What is eHealth (6)? Development of a Conceptual Model for eHealth: Qualitative Study with Key Informants.

BACKGROUND: Despite rapid growth in eHealth research, there remains a lack of consistency in defining and using terms related to eHealth. More widely cited definitions provide broad understanding of eHealth but lack sufficient conceptual clarity to operationalize eHealth and enable its implementation in health care practice, research, education, and policy. Definitions that are more detailed are often context or discipline specific, limiting ease of translation of these definitions across the breadth of eHealth perspectives and situations. A conceptual model of eHealth that adequately captures its complexity and potential overlaps is required. This model must also be sufficiently detailed to enable eHealth operationalization and hypothesis testing. OBJECTIVE: This study aimed to develop a conceptual practice-based model of eHealth to support health professionals in applying eHealth to their particular professional or discipline contexts. METHODS: We conducted semistructured interviews with key informants (N=25) from organizations involved in health care delivery, research, education, practice, governance, and policy to explore their perspectives on and experiences with eHealth. We used purposeful sampling for maximum diversity. Interviews were coded and thematically analyzed for emergent domains. RESULTS: Thematic analyses revealed 3 prominent but overlapping domains of eHealth: (1) health in our hands (using eHealth technologies to monitor, track, and inform health), (2) interacting for health (using digital technologies to enable health communication among practitioners and between health professionals and clients or patients), and (3) data enabling health (collecting, managing, and using health data). These domains formed a model of eHealth that addresses the need for clear definitions and a taxonomy of eHealth while acknowledging the fluidity of this area and the strengths of initiatives that span multiple eHealth domains. CONCLUSIONS: This model extends current understanding of eHealth by providing clearly defined domains of eHealth while highlighting the benefits of using digital technologies in ways that cross several domains. It provides the depth of perspectives and examples of eHealth use that are lacking in previous research. On the basis of this model, we suggest that eHealth initiatives that are most impactful would include elements from all 3 domains.

Using the Knowledge, Process, Practice (KPP) model for driving the design and development of online postgraduate medical education.

BACKGROUND: Online learning is a primary delivery method for continuing health education programs. It is critical that programs have curricula objectives linked to educational models that support learning. Using a proven educational modelling process ensures that curricula objectives are met and a solid basis for learning and assessment is achieved. AIM: To develop an educational design model that produces an educationally sound program development plan for use by anyone involved in online course development. METHODS: We have described the development of a generic educational model designed for continuing health education programs. The Knowledge, Process, Practice (KPP) model is founded on recognised educational theory and online education practice. This paper presents a step-by-step guide on using this model for program development that encases reliable learning and evaluation. RESULTS: The model supports a three-step approach, KPP, based on learning outcomes and supporting appropriate assessment activities. It provides a program structure for online or blended learning that is explicit, educationally defensible, and supports multiple assessment points for health professionals. CONCLUSION: The KPP model is based on best practice educational design using a structure that can be adapted for a variety of online or flexibly delivered postgraduate medical education programs.

Online CME: an effective alternative to face-to-face delivery.

BACKGROUND: The Pharmacotherapies Accreditation Course (PAC) is a continuing medical education (CME) course designed to prepare practitioners for accreditation as pharmacotherapies prescribers for opioid dependence. The course incorporates a preparation stage, a workshop stage and a clinical placement component. The PAC continues to be successfully delivered in face-to-face mode since 2001. From 2003 onwards, an online alternative of the PAC was also implemented. AIMS: The aim of this study was to evaluate the effectiveness of an online alternative to an existing face-to-face CME workshop in preparing practitioners for accreditation as a pharmacotherapies prescriber for opioid dependence. METHODS: Participants were 62 practitioners who undertook the PAC between 2003 and 2006. A pretest/posttest-control group design was used, with outcome measures across the domains of knowledge, skill, and attitudes, together with a course feedback survey for both the online and face-to-face modes of the course. RESULTS: Results demonstrate that the online CME mode was equally as effective as the face-to face mode in preparing participants for their role in the treatment and management of opioid dependence, and was also rated highly by participants. CONCLUSIONS: The findings have implications for the effective design and delivery of e-learning environments for professional practice, in terms of equipping participants with requisite clinical knowledge and skills and facilitating the development of attitudes congruent with professional practice.

Developing a national patient safety education framework for Australia.

BACKGROUND: In 2004, The Australian Council for Safety and Quality in Health Care recognised that the lack of a comprehensive framework describing competencies for patient safety was a barrier to achieving a competent and safe health workforce. This article describes the building of a national patient safety education framework that describes the competencies for healthcare workers. AIM: Develop an educational framework that was patient centred and identified the knowledge, skills and behaviours required by healthcare workers irrespective of their profession, position or location. METHODS: The content of the framework was developed using a four-staged approach: literature review, development of learning areas and topics, classification into learning domains and, lastly, converting into a performance-sbased format. An extensive consultation and validation process was also undertaken. RESULTS: A national patient safety education framework was endorsed by The Australian Council for Safety and Quality in Health Care in 2005. The framework is already being used to develop curricula and train the trainer programmes in patient safety. CONCLUSIONS: The framework, which draws its educational approach from adult learning principles, was extensively researched and built on the experience of healthcare workers. The next challenge is to test different strategies for implementing the framework.

Supporting the problem-based learning process in the clinical years: evaluation of an online Clinical Reasoning Guide.

PURPOSE: Implementing problem-based learning (PBL) in the clinical years of a medical degree presents particular challenges. This study investigated the effectiveness of using an online Clinical Reasoning Guide to assist integration of PBL in the clinical setting and promote further development of students' clinical reasoning abilities. METHOD: A total of 52 students in 6 PBL groups, together with their 6 clinical tutors, participated in the study. Data were analysed from videotaped observations of tutorial activity and follow-up, semistructured interviews. RESULTS: From both the student facilitators' and the clinical tutors' perspectives, the Guide proved an effective tool for augmenting the PBL process in clinical settings and promoting the development of clinical reasoning. By combining computer-aided learning with collaborative PBL tutorials it promoted individual as well as collaborative reasoning. There is also evidence to suggest that the Guide prompted students to look more critically at their own, their colleagues' and other clinicians' reasoning processes.