Development and evaluation of an online education tool on attention deficit hyperactivity disorder for general practitioners: the important contribution of co-production

Co-creating digital educational resources to enhance quality in student nurses' clinical education in nursing homes: Report of a co-creative process

AIM

To report a methodological, co-creative approach for developing an interactive digital educational resource to enhance the quality of student nurses' clinical education in nursing homes and to elucidate the lessons learned from this approach.

DESIGN

This study applied a co-design methodology that builds on participatory design principles.

METHODS

Co-creating the digital educational resource included multiple sequential and interactive phases inspired by the design thinking framework. Workshops were employed as the primary co-creative activity.

RESULTS

Seven separate homogenous or joint heterogeneous workshops were conducted with student nurses, nurse educators, registered nurse mentors and e-learning designers (n = 36) during the active stakeholder engagement phases to inform the educational content, design and functionality of the digital educational resource. These were informed by, and grounded in, learning theory and principles.

CONCLUSION

Co-creative approaches in nursing education are an essential avenue for further research. We still lack systematic knowledge about the impact and benefits of co-created initiatives, stakeholders' motivations, barriers, facilitators to participation and the role of context in supporting effective co-creative processes to increase the quality of nursing education.

IMPACT

This paper demonstrates how digital educational initiatives to enhance quality in clinical nursing education can be co-created with key stakeholders through a novel methodological approach inspired by design thinking. To date, the methodological development process of co-created educational interventions has received limited attention and compared with the content and theoretical underpinnings of such interventions, has rarely been addressed. Therefore, this paper facilitates knowledge exchange and documents vital aspects to consider when co-creating digital educational initiatives incorporating multistakeholder perspectives. This promotes a stronger academic-practice partnership to impact and enhance the quality of clinical nursing education in nursing homes.

PUBLIC CONTRIBUTIONS

Student nurses, nurse educators, and registered nurse mentors worked alongside researchers and e-learning designers in the co-creative process.

Taking stock of the present and looking to the future of ADHD research: a commentary on Sonuga-Barke et al. (2023)

The review by Sonuga-Barke and colleagues offers a thoughtful and wide-ranging appraisal of the current state of ADHD research, while also looking into the future to consider unresolved questions and critical next steps. Furthermore, it grapples with the tension between the need to define a coherent conceptualisation of ADHD for clinical and research purposes, while keeping an open mind to new research that challenges current consensus. In our commentary, we consider several cross-cutting ideas discussed in Sonuga-Barke et al., including the heterogeneous nature of ADHD, ensuring equity of translational research, and the importance of participatory research to support equitable and acceptable clinical practices for all individuals with ADHD.

The Educational Impact of Web-Based, Faculty-Led Continuing Medical Education Programs in Type 2 Diabetes: A Survey Study to Analyze Changes in Knowledge, Competence, and Performance of Health Care Professionals

BACKGROUND

The treatment landscape for type 2 diabetes (T2D) is continually evolving; therefore, ongoing education of health care professionals (HCPs) is essential. There is growing interest in measuring the impact of educational activities, such as through use of the Moore framework; however, data on the benefits of continuing medical education (CME) in the management of T2D remain limited.

OBJECTIVE

This study aimed to evaluate HCP satisfaction; measure improvements in knowledge, competence, and performance following short, case-based, multidisciplinary web-based CME activities; and identify the remaining educational gaps.

METHODS

Two faculty-led, CME-accredited, web-based educational activities on T2D and obesity, touchIN CONVERSATION and touch MultiDisciplinary Team, were developed and made available on a free-to-access medical education website. Each activity comprised 3 videos lasting 10 to 15 minutes, which addressed learning objectives developed based on a review of published literature and faculty feedback. Participant satisfaction (Moore level 2) was evaluated using a postactivity questionnaire. For both activities, changes in knowledge and competence (Moore levels 3 and 4) were assessed using questionnaires completed by representative HCPs before or after participation in the activities. A second set of HCPs completed a questionnaire before and after engaging in activities that assessed changes in self-reported performance (Moore level 5).

RESULTS

Each activity was viewed by approximately 6000 participants within 6 months. The participants expressed high levels of satisfaction (>80%) with both activities. Statistically significant improvements from baseline in knowledge and competence were reported following participation in touchIN CONVERSATION (mean score, SD before vs after activity: 4.36, 1.40 vs 5.42, 1.37; P<.001), with the proportion of learners answering at least six of 7 questions correctly, increasing from 22% (11/50) to 60% (30/50). A nonsignificant improvement in knowledge and competence was observed following participation in touch MultiDisciplinary Team (mean score, SD 4.36, 1.24 vs 4.58, 1.07; P=.35); however, baseline knowledge and competence were relatively high, where 80% of the respondents (40/50) answered at least four of 6 questions correctly. A significant improvement in HCP self-reported performance was observed in a combined analysis of both activities (mean score, SD 2.65, 1.32 vs 3.15, 1.26; P=.03), with the proportion of learners selecting the answer representing the best clinical option for all 4 questions increasing from 32% (11/34) to 59% (20/34) after the activity. Several unmet educational needs were self-reported or identified from the analysis of incorrectly answered questions, including setting individualized glycemic targets and the potential benefits of sodium-glucose cotransporter 2 inhibitor therapies.

CONCLUSIONS

Short, case-based, web-based CME activities designed for HCPs to fit their clinical schedules achieved improvements in knowledge, competence, and self-reported performance in T2D management. Ongoing educational needs identified included setting individualized glycemic targets and the potential benefits of sodium-glucose cotransporter 2 inhibitor therapies.

Improving Pharmacists’ Awareness of Inadequate Antibiotic Use for URTIs through an Educational Intervention: A Pilot Study

The inadequate use of antibiotics led to the development of multi-resistant bacteria that are now causing millions of deaths worldwide. Since most antibiotics are prescribed/dispensed to treat respiratory tract infections, it is important to raise awareness among health professionals to optimize antibiotic use, especially within the primary care context. Thus, this pilot study aimed to evaluate pharmacists’ feedback about the eHealthResp platform, composed by an online course and a mobile application (app) to help in the management of upper respiratory tract infections (URTIs). Ten community pharmacists were invited to participate in this study, exploring the contents of the eHealthResp platforms and answering a content validation questionnaire composed by eight qualitative and thirty-five quantitative questions about the online course and mobile app. The eHealthResp platform is a comprehensive, consistent, and high-quality e-learning tool. Median scores of 5.00 were attributed to the course contents’ and clinical cases’ adequacy and correction. Most qualitative feedback was about completeness and objectivity of the course, and its usefulness for clinical practice. This study showed that eHealthResp has great potential as an e-health tool for the management of URTIs’ symptoms, which may ultimately aid in reducing inappropriate antibiotic use.

Clinical perspectives on the identification of neurodevelopmental conditions in children and changes in referral pathways: qualitative interviews

OBJECTIVE

Previous work has raised questions about the role of general practitioners (GPs) in the identification of neurodevelopmental conditions such as autism spectrum disorders (autism) and attention deficit hyperactivity disorders (ADHD). This study aimed to explore how GPs identify these conditions in practice and their perspectives on recent changes to local referral pathways that mean referrals to the neurodevelopmental team come through educational professionals and health visitors, rather than GPs. This study also aimed to explore Child and Adolescent Mental Health Services (CAMHS) specialist's perspectives on the role of GPs.

SETTING

GP practices, local neurodevelopmental services and specialist CAMHS services in the UK.

PARTICIPANTS

semistructured interviews were conducted with GPs (n=8), specialists in local CAMHS (n=7), and professionals at national CAMHS services around the country (n=10). Interviews were conducted between January and May 2019. A framework approach informed by thematic analysis was used to analyse the data.

RESULTS

GPs drew on various forms of tacit and explicit information including behavioural markers, parental report, prior knowledge of the family, expert and lay resources. Opinions varied between GPs regarding changes to the referral pathway, with some accepting the changes and others describing it as a 'disaster'. CAMHS specialists tended to feel that GPs required more neurodevelopmental training and time to conduct consultations.

CONCLUSION

This study adds to the literature showing that GPs use an array of information sources when making referral decisions for autism and ADHD. Further work is urgently required to evaluate the impact of reconfiguring neurodevelopmental referral pathways such that GPs have a diminished role in identification.

Continuing medical education for general practitioners in Indonesia: Moving toward accountability

OBJECTIVE

The purpose of this study is to determine the effect of an online continuing medical education model on the learning outcomes of general practitioners (GPs) in Indonesia.

METHODS

The method used in this research is a pre-experimental pre-test, post-test group design. 1449 GPs originating from the major islands of Indonesia participated in this study. One hundred fifty questions from 10 disease systems were prepared for the pre-test and post-test with a total score of 100. The results of the pre-test and post-test were tested with paired sample t-test and Independent t-test.

RESULTS

The paired sample t-test revealed significant differences in the learning outcomes of GPs before and following the online module's continuing medical education approach. What is remarkable is the disparity in average post-test results between GPs in West and East Indonesia. The independent t-test revealed that the average post-test score of general practitioners in western Indonesia was higher than that of general practitioners in eastern Indonesia.

CONCLUSION

The findings of this study suggest that continuing medical education in the form of online learning can help general practitioners enhance their knowledge and abilities in disease management. This paradigm of online continuing medical education could be adapted for other professions.