the traditional methods. E learning cannot however replace direct consultant supervision at their place of work in surgical trainees and a combination of both called blended learning has been shown to be most useful. As an example of university-based qualification, one such programme is presented to clarify the components and the process of E learning. Increasing use of E learning and occasional face to face focussed supervision by the teacher is likely to enhance surgical training in the future.
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Affiliation(s)
- Kamal Raj Aryal
- James Paget University Hospital, Great Yarmouth, UK ; University of East Anglia, Norwich, UK
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Bergh AM, Grimbeek J, May W, Gülmezoglu AM, Khan KS, Kulier R, Pattinson RC. Measurement of perceptions of educational environment in evidence-based medicine. ACTA ACUST UNITED AC 2014; 19:123-31. [PMID: 24688088 DOI: 10.1136/eb-2014-101726] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
In recent years, there has been a renewed interest in measuring perceptions regarding different aspects of the medical educational environment. A reliable tool was developed for measuring perceptions of the educational environment as it relates to evidence-based medicine as part of a multicountry randomised controlled trial to evaluate the effectiveness of a clinically integrated evidence-based medicine course. Participants from 10 specialties completed the questionnaire. A working dataset of 518 observations was available. Two independent subsets of data were created for conducting an exploratory factor analysis (n=244) and a confirmatory factor analysis (n=274), respectively. The exploratory factor analysis yielded five 67-item definitive instruments, with five to nine dimensions; all resulted in acceptable explanations of the total variance (range 56.6-65.9%). In the confirmatory factor analysis phase, all goodness of-fit measures were acceptable for all models (root mean square error of approximation ≤ 0.047; comparative fit index ≥ 0.980; normed χ(2) ≤ 1.647; Bentler-Bonett normed fit index ≥ 0.951). The authors selected the factorisation with seven dimensions (factor-7 instrument) as the most useful on pragmatic grounds and named it Evidence-Based Medicine Educational Environment Measure 67 (EBMEEM-67). Cronbach's α for subscales ranged between 0.81 and 0.93. The subscales are: 'Knowledge and learning materials'; 'Learner support'; 'General relationships and support'; 'Institutional focus on EBM'; 'Education, training and supervision'; 'EBM application opportunities'; and 'Affirmation of EBM environment'. The EBMEEM-67 can be a useful diagnostic and benchmarking tool for evaluating the perceptions of residents of the environment in which evidence-based medicine education takes place.
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Affiliation(s)
- Anne-Marie Bergh
- Medical Research Council Unit for Maternal and Infant Health Care Strategies, University of Pretoria, Pretoria, South Africa
| | - Jackie Grimbeek
- Medical Research Council Unit for Maternal and Infant Health Care Strategies, University of Pretoria, Pretoria, South Africa
| | - Win May
- Department of Medical Education, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | | | - Khalid S Khan
- Women's Health Research Unit, The Blizard Institute, Barts and The London School of Medicine, Queen Mary, University of London, London, UK
| | | | - Robert C Pattinson
- Medical Research Council Unit for Maternal and Infant Health Care Strategies, University of Pretoria, Pretoria, South Africa
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de Graaf M, Totte J, Breugem C, van Os-Medendorp H, Pasmans S. Evaluation of the Compliance, Acceptance, and Usability of a Web-Based eHealth Intervention for Parents of Children With Infantile Hemangiomas: Usability Study. JMIR Res Protoc 2013; 2:e54. [PMID: 24345450 PMCID: PMC3875905 DOI: 10.2196/resprot.2897] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2013] [Revised: 10/30/2013] [Accepted: 10/30/2013] [Indexed: 11/18/2022] Open
Abstract
Background Infantile hemangiomas (IH) are common benign vascular tumors in children. Recognition and timely referral of high risk IH to specialized centers is important. This might be achieved by involving parents in the care for IH by means of an eHealth intervention. Objective The objective of our study was to evaluate parent compliance, acceptance, and usability of an open access, Web-based eHealth intervention (including e-learning and e-consult) designed to increase parents’ knowledge and (risk) evaluation of IH. Methods A cross-sectional study of parents who completed the eHealth intervention between October 2010 and November 2012 was carried out. All parents were sent a study questionnaire. Questions to evaluate compliance (to the advice given by a dermatologist during e-consultation) were asked. Acceptance and usability were evaluated by using the modified Technology Acceptance Model. Results A total of 224 parents completed the eHealth intervention and received the questionnaire, 135/224 parents responded (response rate was 60.3%). There were 128/135 questionnaires that were completed and included. A total of 110/128 (85.9%) parents were compliant to the advice of the dermatologist. There were 116.8/128 (91.3%) that perceived the eHealth intervention as useful and almost all parents (98.4%, 126/128) found the information in the e-learning clear. There were 29/128 (22.7%) that experienced technical problems. The majority of the parents (94.5%, 121/128) found the eHealth intervention reliable and most of them (98.4%, 126/128) would recommend the eHealth intervention to other parents. Noncompliant parents judged the eHealth intervention significantly less reliable compared to compliant parents (71%, 10/14 versus 97.3%, 107/110; P=.003). Conclusions Parents of children with an IH showed a high compliance (85.9%, 110/128) to the advice of the dermatologist given via our Web-based eHealth intervention. This high compliance might be positively influenced by the good acceptance and usability of the eHealth intervention and might result in timely presentation and treatment of children with high risk IH in specialized centers.
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Affiliation(s)
- Marlies de Graaf
- Wilhelmina Children's Hospital, Department of Pediatric Dermatology and Allergology, University Medical Center Utrecht, Utrecht, Netherlands.
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