A comparative evaluation of the effect of internet-based CME delivery format on satisfaction, knowledge and confidence

Background: Internet-based instruction in continuing medical education (CME) has been associated with favorable outcomes. However, more direct comparative studies of different Internet-based interventions, instructional methods, presentation formats, and approaches to implementation are needed. The purpose of this study was to conduct a comparative evaluation of two Internet-based CME delivery formats and the effect on satisfaction, knowledge and confidence outcomes. Methods: Evaluative outcomes of two differing formats of an Internet-based CME course with identical subject matter were compared. A Scheduled Group Learning format involved case-based asynchronous discussions with peers and a facilitator over a scheduled 3-week delivery period. An eCME On Demand format did not include facilitated discussion and was not based on a schedule; participants could start and finish at any time. A retrospective, pre-post evaluation study design comparing identical satisfaction, knowledge and confidence outcome measures was conducted. Results: Participants in the Scheduled Group Learning format reported significantly higher mean satisfaction ratings in some areas, performed significantly higher on a post-knowledge assessment and reported significantly higher post-confidence scores than participants in the eCME On Demand format that was not scheduled and did not include facilitated discussion activity. Conclusions: The findings support the instructional benefits of a scheduled delivery format and facilitated asynchronous discussion in Internet-based CME

How useful is thematic analysis as an elicitation technique for analyzing video of human gait in forensic podiatry?

The aim of this study was to evaluate how useful thematic analysis is in the elicitation of observations of gait from a video recording. This was undertaken by providing a video recording of human gait to “novice” and “expert” podiatry students. The observations were explored using the qualitative tool of thematic analysis. The exploration of human gait using this technique gave a rich abundance of information and demonstrated that a basic level of experience or knowledge is required to provide a simple description of human gait. With more expertise came a richer description of observation of human gait by the “expert” group compared to basic observations by the “novice” group. Thematic analysis allows the use of language and the depth of the information to be evaluated when observing human gait from a video recording

Predictive validity of bag and mask ventilation scores in neonatal resuscitation

Background: All personnel dealing with the birth of a newborn infant need to pass Neonatal Resuscitation Program (NRP) course .The validity of the certificate is for 2 years. Evaluation is done on various items learned at the course. All items are scored on scale of 0-2 on a form called megacode assessment form. Some items are mandatory and some non-mandatory. Bag and mask ventilation is one of the key skills acquired at the course. Objectives This study examined the predictive validity of the scores achieved in bag and mask ventilation skill during a formal neonatal resuscitation course and its impact over course of time. Methods This was a Prospective cohort study. 20 third year medical students were enrolled. Two simulated NRP scenarios over 6-8 months were offered and videotaped. Low fidelity manikins were similar to the one used in NRP course. Investigators and the independent rater (Neonatal Nurse Educator) were blinded to original scores. Video recordings scored on megacode forms by the independent rater. Total of 5 items scored, 3 items were mandatory and 2 non-mandatory. Original scores were then requested from the provincial NRP coordinator to compare with the study outcomes. Results The enrolled students had all similar original scores during NRP program (T1); everyone had 10/10 scores for bag and mask ventilation skill. R was constant and not calculated by SPSS. 5 students dropped out of the study. Pearson’s r values were calculated for the first study session (T2) and second study session (T3). The 3 mandatory and 5 total bag and mask ventilation skill items were grouped and compared for the two study sessions. The sum of 3 mandatory items for the two study sessions showed Pearson’s r of 0.299 for n=15, p value of 0.279, the sum of 5 total items showed Pearson’s r of 0.188 and p value of 0.502 Analysis of variance (ANOVA) for pairwise comparison of the means was calculated.T1-T2 Anova for sum of 5 total items showed a very low p value of 0.000 whereas T1-T3 Anova for sum of 5 total items showed p Value of 0.001 T1-T2 as well as T1-T3 Anova for sum of 3 mandatory items showed very low p values of 0.000 Conclusion Most candidates lost BMV skills significantly within 6 months. Practice resuscitation (T2), improved the skill slightly but not significantly. The NRP scores on bag and mask ventilation does not have a good predictive value. More research is required to evaluate alternate ways to enhance retention of acquired skills at the NRP program

A longitudinal review of attitudinal outcomes of interprofessional education curriculum at Memorial University

Background Interprofessional education (IPE) occurs when members (or students) of two or more health and/or social care professions engage in interactive learning activities to improve collaboration and/or the delivery of care. The Centre for Collaborative Health Professional Education, Memorial University has overseen the introduction, expansion and coordination of IPE curriculum at the pre-licensure education level across health and social care professional programs at Memorial. This IPE curriculum combines small-group case-based learning, standardized patient (SP) interaction, large-group panel activities and practice-based interprofessional learning experiences. The overall goal of the curriculum approach has been to promote interprofessional collaboration in health and social care delivery. Objectives A longitudinal review of attitudinal and satisfaction outcomes of a pre-licensure IPE curriculum approach that involves pre-clinical and clinical interprofessional learning experiences for medicine, nursing, pharmacy and social work students. Methods A longitudinal baseline survey examining attitudes towards interprofessional teamwork and IPE has been distributed to pre-licensure students across health professional programs. Students have also been asked to complete evaluation surveys following their participation in IPE activities. Results Students from across professions showed an increase in attitudes towards interprofessional teams following involvement with IPE programming. Female students and students reporting prior experience with IPE report higher mean scores towards interprofessional teamwork. Overall mean student satisfaction scores across IPE activities have increased gradually over time as a result of instructional modifications in response to student and faculty feedback. Greater student satisfaction has been reported for interactive and authentic learning activities such as case-based and SP learning. Conclusions Memorial’s IPE curricular approach involves interactive interprofessional learning that promotes interprofessional collaboration. High levels of student satisfaction and positive attitudes towards interprofessional teamwork suggest IPE has been integrated successfully within health professional education curriculum at Memorial University. The approach supports the principle of early-to-late exposure to elements of interprofessional learning and IPE which is integrated with core curriculum

A Comparative Review of Canadian Health Professional Education Accreditation Systems

Canadian governments and various stakeholder groups are advocating greater interprofessional collaboration amongst health care providers as a fundamental strategy for enhancing coordination and quality of care in the health care system. Interprofessional education for collaborative patient-centred practice (IECPCP) is an educational process by which students/learners (or workers) from different health professions learn together to improve collaboration. The educational system is believed to be a main determinant of interprofessional collaborative practice, yet academic institutions are largely influenced by accreditation, certification and licensure bodies. Accreditation processes have been linked to the continuous improvement of curricula in the health professions, and have also been identified as potential avenues for encouraging educational change and innovation. The purpose of this paper is to summarize the characteristics of the national accreditation systems of select Canadian health professional education programs at both the pre- and post-licensure educational levels and to show how these systems support and/or foster IECPCP. A review of the educational accreditation systems of medicine, nursing, pharmacy, social work, occupational therapy and physiotherapy was undertaken through key informant interviews and an analysis of accreditation process documentation. The results of this comparative review suggest that accreditation systems are more prevalent across the health professions at a pre-licensure level. Accreditation at the post- licensure level, particularly at the continuing professional education level, appears to be less well established across the majority of health professions. Overall, the findings of the review also suggest that current accreditation systems do not appear to promote nor foster interprofessional education for collaborative patient-centred practice in a systematic manner through either accreditation processes or standards. Through a critical adult learning perspective we argue that in order for traditional uni-professional structures within the health professional education system to be challenged, the accreditation system needs to place greater value on interprofessional education for collaborative patient-centred practice.Les gouvernements du Canada ainsi que divers groupes d’intervenants appellent à une plus grande collaboration interprofessionnelle entre les fournisseurs de services de santé comme stratégie fondamentale pour rehausser la coordination et la qualité des soins dans le système des soins de santé. L’éducation interprofessionnelle pour la pratique collaborative centrée sur le patient (IECPCP) constitue un processus éducatif qui permet aux étudiants/apprenants (ou travailleurs) de diverses professions de la santé d’apprendre ensemble à mieux collaborer. Le système éducatif est perçu comme le principal déterminant de la pratique collaborative interprofessionnelle; cependant, les institutions éducatives sont fortement infl uencées par les organismes qui octroient les accréditations, certifi cations et autorisations d’exercer. Les processus d’accréditation ont été reliés à l’amélioration continue des programmes d’études dans les professions de santé et ils ont été également identifi és comme avenues potentielles pour encourager le changement et l’innovation en milieu éducatif. L’objectif de cet article est de résumer les caractéristiques des systèmes nationaux d’accréditation de certains programmes de formation des professionnels de la santé au Canada à tous les niveaux (pré- et post-autorisation d’exercer) et de montrer comment ces systèmes soutiennent ou encouragent l’IECPCP. Nous avons passé en revue les systèmes d’accréditation en médecine, soins infirmiers, pharmacie, travail social, ergothérapie et physiothérapie par le biais d’entrevues avec des personnes-clés et par l’analyse de la documentation sur les processus d’accréditation. Les résultats de cette étude comparative suggèrent que les systèmes d’accréditation dans les services de santé sont plus courants avant l’octroi de l’autorisation d’exercer. L’accréditation post-autorisation d’exercer, en particulier dans le domaine de la formation professionnelle continue, semble être moins bien établie dans la majorité des professions de la santé. Globalement, les résultats de l’étude suggèrent aussi que les systèmes actuels d’accréditation ne semblent pas promouvoir ou encourager la formation interprofessionnelle pour la pratique collaborative centrée sur le patient de façon systématique par les processus ou normes d’accréditation. Dans la perspective critique de l’apprentissage des adultes, nous avançons que, pour remettre en question les structures uniprofessionnelles traditionnelles du système éducatif des professions de la santé, le système d’accréditation doit accorder une plus grande place à l’éducation interprofessionnelle sur la pratique collaborative centrée sur le patient.&nbsp