1
|
Eickmann S, Wolff D, Kobbe G, Dreger P, Kröger N, Herrmann-Johns A. Barriers and Facilitators in Continuous Medical Education Related to Allogeneic Stem Cell Transplantation: A Qualitative Study of Physicians. Oncol Res Treat 2024; 47:136-144. [PMID: 38266509 PMCID: PMC10997258 DOI: 10.1159/000536429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 01/17/2024] [Indexed: 01/26/2024]
Abstract
INTRODUCTION This study explored qualitatively, in a sample of German hematologists working in clinical allogeneic hematopoietic stem cell transplantation (alloHSCT), perceptions of barriers and facilitators to participate in continuous medical education (CME), to provide detailed information on how to improve participation in CME activities related to alloHSCT, which may also be applicable to other areas of medicine. METHODS Based on a recruitment campaign of the German Association for Hematopoietic Stem Cell Transplantation (DAG-HSZT), 21 semi-structured telephone interviews were conducted, transcribed, and analyzed using framework analysis. RESULTS Three clusters of barriers were identified that explain why alloHSCT physicians may or may not participate in CME: individual constraints (e.g., better networking, young physicians being overwhelmed by the complexity of alloHSCT), structural constraints (e.g., time and financial issues, tailoring CME courses according to the targeted audience), and content-related constraints (e.g., requirement of CME sessions, provision of an overview of CME courses, more flexible offers). We discuss the ten most frequently raised issues, including the use of incentives and the need for support at the start of residency, staff shortages, and requirements for learning sessions. CONCLUSION There is a need for a paradigm shift in CME related to alloHSCT toward a more individualized and needs-based approach. Close monitoring of residents' needs and learning progress, as well as feedback systems, could help identify appropriate CME courses that should be integrated into a tiered learning system. CME should be more targeted to specific audiences (i.e., residents, fellows, and attendees) to provide training that is tailored to individual CME needs. On-demand courses can help balance work and family obligations. Finally, peer-reviewed, up-to-date information platforms should be expanded.
Collapse
Affiliation(s)
- Sascha Eickmann
- Department of Epidemiology and Preventive Medicine, Medical Sociology, University Regensburg, Regensburg, Germany
| | - Daniel Wolff
- Department of Medicine III, University Hospital Regensburg, Regensburg, Germany
| | - Guido Kobbe
- Department of Hematology, Oncology and Clinical Immunology, University Hospital Düsseldorf, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Peter Dreger
- Department of Hematology, Oncology, and Rheumatology, University Hospital Heidelberg, Heidelberg, Germany
| | - Nicolaus Kröger
- Department for Stem Cell Transplantation, University Medical Center Hamburg, Hamburg, Germany
| | - Anne Herrmann-Johns
- Department of Epidemiology and Preventive Medicine, Medical Sociology, University Regensburg, Regensburg, Germany
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
| |
Collapse
|
2
|
Ibsen H, Lillevang G, Søndergaard J, Kjaer NK. "We don't need no education" - a qualitative study of barriers to continuous medical education among Danish general practitioners. BMC Med Educ 2023; 23:450. [PMID: 37337212 DOI: 10.1186/s12909-023-04432-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Accepted: 06/07/2023] [Indexed: 06/21/2023]
Abstract
BACKGROUND Continuous medical education is essential for the individual patient care, the society, and the wellbeing of the general practitioner. There has been research into the reasons for participation in continuous medical education, but little is known about the barriers to participation. To tailor continuous medical education targeting general practitioners who are currently deselecting education, systematic knowledge of the barriers is needed. Continuous medical education can in addition to professional growth stimulate job satisfaction, diminish burnout, and reinforce feelings of competence. Continuous medical education may have positive implications for patients and for healthcare expenditures. Despite renumeration and a comprehensive continuous education model some Danish general practitioners do not participate in continuous medical education. METHODS From a total of 3440 Danish general practitioners 243 did not apply for reimbursement for accredited continuous medical education in a two-year period. Ten general practitioners were selected for an interview regarding maximum variation in practice form, number of listed patients, seniority as a general practitioner, geography, gender, and age. All ten selected general practitioners accepted to be interviewed. The interviews were analysed using Systematic Text Condensation. RESULTS Each of the ten interviewed general practitioners mentioned several barriers for participating in continuous education. The barriers fell into three main categories: barriers related to the individual general practitioner barriers related to the clinic barriers related to the accredited continuous medical education offered CONCLUSIONS: Approximately 7% of the Danish general practitioners did not participate in accredited remunerated continuous medical education. A knowledge of the barriers for participating in accredited continuous medical education can be used to better target continuous medical education to the general practitioners.
Collapse
Affiliation(s)
- Helle Ibsen
- Department of Public Health, Research Unit of General Practice, University of Southern Denmark, Finsensvej 35, 6700, Esbjerg, Denmark.
| | - Gunver Lillevang
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen N, Denmark
| | - Jens Søndergaard
- Department of Public Health, Research Unit of General Practice, University of Southern Denmark, WP 9, 5000, Odense, Denmark
| | - Niels Kristian Kjaer
- Department of Public Health, Research Unit of General Practice, University of Southern Denmark, Finsensvej 35, 6700, Esbjerg, Denmark
| |
Collapse
|
3
|
Hannula O, Hällberg V, Meuronen A, Suominen O, Rautiainen S, Palomäki A, Hyppölä H, Vanninen R, Mattila K. Self-reported skills and self-confidence in point-of-care ultrasound: a cross-sectional nationwide survey amongst Finnish emergency physicians. BMC Emerg Med 2023; 23:23. [PMID: 36859177 PMCID: PMC9979460 DOI: 10.1186/s12873-023-00795-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 02/21/2023] [Indexed: 03/03/2023] Open
Abstract
BACKGROUND The use of point-of-care ultrasound (POCUS) is increasing. Numerous investigators have evaluated the learning curves in POCUS, but there are no published studies on how emergency physicians perceive their own competence level with this skill. METHODS A nationwide survey amongst Finnish emergency physicians was conducted. The respondents reported their use of POCUS and how it has affected their clinical decision-making. The number of POCUS examinations performed was compared to the self-assessed skill level with different applications. Cut-off values were determined for the number of examinations required to acquire a good self-assessed skill level in each POCUS application. The correlation between self-confidence and the self-estimated skill level was analyzed. Several different statistical methods were used, such as Student's t-test, Pearson's correlation test, Loess method and ROC curve analysis. RESULTS A total of 134 out of 253 Finnish emergency medicine specialists and residents (52%) responded to the survey. The most commonly used POCUS applications were POCUS-assisted procedures, pleural effusion and pneumothorax, inferior vena cava and lower extremity deep venous thrombosis. The initial rate of perceived skill acquisition was very steep with the curve flattening with greater skill and more experience. The number of examinations performed to reach a self-assessed good competence varied from seven to 75 with different applications. The lowest cut-off point for self-assessed good competence was obtained for rapid ultrasound for the shock and hypotension-protocol and the highest for focused cardiac examinations. There was an excellent correlation between self-confidence and the self-assessed skill level. CONCLUSIONS The Finnish emergency practitioners' self-assessed development of POCUS skills parallels the previously published learning curves of POCUS. The correlation of self-confidence and the self-assessed skill level was found to be excellent. These findings add information on the development of perceived POCUS skills amongst emergency physicians and could complement a formal performance assessment.
Collapse
Affiliation(s)
- Ossi Hannula
- School of Medicine, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland. .,Emergency Department, Päijät-Häme Social and Health Care District, Lahti, Finland.
| | - Ville Hällberg
- Emergency Department, Kanta-Häme Central Hospital, Hämeenlinna, Finland
| | - Anna Meuronen
- Emergency Department, Helsinki University Hospital, Porvoo, Finland
| | - Olli Suominen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Suvi Rautiainen
- School of Medicine, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.,Pihlajalinna Medical Centre Eastern Finland, Kuopio, Finland
| | - Ari Palomäki
- Emergency Department, Kanta-Häme Central Hospital, Hämeenlinna, Finland.,Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Harri Hyppölä
- Emergency Department, South Savo Central Hospital, Mikkeli, Finland
| | - Ritva Vanninen
- School of Medicine, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.,Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland
| | - Kalle Mattila
- Emergency Department, Turku University Hospital, Turku, Finland.,Faculty of Medicine, University of Turku, Turku, Finland
| |
Collapse
|
4
|
Ng SM, Kalaitzoglou E, Utari A, van Wijngaard-de Vugt C, Donaldson M, Wolfsdorf JI, Boot AM, Drop S. Ten-Year Experience of a Global and Freely Accessible e-Learning Website for Pediatric Endocrinology and Diabetes. Horm Res Paediatr 2022; 96:366-375. [PMID: 36349753 DOI: 10.1159/000527984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 09/08/2022] [Indexed: 11/11/2022] Open
Abstract
The European Society for Paediatric Endocrinology (ESPE) interactive website, https://www.espe-elearning.org, was first published online in 2012. We describe the various applications of the content of the e-learning website that has been greatly expanded over the last 10 years. A large module on pediatric diabetes was added with the support of the International Society for Paediatric and Adolescent Diabetes (ISPAD). A separate multilingual module was created that focuses on frontline health care providers in limited resource settings. This module has been well received, particularly in targeted parts of the world. e-Learning may also be an opportunity to expand or tailor educational activities for learners according to their differing learning needs. The e-learning website provides guidelines for those interested in general pediatrics, neonatology, clinical genetics, and pediatric gynecology. We also describe various new applications such as master classes in the format of interactive video lectures and joint and complementary e-learning/e-consultation webinars. Finally, international certification was recently realized as e-learning courses were recognized by the European Accreditation Council for Continuing Medical Education (EACCME). As a result of the social distancing measures introduced to control the COVID-19 pandemic, digital education, whether individual or in a virtual classroom setting, has become even more important since e-learning can connect and engage individuals across geographic boundaries as well as those who live in remote areas. The future of education delivery may include hybrid learning strategies, which include in-person and e-learning platforms. Combined e-learning and e-consultation webinars illustrate how international academic institutions, learned medical specialty societies and networks are uniquely placed to deliver balanced, disease-oriented, and patient-centered e-learning education and at the same time provide expert consultation. Moreover, they are well equipped to maintain professional standards and to offer appropriate accreditation.
Collapse
Affiliation(s)
- Sze May Ng
- Department of Paediatric, Southport and Ormskirk NHS Trust, Southport, UK
- Department of Women's and Children's Health, University of Liverpool, Liverpool, UK
| | - Evangelia Kalaitzoglou
- Department of Pediatrics and Barnstable Brown Diabetes Center, University of Kentucky, Lexington, Kentucky, USA
| | - Agustini Utari
- Division of Pediatric Endocrinology, Department of Pediatrics, Faculty of Medicine, Diponegoro University, Semarang, Indonesia
| | | | - Malcolm Donaldson
- Honorary Senior Research Fellow, Glasgow University School of Medicine, Glasgow, UK
| | - Joseph I Wolfsdorf
- Division of Endocrinology, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Annemieke M Boot
- Division Endocrinology, Department of Pediatrics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Stenvert Drop
- Department of Pediatrics, Division Endocrinology, Sophia Children's Hospital, Erasmus MC, Rotterdam, The Netherlands
| |
Collapse
|
5
|
Edlinger M, Schneider M, Lagally L, Lob-Corzilius T, Mertes H, Deering K, Schoierer J, Böse-O'Reilly S. [Climate change and child health: A nationwide survey among paediatricians in Germany]. Z Evid Fortbild Qual Gesundhwes 2022; 172:102-111. [PMID: 35710526 DOI: 10.1016/j.zefq.2022.03.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 01/10/2022] [Accepted: 03/19/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Children are a vulnerable group affected by climate change. Paediatricians are important actors in protecting children from climate change-related health risks and in identifying and treating relevant health effects. The main objectives of this study were to determine how paediatricians assess the relevance of climate change-related health impacts, through which channels paediatricians can be reached most effectively, how often climate change-specific prevention measures are implemented and how they are assessed. METHODS Between February and July 2020, an online survey was conducted among paediatricians. The cross-sectional survey was designed to gather knowledge and attitudes about the relevance of climate change, sources of information and prevention measures. All participants who answered only one question or none at all were excluded. Differences between groups were determined using one-factorial analysis of variance. Correlations were determined using Pearson's bivariate correlation analysis and tested for two-sided significance. RESULTS A total of 408 questionnaires were analysed. Over 95% of the respondents were paediatricians, with just under half of them working in children's hospitals and a good third in paediatric practices. According to paediatricians, climate change has a relevant impact on children's health. The most significant effects on children's health were considered to be longer and stronger pollen seasons, neophytes and neozoa, Lyme disease and TBE (tick-borne encephalitis, summer meningoencephalitis), UV radiation and air pollutants. Certified training options in professional journals and participation in lectures or workshops at relevant congresses were identified as the two preferred types of training. Especially professional journals as the most frequently used source of information could function as a suitable tool to reach as many paediatricians as possible. 76% of the paediatricians have not yet carried out any corresponding prevention activities, although information activities for parents or children were seen as being effective by 80%. Whereas the possibilities of integrating climate change-oriented prevention activities into everyday practice, were perceived less positively. The most frequent reason given was lack of time. DISCUSSION To satisfy this future need for knowledge, but also for offerings from paediatricians for patients and their parents, concrete further continuous education and consultancy services must be prepared. In the future, further training offers, including the consultancy services, should be integrated into profession-specific training modules, presented at congresses, and then implemented into paediatricians' daily routine. CONCLUSION The results of the study illustrate that the topic "climate change and health" has a high relevance for paediatricians and that information measures for parents are considered to be effective. Although paediatricians are concerned with the topic, there is an implementation deficit. Support is needed in the form of intensifying awareness-raising projects and educational modules for paediatricians to move from knowledge to action.
Collapse
Affiliation(s)
- Maximilian Edlinger
- LMU München, Klinikum der Universität, Institut und Poliklinik für Arbeits-, Sozial- und Umweltmedizin, München, Deutschland
| | - Michael Schneider
- Ludwig-Maximilians-Universität München, Institut für Soziologie, München, Deutschland
| | - Lena Lagally
- LMU München, Klinikum der Universität, Institut und Poliklinik für Arbeits-, Sozial- und Umweltmedizin, München, Deutschland
| | - Thomas Lob-Corzilius
- LMU München, Klinikum der Universität, Institut und Poliklinik für Arbeits-, Sozial- und Umweltmedizin, München, Deutschland; Deutsche Akademie für Prävention und Gesundheitsförderung im Kindes- und Jugendalter, Bochum, Deutschland
| | - Hanna Mertes
- LMU München, Klinikum der Universität, Institut und Poliklinik für Arbeits-, Sozial- und Umweltmedizin, München, Deutschland
| | - Katharina Deering
- LMU München, Klinikum der Universität, Institut und Poliklinik für Arbeits-, Sozial- und Umweltmedizin, München, Deutschland
| | - Julia Schoierer
- LMU München, Klinikum der Universität, Institut und Poliklinik für Arbeits-, Sozial- und Umweltmedizin, München, Deutschland; Deutsche Akademie für Prävention und Gesundheitsförderung im Kindes- und Jugendalter, Bochum, Deutschland
| | - Stephan Böse-O'Reilly
- LMU München, Klinikum der Universität, Institut und Poliklinik für Arbeits-, Sozial- und Umweltmedizin, München, Deutschland; Deutsche Akademie für Prävention und Gesundheitsförderung im Kindes- und Jugendalter, Bochum, Deutschland; UMIT Private Universität für Gesundheitswissenschaften, Medizinische Informatik und Technik GmbH, Department für Public Health, Versorgungsforschung und Health Technology Assessment, Hall in Tirol, Österreich.
| |
Collapse
|
6
|
Li B, Sarria GR, Hermansen M, Hao J, Martinez D, Garcia B, Liu J, McLeod M, Castaneda S, Oladeru OT, Lee B, Sarria GJ, Gay H, Chetty IJ, Roa D. Impact of a SBRT/SRS longitudinal telehealth training pilot course in Latin America. Crit Rev Oncol Hematol 2020; 154:103072. [PMID: 32805497 DOI: 10.1016/j.critrevonc.2020.103072] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 07/27/2020] [Accepted: 07/29/2020] [Indexed: 12/12/2022] Open
Abstract
PURPOSE To assess the impact of longitudinal telehealth training in stereotactic body radiation therapy (SBRT) and stereotactic radiosurgery (SRS) for clinicians in Latin America. MATERIALS AND METHODS Professionals from two Peruvian centers received an initial SBRT/SRS on-site training course and subsequently received follow-up telehealth training (interventional group) or not (negative control arm). Twelve live video conference sessions were scheduled. Surveys pre- and post-curriculum measured participants' confidence in seven practical domains of SBRT/SRS, based on Likert scales of 1-5, and post-curriculum surveys assessed educators' experiences. RESULTS Sixty-one participants were registered, with an average of 24 attendees per session. Pre- and post- surveys were completed by 22 participants. For interventional and negative-control groups, mean changes in Likert scale were satisfactory for the former and remained unmodified for the latter. CONCLUSIONS Conducting telehealth educational programs via virtual classroom sessions could be a reliable method to augment training for SBRT and SRS.
Collapse
Affiliation(s)
- Benjamin Li
- Rayos Contra Cancer, Inc. Nashville, TN, USA; University of California San Francisco, Dept. of Radiation Oncology, San Francisco, CA, USA
| | - Gustavo R Sarria
- Rayos Contra Cancer, Inc. Nashville, TN, USA; University Hospital Bonn, Department of Radiation Oncology, University of Bonn, Bonn, Germany.
| | | | - Jackie Hao
- Rayos Contra Cancer, Inc. Nashville, TN, USA; Midwestern University, Glendale, AZ, USA
| | | | - Bertha Garcia
- Clínica AUNA, Dept. of Radiation Oncology, Lima, Peru
| | - Jingxia Liu
- Washington University in St. Louis, Dept. of Radiation Oncology, St. Louis, MO, USA
| | - Megan McLeod
- Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Serguei Castaneda
- Rayos Contra Cancer, Inc. Nashville, TN, USA; Sidney Kimmel Cancer Center at Thomas Jefferson University, Dept. of Radiation Oncology, Philadelphia, PA, USA
| | - Oluwadamilola T Oladeru
- Rayos Contra Cancer, Inc. Nashville, TN, USA; Massachusetts General Hospital, Department of Radiation Oncology, Harvard Medical School, Boston, MA, USA
| | - Becky Lee
- Loma Linda University, Dept. of Radiation Oncology, Loma Linda, CA, USA
| | - Gustavo J Sarria
- Instituto Nacional de Enfermedades Neoplásicas, Dept. of Radiation Oncology, Lima, Peru
| | - Hiram Gay
- Washington University in St. Louis, Dept. of Radiation Oncology, St. Louis, MO, USA
| | - Indrin J Chetty
- Henry Ford Cancer Institute, Dept. of Radiation Oncology, Henry Ford Health System, Detroit, MI, USA
| | - Dante Roa
- Rayos Contra Cancer, Inc. Nashville, TN, USA; University of California Irvine, Orange, CA, USA
| |
Collapse
|
7
|
Abstract
Introduction Radiologists’ image reading skills vary, such variations in image interpretations can influence the effectiveness of the early treatment of disease and may have important clinical and economic implications. In screening mammography, clinical audits are used to assess radiologists’ performance annually, however, the nature of these audits prevent robust data analysis due to the low prevalence of breast cancer and the long waiting periods for the audit results. Research-based evidence revealed a need for changes in the methods utilised to optimise the assessment of the efficacy of radiologists’ interpretations. Methods A cloud-based platform was developed to assess and enhance radiologists’ performance help reduce variability in medical image interpretations in a research environment; however, to address a number of limitations, the platform was commercialised to make it available worldwide. Results DetectED-X’s team have been able to make their cloud-based platform available worldwide, tailored to the needs of radiologists and accredited for continuing medical/professional education; thus, changing the continuous professional development practice globally. Conclusion DetectED-X’s Rivelato, was developed to address a need for effective, available and affordable educational solutions for clinicians and health care workers wherever they are located. A true fusion of industry, academia, clinics and consumer to adapt to the growing needs of clinicians’ around the world, the latest being COVID-19 global pandemic. DetectED-X repurposed its platform to educate physicians around the world on the appearances of COVID-19 on Lung Computed Tomography scans, introducing CovED to clinicians worldwide free of charge as a multi-national consortium of collaboration to help fight COVID-19, showing how research-based evidence can create effective and scalable change globally.
Collapse
Affiliation(s)
- M E Suleiman
- L02 H04, Merewether Building, The University of Sydney, Sydney, NSW, 2006, Australia.
| | - M Rickard
- L02 H04, Merewether Building, The University of Sydney, Sydney, NSW, 2006, Australia.
| | - P C Brennan
- The University of Sydney, Faculty of Health Sciences, M205, Cumberland Campus, 75 East St, Lidcombe, NSW, 2141, Australia.
| |
Collapse
|
8
|
Ternov NK, Vestergaard T, Hölmich LR, Karmisholt K, Wagenblast AL, Klyver H, Hald M, Schøllhammer L, Konge L, Chakera AH. Reliable test of clinicians' mastery in skin cancer diagnostics. Arch Dermatol Res 2020; 313:235-243. [PMID: 32596742 DOI: 10.1007/s00403-020-02097-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 06/17/2020] [Indexed: 11/25/2022]
Abstract
Differentiating between benign and malignant skin lesions can be very difficult and should only be done by sufficiently trained and skilled clinicians. To our knowledge there are no validated tests for reliable assessments of clinicians' ability to perform skin cancer diagnostics. To develop and gather validity evidence for a test in skin cancer diagnostics, a multiple-choice questionnaire (MCQ) was developed based on informal interviews with seven content experts from five skin cancer centers in Denmark. Validity evidence for the test was gathered from May until July 2019 using Messick's validity framework (content, response process, internal structure, relationship to other variables and consequences). Item content was revised through a Delphi-like review process and then piloted on 36 medical students and 136 doctors using a standardized response process. Results enabled an analysis of the internal structure and relationship to other variables of the test. Finally, the contrasting groups method was used to investigate the test's consequences (pass-fail standard). The initial 90-item MCQ was reduced to 40 items during the Delphi-like review process. Item analysis revealed that 25 of the 40 selected items were level I-III quality items with a high internal consistency (Cronbach's α = 0.83) and highly significant (P ≤ 0.0001) differences in test scores between participants with different occupations or levels of experience. A pass-fail standard of 12 (48%) correct answers was established using the contrasting groups' method. The skin cancer diagnostics MCQ developed in this study can be used for reliable assessments of clinicians' competencies.
Collapse
Affiliation(s)
- Niels Kvorning Ternov
- Department of Plastic Surgery, Herlev and Gentofte University Hospital, Herlev Ringvej 75, Herlev, 2730, Copenhagen, Denmark. .,Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark. .,Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark.
| | - T Vestergaard
- Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark.,Faculty of Health Sciences, University of Southern Denmark, Copenhagen, Denmark
| | - L Rosenkrantz Hölmich
- Department of Plastic Surgery, Herlev and Gentofte University Hospital, Herlev Ringvej 75, Herlev, 2730, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark
| | - K Karmisholt
- Department of Dermatology, Bispebjerg University Hospital, Copenhagen, Denmark
| | - A L Wagenblast
- Department of Plastic Surgery, Breast Surgery and Burns Treatment, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - H Klyver
- Department of Plastic Surgery, Breast Surgery and Burns Treatment, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - M Hald
- Department of Dermatology, Herlev and Gentofte University Hospital, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark
| | - L Schøllhammer
- Department of Plastic Surgery, Odense University Hospital, Odense, Denmark
| | - L Konge
- Copenhagen Academy for Medical Education and Simulation, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark
| | - A H Chakera
- Department of Plastic Surgery, Herlev and Gentofte University Hospital, Herlev Ringvej 75, Herlev, 2730, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark
| |
Collapse
|
9
|
Scoazec JY, Wissler MP, Staroz F, Copin MC. [The "Conseil national professionnel d'anatomie et cytologie pathologiques" (CNPath): At the service of the profession]. Ann Pathol 2020; 40:384-388. [PMID: 32448644 DOI: 10.1016/j.annpat.2020.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Accepted: 04/14/2020] [Indexed: 10/24/2022]
Abstract
The « conseils nationaux professionnels » (CNP) are professional boards existing since 2010. Their missions, organization and functioning have been defined by the decree 2019-17 of January 9, 2019. CNPs represent all the members of a medical specialty (or health profession). CNPs must include all the learned societies and all the representative structures and associations of the same medical specialty. Their bodies must strictly respect the parity between public and private health sectors. The main missions of CNPs include the contribution to the elaboration of the national priority directions for continuous medical education and the definition of the individual plan for continuous professional development (DPC) recommended for the specialty. CNPs also behave as a single window for ministries, State agencies, welfare system and colleges of physicians. They are likely to be strongly involved in the process of re-certification of physicians, established in July 2019. The Conseil national professionnel d'anatomie et cytologie pathologiques, termed CNPath, has been created in 2010 and officially recognized by the Ministry of Health in August 2019. The main current actions of CNPath are: the elaboration of the individual DPC scheme for the specialty and the definition of the minimal obligations requested for its validation, the long-expected recognition of the expertal consultation in pathology, the support to the nation-wide effort for the production of structured pathological reports and the launching of a plan for implementing digital pathology. An internet site is under construction, to diffuse all the relevant information and make available the documents useful to all pathologists.
Collapse
Affiliation(s)
- Jean-Yves Scoazec
- Service de pathologie, département de biologie et pathologie médicales, institut Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France.
| | - Marie-Pierre Wissler
- Service de pathologie, département de biologie et pathologie médicales, institut Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France
| | - Frédéric Staroz
- Service de pathologie, département de biologie et pathologie médicales, institut Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France
| | - Marie-Christine Copin
- Service de pathologie, département de biologie et pathologie médicales, institut Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France
| | -
- Service de pathologie, département de biologie et pathologie médicales, institut Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France
| |
Collapse
|
10
|
Xiberta P, Boada I, Thió-Henestrosa S, Ortuño P, Pedraza S. Introducing Online Continuing Education in Radiology for General Practitioners. J Med Syst 2020; 44:55. [PMID: 31950280 DOI: 10.1007/s10916-019-1499-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 11/14/2019] [Indexed: 11/30/2022]
Abstract
The aim of this study was to determine whether e-learning as a new teaching methodology was acceptable for general practitioners in continuous education courses of radiology. Generally, these courses are face-to-face with the corresponding time and place limitations. To overcome these limitations, we transformed one of these courses to an online one evaluating its acceptance. The course was about thorax radiology and it was delivered to 249 participants. The experiment was carried out in two phases: Phase 1, as a pilot testing with 12 general practitioners (G1), and Phase 2, with 149 general practitioners (G2), 12 radiologists (G3) and 76 medical residents (G4). All participants evaluated the course design, the delivering e-learning platform, and the course contents using a five-point Likert scale (satisfaction level from 1 to 5). Collected data was analysed using t, Mann-Whitney U and Kruskal-Wallis tests. In Phase 1, the rounded scores of all questions except one surpassed 3.5. In Phase 2, all the rounded scores surpassed 4.0 indicating that a total agreement on all items was achieved. All collected impressions indicate the high acceptance of the proposed methodology.
Collapse
Affiliation(s)
- Pau Xiberta
- Graphics and Imaging Laboratory, Universitat de Girona, 17003, Girona, Catalonia.
| | - Imma Boada
- Graphics and Imaging Laboratory, Universitat de Girona, 17003, Girona, Catalonia
| | - Santiago Thió-Henestrosa
- Departament d'Informàtica, Matemàtica Aplicada i Estadística, Universitat de Girona, 17003, Girona, Catalonia
| | - Pedro Ortuño
- Department of Radiology-IDI and IDIBGI, Hospital Universitari Dr Josep Trueta, Ctra. França, 17007, Girona, Catalonia
| | - Salvador Pedraza
- Department of Radiology-IDI and IDIBGI, Hospital Universitari Dr Josep Trueta, Ctra. França, 17007, Girona, Catalonia
| |
Collapse
|
11
|
Martinengo L, Yeo NJY, Markandran KD, Olsson M, Kyaw BM, Car LT. Digital health professions education on chronic wound management: A systematic review. Int J Nurs Stud 2019; 104:103512. [PMID: 32086027 DOI: 10.1016/j.ijnurstu.2019.103512] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 12/17/2019] [Accepted: 12/20/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND Continuing education is crucial for healthcare professionals to keep up with research but attending classroom lectures is a major barrier. Chronic wound management is increasingly relevant for continuous professional training. Digital education offers learning tailored to individual needs and could be an effective alternative to healthcare professionals' training. However, the effectiveness of digital education for chronic wound management training has not been explored. OBJECTIVES To assess the effectiveness of digital education in improving healthcare professionals' knowledge, attitudes, practical skills and behaviour change on chronic wound management, and their satisfaction with the intervention. DESIGN This systematic review follows Cochrane methodology and is one of a series of reviews on the use of digital education for health professions education. Protocol registration: PROSPERO CRD42018109971 DATA SOURCES: Searches were conducted in MEDLINE, Embase, Web of Science, ERIC, PsycINFO, CINAHL, CENTRAL, and ProQuest Dissertation and Theses Database. REVIEW METHODS We included randomised control trials, cluster randomised control trials and quasi-randomised control trials comparing digital or blended education with traditional learning, no intervention or other forms of digital or blended education for pre- or post-registration healthcare professionals in chronic wound management. A narrative summary of findings is presented. RESULTS Seven studies (1,404 participants) were included. All studies investigated interventions for nursing students or professionals working in hospitals or community settings, and all but one study focused on pressure ulcers. Five studies (935 participants) assessed post-intervention knowledge, and indicated that digital education was more effective than no intervention, while blended learning was superior to exclusive digital education. Three studies (543 participants) assessed post-intervention skills and reported mixed results. One study (140 participants) compared post-intervention behaviour change and satisfaction with blended and online digital education, and reported no difference in behaviour between the groups, and higher satisfaction with blended education. For knowledge retention up to six months, digital education was more effective than no intervention, while blended learning was superior to digital education. The risk of bias in included studies was mostly high or unclear. CONCLUSIONS Digital education on chronic wound management appears to be less effective than blended education and more effective than no intervention in improving knowledge among nurses and nursing students. Data for other outcomes is scarce and inconclusive. Future studies should assess participants' skills, attitudes, satisfaction and behaviour change; cost-effectiveness and potential untoward effects of digital education, compare digital education to other learning modalities and include other healthcare professionals in diverse clinical settings.
Collapse
Affiliation(s)
- Laura Martinengo
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road Level 18, Singapore 308232, Singapore.
| | - Natalie Jia Ying Yeo
- Laboratory of Molecular and Vascular Medicine, Lee Kong Chian School of Medicine, Nanyang Technological University, 59 Nanyang Drive, Level 3, Singapore 636921, Singapore.
| | - Kasturi D/O Markandran
- Laboratory of Muscle and Cardiac Biophysics, Lee Kong Chian School of Medicine, Nanyang Technological University, 59 Nanyang Drive, Level 3, Singapore 636921, Singapore.
| | - Maja Olsson
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road Level 18, Singapore 308232, Singapore; Institute of Health and Biomedical Innovation, Queensland University of Technology, 149 Victoria Park Rd, Kelvin Grove, Queensland 4059, Australia
| | - Bhone Myint Kyaw
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road Level 18, Singapore 308232, Singapore; Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road Level 18, Singapore 308232, Singapore.
| | - Lorainne Tudor Car
- Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road Level 18, Singapore 308232, Singapore; Department of Primary Care and Public Health, School of Public Health, Imperial College London, The Reynolds Building, St Dunstan's Road, London W6 8RP, UK.
| |
Collapse
|
12
|
Abstract
Context/Objective Autonomic dysreflexia is a clinical syndrome affecting persons with spinal cord lesions. The aim of the study was to detect the level of knowledge among students about autonomic dysreflexia in persons with spinal cord lesions.Design: Single centre questionnaire study.Setting: Faculty of Health Studies, Rijeka, Croatia.Participants Nursing (n = 43) and physiotherapy (n = 48) students.Outcome Measures: AD knowledge test.Results: More of the half of the students (57%) had contact with persons with spinal cord lesions during work, especially nursing students. The self-estimated knowledge of autonomic dysreflexia was judged as poor or none in 73.6% of students. On the autonomic dysreflexia knowledge test, nursing students collected mean of 5.6 points and physiotherapy students 4.9 points (P = 0.173). There was no difference in the autonomic dysreflexia test results regardless of work experience or group affiliation.Conclusion: The level of knowledge about autonomic dysreflexia among students was low. Our results suggest the need for more education of students and health care professionals to apply adequate treatment to persons with episodes of autonomic dysreflexia.
Collapse
Affiliation(s)
- Nada Strčić
- Faculty of Health Studies, University of Rijeka, Rijeka, Croatia,Special Hospital Medico, Rijeka, Croatia
| | - Dean Markić
- Faculty of Medicine, University of Rijeka, Rijeka, Croatia,Department of Urology, University Hospital Rijeka, Rijeka, Croatia,Correspondence to: Dean Markić, Department of Urology, University Hospital Rijeka, Tome Strižića 3, 51 000 Rijeka, Croatia.
| |
Collapse
|
13
|
Spitaels D, Hermens RPMG, Luyten FP, Vandenneucker H, Aertgeerts B, Verschueren S, Van Assche D, Vankrunkelsven P. Educational outreach visits to improve knee osteoarthritis management in primary care. BMC Med Educ 2019; 19:66. [PMID: 30823900 PMCID: PMC6397491 DOI: 10.1186/s12909-019-1504-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 02/22/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Knee osteoarthritis is a common problem, but often underdiagnosed and undertreated in primary care as compared to evidence-based guidelines. Educational outreach visits are an effective strategy to improve guideline adherence, but its contribution to knee osteoarthritis management is largely unknown. The aim of this study was to evaluate the overall effectiveness of educational outreach visits on process quality indicators for knee osteoarthritis management, more specifically on the referral for physical therapy. METHODS An educational intervention study, non-randomized and controlled, was designed for general practitioners (GPs) in Belgium. During four months, 426 GPs were visited by academic detailers and allocated to the intervention group. The control group was selected from GPs not visited by academic detailers during the study period. Six months post-intervention, both groups received a questionnaire with two case-vignettes to measure the effectiveness of the educational outreach. Outcomes were assessed with a Belgian set of quality indicators for knee osteoarthritis management and focused on the number of prescriptions for appropriate physical therapy (i.e. muscle strengthening, aerobic, functional or range of motion exercises) and the adherence to eight additional quality indicators related to knee osteoarthritis management. For the analysis, multivariable logistic regression models were used and Generalized Estimating Equations to handle the correlation between the multiple results per GP. RESULTS The intervention group showed a tendency to prescribe more frequently at least one appropriate physical therapy for a case (43.8%), compared to the control group (31.3%, p = 0.057). Muscle strengthening exercises were the most frequently prescribed therapy with 37.0% in the intervention versus 26.9% in the control group. The adherence to the other quality indicators showed no significant difference between the intervention and control group and varied between 8.9 and 100% in the intervention group. CONCLUSIONS This intervention did not alter significantly the adherence to quality indicators and in particular the probability of prescribing physical therapy. To change general practitioners' prescription behavior, more extensive or combined interventional approaches seem warranted.
Collapse
Affiliation(s)
- David Spitaels
- Academic Center for General Practice, KU Leuven, Kapucijnenvoer 33, J building, 3000 Leuven, Belgium
| | - Rosella P. M. G. Hermens
- Academic Center for General Practice, KU Leuven, Kapucijnenvoer 33, J building, 3000 Leuven, Belgium
- Radboud Institute for Health Sciences (RIHS), IQ Healthcare, Radboud University Medical Center, Nijmegen, Netherlands
| | - Frank P. Luyten
- Division of Rheumatology, University Hospitals Leuven, Leuven, Belgium
| | - Hilde Vandenneucker
- Division of Orthopedic Surgery, University Hospitals Leuven, Pellenberg, Belgium
| | - Bert Aertgeerts
- Academic Center for General Practice, KU Leuven, Kapucijnenvoer 33, J building, 3000 Leuven, Belgium
| | | | - Dieter Van Assche
- Division of Rheumatology, University Hospitals Leuven, Leuven, Belgium
- Department of Rehabilitation Sciences, KU Leuven, Heverlee, Belgium
| | - Patrik Vankrunkelsven
- Academic Center for General Practice, KU Leuven, Kapucijnenvoer 33, J building, 3000 Leuven, Belgium
| |
Collapse
|
14
|
Lönnbro J, Nylén K, Wallerstedt SM. Developing professional confidence in the art of prescribing-a randomized controlled study on structured collegial discussions during internship. Eur J Clin Pharmacol 2019; 75:687-696. [PMID: 30693366 DOI: 10.1007/s00228-018-02619-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 12/21/2018] [Indexed: 11/30/2022]
Abstract
PURPOSE To evaluate whether an educational intervention based on collegial discussions on patient cases could increase interns' professional confidence in prescribing. METHODS In a randomized controlled study at Sahlgrenska University Hospital, Gothenburg, Sweden, 69 interns (median age: 29 years, 54% female) were allocated to an intervention or control group. The intervention consisted of two 3-h seminars based on collegial discussions of patient cases focused on performing medication reviews. This included reconciling the drug treatment and ascertaining that it is reasonable given the patient's current health status, as well as tips on practical handling of the medical records system and integrated decision support. Self-assessed confidence in performing medication reviews was evaluated with questionnaires distributed at baseline and at 6-month follow-up. RESULTS Fifty-seven (83%) interns completed the questionnaires. Although the opposite was found at baseline, intervention interns, in comparison with controls, at follow-up, were more confident in performing medication reviews (4.3 ± 0.9 vs. 3.6 ± 1.3, P = 0.034; 1 = completely disagree to 5 = completely agree). At follow-up, the intervention participants had increased their confidence in prescribing to a greater extent compared with the control participants, including performing medication reviews as well as taking responsibility for the medication list at discharge: + 1.5/+ 1 vs ± 0 on the 5-point agreement scale (all P ≤ 0.01). Among other positive outcomes, the intervention increased the interns' awareness of adverse effects as a potential cause of symptoms and their confidence in withdrawing a medication. CONCLUSION Structured collegial discussions on pharmacotherapy, even of a relatively short duration, can increase junior physicians' professional confidence in prescribing medicines.
Collapse
Affiliation(s)
- Johan Lönnbro
- Department of Medicine, Sahlgrenska University Hospital, 413 46, Gothenburg, Sweden
| | - Karin Nylén
- Department of Pharmacology, Sahlgrenska Academy, University of Gothenburg, 413 90, Gothenburg, Sweden
| | - Susanna M Wallerstedt
- Department of Pharmacology, Sahlgrenska Academy, University of Gothenburg, 413 90, Gothenburg, Sweden. .,Department of Clinical Pharmacology, Sahlgrenska University Hospital, Gothenburg, Sweden.
| |
Collapse
|
15
|
Al-Amri S, Bharti R, Alsaleem SA, Al-Musa HM, Chaudhary S, Al-Shaikh AA. Knowledge and practices of primary health care physicians regarding updated guidelines of MERS-CoV infection in Abha city. J Family Med Prim Care 2019; 8:455-461. [PMID: 30984654 PMCID: PMC6436268 DOI: 10.4103/jfmpc.jfmpc_336_18] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Background: Human coronaviruses (hCoV) usually cause mild to moderate upper respiratory tract illnesses. The novel coronavirus (nCoV), or Middle East respiratory syndrome coronavirus (MERS-CoV), is a particular strain different from any other known hCoV with the possibility of human and also zoonotic transmissions. The aim of the study to assess primary health care (PHC) physicians’ knowledge and adherence regarding Saudi Ministry of Health guidelines regarding MERS-CoV. Materials and Methods: A cross-sectional study design was followed to include 85 PHC physicians in Abha city. An interview questionnaire has been designed by the researcher that was used to assess knowledge and practices of PHC physicians regarding diagnosis and management of MERS-CoV. It includes personal characteristics, the MERS-CoV knowledge assessment questionnaire, and practices related to adherence toward guidelines regarding MERS-CoV. Results: PHC physicians’ knowledge gaps regarding MERS-CoV included protected exposure (32.9%), highest seasonal incidence of MERS-CoV in Saudi Arabia (60%), relation between incidence of MERS-CoV and overcrowding (62.4%), case fatality of MERS-CoV cases (63.5%), and collecting specimens from MERS-CoV patients (64.7%). The knowledge of PHC physicians about MERS-CoV was poor among 5.9%, good among 63.5%, and excellent among 30.6%. Personal protective equipment to be used when seeing suspected cases of MERS-CoV infection were mainly the mask (94.1%), gloves (78.8%), the gown (60%), goggles (31.8%), and the cap (22.4%). All participants stated that the most important standard precaution that should be applied when seeing a case of MERS-CoV infection is hand washing, whereas 97.6% stated that the most important respiratory precaution to prevent transmission of respiratory infections in PHC setting when seeing a case of MERS-CoV infection is masking and separation of suspected MERS-CoV patients, and 81.2% stated that upon exit from the room of a MERS-CoV patient, the physician should remove and discard personal protective equipment. PHC physicians’ knowledge about MERS-CoV differed significantly according to their nationality (P = 0.038), with non-Saudi physicians expressing higher percent of excellent knowledge than Saudi physicians (40% and 20%, respectively). Those who attended continuing medical education (CME) activities had significantly higher percent of excellent knowledge than those who did not attend a CME activity (55.6% and 23.9%, respectively, P = 0.011). PHC physicians’ knowledge did not differ significantly according to their age, gender, qualification, experience in PHC, and practice-related adherence to guidelines. PHC physicians’ practice-related adherence to guidelines about MERS-CoV differed significantly according to their position (P = 0.035), with specialists having the highest percent of excellent practice (13%). Conclusions: There are knowledge gaps among PHC physicians in Abha city, and their practice is suboptimal regarding MERS-CoV infection. Less than one-fourth of PHC physicians attend CME activities about MERS-CoV infection. However, significantly less practice-related adherence to guidelines are associated with Saudi PHC physicians, those who did not attend a related CME activity, and MBBS qualified physicians’ general practitioners. To increase awareness, more CME activities related to MERS-CoV infection management needs to be organized.
Collapse
Affiliation(s)
- Saad Al-Amri
- Department of Family Medicine, Ministry of Health, Abha, KSA
| | - Rishi Bharti
- Department of Family and Community Medicine, College of Medicine, KingKhalid University, Abha, Kingdom of Saudi Arabia
| | - Safar A Alsaleem
- Department of Family and Community Medicine, College of Medicine, KingKhalid University, Abha, Kingdom of Saudi Arabia
| | - Hassan M Al-Musa
- Department of Family and Community Medicine, College of Medicine, KingKhalid University, Abha, Kingdom of Saudi Arabia
| | - Shweta Chaudhary
- Department of Anatomy, College of Medicine, KingKhalid University, Abha, Kingdom of Saudi Arabia
| | | |
Collapse
|
16
|
Sandelowsky H, Natalishvili N, Krakau I, Modin S, Ställberg B, Nager A. COPD management by Swedish general practitioners - baseline results of the PRIMAIR study. Scand J Prim Health Care 2018; 36:5-13. [PMID: 29334861 PMCID: PMC5901441 DOI: 10.1080/02813432.2018.1426148] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 12/10/2017] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is a common cause of suffering and death. Evidence-based management of COPD by general practitioners (GPs) is crucial for decreasing the impact of the disease. Efficient strategies include early diagnosis, smoking cessation and multimodal treatment. AIM To describe knowledge about and skills for managing COPD in GPs in Sweden. METHODS Prior to COPD education (the PRIMAIR Study), GPs at primary health care centers (PHCCs) in Stockholm replied to 13 written, patient-case based, multiple choice and free-text questions about COPD. Their knowledge and practical management skills were assessed by assigned points that were analyzed with non-parametric tests. RESULTS Overall, 250 GPs at 34 PHCCs replied (89% response rate). Total mean score was 9.9 (maximum 26). Scores were highest on 'management of smoking cessation', 'follow-up after exacerbation' and 'diagnostic procedures'. Spirometry was used frequently, although interpretation skills were suboptimal. 'Management of maintenance therapy', 'management of multimorbidity' and 'interprofessional cooperation' had mediocre scores. Scores were unrelated to whether there was a nurse-led asthma/COPD clinic at the PHCC. CONCLUSIONS Swedish GPs' knowledge of COPD and adherence to current guidelines seem insufficient. A nurse-led asthma/COPD clinic at the PHCC does not correlate with sufficient COPD skills in the GPs. The relevance of this study to participants' actual clinical practice and usefulness of easy-to-access clinical guides are interesting topics for future investigation. To identify problem areas, we suggest using questionnaires prior to educational interventions. Key Points General practitioners (GPs) play a crucial role in providing evidence-based care for patients with chronic obstructive pulmonary disease (COPD) who are treated in primary care. Swedish GPs' knowledge about COPD and adherence to current guidelines seem insufficient. Areas in greatest need of improvement are spirometry interpretation, management of maintenance therapy, management of multimorbidity in patients with COPD and interprofessional cooperation.
Collapse
Affiliation(s)
- Hanna Sandelowsky
- NVS, Section for Family Medicine and Primary Care, Karolinska Institutet, Stockholm, Sweden
- Academic Primary Health Care Centre, Stockholm County Council, Stockholm, Sweden
| | | | - Ingvar Krakau
- NVS, Section for Family Medicine and Primary Care, Karolinska Institutet, Stockholm, Sweden
- Department of Medicine, Division of Clinical Epidemiology, Karolinska Institutet, Stockholm, Sweden
| | - Sonja Modin
- NVS, Section for Family Medicine and Primary Care, Karolinska Institutet, Stockholm, Sweden
| | - Björn Ställberg
- Department of Public Health and Caring Science, Family Medicine and Preventive medicine, Uppsala University, Uppsala, Sweden
| | - Anna Nager
- NVS, Section for Family Medicine and Primary Care, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
17
|
Abstract
Live-case demonstrations have become essential teaching tools. Debate about their added educational value and risk-benefit considerations vis-à-vis patient safety demand that major interventional cardiology meetings offering live-case demonstrations carefully define and monitor the objectives and quality of the cases included at their meetings. To this end, Europa Organisation, the content-providing group that supports EuroPCR and other PCR conferences internationally, has convened the PCR VITAL-Live Workshop, bringing together senior interventional cardiologists and experienced live-case operators with the aim of defining and reviewing the key components and goals of valuable live-case demonstrations. The Vital-Live participants unanimously agreed that live cases provide an educational experience with an immediacy and intensity that is unmatched by taped cases, through audience engagement with unfiltered reality and participation in real-time decision-making. Best practices regarding case selection, preparation, objectives, delivery, and discussion of the demonstrations were designed to ensure that the lessons learned would be clear and implementable by audience members, leading to improved patient care and safety in their own practices. Today's on-line accessibility of live-cases underscores the need for operators, hospitals, panels, and meeting chairs to insure that the content, quality, and intent anticipate any public scrutiny. This requires putting patient outcomes first, both at the level of the live demonstration itself and its broader educational worth.
Collapse
Affiliation(s)
- Jean Fajadet
- Cardiovascular Research Center Aalst, OLV Hospital, Moorselbaan 164, Aalst 9300, Belgium
| | - Shelley Wood
- Cardiovascular Research Center Aalst, OLV Hospital, Moorselbaan 164, Aalst 9300, Belgium
| | - William Wijns
- Cardiovascular Research Center Aalst, OLV Hospital, Moorselbaan 164, Aalst 9300, Belgium
| |
Collapse
|
18
|
Wong WCW, Zhu S, Ong JJ, Peng M, Lam CLK, Kidd MR, Roland M, Jiang S. Primary care workforce and continuous medical education in China: lessons to learn from a nationwide cross-sectional survey. BMJ Open 2017; 7:e015145. [PMID: 28710208 PMCID: PMC5734561 DOI: 10.1136/bmjopen-2016-015145] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 05/27/2017] [Accepted: 06/12/2017] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES This study aimed to examine the education and training background of Chinese community health centres (CHCs) staff, continuous medical education (CME) and factors affecting participation in CME. DESIGN Cross-sectional survey. SETTING Community health centres (CHCs). PARTICIPANTS All doctors and nurses working in selected CHCs (excluding those solely practising traditional Chinese Medicine). MAIN OUTCOME MEASURES CME recorded by CHCs and self-reported CME participation. METHODS A stratified random sample of CHCs based on geographical distribution and 2:1 urban-suburban ratio was selected covering three major regions of China. Two questionnaires, one for lead clinicians and another for frontline health professionals, were administered between September-December 2015, covering the demographics of clinic staff, staff training and CME activities. RESULTS 149 lead clinicians (response rate 79%) and 1734 doctors and 1846 nurses completed the survey (response rate 86%). Of the doctors, 54.5% had a bachelor degree and only 47% were registered as general practitioners (GPs). Among the doctors, 10.5% carried senior titles. Few nurses (4.6%) had training in primary care. Those who have reported participating in CME were 91.6% doctors and 89.2% nurses. CME participation in doctors was more commonly reported by older doctors, females, those who were registered as a GP and those with intermediate or senior job titles. CME participation in nurses was more common among those with a bachelor degree or intermediate/senior job titles or those with longer working experience in the CHC. CONCLUSION Only half of doctors have bachelor degrees or are registered as GPs as their prime registration in the primary care workforce in China. The vast majority of CHC staff participated in CME but there is room for improvement in how CME is organised.
Collapse
Affiliation(s)
- William C W Wong
- Department of Family Medicine and Primary Care, University of Hong Kong, Hong Kong, China
| | - ShanZhu Zhu
- General Practice Department, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jason J Ong
- Central Clinical School, Monash University, Melbourne, Australia
| | - MingHui Peng
- General Practice Department, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Cindy L K Lam
- Department of Family Medicine and Primary Care, University of Hong Kong, Hong Kong, China
| | - Michael R Kidd
- Department of Family & Community Medicine, University of Toronto, Toronto, Canada
| | - Martin Roland
- Institute of Public Health, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - SunFang Jiang
- General Practice Department, Zhongshan Hospital, Fudan University, Shanghai, China
| |
Collapse
|
19
|
Sandelowsky H, Krakau I, Modin S, Ställberg B, Nager A. Case Method in COPD education for primary care physicians: study protocol for a cluster randomised controlled trial. Trials 2017; 18:197. [PMID: 28449709 PMCID: PMC5408477 DOI: 10.1186/s13063-017-1889-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 03/09/2017] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is a common cause of morbidity and mortality worldwide. It is often undiagnosed and insufficiently managed. Effective forms of continuing medical education (CME) for primary care physicians (PCPs) are necessary to ensure the implementation of guidelines in clinical practice and, thus, improve patients' health. METHODS In this study, we will measure the effects of CME by Case Method and compare them against those of traditional lectures and no CME at all through an unblinded, cluster randomised controlled trial (CRCT). Thirty-three primary health care centres (PHCCs) in Stockholm, Sweden, with a total of 180 PCPs will be involved. Twenty-two primary PHCCs, will be cluster-randomised into: an intervention group who will receive CME by Case Method (n = 11) and a control group who will receive traditional lectures (n = 11). The remaining PHCCs (n = 11) will be a reference group and will receive no CME. From the intervention and control groups, 460 randomly selected patients with COPD in GOLD stages 2 and 3 will participate, while no patients will be recruited from the reference group. For the patients, smoking status, actual treatment and urgent visits to a health provider due to airway problems will be registered. For the PCPs, professional competence (i.e. knowledge and management skills) in COPD, will be measured using a questionnaire based on current guidelines and guideline implementation problems in clinical practice which has previously been described by the authors. Data will be collected at baseline and at follow-up, which will be after 1.5 years for the patients, and 1 year for the PCPs. Statistical methods for individual-level and cluster-level analyses will be used. DISCUSSION COPD is considered a particularly complex clinical challenge involving managing multimorbidity, symptom adaptation, and lifestyle problematisation. Case Method in CME for PCPs may contribute to a better understanding of the impact of COPD on patients' lives and, thus, improve their management of it. The present study is expected to contribute scientific knowledge about indicators for an effective CME in COPD that is tailor-made to primary care physicians. TRIAL REGISTRATION ClinicalTrials.gov, identifier: NCT02213809 . Registered on 10 August 2014. Protocol version: Issue date: May 2014.
Collapse
Affiliation(s)
- Hanna Sandelowsky
- Division of Family Medicine and Primary Care, NVS, Karolinska Institutet, Alfred Nobels Allé 23, D2, Huddinge, Stockholm 14183 Sweden
| | - Ingvar Krakau
- Division of Family Medicine and Primary Care, NVS, Karolinska Institutet, Alfred Nobels Allé 23, D2, Huddinge, Stockholm 14183 Sweden
| | - Sonja Modin
- Division of Family Medicine and Primary Care, NVS, Karolinska Institutet, Alfred Nobels Allé 23, D2, Huddinge, Stockholm 14183 Sweden
| | - Björn Ställberg
- Department of Public Health and Caring Science, Family Medicine and Preventive Medicine, Uppsala University, Uppsala, Sweden
| | - Anna Nager
- Division of Family Medicine and Primary Care, NVS, Karolinska Institutet, Alfred Nobels Allé 23, D2, Huddinge, Stockholm 14183 Sweden
| |
Collapse
|
20
|
Muriel Fernandez J, Sánchez Ledesma MJ, López Millan M, García Cenador MB. Study of the uses of Information and Communication Technologies by Pain Treatment Unit Physicians. J Med Syst 2017; 41:78. [PMID: 28349348 DOI: 10.1007/s10916-017-0726-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 03/17/2017] [Indexed: 11/28/2022]
Abstract
Adequate use of Information and Communication Technologies (ICTs) in health has been shown to save the patient and caregiver time, improve access to the health system, improve diagnosis and control of disease or treatment. All this results in cost savings, and more importantly, they help improve the quality of service and the lives of patients. The purpose of this study is to analyse the differences in the uses of this ICTs between those physicians that belong to Pain Treatment Units (PU) and other physicians that work in pain not linked to these PUs. An online survey, generated by Netquest online survey tool, was sent to both groups of professionals and the data collected was statistical analysed through a logistic regression methodology which is the Logit binomial model. Our results show that those physicians that belong to PUs use ICTs more frequently and consider it more relevant to their clinical practice.
Collapse
Affiliation(s)
- Jorge Muriel Fernandez
- Department of Surgery, School of Medicine, University of Salamanca, Avda Alfonso X El Sabio s/n, 37007, Salamanca, Spain.
| | | | - Manuel López Millan
- Anaesthesiology Service, University Hospital Virgen Macarena, Sevilla, Spain
| | - María Begoña García Cenador
- Department of Surgery, School of Medicine, University of Salamanca, Avda Alfonso X El Sabio s/n, 37007, Salamanca, Spain
| |
Collapse
|
21
|
Fernandez JM, Cenador MBG, Manuel López Millan J, Méndez JAJ, Ledesma MJS. Use of Information and Communication Technologies in Clinical Practice Related to the Treatment of Pain. Influence on the Professional Activity and the Doctor-Patient Relationship. J Med Syst 2017; 41:77. [PMID: 28337668 DOI: 10.1007/s10916-017-0724-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 03/10/2017] [Indexed: 12/30/2022]
Abstract
The increasing relevance of Information and Communication Technologies (ICTs) in medical care is indisputable. This evidence makes it necessary to start studies that analyse the scope these new forms of access to information and understanding of medicine have on the professional activity of the physician, on the attitude and on the knowledge of patients or, on the doctor-patient relationship. The purpose of this study is to explore some of these aspects in a group of physicians whose clinical activity is related to one of the greatest social impact health problems which is the treatment of chronic pain. Starting with the completion of a questionnaire, in the study group it is observed that the interaction between social structure, increase of information flows and ICTs generate transformations in social practices and behaviour of the actors of the health system. Internet is confirmed as an information space on the subject, but is shown as an underutilized space of interaction between the doctor and his patient.
Collapse
|
22
|
Hatziisaak T, Keller U. [Not Available]. Praxis (Bern 1994) 2017; 106:513-518. [PMID: 28488533 DOI: 10.1024/1661-8157/a002675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Zusammenfassung. Den Mitgliedern der Schweizerischen Gesellschaft für Allgemeine Innere Medizin (SGAIM) werden 30 Stunden Selbststudium pro Jahr vorgeschrieben. Wie wird dieses Selbststudium von Hausärzten praktiziert? In unserer Umfrage zeigte sich, dass vornehmlich werbefreie oder werbearme, qualitativ hochwertige und vertrauenswürdige schweizerische medizinische Zeitschriften gelesen werden. Lehrbücher, medizinische Webseiten und Online-Fortbildungen spielen eine untergeordnete Rolle.
Collapse
Affiliation(s)
| | - Urs Keller
- 1 PizolCare Praxis Wartau und Sargans, Trübbach
| |
Collapse
|
23
|
Nizamov IG, Sadykova TI. Quality of postgraduate medical education. Int J Risk Saf Med 2015; 27 Suppl 1:S93-4. [PMID: 26639731 DOI: 10.3233/jrs-150704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND In recent years, huge efforts to improve quality control process and efficiency of healthcare were put in advancing health systems in Russia. There are measurable and noteworthy achievements, there are unresolved issues.It's impossible to manage the process of improving the quality and efficiency of care without high-quality training of respective troops. However, in the last decade a phrase about the poor quality of postgraduate medical education has been heard periodically in the speeches of the leaders at various levels. The source is unknown, but this information continues to be spread by word of mouth as a regular component of speeches about health issues. Considering that the "poor quality" of postgraduate education has not been substantiated by solid evidence, this informational spam, of course, needs to be overcome. It is not only harmful to health system overall, it is harmful in particular for the process of formation of personnel reserve, but it also discredits the whole system of postgraduate education and a titanic work of thousands of teachers, who work as enthusiasts, most of them performing valuable research, teaching and organizational work. OBJECTIVE To provide situation analysis in the field of postgraduate medical education. RESULTS First of all, it begs the question - how and who measures the quality of education. What indicators in the evaluation process are key? As a rule, when assessing quality in any field, preference is given to the opinion of the consumer.Our direct customers are the heads of health organs and institutions who regularly undergo advanced training in the specialty "Public Health and Health Care" at sub-faculty. After the completion of each cycle of training and exams, each participant fills out a questionnaire, which points out the level of quality of pedagogical activity of the sub-faculty. The analysis of these questionnaires shows that the students generally give high assessment of the quality of pedagogical process. The health authorities of subjects of Russia that send the heads of their subordinate medical organizations to study public health and healthcare are satisfied with the work of sub-faculty, professorial teaching staff, they send thank-you letters to the educational organization.In this regard, natural questions related to the overall methodology for the assessment of the quality of education in the system of postgraduate training of doctors arise, which today is still very insufficiently developed.The quality of education in the system of continuous medical education of physicians can be assessed in the following levels with the help of quality indicators, which have to be developed appropriately for each particular level. In our opinion, the following levels should be included:1)The level of the sub-faculty2)The level of the faculty3)The level of the medical organization4)The level of the territorial health authority5)The level of the subject of the federation. CONCLUSIONS Multidimensional assessment of the results of evaluation in the mentioned levels will allow providing an integrated assessment system of quality of continuous medical education in the country.
Collapse
|
24
|
Macerollo A, Róna-Vörös K, Holler N, Chiperi R, Györfi O, Papp V, Sauerbier A, Balicza P, Sellner J. Preferences of residents and junior neurologists to attend conferences--an EAYNT survey. J Neurol Sci 2015; 357:297-9. [PMID: 26145197 DOI: 10.1016/j.jns.2015.06.060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Revised: 05/26/2015] [Accepted: 06/24/2015] [Indexed: 11/19/2022]
Affiliation(s)
- Antonella Macerollo
- Sobell Department of Motor Neuroscience and Movement Disorders, The National Hospital of Neurology and Neurosurgery, Institute of Neurology, University College London, London, United Kingdom; Department of Basic Medical Sciences, Neuroscience and Sense Organs, Aldo Moro University of Bari, Bari, Italy.
| | | | - Natalja Holler
- Department of Neurology, University Medical Centre Regensburg, Regensburg, Germany
| | - Ramona Chiperi
- Department of Neurology, Faculty of Medicine, Transilvania University, Brasov, Romania
| | - Orsolya Györfi
- Nyírő Gyula Hospital, National Institute of Psychiatry and Addictions, Budapest, Hungary
| | - Victoria Papp
- Department of Neurology, Holstebro Hospital, Denmark
| | - Anna Sauerbier
- King's College London and King's College Hospital, London, United Kingdom
| | - Peter Balicza
- Institute of Genomic Medicine and Rare Disorders, Semmelweis University, Hungary
| | - Johann Sellner
- Department of Neurology, Christian Doppler Medical Center, Paracelsus Medical University, Salzburg, Austria; Department of Neurology, Klinikum rechts der Isar, Technische Universität München, Germany
| |
Collapse
|
25
|
Mohammadi A, Mojtahedzadeh R, Emami A, Dehpour M. Pamphlet as a tool for continuing medical education: performance assessment in a randomized controlled interventional study. Med J Islam Repub Iran 2015; 29:252. [PMID: 26793643 PMCID: PMC4715387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2014] [Accepted: 03/17/2015] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Pamphlet is a tool used for distance continuous professional development programs. In this study, we assessed the impact of an educational pamphlet on improving prescription writing errors in general physicians' performance. METHODS In this randomized controlled interventional study, we prepared a training pamphlet according to the most prevalent prescription writing problems. We randomized 200 participants among general physicians affiliated with Tehran Social Security Insurance Organization, and randomly divided them into intervention and control groups. Participants' prescriptions (N= 34888) were investigated over a month, and then the prepared pamphlet was sent out to the participants in the intervention group. After three months we examined their one-month prescriptions again (N= 30296) and investigated the changes in prescription errors. RESULTS There was no significant difference in the mean number of prescriptions in two groups before and after intervention (p= 0.076). Mean number of medicinal items reduced significantly in intervention group. Also mean number of prescriptions including injection drugs (p= 0.024), Corticosteroids (p= 0.036), Cephalosporin (p= 0.017) and non-steroidal anti-inflammatory drugs (p=0.005) reduced significantly. No significant differences were found for other errors. CONCLUSION This study showed that use of an appropriate pamphlet has a considerable impact on improving general physicians' performance and could be applied for continuous professional development.
Collapse
Affiliation(s)
- Aeen Mohammadi
- 1 PhD candidate, Department of Medical Education, Iran University of Medical Sciences, Tehran, Iran.
| | - Rita Mojtahedzadeh
- 2 Assistant Professor, Department of e-learning in Medical Education, Virtual School, Center for Excellence in E-learning in Medical Education, Tehran University of Medical Sciences, Tehran, Iran.
| | - AmirHossein Emami
- 3 Associate Professor, Department of Internal Medicine, Medical School, Educational Development Center, Tehran University of Medical Sciences, Tehran, Iran. ,(Corresponding author) Associate Professor, Department of Internal Medicine, Medical School, Educational Development Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Marjaneh Dehpour
- 4 Department of Medical Education, Medical School, Tehran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|