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2.
JMIR Med Educ ; 10: e52906, 2024 Aug 08.
Artículo en Inglés | MEDLINE | ID: mdl-39119741

RESUMEN

Unlabelled: Virtual care appointments expanded rapidly during COVID-19 out of necessity and to enable access and continuity of care for many patients. While previous work has explored health care providers' experiences with telehealth usage on small-scale projects, the broad-level adoption of virtual care during the pandemic has expounded opportunities for a better understanding of how to enhance the integration of telehealth as a regular mode of health care services delivery. Training and education for health care providers on the effective use of virtual care technologies are factors that can help facilitate improved adoption and use. We describe our approach to designing and developing an accredited continuing professional development (CPD) program using e-learning technologies to foster better knowledge and comfort among health care providers with the use of virtual care technologies. First, we discuss our approach to undertaking a systematic needs assessment study using a survey questionnaire of providers, key informant interviews, and a patient focus group. Next, we describe our steps in consulting with key stakeholder groups in the health system and arranging committees to inform the design of the program and address accreditation requirements. The instructional design features and aspects of the e-learning module are then described in depth, and our plan for evaluating the program is shared as well. As a CPD modality, e-learning offers the opportunity to enhance access to timely continuing professional education for health care providers who may be geographically dispersed across rural and remote communities.


Asunto(s)
COVID-19 , Telemedicina , Humanos , COVID-19/epidemiología , Educación a Distancia/métodos , Educación Médica Continua/métodos , Acreditación , Desarrollo de Programa/métodos , Personal de Salud/educación , Educación Continua/métodos , Educación Continua/organización & administración
3.
Can Med Educ J ; 15(3): 18-25, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-39114774

RESUMEN

Background: Although medical courses are frequently evaluated via surveys with Likert scales ranging from "strongly agree" to "strongly disagree," low response rates limit their utility. In undergraduate medical education, a new method with students predicting what their peers would say, required fewer respondents to obtain similar results. However, this prediction-based method lacks validation for continuing medical education (CME), which typically targets a more heterogeneous group than medical students. Methods: In this study, 597 participants of a large CME course were randomly assigned to either express personal opinions on a five-point Likert scale (opinion-based method; n = 300) or to predict the percentage of their peers choosing each Likert scale option (prediction-based method; n = 297). For each question, we calculated the minimum numbers of respondents needed for stable average results using an iterative algorithm. We compared mean scores and the distribution of scores between both methods. Results: The overall response rate was 47%. The prediction-based method required fewer respondents than the opinion-based method for similar average responses. Mean response scores were similar in both groups for most questions, but prediction-based outcomes resulted in fewer extreme responses (strongly agree/disagree). Conclusions: We validated the prediction-based method in evaluating CME. We also provide practical considerations for applying this method.


Contexte: Bien que les cours de médecine soient fréquemment évalués au moyen d'enquêtes avec des échelles de Likert allant de « totalement d'accord ¼ à « totalement en désaccord ¼, les faibles taux de réponse en limitent l'utilité. Dans l'enseignement médical prédoctoral, une nouvelle méthode dans laquelle les étudiants prédisent ce que leurs pairs diraient, nécessite moins de répondants pour obtenir des résultats similaires. Cependant, cette méthode fondée sur la prédiction n'est pas validée pour la formation médicale continue (FMC), qui cible généralement un groupe plus hétérogène que les étudiants en médecine. Méthodes: Dans cette étude, 597 participants à un grand cours de FMC ont été choisis au hasard pour exprimer leur opinion personnelle sur une échelle de Likert en cinq points (méthode fondée sur l'opinion; n = 300) ou à prédire le pourcentage de leurs pairs choisissant chaque option de l'échelle de Likert (méthode fondée sur la prédiction; n = 297). Pour chaque question, nous avons calculé le nombre minimum de répondants nécessaire pour obtenir des résultats moyens stables à l'aide d'un algorithme itératif. Nous avons comparé les scores moyens et la distribution des scores entre les deux méthodes. Résultats: Le taux de réponse global était de 47 %. La méthode fondée sur la prédiction a nécessité moins de répondants que celle fondée sur l'opinion pour des réponses moyennes similaires. Les scores moyens des réponses étaient similaires dans les deux groupes pour la plupart des questions, mais les résultats fondés sur la prédiction ont donné lieu à moins de réponses extrêmes (totalement d'accord/totalement en désaccord). Conclusions: Nous avons validé la méthode fondée sur la prédiction dans l'évaluation de la FMC. Nous présentons également des considérations pratiques pour la mise en œuvre de cette méthode.


Asunto(s)
Educación Médica Continua , Grupo Paritario , Humanos , Educación Médica Continua/métodos , Evaluación Educacional/métodos , Masculino , Femenino , Encuestas y Cuestionarios , Estudiantes de Medicina/psicología , Estudiantes de Medicina/estadística & datos numéricos , Adulto
4.
BMC Med Educ ; 24(1): 697, 2024 Jun 26.
Artículo en Inglés | MEDLINE | ID: mdl-38926822

RESUMEN

BACKGROUND: During the COVID-19 pandemic, large in-person conferences were mostly cancelled to avoid further disease contagion. Physicians continued to demand changes in form to enable participation in lifelong medical education programs, and the traditional model of in-person conferences needed to be rethought. As such, a regional branch of the national orthopedic association tried to move in-person conferences onto a virtual platform. This study aimed to investigate the effect of transitioning large in-person conferences to a virtual model during the COVID-19 pandemic, especially examining any differences in the attendance of each type of conference. METHODS: In this retrospective observational study, 776 participants in virtual conferences and 575 participants in in-person conferences were analyzed. Institutions were classified based on their location in a central city and two neighboring cities. Affiliated institutions were divided into resident training hospitals, general hospitals, and private clinics. The change in the number and proportion of participants between the virtual conference year and in-person conference year was calculated. RESULTS: The number of virtual conference participants was significantly greater than that of in-person conference participants (P = 0.01). Although the highest number of participants was from central city for both years, the proportion of participants from the two neighboring cities increased. Although the proportion of participants from resident training hospitals and private clinics decreased, the proportion of participants from general hospitals increased. CONCLUSIONS: We implemented a virtual platform to tackle challenges associated with lifelong medical education during the COVID-19 pandemic. The virtual platforms can be helpful for organizations that must hold regular lifelong medical education programs for members spread across a wide geographic region.


Asunto(s)
COVID-19 , Educación Médica Continua , Humanos , COVID-19/epidemiología , Estudios Retrospectivos , Educación Médica Continua/métodos , Educación Médica Continua/organización & administración , Pandemias , SARS-CoV-2 , Educación a Distancia/métodos , Educación a Distancia/organización & administración
5.
Clin Obstet Gynecol ; 67(3): 474-482, 2024 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-38881535

RESUMEN

Continuous professional development (CPD) in health care refers to the process of lifelong learning including the acquisition of new competencies, knowledge, and professional growth throughout the career of a health care professional. Since implementation, there has seen little change or innovation in CPD. This perspective will review the current state of CPD, including the challenges in traditional CPD models, foundations and strategies for redesign to meet the needs of current and future physicians, and suggestions for changes to modernize CPD. Precision education and the use of technology, including artificial intelligence, and their application to CPD will be discussed.


Asunto(s)
Competencia Clínica , Educación Médica Continua , Humanos , Educación Médica Continua/métodos , Inteligencia Artificial , Obstetricia/educación , Aprendizaje , Ginecología/educación
6.
Patient Educ Couns ; 125: 108297, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38728998

RESUMEN

OBJECTIVE: Motivational Interviewing (MI) is an evidence-based approach to enhance patients' motivation and is increasingly in demand in medical practice. Online teaching methods offer advantages to train health care professionals, but only very few studies examined whether MI-specific interviewing skills (""MI-skills""), and especially MIspecific attitudes (the "MI-spirit"), can be taught online and whether learning gains differ from those in face-to-face courses. This study compared the effects of 7 h of basic training for experienced general practitioners (GP) in either an online or a traditional face-to-face format with a non-trained control group. METHODS: "MI-skills" and "MI-spirit" were measured in a prospective analysis in 49 experienced GPs before and one week after training RESULTS: An ANOVA on gain-scores demonstrated significant differences between groups in both MI-specific skills (VASE-R, p = 0.006) and "MIspirit" (MIKAT, p = 0.029; HRQ, p < 0.001) from pre- to posttest. Post-hoc comparisons revealed significant improvement only in the training groups (VASE-R, p < 0.001; MIKAT, p = 0.014 for online, p = 0.003 for face-to-face; HRQ, p < 0.001). CONCLUSION: The results suggest similar effects of both online and face-to-face training of "MI-skills" and "MI-spirit" to GPs. PRACTICE IMPLICATION: Online learning opportunities should be integrated in MIT programs for general practitioners where appropriate.


Asunto(s)
Médicos Generales , Entrevista Motivacional , Humanos , Entrevista Motivacional/métodos , Masculino , Médicos Generales/educación , Femenino , Estudios Prospectivos , Adulto , Persona de Mediana Edad , Internet , Competencia Clínica , Motivación , Educación Médica Continua/métodos , Encuestas y Cuestionarios
7.
Perm J ; 28(2): 26-35, 2024 Jun 14.
Artículo en Inglés | MEDLINE | ID: mdl-38727254

RESUMEN

INTRODUCTION: Adapting clinical care decisions for patient-reported social risks is essential to social health integration and patient-centered care. Most research in this area focuses on awareness and assistance (social-needs-targeted care), such as screening and referral to food, financial, and other resources. Limited evidence for adjustment strategies (social risk-informed care) or adapting care for social risks made it difficult for Kaiser Permanente to implement new initiatives. This article describes a codesign process to build a novel, adjustment-focused continuing medical education course. METHODS: The authors codeveloped the online continuing medical education course with patients and clinicians using user-centered design. Transcripts from codesign activities were coded and analyzed by thematic analysis to identify major themes, including perceptions of social risk-informed care and barriers to care adjustment. RESULTS: Practical hurdles for implementing social risk-informed care emerged, including clinicians' concerns about the ethics of adjustment as substandard care, particularly without robust assistance activities. However, patients expressed a desire for their care to be adapted to their social circumstances, to allow for more realistic care plans. DISCUSSION: Implementation barriers identified from the codesign were addressed through an interactive, case-study approach. Existing evidence on contextualized care and shared decision making informed a general framework for primary care providers to engage in awareness and adjustment activities, paired with 3 interactive case studies based on real-world, clinician-supplied scenarios. CONCLUSION: The authors recommend that multiple stakeholder perspectives be incorporated during the development of social health integration initiatives, particularly adjustment. Education complemented by active, nuanced, flexible implementation strategies may be necessary for the successful uptake of care-delivery-based social health integration activities.


Asunto(s)
Educación Médica Continua , Atención Primaria de Salud , Humanos , Educación Médica Continua/métodos , Atención Dirigida al Paciente , Educación a Distancia/métodos , Masculino , Femenino
8.
Medicine (Baltimore) ; 103(17): e37947, 2024 Apr 26.
Artículo en Inglés | MEDLINE | ID: mdl-38669423

RESUMEN

Continuing medical education plays a pivotal role in fostering and upholding the standard of excellence in medicine. Both SPOC (small private online course) and BOPPPS (bridge-in, learning objective, pretest, participatory learning, posttest, and summary) methodologies are rooted in the same educational and learning theories, emphasizing active student engagement, interaction, and feedback. Using ultrasound-guided spinal anesthesia as an exemplar, we aimed to investigate the feasibility of blended teaching (combination of BOPPPS and SPOC) for anesthesiology clinicians and explore trainees' and trainers' perspectives towards the innovative method. Twenty-seven attending anesthesiologists were randomly divided into experimental group (n = 14, blended teaching method) and control group (n = 13, traditional teaching method). The questionnaire was administered before and a week post-training. Their operative skills (measured by operation time) were assessed. The students' cognitive evaluation of the blended teaching mode was conducted in the experimental group. The experimental group demonstrated notably higher theoretical scores compared to the control group [(46.42 ±â€…5.345) vs (41.92 ±â€…5.219), t = 2.213, P < .05]. The operation time in the experimental group was significantly shorter than that in the control group [(84.79 ±â€…28.450) seconds vs (114.23 ±â€…35.607) seconds, t = -2.383, P < .05]. Most participants preferred blended learning as it was more effective than traditional learning. Suggestions for enhancement included enhanced online interactivity with trainers and the inclusion of case analysis. Integration of blended teaching incorporating BOPPPS and SPOC methodologies holds promise for enhancing the efficiency of skill training among anesthesiologists. Blended learning may become a viable and well-received option among anesthesia clinicians in China.


Asunto(s)
Anestesiología , Educación Médica Continua , Estudios de Factibilidad , Humanos , Anestesiología/educación , Educación Médica Continua/métodos , Masculino , Femenino , Adulto , Competencia Clínica , Anestesia Raquidea/métodos , Anestesiólogos/educación , Encuestas y Cuestionarios , Cuerpo Médico de Hospitales/educación
9.
Public Health Rep ; 139(1_suppl): 37S-43S, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38646821

RESUMEN

OBJECTIVES: Implicit bias can affect clinical decisions that influence the care received by patients whose ancestors had been subjected to unfair medical and social practices. However, literature describing the effects of implicit bias training as part of continuing medical and nursing education is scarce. We conducted a longitudinal evaluation of a training for maternal health care clinical and nonclinical staff. METHODS: A total of 80 staff members at 2 clinical sites in Cleveland, Ohio, participated in the training and evaluation in 2020 and 2021. We used a mixed-methods evaluation to capture changes in knowledge, awareness of bias, and application of strategies to reduce biased behavior by conducting pre- and posttraining surveys immediately after training and interviews at 3 and 6 months posttraining. We conducted univariate and bivariate analyses of the surveys and recorded, transcribed, and analyzed interviews for themes. RESULTS: Using a threshold of answering 3 of 5 knowledge questions correctly, 50 of 80 (62.5%) trainees who engaged in the evaluation passed the pretraining knowledge questions and 67 (83.8%) passed the posttraining knowledge questions. Of the 80 participants, 75 (93.8%) were women. Interviewees (n = 11) said that low staff-to-patient ratios, lack of racial and ethnic diversity in leadership, inadequate training on implicit bias, and lack of institutional consequences for poor behavior exacerbated bias in maternity care. Interviewees reported having heightened awareness of bias and feeling more empowered after the training to advocate for themselves and patients to prevent and mitigate bias in the hospital. CONCLUSION: Additional study describing the effect of implicit bias training as part of continuing medical education should be conducted, and administrative and management changes should also be made to prevent bias and improve quality of care.


Asunto(s)
Servicios de Salud Materna , Racismo , Humanos , Femenino , Servicios de Salud Materna/normas , Educación Médica Continua/métodos , Educación Médica Continua/organización & administración , Ohio , Masculino , Adulto , Educación Continua en Enfermería/organización & administración , Estudios Longitudinales
10.
Chirurgie (Heidelb) ; 95(6): 466-472, 2024 Jun.
Artículo en Alemán | MEDLINE | ID: mdl-38498122

RESUMEN

BACKGROUND: Structured competency-based training is one of the most frequently articulated wishes of residents. METHODS: A survey of 19 residents was conducted regarding their satisfaction with the resident education at a level 1 trauma center. In this article the development of a revised competency-based education concept was carried out. RESULTS: The survey reflected uncertainty as to whether the current structures could meet the requirements of the residency regulations. The improved competency-based education concept consists of clinical mentoring, competency-based catalogs of learning objectives, regular theoretical and practical workshops as well as regular and structured staff evaluations. CONCLUSION: The education concept presented reflects the attempt to establish a contemporary surgical training program which will be evaluated as it progresses.


Asunto(s)
Educación Basada en Competencias , Educación Médica Continua , Internado y Residencia , Centros Traumatológicos , Humanos , Educación Basada en Competencias/métodos , Educación Médica Continua/métodos , Alemania , Encuestas y Cuestionarios , Competencia Clínica/normas , Masculino , Femenino , Traumatología/educación , Satisfacción Personal , Actitud del Personal de Salud , Adulto
11.
Vox Sang ; 119(6): 563-571, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38425034

RESUMEN

BACKGROUND AND OBJECTIVES: Blood transfusion is performed daily in hospitals. Gaps exist between transfusion guidelines and day-to-day clinical care. These gaps are prevalent in resource-limited settings due to scarce continuing medical education. Transfusion Camp Rwanda aims to bridge this gap by (1) delivering context-appropriate up-to-date education, (2) teaching participants how to independently deliver a case-based curriculum and (3) identifying strategies to promote change in transfusion practice in Rwanda. MATERIALS AND METHODS: In May 2023, a multidisciplinary team from Canada and Rwanda carried out a Transfusion Camp train-the-trainer workshop for clinicians from all five provinces in Rwanda. Participants attended in-person lectures, seminars and workshop group discussions on the implementation of the Rwanda National Directives on Rational Use of Blood and Blood Components. Course feedback was based on the Kirkpatrick Model of Training and Evaluation. RESULTS: Fifty-one physicians and laboratory technicians participated in the course. Confidence in caring for patients based on transfusion guidelines was self-rated as 'excellent' by 23% of participants before and 77% after, while 84% reported they planned to teach Transfusion Camp to others and 100% responded that they will apply course content to clinical practice. Workshop groups recommended strategies to improve transfusion medicine practice in Rwanda in four domains: Communication, Institutional Approval, Practice Audits and Education. CONCLUSION: Transfusion medicine education in Rwanda using a train-the-trainer approach was well-received by participants and allowed for a more detailed understanding of the local medical and educational environment. These observations can inform the further expansion of the Transfusion Camp Rwanda project.


Asunto(s)
Transfusión Sanguínea , Medicina Transfusional , Rwanda , Humanos , Medicina Transfusional/educación , Investigación Biomédica Traslacional/educación , Educación Médica Continua/métodos , Liderazgo , Femenino , Masculino , Curriculum
12.
Acta Anaesthesiol Scand ; 68(6): 839-847, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38442873

RESUMEN

BACKGROUND: An Utstein style meeting of key stakeholders from the existing collaboration surrounding post-graduate training was arranged to set a direction for continuing professional development (CPD) of anesthesiologists in Denmark. A 2-day meeting was planned to guide discussions about competencies in anesthesiology, facilitate the development of a blueprint for a portfolio-based CPD program and provide examples of how a portfolio can be used in practice. METHODS: The meeting agenda was based on an adaptation of Kern's six-step approach to curriculum development. Twenty-four participants from the university hospitals in Denmark were invited. Prior to the meeting participants were informed of the objectives and the Utstein style process. RESULTS: Participants acknowledged a need for a more structured approach to CPD, preferably within the current organizational set up at the departmental level, and with a portfolio-based, individualized curriculum. It was recognized that CPD should contain an array of possibilities to accommodate needs and wants of both the individual and the department. It was emphasized that, while anesthesiologists are used to give feedback to trainees, many are less familiar in providing the same to peers, and psychological safety was identified as a prerequisite to support a culture where specialists can reflect openly on each other's performance. CONCLUSION: The results provide an insight into the attitudes, opportunities, and challenges of anesthesiologists in relation to continuing professional development in Denmark. Generally, participant suggestions are in line with the shift in medical education toward workplace-based learning, feedback and lifelong learning.


Asunto(s)
Anestesiología , Competencia Clínica , Curriculum , Educación Médica Continua , Anestesiología/educación , Humanos , Educación Médica Continua/métodos , Dinamarca , Anestesiólogos/educación
13.
BMC Med Educ ; 24(1): 272, 2024 Mar 12.
Artículo en Inglés | MEDLINE | ID: mdl-38475806

RESUMEN

BACKGROUND: Pakistan has made numerous attempts to establish and implement a national mandatory CME program which currently do not exist. The purpose of this study is to explore the views of major CME providers in order to identify possible strengths and weaknesses in the current program, and offer evidence-based recommendations to help further enhance the national CME program in Pakistan. METHODS: An exploratory study design using a case study approach through in depth interviews was conducted to examine CME providers' experiences and perceptions. The study was conducted in Pakistan between August and November 2019 with CME providers from Sindh, Punjab, the North-West Frontier Province, and the Federal Capital Territory. Thirty-six providers recognised by the Pakistan Medical and Dental Council who were involved in providing CME activities at the national level and whose contact information was publicly available on their websites, were selected for the study. Of the 36 providers invited, 22 participated in this study. RESULTS: The results generated several organising themes grouped into three major themes: (1) CME current practices, (2) CME past experiences, and (3) Future developments. CONCLUSION: Participants recommended needs-based educational activities for physicians, a well-structured central regulatory CME body collaborating with existing providers, involving experienced providers for rural CME, accrediting diverse local providers, limiting commercial entities' role, and implementing CME with proper preparation and a phased approach.


Asunto(s)
Médicos , Humanos , Pakistán , Educación Médica Continua/métodos , Población Rural
14.
Eur Eat Disord Rev ; 32(4): 687-699, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38416595

RESUMEN

BACKGROUND: Over two-thirds of people present to their primary care physician (or general practitioner; GP) as a first point of contact for mental health concerns. However, eating disorders (EDs) are often not identified in a primary care setting. A significant barrier to early detection and intervention is lack of primary care physician training in EDs; compounded by the significant time commitments required for training by already time-poor general practitioners. The aim of the current study was to pilot and evaluate a microlearning programme that can be delivered to general practitioners with high workloads to help support patients with, or at risk of, developing an ED. METHODS: Fifty-one Australian general practitioners aged between 25-to-60 years old were recruited. Participants completed a baseline questionnaire to ascertain their experience working in general practice and with EDs. Participants then completed an online programme consisting of a series of 10 case studies (vignettes) delivered over a 6-10 week period related to various facets of ED care. Following conclusion of the programme, participants were asked to complete an evaluative questionnaire related to the content of the programme; perceived knowledge, confidence, willingness-to-treat, skill change; and their overall experience of microlearning. RESULTS: All 51 GPs completed the programme and reached completion criteria for all vignettes, 40 of whom completed the programme evaluation. Participants indicated improved skill, confidence, willingness-to-treat, and knowledge following the completion of the pilot programme. Almost all (97.5%; n = 39) found microlearning to be an effective method to learn about EDs; with 87.5% (n = 35) of participants reporting they felt able to apply what was learnt in practice. Qualitative feedback highlighted the benefit of microlearning's flexibility to train general practitioners to work with complex health presentations, specifically EDs. CONCLUSIONS: Findings from the current study lend support to the use of microlearning in medical health professional training; notably around complex mental health concerns. Microlearning appears to be an acceptable and effective training method for GPs to learn about EDs. Given the significant time demands on GPs and the resulting challenges in designing appropriate training for this part of the workforce, this training method has promise. The pre-existing interest in EDs in the current study sample was high; future studies should sample more broadly to ensure that microlearning can be applied at scale.


Asunto(s)
Trastornos de Alimentación y de la Ingestión de Alimentos , Humanos , Proyectos Piloto , Adulto , Persona de Mediana Edad , Femenino , Masculino , Encuestas y Cuestionarios , Médicos de Atención Primaria/educación , Australia , Educación Médica Continua/métodos , Competencia Clínica , Atención Primaria de Salud
15.
Am J Phys Med Rehabil ; 103(6): 510-517, 2024 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-38261785

RESUMEN

OBJECTIVE: This study compared the effectiveness of traditional lectures and microvideos in teaching baclofen pump programming and refilling to physicians who have completed less than 10 refills for the previous 2 yrs. DESIGN: A mixed-method approach was used with 60 participating physicians specializing in physical medicine and rehabilitation or pain management. Preintervention and postintervention assessments were conducted using a rubric, and the participants' perceptions and preferences were gathered through focus group sessions. RESULTS: Two thirds of the participants specialized in physical medicine and rehabilitation. No significant differences in the preintervention, postintervention, or knowledge retention scores were found between the traditional lecture and microvideo groups. Both methods demonstrated comparable effectiveness in improving the baclofen pump refilling and programming skills. Qualitatively, participants perceived both approaches as equally helpful, but those in the microvideo group raised concerns because of instructors' unavailability and online platform navigation. Nevertheless, they preferred the convenience, accessibility, and time efficiency of the microvideos. CONCLUSIONS: The study concluded that microvideos are an effective alternative to traditional lectures for acquiring knowledge on baclofen pump programming and refilling. Further research should consider learners' characteristics and investigate the benefits of blended learning in medical education.


Asunto(s)
Baclofeno , Relajantes Musculares Centrales , Humanos , Baclofeno/administración & dosificación , Relajantes Musculares Centrales/administración & dosificación , Femenino , Masculino , Medicina Física y Rehabilitación/educación , Enseñanza , Adulto , Grupos Focales , Persona de Mediana Edad , Grabación en Video , Bombas de Infusión Implantables , Educación Médica Continua/métodos , Espasticidad Muscular/tratamiento farmacológico
16.
Clin Exp Dermatol ; 49(6): 591-598, 2024 May 21.
Artículo en Inglés | MEDLINE | ID: mdl-38214576

RESUMEN

BACKGROUND: Dermoscopy is known to increase the diagnostic accuracy of pigmented skin lesions (PSLs) when used by trained professionals. The effect of dermoscopy training on the diagnostic ability of dermal therapists (DTs) has not been studied so far. OBJECTIVES: This study aimed to investigate whether DTs, in comparison with general practitioners (GPs), benefited from a training programme including dermoscopy, in both their ability to differentiate between different forms of PSL and to assign the correct therapeutic strategy. METHODS: In total, 24 DTs and 96 GPs attended a training programme on PSLs. Diagnostic skills as well as therapeutic strategy were assessed, prior to the training (pretest) and after the training (post-test) using clinical images alone, as well as after the addition of dermatoscopic images (integrated post-test). Bayesian hypothesis testing was used to determine statistical significance of differences between pretest, post-test and integrated post-test scores. RESULTS: Both the DTs and the GPs demonstrated benefit from the training: at the integrated post-test, the median proportion of correctly diagnosed PSLs was 73% (range 30-90) for GPs and 63% (range 27-80) for DTs. A statistically significant difference between pretest results and integrated test results was seen, with a Bayes factor > 100. At 12 percentage points higher, the GPs outperformed DTs in the accuracy of detecting PSLs. CONCLUSIONS: The study shows that a training programme focusing on PSLs while including dermoscopy positively impacts detection of PSLs by DTs and GPs. This training programme could form an integral part of the training of DTs in screening procedures, although additional research is needed.


Asunto(s)
Competencia Clínica , Dermoscopía , Médicos Generales , Dermoscopía/educación , Dermoscopía/métodos , Humanos , Médicos Generales/educación , Neoplasias Cutáneas/diagnóstico , Neoplasias Cutáneas/diagnóstico por imagen , Femenino , Masculino , Dermatólogos/educación , Dermatólogos/estadística & datos numéricos , Educación Médica Continua/métodos , Adulto
17.
Rural Remote Health ; 24(1): 8032, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38296265

RESUMEN

INTRODUCTION: In Australia, remote consultations have been used as an adjunct to traditional healthcare delivery during the COVID-19 pandemic using telephone and video techniques with an increase in the use of telephone consultations, and to a lesser extent video consultations, for management of patient conditions, assessment, treatment, monitoring and diagnosis. METHODS: To establish the needs of rural doctors for training in the provision of remote consultations, an online survey of members of the Australian College of Rural and Remote Medicine was undertaken. Subsequently an online scenario-based training program was designed to improve the competencies of members in providing these consultations. The outcomes of this program were analysed using pre- and post-intervention surveys, and qualitative analysis of session recordings. RESULTS: The program improved trainee confidence and competence in providing safe, quality remote consultations, particularly when using video technologies. Competencies in communication, history taking, physical online examination, clinical management and professionalism improved. Trainees adapted their practice because they were then able to manage potential issues, were more aware of the capabilities of telehealth technologies and could assist a health professional, such as a nurse or Aboriginal Health Worker (with the patient) to do an examination. Concerns remained about set-up time, technical quality, privacy, interaction with and examination of patients, and how to assess the severity of conditions. CONCLUSION: The outcomes of the program showed significant improvement in the levels of confidence and competencies required for providing remote consultations using telehealth services. A need remains to improve virtual interactions with patients, and to acquire better technology and financial support for remote consultations. In an environment where government is asking whether remote consultations are appropriate and clinically effective, these findings provide guidance from a professional group of experienced rural practitioners.


Asunto(s)
COVID-19 , Servicios de Salud del Indígena , Telemedicina , Humanos , Australia , Pandemias , Telemedicina/métodos , Población Rural , Educación Médica Continua/métodos
18.
Recenti Prog Med ; 115(2): 76-81, 2024 Feb.
Artículo en Italiano | MEDLINE | ID: mdl-38291932

RESUMEN

INTRODUCTION: Health technology assessment (Hta) is a multidisciplinary process that uses explicit methods to determine the value of a health technology across various domains. It aims at supporting decision-makers in promoting an equitable, efficient, and high-quality healthcare system. During 2023, the Italian Minister of Health officially endorsed the National program for Hta on medical devices 2023-2025 (Pnhta), aligning with EU Regulation 2017/745 and EU Regulation 2017/746. A key objective of Pnhta is to launch a continuous training initiative targeting all professionals within the Italian Health Service to enhance their knowledge and usability of Hta. To support this effort, a national analysis of educational offerings on medical devices (MD) during the 2019-2021 triennium was undertaken. METHODS: The Italian database of accredited Continuing medical education (Cme/Ecm) events was queried using relevant keywords. A descriptive analysis of the educational offerings was conducted based on variables already provided by the database. The analysis was structured according to pre-identified categories related to the courses' objectives ("correct use", "appropriate use", "procurement", "expert patient") and clinical-care areas of interest. RESULTS: Overall, 1,450 training events were included in the analysis. Courses specifically focused on MD were less than 2% of all Cme/Ecm events. The number of participants trained in MD-related topics decreased in 2020 compared to 2019 (14,787 vs 32,784). However, the average number of credits per course and per participant increased in both 2020 and 2021. Distance learning showed an upward trajectory, rising from 16 events in 2019 to 132 in 2021. Regarding the courses' objectives, 73.2% of events concerned the "proper use" of MD, 31.9% focused on their "appropriateness", 14.7% on "updates", 1.2% on "procurement", while no course was specifically dedicated to the "expert patient". Most of the events were related to dentistry/orthodontics (50.4%), followed by orthopedics (8.1%), laparoscopic, general, and plastic surgery (7%). The telemedicine sector has grown, almost quadrupling the number of educational events offered in 2021 compared to 2019 (12 vs 46). CONCLUSIONS: Future Hta training should encompass a diverse range of thematic areas and should place particular emphasis on procurement issues, as well as the involvement of adequately trained patients and caregivers. Finally, the increase in telemedicine-focused courses during the triennium suggests the need for further reflection on this topic. KEY WORDS: Continuing medical education, Hta, medical devices, telemedicine.


Asunto(s)
Atención a la Salud , Educación Médica Continua , Humanos , Educación Médica Continua/métodos , Italia
19.
BMC Med Educ ; 24(1): 70, 2024 Jan 17.
Artículo en Inglés | MEDLINE | ID: mdl-38233905

RESUMEN

BACKGROUND: The traditional face-to-face of medical education is gradually being replaced with online education. However, the rate of adoption of online continuing medical education (OCME) as a learning method among practicing clinical physiotherapists (PTs) is unclear. The objectives of this study were to measure the satisfaction with, attitudes towards, and impact of OCME among practicing clinical PTs in Saudi Arabia (SA) and to examine the factors that affect the findings for satisfaction, attitude, and impact towards OCME. METHODS: This cross-sectional survey was conducted between October 2021 and January 2022. PTs employed at various medical facilities and specialties in Saudi Arabia completed an online survey to assess satisfaction with, attitudes towards, and impact of OCME. RESULTS: Of the 127 participants, 48 were female (37.8%), 44.1% were aged between 24 and 30 years. Overall, 57.5% of the respondents were satisfied with OCME compared with conventional face-to-face education, and 45.7% agreed and 18.1% strongly agreed that OCME was more flexible. Further, 52.8% of the respondents thought that OCME programs could supplement traditional face-to-face education. The majority of the participants (63.8%) agreed that participating in OCME programs increased their knowledge, and 55.1% and 51.2% agreed that attending these programs improved patient outcomes and increased their confidence in patient management, respectively. However, only 38.6% agreed that participating in OCME programs enhanced their clinical expertise. The mean satisfaction, attitude, and impact scores differed significantly according to age group, marital status, number of years of practice, and specialty (p < 0.0001). Multiple regression analysis showed that older age was independently associated with better satisfaction and more positive attitudes and impact. Further, having a specialization also seemed to improve the impact of OCME. CONCLUSION: The PTs were satisfied with and had positive attitudes towards OCME, and also found that it had a positive impact on their clinical practice. Thus, existing OCME programs are a good option for expanding the number of PTs proficient in clinical care.


Asunto(s)
Fisioterapeutas , Humanos , Femenino , Adulto Joven , Adulto , Masculino , Educación Médica Continua/métodos , Estudios Transversales , Actitud , Satisfacción Personal , Conocimientos, Actitudes y Práctica en Salud
20.
Afr J Prim Health Care Fam Med ; 15(1): e1-e8, 2023 Oct 18.
Artículo en Inglés | MEDLINE | ID: mdl-37916721

RESUMEN

BACKGROUND: Continuing professional development (CPD) activities relevant to medical doctors and their patients should be informed by current assessed training needs. The CPD provision is expected to improve the quality of professional practice and ethics. However, the Uganda Medical and Dental Practitioners' Council still receives about 40 reports of malpractice every month. AIM: The study aimed to describe the CPD training needs of doctors working in public primary care facilities in central Uganda. SETTING: The district health system of central Uganda comprised 10 General Hospitals (GH) and 37 Health Center IVs (HC IVs) with a staffing norm of six and two doctors, respectively. METHODS: This was a cross-sectional survey of 100 doctors working in public primary care facilities using the World Health Organization (WHO) Hennessy-Hicks questionnaire. Descriptive statistics of the importance, current performance, and training need of each skilled activity were calculated. Content analysis was applied to data from the open-ended questions. RESULTS: The response rate was 91%, majority were males, 80 (87.9%) from 7 GHs and 24 HC IVs with an average age of 37.9 years. The domain with the highest CPD training need for the doctors was research and audit, with a mean score (standard deviation [s.d.]) of 1.94 (±1.69), followed by administration 1.58 (±1.61) and clinical tasks 1.28 (±1.29). The clinical tasks domain had the most suggested CPD topics. CONCLUSION: Research and audit and clinical tasks were identified as important domains for CPD training for doctors in this setting.Contribution: The results give insight into CPD training needs of primary care doctors and guide various CPD providers.


Asunto(s)
Odontólogos , Educación Médica Continua , Masculino , Humanos , Adulto , Femenino , Educación Médica Continua/métodos , Estudios Transversales , Uganda , Rol Profesional , Encuestas y Cuestionarios , Atención Primaria de Salud
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