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Marceau M, Vachon Lachiver É, Lambert D, Daoust J, Dion V, Langlois MF, McConnell M, Thomas A, St-Onge C. Assessment Practices in Continuing Professional Development Activities in Health Professions: A Scoping Review. THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS 2023; 44:81-89. [PMID: 37490015 DOI: 10.1097/ceh.0000000000000507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/26/2023]
Abstract
INTRODUCTION In continuing professional development (CPD), educators face the need to develop and implement innovative assessment strategies to adhere to accreditation standards and support lifelong learning. However, little is known about the development and validation of these assessment practices. We aimed to document the breadth and depth of what is known about the development and implementation of assessment practices within CPD activities. METHODS We conducted a scoping review using the framework proposed by Arksey and O'Malley (2005) and updated in 2020. We examined five databases and identified 1733 abstracts. Two team members screened titles and abstracts for inclusion/exclusion. After data extraction, we conducted a descriptive analysis of quantitative data and a thematic analysis of qualitative data. RESULTS A total of 130 studies were retained for the full review. Most reported assessments are written assessments (n = 100), such as multiple-choice items (n = 79). In 99 studies, authors developed an assessment for research purpose rather than for the CPD activity itself. The assessment validation process was detailed in 105 articles. In most cases, the authors examined the content with experts (n = 57) or pilot-tested the assessment (n = 50). We identified three themes: 1-satisfaction with assessment choices; 2-difficulties experienced during the administration of the assessment; and 3-complexity of the validation process. DISCUSSION Building on the adage "assessment drives learning," it is imperative that the CPD practices contribute to the intended learning and limit the unintended negative consequences of assessment. Our results suggest that validation processes must be considered and adapted within CPD contexts.
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Affiliation(s)
- Mélanie Marceau
- Dr. Marceau: Assistant Professor, School of Nursing, Université de Sherbrooke, Sherbrooke, Québec, Canada. Ms. Vachon Lachiver: PhD Candidate in research in Health Sciences, Université de Sherbrooke, Sherbrooke, Québec, Canada. Ms. Lambert: Student, Université du Québec en Outatouais, Gatineau, Québec, Canada. Ms. Daoust: Student at Ontario College of Traditional Chinese Medicine, Toronto, Ontario, Canada. Mr. Dion: Undergraduate Medical Student, Université de Sherbrooke, Sherbrooke, Québec, Canada. Dr. Langlois: Full Professor, Department of Medicine and Continuing Professional Development Office, Université de Sherbrooke, Sherbrooke, Québec, Canada. Dr. McConnell: Associate Professor, Department of Innovation in Medical Education, Department of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, Ontario, Canada. Dr. Thomas: Associate Professor, School of Physical and Occupational Therapy, Institute of Health Sciences Education, Faculty of Medicine and Health Sciences, McGill University, Montréal, Québec, Canada. Dr. St-Onge: Full Professor, Department of Medicine and Health Sciences Pedagogy Center, Université de Sherbrooke, Sherbrooke, Québec, Canada
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Beal EW, Owen M, McNamara M, McAlearney AS, Tsung A. Patient-, Provider-, and System-Level Barriers to Surveillance for Hepatocellular Carcinoma in High-Risk Patients in the USA: a Scoping Review. J Gastrointest Cancer 2023; 54:332-356. [PMID: 35879510 DOI: 10.1007/s12029-022-00851-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2022] [Indexed: 12/12/2022]
Abstract
PURPOSE Hepatocellular carcinoma has a dismal prognosis, except in patients diagnosed early who are candidates for potentially curative therapies. Most HCC cases develop in patients with chronic liver disease. Therefore, expert society guidelines recommend surveillance every 6 months with ultrasound with or without serum alpha-fetoprotein for high-risk patients. However, fewer than 20% of patients in the USA undergo appropriate surveillance. METHODS A systematic scoping review was performed with the objective of identifying barriers to screening among high-risk patients in the USA including mapping key concepts in the relevant literature, identifying the main sources and types of evidence available, and identifying gaps in the literature. A total of 43 studies published from 2007 to 2021 were included. Data were extracted and a conceptual framework was created. RESULTS Assessment of quantitative studies revealed poor surveillance rates, often below 50%. Three categories of barriers to surveillance were identified: patient-level, provider-level, and system-level barriers. Prevalent patient-level barriers included financial constraints, lack of awareness of surveillance recommendations, and scheduling difficulties. Common provider-level barriers were lack of provider awareness of guidelines for surveillance, difficulty accessing specialty resources, and time constraints in the clinic. System-level barriers included fewer clinic visits and rural/safety-net settings. Proposed interventions include improved patient/provider education, patient navigators, increased community/academic collaboration, and EMR-based reminders. CONCLUSION Based on these findings, there is a crucial need to implement and evaluate proposed interventions to improve HCC surveillance.
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Affiliation(s)
- Eliza W Beal
- The Ohio State University Comprehensive Cancer Center, Columbus, OH, 43210, USA.
- The Center for the Advancement of Team Science, Systems Thinking in Health Services and Implementation Science Research (CATALYST, The Ohio State University College of Medicine, AnalyticsColumbus, OH, 43210, USA.
| | - Mackenzie Owen
- The Ohio State University College of Medicine, Columbus, OH, 43210, USA
| | - Molly McNamara
- The Ohio State University College of Medicine, Columbus, OH, 43210, USA
| | - Ann Scheck McAlearney
- The Ohio State University Comprehensive Cancer Center, Columbus, OH, 43210, USA
- The Center for the Advancement of Team Science, Systems Thinking in Health Services and Implementation Science Research (CATALYST, The Ohio State University College of Medicine, AnalyticsColumbus, OH, 43210, USA
- The Department of Family and Community Medicine, The Ohio State University College of Medicine, Columbus, OH, 43210, USA
| | - Allan Tsung
- The Ohio State University Comprehensive Cancer Center, Columbus, OH, 43210, USA
- The Center for the Advancement of Team Science, Systems Thinking in Health Services and Implementation Science Research (CATALYST, The Ohio State University College of Medicine, AnalyticsColumbus, OH, 43210, USA
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Thai TTN, Nguyen KT, Pham TT, Nguyen PM, Derese A. Can combined online and face-to-face continuing medical education improve the clinical knowledge and skills of family doctors in Vietnam? A cluster randomised controlled trial. Trop Med Int Health 2020; 25:388-396. [PMID: 31955480 DOI: 10.1111/tmi.13372] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To assess the effectiveness of a combined online and face-to-face continuing medical education (CME) programme, for improvement in clinical knowledge and skills of family doctors, in comparison with a control group; and to explore the self-reported satisfaction, competencies and confidence of those in the intervention group. METHODS We used a cluster randomised controlled trial, with pre- and post-testing, and a feedback survey at the end of the 18-month CME programme. The measurements consisted of a multiple-choice test, an objective structured clinical examination test and an anonymously self-administered questionnaire. RESULTS There were 58 family doctors from four provinces in the intervention group and 32 doctors from three provinces in control group, both in the Mekong Delta region in Vietnam. The mean age of participants was 47.8 years, and the female/male ratio was 1/2.9. After training, the intervention group had significantly higher scores on overall knowledge (mean difference = 1.4, 95% CI 1.0-1.86, P < 0.001; Cohen's d 1.36, Pearson's r 0.53), in four of the five education modules: peptic disorders, diabetes, hypertension and bone-muscle-joint diseases (Pearson's r 0.56, 0.56, 0.34 and 0.4, respectively), and in problem-solving skills (Pearson's r 0.27). Self-reports showed a positive learning attitude, strong interest and improved confidence and competency among doctors in the intervention group. CONCLUSIONS A combined online and face-to-face CME programme proved applicable and effective for improving the clinical knowledge and problem-solving skills of family doctors in Vietnam.
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Affiliation(s)
- Thuy T N Thai
- Department of Family Medicine, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam
| | - Kien T Nguyen
- Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam
| | - Tam T Pham
- Faculty of Public Health, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam
| | - Phuong M Nguyen
- Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam.,Skillslab Unit, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam
| | - Anselme Derese
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
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Le L, Schairer C, Hablas A, Meza J, Watanabe-Galloway S, Ramadan M, Merajver SD, Seifeldin IA, Soliman AS. Reliability of medical records in diagnosing inflammatory breast cancer in Egypt. BMC Res Notes 2017; 10:126. [PMID: 28302157 PMCID: PMC5356360 DOI: 10.1186/s13104-017-2433-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2015] [Accepted: 02/16/2017] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Inflammatory breast cancer (IBC) is a rare, aggressive breast cancer diagnosed clinically by the presence of diffuse erythema, peau d'orange, and edema that arise quickly in the affected breast. This study evaluated the validity of medical records in Gharbiah, Egypt in identifying clinical signs/symptoms of IBC. For 34 IBC cases enrolled in a case-control study at the Gharbiah Cancer Society and Tanta Cancer Center, Egypt (2009-2010), we compared signs/symptoms of IBC noted in medical records to those recorded on a standardized form at the time of IBC diagnosis by clinicians participating in the case-control study. We calculated the sensitivity and specificity of medical records as compared to the case-control study for recording these signs/symptoms. We also performed McNemar's tests. RESULTS In the case-control study, 32 (94.1%) IBC cases presented with peau d'orange, 30 (88.2%) with erythema, and 31 (91.2%) with edema. The sensitivities of the medical records as compared to the case-control study were 0.8, 0.5, and 0.2 for peau d'orange, erythema, and edema, respectively. Corresponding specificities were 1.0, 0.5, and 1.0. p values for McNemar's test were <0.05 for all signs. Medical records had data on the extent and duration of signs for at most 27% of cases for which this information was recorded in the case-control study. Twenty-three of the 34 cases (67.6%) had confirmed diagnosis of IBC in their medical records. CONCLUSION Medical records lacked information on signs/symptoms of IBC, especially erythema and edema, when compared to the case-control study. Deficient medical records could have implications for diagnosis and treatment of IBC and proper documentation of cases in cancer registries.
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Affiliation(s)
- Lynne Le
- University of Nebraska Medical Center College of Public Health, 984395 Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Catherine Schairer
- National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD, 20892, USA
| | | | - Jane Meza
- University of Nebraska Medical Center College of Public Health, 984395 Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Shinobu Watanabe-Galloway
- University of Nebraska Medical Center College of Public Health, 984395 Nebraska Medical Center, Omaha, NE, 68198, USA
| | | | - Sofia D Merajver
- University of Michigan Medical School, 1500 E Medical Center Dr, Ann Arbor, MI, 48109, USA
| | | | - Amr S Soliman
- Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, 984395 Nebraska Medical Center, Omaha, NE, 68198-4395, USA.
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KUPFER SONIAS, CARR ROTONYAM, CARETHERS JOHNM. Reducing colorectal cancer risk among African Americans. Gastroenterology 2015; 149:1302-4. [PMID: 26302487 PMCID: PMC4955535 DOI: 10.1053/j.gastro.2015.08.033] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
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Nguyen BH, McPhee SJ, Stewart SL, Doan HT. Effectiveness of a controlled trial to promote colorectal cancer screening in Vietnamese Americans. Am J Public Health 2010; 100:870-6. [PMID: 20299659 PMCID: PMC2853624 DOI: 10.2105/ajph.2009.166231] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2009] [Indexed: 12/31/2022]
Abstract
OBJECTIVES We conducted a controlled trial of a public education and provider intervention to increase colorectal cancer (CRC) screening rates among Vietnamese Americans, who typically have lower rates than non-Hispanic Whites. METHODS The public education intervention included a Vietnamese-language CRC screening media campaign, distribution of health educational material, and a hotline. The provider intervention consisted of continuing medical education seminars, newsletters, and DVDs. Vietnamese in Alameda and Santa Clara Counties, California, received the intervention from 2004 to 2006; Vietnamese in Harris County, Texas, were controls and received no intervention. A quasi-experimental study design with pre- and postintervention surveys of the same 533 participants was used to evaluate the combined intervention. RESULTS The postintervention-to-preintervention odds ratio for having ever had a sigmoidoscopy or colonoscopy was 1.4 times greater in the intervention community than in the control community. Knowledge and attitudes mediated the effect of the intervention on CRC screening behavior. Media exposure mediated the effect of the intervention on knowledge. CONCLUSIONS Improving CRC knowledge through the media contributed to the effectiveness of the intervention.
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Affiliation(s)
- Bang H Nguyen
- Northern California Cancer Center, 2201 Walnut Ave, Suite 300, Fremont, CA 94538, USA.
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