Multistakeholder perspectives on the strengthening and embedding of mandatory continuing medical education in Georgia: a qualitative study.

OBJECTIVE: Continuing medical education (CME) is a vital component of health systems. Setting up a CME system is a complex task, requiring involvement of stakeholders including educators, learners, institutions and policy makers. The aim of the study was to conduct qualitative research involving multiple stakeholders to explore the perceived effectiveness and shortcomings of the CME system in Georgia, its place in the health system and potential means of improving it. DESIGN: This is a qualitative study. All data were collected using semistructured individual interviews. The questions were derived from the relevant literature. Data analysis was conducted using comparative strategy. PARTICIPANTS: We interviewed individuals from CME providers, medical establishments, the professional development board (PDB), and the Regulatory Agency for Medical and Pharmaceutical Activities. We thus interviewed 23 people (11 people from CME providers, 8 people from medical establishments, 3 PDB members and 1 person from Legal Entity under Public Law Regulatory Agency for Medical and Pharmaceutical Activities). RESULTS: Georgia has had experience of mandatory CME in the past, which had been criticised for its poor quality and bureaucratic processes. CME is viewed as an essential developmental process for medical professionals, the outcome of which is to deliver high-quality medical care. Our interviewees identified a clear need for high-quality CME courses. However, significant challenges that need to be overcome include financial barriers, doctors' attitudes to CME, a lack of CME courses in all medical specialties and relatively weak professional associations. CONCLUSION: CME is widely recognised as an essential pillar in providing quality medical care. Establishing high-quality CME requires a strategic and holistic approach. In order to ensure the sustainable and effective implementation of the CME process, we need to take into account stakeholders' interests and expectations, the socioeconomic status and development of the country, and past experiences of all relevant individuals and organisations.

E-learning in healthcare professional education: an analysis of political, economic, social, technological, legal and environmental (PESTLE) factors.

This article was migrated. The article was marked as recommended. Healthcare professional education is a vitally important part of the healthcare system. E-learning as a means of delivering this education has grown in significance over the years. Research evidence shows that e-learning can help healthcare professionals learn new knowledge and skills. E-learning is fundamentally about education, but it is also a social phenomenon and part of a wider technological revolution. The provision of e-learning for healthcare professional development can be influenced by a number of different factors. These include political, economic, social, technological, legal and environmental factors (PESTLE). All these phenomena influence e-learning in healthcare professional education - their degree of influence often depends on the exact context that is being discussed. A PESTLE analysis uses a framework of these macro-environmental factors that can be used in the strategic analysis of a specific domain. This paper describes an analysis of political, economic, social, technological, legal and environmental factors that can influence e-learning in healthcare professional education.

Education and Support for Healthcare Professionals to Prevent Future Pandemics: Report of a Conference Workshop.

INTRODUCTION: Pandemic infectious diseases pose a real threat to patients and public health in all countries around the world. Healthcare professionals need education and support to prevent these pandemics. However, the provision of this education is not always straightforward, and the views of healthcare professionals from different sectors and different countries should be continually taken into account when providing new educational resources. The following is the report of a workshop that was held to seek the views of healthcare professionals on e-learning and clinical decision support resources as means of providing education in pandemic infectious diseases. THEMES: There was consensus among delegates that just providing e-learning or clinical decision support on its own is not enough - you need to do more if you are going to drive usage, achieve clinical engagement, and ensure that users put their learning from the e-resources into action for the benefit of their patients. Drivers of these outcomes include the provision of content in the appropriate languages, overcoming technology barriers, linking the resources to CPD programmes or existing curricula, strategic engagement of different types of healthcare professionals, and giving due consideration to sustainability and cost effectiveness. CONCLUDING REMARKS: Providing e-learning and clinical decision support resources will be essential if we are to achieve the goal of preventing infectious disease pandemics. But this will not be achievable unless we listen to the practical problems that different stakeholders have in implementing educational programmes. The purpose of this paper is to share these challenges and potential solutions with the wider infectious diseases and global health communities.

Use of behavior change techniques in clean cooking interventions: a review of the evidence and scorecard of effectiveness.

Despite decades of effort, around 2.8 billion people still rely on solid fuels to meet domestic energy needs. There is robust evidence this causes premature death and chronic disease, as well as wider economic, social, and environmental problems. Behavior change interventions are effective to reduce exposure to harm such as household air pollution, including those using health communications approaches. This article reports the findings of a project that reviewed the effectiveness of behavior change approaches in cleaner cooking interventions in resource-poor settings. The authors synthesized evidence of the use of behavior change techniques, along the cleaner cooking value chain, to bring positive health, economic, and environmental impacts. Forty-eight articles met the inclusion criteria, which documented 55 interventions carried out in 20 countries. The groupings of behavior change techniques most frequently used were shaping knowledge (n = 47), rewards and threats (n = 35), social support (n = 35), and comparisons (n = 16). A scorecard of behavior change effectiveness was developed to analyze a selection of case study interventions. Behavior change techniques have been used effectively as part of multilevel programs. Cooking demonstrations, the right product, and understanding of the barriers and benefits along the value chain have all played a role. Often absent are theories and models of behavior change adapted to the target audience and local context. Robust research methods are needed to track and evaluate behavior change and impact, not just technology disseminated. Behavior change approaches could then play a more prominent role as the "special sauce" in cleaner cooking interventions in resource poor settings.

Using the Receptivity model to uncover 'urine blindness': perceptions on the re-use of urine.

Population growth, climatic changes and over-exploitation of natural resources are at the basis of the world's food crisis, which counts almost one million people without sufficient food sustenance. These changes require novel environmental practices which are based on nutrient recovery and management in agriculture. This contribution analyses and discusses users' perceptions on re-use of urine as fertilizer through the lenses of the Receptivity model. A search was performed on Scopus (as well as other web search engines) using the keywords: urine, nutrient recovery and sanitation. Results shows how questions related to awareness, association, acquisition and application of the environmental change can represent hurdles to novel models of nutrient recovery and the use of urine in agriculture. Examples of hurdles identified from the literature relate to poor understanding of potential for urine reuse, social stigma attached to using dry sanitation and applying urine in agriculture and poor operational knowledge of application of urine in agriculture. Conclusion relates to the illustration of implications of such challenges on the design of environmental interventions.

Evaluation of community participation in the implementation of community-based sanitation systems: a case study from Indonesia.

Acceptance and adequate use of water and sanitation technologies in least developed countries is still a chimera, with one billion people using unimproved water supply sources and 2.5 billion not benefitting from adequate sanitation. Public participation in water and sanitation planning and pre-implementation phases has become increasingly important for technology providers seeking solutions to implementation challenges towards the achievement of the Millennium Development Goals (MDGs). Based on the principle that successful implementation of WATSAN technologies ultimately depends on recipients' ability to absorb a technology and adapt it to their own needs, this study analyses the impacts of participatory methods adopted by community-based sanitation (CBS) providers on communities' receptivity of the transferred systems. A fieldwork activity was undertaken in Indonesia and a multiple case study approach adopted to analyse indicators of receptivity of the transferred technologies. Conclusions show that community involvement through participatory methods in the implementation of CBS systems can enhance the process of acceptance and management of the technologies, thereby increasing the progress towards the achievement of the Millennium Development Goals.