Content and discontent: a qualitative exploration of obstacles to elearning engagement in medical students.

BACKGROUND: Elearning is ubiquitous in healthcare professions education. Its equivalence to 'traditional' educational delivery methods is well established. There is a research imperative to clarify when and how to use elearning most effectively to mitigate the potential of it becoming merely a 'disruptive technology.' Research has begun to broadly identify challenges encountered by elearning users. In this study, we explore in depth the perceived obstacles to elearning engagement amongst medical students. Sensitising concepts of achievement emotions and the cognitive demands of multi-tasking highlight why students' deeply emotional responses to elearning may be so important in their learning. METHODS: This study used focus groups as a data collection tool. A purposeful sample of 31 participated. Iterative data gathering and analysis phases employed a constant comparative approach to generate themes firmly grounded in participant experience. RESULTS: Key themes that emerged from the data included a sense of injustice, passivity and a feeling of being 'lost at sea'. The actual content of the elearning resource provided important context. CONCLUSIONS: The identified themes have strong emotional foundations. These responses, interpreted through the lens of achievement emotions, have not previously been described. Appreciation of their importance is of benefit to educators involved in curriculum development or delivery.

Online health information - what the newspapers tell their readers: a systematic content analysis.

BACKGROUND: This study investigated the nature of newspaper reporting about online health information in the UK and US. Internet users frequently search for health information online, although the accuracy of the information retrieved varies greatly and can be misleading. Newspapers have the potential to influence public health behaviours, but information has been lacking in relation to how newspapers portray online health information to their readers. METHODS: The newspaper database Nexis®UK was searched for articles published from 2003 - 2012 relating to online health information. Systematic content analysis of articles published in the highest circulation newspapers in the UK and US was performed. A second researcher coded a 10% sample to establish inter-rater reliability of coding. RESULTS: In total, 161 newspaper articles were included in the analysis. Publication was most frequent in 2003, 2008 and 2009, which coincided with global threats to public health. UK broadsheet newspapers were significantly more likely to cover online health information than UK tabloid newspapers (p = 0.04) and only one article was identified in US tabloid newspapers. Articles most frequently appeared in health sections. Among the 79 articles that linked online health information to specific diseases or health topics, diabetes was the most frequently mentioned disease, cancer the commonest group of diseases and sexual health the most frequent health topic. Articles portrayed benefits of obtaining online health information more frequently than risks. Quotations from health professionals portrayed mixed opinions regarding public access to online health information. 108 (67.1%) articles directed readers to specific health-related web sites. 135 (83.9%) articles were rated as having balanced judgement and 76 (47.2%) were judged as having excellent quality reporting. No difference was found in the quality of reporting between UK and US articles. CONCLUSIONS: Newspaper coverage of online health information was low during the 10-year period 2003 to 2012. Journalists tended to emphasise the benefits and understate the risks of online health information and the quality of reporting varied considerably. Newspapers directed readers to sources of online health information during global epidemics although, as most articles appeared in the health sections of broadsheet newspapers, coverage was limited to a relatively small readership.

Randomised controlled trial of home-based walking programmes at and below current recommended levels of exercise in sedentary adults.

OBJECTIVES: To determine, using unsupervised walking programmes, the effects of exercise at a level lower than currently recommended to improve cardiovascular risk factors and functional capacity. DESIGN: 12 week randomised controlled trial. SETTING: Northern Ireland Civil Service; home-based walking. PARTICIPANTS: 106 healthy, sedentary 40 to 61 year old adults of both sexes. INTERVENTIONS: Participants were randomly allocated to a walking programme (30 minutes brisk walking three days a week (n = 44) or five days a week (n = 42)) or a control group (n = 20). Participants could choose to walk in bouts of at least 10 minutes. They used pedometers to record numbers of steps taken. Intention to treat analysis of changes within groups was done using paired t tests; extent of change (baseline to 12 week measurements) was compared between groups using analysis of variance and Gabriel's post hoc test. MAIN OUTCOME MEASURES: Blood pressure, serum lipids, body mass index, waist:hip ratio, and functional capacity (using a 10 m shuttle walk test). MAIN RESULTS: 89% (93/106) completed the study. Systolic blood pressure and waist and hip circumferences fell significantly both in the three day group (5 mm Hg, 2.6 cm, and 2.4 cm, respectively) and in the five day group (6 mm Hg, 2.5 cm, and 2.2 cm) (p<0.05). Functional capacity increased in both groups (15%; 11%). Diastolic blood pressure fell in the five day group (3.4 mm Hg, p<0.05). No changes occurred in the control group. CONCLUSIONS: This study provides evidence of benefit from exercising at a level below that currently recommended in healthy sedentary adults. Further studies are needed of potential longer term health benefits for a wider community from low levels of exercise.

Questionnaire survey of PHysical activITy in General Practitioners (PHIT GP Study).

OBJECTIVES: To assess the levels of physical activity and other health related behaviours of General Practitioners (GPs) and compare their reported levels of physical activity with those of the general population. STUDY DESIGN: Cross sectional postal questionnaire survey. METHODS: A questionnaire, which did not allow identification of individual respondents, was posted to all 1074 (GPs) in Northern Ireland. It included the validated International Physical Activity Questionnaire (IPAQ) and questions relating to smoking and alcohol consumption. A national survey of a representative sample of the general population of similar age (29-67 years; n = 3010) provided comparative data. RESULTS: 735 GPs responded (68.4%). IPAQ data indicated that fewer GPs (43.4%) were "physically inactive" compared to the general population (56.2%) (p < 0.001) and to a subgroup of professionals (51.8%) (p < 0.016). Compared to the general population, relatively fewer GPs reported smoking (4.2% v 29%; p < 0.001); more reported drinking alcohol (86.5% v 71.6%; p < 0.001) but fewer reported drinking above recommended limits (12.6% v 16.9%; p < 0.001). CONCLUSIONS: Our findings suggest that GPs are better than the general population at following health promotion advice. Since their personal habits influence the impact of their advice to their patients, their healthy lifestyles should be encouraged and further efforts should be made to promote activity among those who are physically inactive.

Creating a virtual sanctuary for scholars.

When people work together digitally, material can be added to a safe shared environment at anytime and can be accessed anywhere. The solutions generate new questions and new problems that then become interconnected. Cultivating this new and rapidly evolving technology of peer-to-peer platforms (1) may prove to be an extremely cost effective way to solve complex institutional or individual dilemmas. The solutions reflect the richness of two or more protected and engaged scholars or institutions working together with a refined degree of connection. After all, as Philip Condit, the CEO of the Boeing Company is often quoted as saying ... "none of us is as smart as all of us." The path to global connection hinges on relationships that are made and sustained one at a time. Progress together along the path similarly is made one step at a time. Sustained progress requires compelling reasons to do this in ways that are consonant with what it means to be human.

Objective structured assessment of technical skills and checklist scales reliability compared for high stakes assessments.

BACKGROUND: The establishment of assessment reliability at the level of the individual trainee is an important attribute of assessment methodologies, particularly for doctors who have been failed. This issue is of particular importance for the process of competence assessment in the USA, UK, Australia and New Zealand. METHODS: We use data from 19 applicants for higher surgical training in 2008 at the Royal College of Surgeons in Ireland to compare: (i) the objective structured assessment of technical skills (OSATS) method; and (ii) a procedure-specific checklist to assess surgical technical skills in the excision of a sebaceous cyst task by two experienced senior surgeons. RESULTS: The overall interrater reliability (IRR) of the OSATS assessment as determined by a correlation coefficient was 0.507 (P < 0.03) and 0.67 with coefficient alpha, considerably below the accepted 0.8 level of IRR. The checklist's overall IRR was 0.89. Individually, only five (26%) of the OSATS assessments reached the 0.8 level of IRR in contrast to 18 (95%) of the checklist assessments. DISCUSSION: We propose binary procedure-based assessment checklists as more reliable assessment instruments with more robust reproducibility.