On the advantages and disadvantages of virtual continuing medical education: a scoping review

To be (virtual) or not to be: six ways to get a grip on choosing a delivery method for your educational program

In the post-pandemic era, modalities for delivering medical education are at a crossroads. The pandemic disrupted the traditional in-person model, and a boom of virtual meetings and sessions quickly found their place in medical education. Now, educators are left with a selection of in-person, virtual, and hybrid approaches to structure medical education programming. We provide six tips to help guide medical educators on deciding between the variety of educational delivery methods.

Promoting real-world evidence use for antimicrobial stewardship in Latin America: evaluation of impact of a two-part educational webinar series

Background

Educational programs on the use of real-world evidence (RWE) in antimicrobial stewardship (AMS) are scarce in Latin America (LATAM).

Objectives

To develop and evaluate an online educational program supporting LATAM healthcare professionals (HCP)'s ability to use and generate RWE for effective antimicrobial agent use, aligned with AMS principles.

Methods

Two 90-min webinars were developed by subject matter experts. Changes in knowledge, skills, confidence and attitudes were measured via paired PRE-and POST-intervention survey questions. Satisfaction, intent to change and remaining barriers were surveyed POST-intervention. McNemar and Wilcoxon Signed Rank statistical tests assessed differences in paired dichotomous and ordinal data, respectively. Unpaired data underwent descriptive analysis. Open-ended responses were subject to thematic content analysis (inductive reasoning approach).

Results

The analysis sample included 741 PRE-intervention survey completers (epidemiologists, infection control specialists, chemists, pharmacists, biologists, microbiologists, bacteriologists and other physicians), with 47 completing the full POST survey (33 following webinar 1, and 14 following webinar 2). A significant increase in the percent of completers who were confident of 'what constitutes RWE' was found PRE (31%) to POST (73%) intervention (P < 0.001). Median self-reported skill levels changed from '2-basic' to '3-intermediate' for providing examples of RWE and applying RWE in the context of AMS (P < 0.05). Barriers included low perceived value of RWE by administrators and limited access to appropriate data.

Conclusions

This education improved HCPs' confidence in knowing what constitutes RWE. Findings provide direction for future interventions aimed at enhancing access to and appropriate use of RWE to inform AMS in LATAM.

Benefits and limitations of the transfer online of Irish College of General Practitioners continuing medical education small group learning during the COVID pandemic: a national Delphi study

BACKGROUND

In Ireland and internationally, small-group learning (SGL) has been shown to be an effective way of delivering continuing medical education (CME) and changing clinical practice.

RESEARCH QUESTION

This study sought to determine the benefits and limitations, as reported by Irish GPs, of the change of CME-SGL from face-to-face to online learning during COVID.

METHODS

GPs were invited to participate via email through their respective CME tutors. The first of three rounds of a survey using the Delphi method gathered demographic information and asked GPs about the benefits and/or limitations of learning online in their established small groups. Subsequent rounds obtained a consensus opinion.

RESULTS

Eighty-eight GPs across Ireland agreed to participate. Response rates varied from 62.5% to 72% in different rounds. These GPs reported that attending their established CME-SGL groups allowed them to discuss the practical implications of applying guidelines in COVID care into practice (92.7% consensus), reviewing new local services and comparing their practice with others (94% consensus); helping them feel less isolated (98% consensus). They reported that online meetings were less social (60% consensus), and informal learning that occurs before and after meetings did not take place (70% consensus). GPs would not like online learning to replace face-to face-CME-SGL after COVID (89% consensus).

CONCLUSION

GPs in established CME-SGL groups benefited from online learning as they could discuss how to adapt to rapidly changing guidelines while feeling supported and less isolated. They report that face-to-face meetings offer more opportunities for informal learning.

Dental students' perceptions of integrating online learning in the dental curriculum

INTRODUCTION

Following the worldwide lockdown due to COVID-19, education globally switched from classroom to online learning. This transition impacted the teaching techniques used in dental education. Thus, the objective of this study was to explore the perceptions and attitudes of undergraduate dental students' experience with online learning. The benefits and drawbacks of integrating online learning into dental teaching were assessed as well as the factors that enhanced the online learning experience.

METHODS

This is a cross sectional descriptive study employing a survey design. A web-based survey was distributed to the undergraduate dental students at Jordan University of Science and Technology. All dental undergraduate students of different academic levels were eligible to participate (n = 1500). The responses were collected anonymously through August 2022. Descriptive statistics and the Pearson Chi-square test were utilized.

RESULTS

A total of 984 undergraduate dental students participated in this questionnaire. Females and year four students dominated the study population (64.7%, 31.3%). Internet connection was not a barrier to online learning for most students (61.4%). The preference for online learning over on campus for most students was due to time and money saving, better comprehension, and less social anxiety (n = 421, 45.7%). Drawbacks of online learning for most students (60%) were the difficulty of maintaining focus and the poor design of lectures (76.3%). The low cost of the internet was a factor that significantly encouraged students to favour online learning (P value = 0.01). Active interaction during lectures was a main factor that encouraged students to stay focused during online sessions (P value < 0.001). For a significant number of students, the lecturers demonstrated superior teaching skills during online sessions in comparison to the classroom (P < 0.001).

CONCLUSION

Despite the positive attitude of undergraduate dental students towards online learning, many improvements are required. Enhancing online lecture design which can be facilitated by implementing comprehensive training and workshop programs for lecturers. Actively engaging students during lectures is necessary to help students regain focus during online sessions. Finally, decreasing lecture times to match students' attention spans is fundamental. By focusing on interface design and providing structured training for lecturers, a more effective online learning environment can be achieved.

Considerations for continuing professional development in the post-pandemic era: national experiences from psychiatry

Introduction

COVID-19 led to rapid innovations in continuing professional development (CPD). We surveyed Canadian Psychiatry CPD directors to understand the pandemic's impact and to identify effective practices.

Methods

In fall 2021, an online 31-item survey was created iteratively based on discussions among CPD educators and disseminated to CPD program leaders at 17 Canadian medical schools through the Council of Psychiatry Continuing Education (COPCE). We collected information on each CPD program, adaptations associated with pandemic restrictions, and intentions regarding future delivery of CPD.

Results

Nine responses were received. COVID-19 led to a shift to virtual CPD delivery, with creative and transformative strategies to maintain engagement and online security. Virtual CPD was associated with an increase in attendance and decrease in costs. Many respondents anticipated that virtual or hybrid modalities would continue post-COVID-19.

Conclusion

The pandemic led to a pivot to virtual delivery of Psychiatry CPD programming. Hybrid delivery will likely be the prevalent mode of future CPD programming, requiring more technological, financial, and human resources to tackle potential challenges. In times of rapid adaptation, a national network of CPD directors can provide an important venue for knowledge exchange about innovations and effective practices and build capacity of expertise.

The Quality and Cultural Safety of Online Osteoarthritis Information for Affected Persons and Health Care Professionals: Content Analysis

BACKGROUND

Osteoarthritis is more prevalent and severe among women than among men, but women are less likely to access early diagnosis and first-line management, particularly racialized immigrant women. Previous research advocated for greater access to culturally safe osteoarthritis information for both diverse women and health care professionals. The internet can reduce disparities by facilitating access to health information, but online materials can vary in quality.

OBJECTIVE

This study aimed to assess the quality and cultural safety of online osteoarthritis materials for persons affected by osteoarthritis and health care professionals.

METHODS

Content analysis was used to describe publicly available materials on osteoarthritis first-line management developed by Canadian organizations for affected persons or health care professionals. Searching, screening, and data extraction were performed in triplicate. We identified materials by searching Google, MEDLINE, and references of osteoarthritis-relevant guidelines and policies, and consulting our research team and collaborators. We assessed quality using DISCERN (University of Oxford) and a compiled framework for affected persons and health care professionals. We compiled frameworks to assess cultural safety. We derived an overall score, categorized as low (<50%), moderate (50%-69%), or high (≥70%+) for criteria met.

RESULTS

After screening 176 items and eliminating 129, we included 47 osteoarthritis materials published between 2013 and 2023. Of those, 43 were for persons with osteoarthritis, most were developed by charities (n=31, 72.1%), based on expert advice (n=16, 55.2%), and in the format of booklets (n=15, 34.9%) or text on web pages (n=10, 23.3%). Of those, 23.3% (10/43) low, 46.5% (20/43) moderate, and 30.2% (13/43) high scored quality; and 25.6% (11/43), 48.8% (21/43), and 25.6% (11/43) were rated low, moderate, and high cultural safety, respectively. Of the 47 included osteoarthritis materials, 4 were for health care professionals. They were developed by a consortium (2/4, 50%), a charity (1/4, 25%), and a professional society (1/4, 25%), and largely based on expert advice (3/4, 75%). The format included infographics (3/4, 75%) and text on web pages (1/4, 25%). Of those, 25% (1/4), 25% (1/4), and 50% (2/4) were rated low, moderate, and high quality, respectively; and all were rated low for cultural safety. Quality and cultural safety did not appear to be associated with the characteristics of osteoarthritis materials (eg, type of developer, development method, and format).

CONCLUSIONS

Overall, included osteoarthritis materials for persons with osteoarthritis and health care professionals were of low to moderate quality and cultural safety. These findings reveal the need for further efforts to improve existing or develop new osteoarthritis materials for both affected persons, including ethnoculturally diverse immigrant women, and health care professionals. Further research is needed to assess the quality and cultural safety of osteoarthritis materials developed by organizations outside of Canada and to establish a framework or instrument to assess cultural safety in the osteoarthritis context.

Perceived Needs, Barriers, and Challenges to Continuing Professional Development (CPD): A Qualitative Exploration among Hospital Pharmacists

Continuing professional development (CPD) is an essential tool for healthcare professionals to remain up-to-date with the latest advancements in their field. In Saudi Arabia, pharmacists are officially registered healthcare professionals by the Saudi Commission for Health Specialties (SCFHS). To uphold their licensure, they must complete 40 h of CPD every two years. This qualitative study aimed to explore hospital pharmacists' perceptions, barriers, and challenges of CPD, as well as their recommendations for improving CPD activities. A qualitative descriptive approach with semi-structured face-to-face interviews was employed. Using purposive sampling, 12 hospital pharmacists were interviewed. The recorded data were transcribed and analyzed using thematic analysis. Pharmacists generally showed positive perceptions of CPD, recognizing its importance for their professional development and the provision of high-quality patient care. However, some pharmacists expressed dissatisfaction with the current system. Several barriers to participation such as heavy workloads, lack of time, and limited financial support were highlighted. The primary motivations for engaging in CPD included fulfilling regulatory requirements. Workshops were the most beneficial CPD activities among others. Additionally, importance of more specialized, practice-oriented programs was highlighted. The study provides valuable insights into the needs and challenges faced by hospital pharmacists in Saudi Arabia regarding CPD. The insights gained can inform theory, policy, and practice relating to pharmacists' CPD at both professional and governmental levels.

"The genie is out of the bottle": a qualitative study on the impact of COVID-19 on continuing professional development

BACKGROUND

The onset of the COVID-19 pandemic catalysed a monumental shift in the field of continuing professional development (CPD). Prior to this, the majority of CPD group-learning activities were offered in-person. However, the pandemic forced the field to quickly pivot towards more novel methods of learning and teaching in view of social distancing regulations. The purpose of this study was to obtain the perspectives of CPD leaders on the impact of the pandemic to elucidate trends, innovations, and potential future directions in the field.

METHODS

Semi-structured interviews were conducted between April-September 2022 with 23 CPD leaders from Canada and the USA. Interviews were audio-recorded, transcribed, and de-identified. A thematic analysis approach was used to analyse the data and generate themes.

RESULTS

Participants characterised COVID-19 as compelling widespread change in the field of CPD. From the interviews, researchers generated six themes pertaining to the impact of the pandemic on CPD: (1) necessity is the mother of innovation, (2) the paradox of flexibility and accessibility, (3) we're not going to unring the bell, (4) reimagining design and delivery, (5) creating an evaluative culture, and (6) a lifeline in times of turmoil.

CONCLUSION

This qualitative study discusses the impact of the pandemic on the field of CPD and leaders' vision for the future. Despite innumerable challenges, the pandemic created opportunities to reform design and delivery. Our findings indicate a necessity to maintain an innovative culture to best support learners, to improve the healthcare system, and to prepare for future emergencies.

Barriers, facilitators and needs to deprescribe benzodiazepines and other sedatives in older adults: a mixed methods study of primary care provider perspectives

BACKGROUND

Benzodiazepines and other sedative hypnotic drugs (BSHs) are frequently prescribed for sleep problems, but cause substantial adverse effects, particularly in older adults. Improving knowledge on barriers, facilitators and needs of primary care providers (PCPs) to BSH deprescribing could help reduce BSH use and thus negative effects.

METHODS

We conducted a mixed methods study (February-May 2023) including a survey, semi-structured interviews and focus groups with PCPs in Switzerland. We assessed barriers, facilitators and needs of PCPs to BSH deprescribing. Quantitative data were analyzed descriptively, qualitative data deductively and inductively using the Theoretical Domain Framework (TDF). Quantitative and qualitative data were integrated using meta-interferences.

RESULTS

The survey was completed by 126 PCPs (53% female) and 16 PCPs participated to a focus group or individual interview. The main barriers to BSH deprescribing included patient and PCP lack of knowledge on BSH effects and side effects, lack of PCP education on treatment of sleep problems and BSH deprescribing, patient lack of motivation, PCP lack of time, limited access to cognitive behavioral therapy for insomnia and absence of public dialogue on BSHs. Facilitators included informing on side effects to motivate patients to discontinue BSHs and start of deprescribing during a hospitalization. Main PCP needs were practical recommendations for pharmacological and non-pharmacological treatment of sleep problems and deprescribing schemes. Patient brochures were wished by 69% of PCPs. PCPs suggested the brochures to contain explanations about risks and benefits of BSHs, sleep hygiene and sleep physiology, alternative treatments, discontinuation process and tapering schemes.

CONCLUSION

The barriers and facilitators as well as PCP needs and opinions on patient material we identified can be used to develop PCP training and material on BSH deprescribing, which could help reduce the inappropriate use of BSHs for sleep problems.

Satisfaction and attitudes towards online continuous medical education and its impact on clinical practice among physiotherapists

BACKGROUND

The traditional face-to-face of medical education is gradually being replaced with online education. However, the rate of adoption of online continuing medical education (OCME) as a learning method among practicing clinical physiotherapists (PTs) is unclear. The objectives of this study were to measure the satisfaction with, attitudes towards, and impact of OCME among practicing clinical PTs in Saudi Arabia (SA) and to examine the factors that affect the findings for satisfaction, attitude, and impact towards OCME.

METHODS

This cross-sectional survey was conducted between October 2021 and January 2022. PTs employed at various medical facilities and specialties in Saudi Arabia completed an online survey to assess satisfaction with, attitudes towards, and impact of OCME.

RESULTS

Of the 127 participants, 48 were female (37.8%), 44.1% were aged between 24 and 30 years. Overall, 57.5% of the respondents were satisfied with OCME compared with conventional face-to-face education, and 45.7% agreed and 18.1% strongly agreed that OCME was more flexible. Further, 52.8% of the respondents thought that OCME programs could supplement traditional face-to-face education. The majority of the participants (63.8%) agreed that participating in OCME programs increased their knowledge, and 55.1% and 51.2% agreed that attending these programs improved patient outcomes and increased their confidence in patient management, respectively. However, only 38.6% agreed that participating in OCME programs enhanced their clinical expertise. The mean satisfaction, attitude, and impact scores differed significantly according to age group, marital status, number of years of practice, and specialty (p < 0.0001). Multiple regression analysis showed that older age was independently associated with better satisfaction and more positive attitudes and impact. Further, having a specialization also seemed to improve the impact of OCME.

CONCLUSION

The PTs were satisfied with and had positive attitudes towards OCME, and also found that it had a positive impact on their clinical practice. Thus, existing OCME programs are a good option for expanding the number of PTs proficient in clinical care.

Self-reported preferences and barriers to continued professional development in primary care physicians: a cross-sectional web-based survey in Qatar

INTRODUCTION

High quality and effective primary healthcare is a national priority in Qatar. Continuing professional development (CPD) for physicians is a cornerstone of this objective, yet little is known about physicians' preferences or barriers to CPD participation.

METHOD

A needs assessment was conducted using a cross-sectional web-based survey of primary care physicians registered with the Department of Healthcare Practitioners (DHP) between March and June 2017.

RESULTS

Two-hundred-and-eighty-one complete surveys were submitted representing physicians in both public (N = 129) and private sectors (N = 152). Physicians completed medical degrees and postgraduate training across multiple countries, and most had been practicing in Qatar for 5 years or less. 'Activities during working hours', 'cost' and 'work commitments' were the most common barriers. There was little consensus regarding the optimal timing of CPD activities, although public sector physicians were more likely to indicate weekend activities as a barrier to participation (30% vs. 9%). Over 90% of participants preferred traditional lectures, workshops, case-based sessions, small group and online self-paced learning as formats for CPD delivery, however alternative modes of delivery were also deemed acceptable (> 80% agreement).

CONCLUSION

Understanding primary care physicians' barriers and preferences is an essential component of a larger necessitated needs assessment of CPD in primary care practitioners in Qatar. Further research is warranted to understand the underlying beliefs driving physicians' choices and the apparent variation between those working in the public and private sectors. CPD developers should consider approaches to mitigate perceived barriers and understand preferences to maximize the quality of participation.