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Author: Brian S McGowan, PhD

MANUSCRIPT: Audio podcasts in practical courses in biochemistry – cost-efficient e-learning in a well-proven format from radio broadcasting.

INTRODUCTION:
Audio podcasts are an e-learning format that may help to motivate students to deal with the contents of medical education more intensely. We adopted a well-proven format from radio broadcasting, the radio documentary, to direct the listeners’ attention to information about practical courses in biochemistry over a period of 20 minutes at most. Information, original sounds, and a specific atmosphere allow listeners to perceive the contents intensely.
METHOD:
In order to organise the production of the podcast as cost-efficient and least time-consuming as possible, a student, a teacher, a clinician, and a technical assistant compile the core themes of their respective text blocks in an editorial conference first. After that, the speakers can elaborate on and record their blocks independently. Coordination is widely handled by the student. At two points of time, the podcasts were evaluated by the medical students by means of a questionnaire.
RESULTS:
With little cost and time expenses, eight podcasts were produced. They have been used by the students extensively and have also been evaluated very positively by non-student listeners. For long-term usage, a regular reference to the podcast offer is required in the courses.
CONCLUSION:
Involving students, successful podcasts can be produced to support classroom teaching with little expenses and contribute to the external presentation of the medical faculty.

via Audio podcasts in practical courses in biochemistry – cost-efficient e-learning in a well-proven format from radio broadcasting. – PubMed – NCBI.

ABSTRACT: The long-term impact of a performance improvement continuing medical education intervention on osteoporosis screening

INTRODUCTION:
The purpose of this study is to determine whether a performance improvement continuing medical education (PI CME) initiative that utilizes quality improvement (QI) principles is effective in producing sustainable change in practice to improve the screening of patients at risk for osteoporosis.
METHODOLOGY:
A health care center participated in a PI CME program designed to increase appropriate osteoporosis screening. There were eight 1-hour educational sessions for this activity over a 9-month period. Thirteen providers completed all 3 stages of the PI CME program. A variety of other clinicians, in addition to the 13 providers, participated in the educational sessions. Data were collected at the beginning and end of the PI CME activity and at three intervals during the 5 years after the completion of the activity.
RESULTS:
The percentage of tests for osteoporosis ordered and performed increased significantly from Stage A to Stage C of the PI CME activity and continued to increase after the completion of the PI CME activity. Follow-up data at 4 and 40 months (for ordering and performing osteoporosis screening) and 49 months (for performing the screening only) reflect the impact of the PI CME activity plus the continuing QI interventions. The percentage of BMD tests ordered continued to increase substantially over the post-PI CME periods: 4 and 40 months (F(3,46) = 4.04, p < .05). Similarly, the percentage of BMD tests performed continued to increase at 4, 40, and 49 months after the conclusion of the PI CME activity (F(4,55) = 12.55, p < .0001).
DISCUSSION:
The data indicate that PI CME utilizing QI principles can be effective in producing sustainable change in practice to improve the screening of patients at risk for osteoporosis. Further research is needed to determine the extent to which such changes can be directly attributed to this type of intervention.

via The long-term impact of a performance improvement continuing medical education intervention on osteoporosis screening. – PubMed – NCBI.

ABSTRACT: What do primary care practitioners want to know? A content analysis of questions asked at the point of care

INTRODUCTION:
Assessing physician needs to develop continuing medical education (CME) activities is an integral part of CME curriculum development. The purpose of the present study was to demonstrate the feasibility of identifying areas of perceived greatest needs for continuing medical education (CME) by using questions collected electronically at the point of care.
METHODS:
This study is a secondary analysis of the “Just-in-Time” (JIT) information librarian consultation service database of questions using quantitative content analysis methods. The original JIT project demonstrated the feasibility of a real-time librarian service for answering questions asked by primary care clinicians at the point of care using a Web-based platform or handheld device. Data were collected from 88 primary care practitioners in Ontario, Canada, from October 2005 to April 2006. Questions were answered in less than 15 minutes, enabling clinicians to use the answer during patient encounters.
RESULTS:
Description of type and frequency of questions asked, including the organ system on which the questions focused, was produced using 2 classification systems, the “taxonomy of generic clinical questions” (TGCQ), and the International Classification for Primary Care version 2 (ICPC-2). Of the original 1889 questions, 1871 (99.0%) were suitable for analysis. A total of 970 (52%) of questions related to therapy; of these, 671 (69.2%) addressed questions about drug therapy, representing 36% of all questions. Questions related to diagnosis (24.8%) and epidemiology (13.5%) were also common. Organ systems questions concerning musculoskeletal, endocrine, skin, cardiac, and digestive systems were asked more than other categories.
DISCUSSION:
Questions collected at the point of care provide a valuable and unique source of information on the true learning needs of practicing clinicians. The TGCQ classification allowed us to show that a majority of questions had to do with treatment, particularly drug treatment, whereas the use of the ICPC-2 classification illustrated the great variety of questions asked about the diverse conditions encountered in primary care. It is feasible to use electronically collected questions asked by primary care clinicians in clinical practice to categorize self-identified knowledge and practice needs. This could be used to inform the development of future learning activities.

via What do primary care practitioners want to know? A content analysis of questions asked at the point of care. – PubMed – NCBI.

ABSTRACT: udiovisual preconditioning enhances the efficacy of an anatomical dissection course: A randomised study

The benefits of incorporating audiovisual materials into learning are well recognised. The outcome of integrating such a modality in to anatomical education has not been reported previously. The aim of this randomised study was to determine whether audiovisual preconditioning is a useful adjunct to learning at an upper limb dissection course. Prior to instruction participants completed a standardised pre course multiple-choice questionnaire (MCQ). The intervention group was subsequently shown a video with a pre-recorded commentary. Following initial dissection, both groups completed a second MCQ. The final MCQ was completed at the conclusion of the course. Statistical analysis confirmed a significant improvement in the performance in both groups over the duration of the three MCQs. The intervention group significantly outperformed their control group counterparts immediately following audiovisual preconditioning and in the post course MCQ. Audiovisual preconditioning is a practical and effective tool that should be incorporated in to future course curricula to optimise learning. Level of evidence This study appraises an intervention in medical education.

via Audiovisual preconditioning enhances the efficacy of an anatomical dissection course: A randomised study. – PubMed – NCBI.

ABSTRACT: Managing Diabetes Mellitus: A Survey of Attitudes and Practices Among Family Physicians

Due to the increasing prevalence of diabetes and the shortage of endocrinologists, family physicians have an important role in diabetes management. The purpose of this study was to examine the sources of knowledge, attitudes and practices of family physicians regarding the management of type 2 diabetes. Attendees at continuous medical education (CME) programs in Israel were requested to respond anonymously to written questions about their sources of knowledge about diabetes, the methods of diabetes management they advise their patients, their knowledge of diabetes medication treatments, and their attitudes toward people with type 2 diabetes. Questionnaires were completed by 362 family physicians (79 % response rate). Of them, 329 (91 %) reported that they usually manage their patients’ diabetes care, including that of patients with concomitant risk factors. Their most common recommendations for diabetes control were: to increase physical activity, decrease total calorie intake, consult with a dietitian and undergo weight loss counseling. Almost all physicians (97 %) reported providing lifestyle change counseling. Sixty percent reported lacking knowledge about nutritional issues. Only 58 % answered correctly regarding the effect of the anti-diabetic drug, GLP1 analog. Board certified family physicians and their residents exhibited more knowledge about diabetes practice than did non-board certified family physicians. The great majority of family physicians surveyed usually manage their patients’ diabetes themselves, and do not refer them to diabetes specialists. The implementation of strategies that will enhance the competencies and confidence of family physicians in diabetes management are important for achieving successful treatment.

via Managing Diabetes Mellitus: A Survey of Attitudes and Practices Among Family Physicians. – PubMed – NCBI.

MANUSCRIPT: Teaching differential diagnosis in primary care using an inverted classroom approach: student satisfaction and gain in skills and knowledge.

BACKGROUND:
Differential diagnosis is a crucial skill for primary care physicians. General practice plays an increasing important role in undergraduate medical education. Via general practice, students may be presented with an overview of the whole spectrum of differential diagnosis in regard to common symptoms encountered in primary care. This project evaluated the impact of a blended learning program (using the inverted classroom approach) on student satisfaction and development of skills and knowledge.
METHODS:
An elective seminar in differential diagnosis in primary care, which utilized an inverted classroom design, was offered to students. Evaluation followed a mixed methods design: participants completed a pre- and post-test, a questionnaire, and a focus group discussion. Interviews were transcribed verbatim and answers were grouped according to different themes. Test results were analysed using the Wilcoxon matched-pairs signed-ranks test.
RESULTS:
Participants (n = 17) rated the course concept very positively. Especially the inverted classroom approach was appreciated by all students, as it allowed for more time during the seminar to concentrate on interactive and practice based learning. Students (n = 16) showed a post-test significant overall gain in skills and knowledge of 33%.
CONCLUSIONS:
This study showed a positive effect of the inverted classroom approach on students’ satisfaction and skills and knowledge. Further research is necessary in order to explore the potentials of this approach, especially the impact on development of clinical skills.

via Teaching differential diagnosis in primary care using an inverted classroom approach: student satisfaction and gain in skills and knowledge. – PubMed – NCBI.

ABSTRACT: Changing physician behavior: what works?

Objectives There are various interventions for guideline implementation in clinical practice, but the effects of these interventions are generally unclear. We conducted a systematic review to identify effective methods of implementing clinical research findings and clinical guidelines to change physician practice patterns, in surgical and general practice. Study Design Systematic review of reviews. Methods We searched electronic databases (MEDLINE, EMBASE, and PubMed) for systematic reviews published in English that evaluated the effectiveness of different implementation methods. Two reviewers independently assessed eligibility for inclusion and methodological quality, and extracted relevant data. Results Fourteen reviews covering a wide range of interventions were identified. The intervention methods used include: audit and feedback, computerized decision support systems, continuing medical education, financial incentives, local opinion leaders, marketing, passive dissemination of information, patient-mediated interventions, reminders, and multifaceted interventions. Active approaches, such as academic detailing, led to greater effects than traditional passive approaches. According to the findings of 3 reviews, 71% of studies included in these reviews showed positive change in physician behavior when exposed to active educational methods and multifaceted interventions. Conclusions Active forms of continuing medical education and multifaceted interventions were found to be the most effective methods for implementing guidelines into general practice. Additionally, active approaches to changing physician performance were shown to improve practice to a greater extent than traditional passive methods. Further primary research is necessary to evaluate the effectiveness of these methods in a surgical setting.

via Changing physician behavior: what works? – PubMed – NCBI.

MANUSCRIPT: Medical student web-based formative assessment tool for renal pathology

BACKGROUND:
Web-based formative assessment tools have become widely recognized in medical education as valuable resources for self-directed learning.
OBJECTIVES:
To explore the educational value of formative assessment using online quizzes for kidney pathology learning in our renal pathophysiology course.
METHODS:
Students were given unrestricted and optional access to quizzes. Performance on quizzed and non-quizzed materials of those who used (‘quizzers’) and did not use the tool (‘non-quizzers’) was compared. Frequency of tool usage was analyzed and satisfaction surveys were utilized at the end of the course.
RESULTS:
In total, 82.6% of the students used quizzes. The greatest usage was observed on the day before the final exam. Students repeated interactive and more challenging quizzes more often. Average means between final exam scores for quizzed and unrelated materials were almost equal for ‘quizzers’ and ‘non-quizzers’, but ‘quizzers’ performed statistically better than ‘non-quizzers’ on both, quizzed (p=0.001) and non-quizzed (p=0.024) topics. In total, 89% of surveyed students thought quizzes improved their learning experience in this course.
CONCLUSIONS:
Our new computer-assisted learning tool is popular, and although its use can predict the final exam outcome, it does not provide strong evidence for direct improvement in academic performance. Students who chose to use quizzes did well on all aspects of the final exam and most commonly used quizzes to practice for final exam. Our efforts to revitalize the course material and promote learning by adding interactive online formative assessments improved students’ learning experience overall.

via Medical student web-based formative assessment tool for renal pathology. – PubMed – NCBI.

ABSTRACT: Prior Podcast Experience Moderates Improvement in Electroencephalography Evaluation After Educational Podcast Module

BACKGROUND:
There is continued interest in using technology to enhance medical education and the variables that may affect its success.
METHODS:
Anesthesiology residents and fourth-year medical students participated in an electroencephalography (EEG) educational video podcast module. A 25-item evaluation tool was administered before any EEG education was provided (baseline), and the podcast was then viewed. Another 25-item evaluation tool was administered after podcast viewing (after podcast). Ten EEG interpretations were completed with a neurophysiologist with an additional 25-item evaluation tool administered after the interpretations (after 10 EEG interpretations). Participants were surveyed concerning technology and podcasting experience before the educational module and their responses to the podcast educational model. Multiple analyses were performed (1) to evaluate differences in improvement in EEG evaluation scores between the podcast module and the standard didactics (control group); and (2) to evaluate potential moderation by technology and the podcast experience on the change in mean EEG evaluation scores from after the podcast module to after 10 EEG interpretations.
RESULTS:
A total of 21 anesthesiology residents and 12 fourth-year medical students participated. Scores on the 25-item evaluation tool increased with each evaluation time (P ≤ 0.001). Moderation analyses revealed that individuals with more podcast experience (≥4 previous podcasts) had greater increases in scores after a podcast and 10 EEG interpretations compared with individuals with less experience (≤3 previous podcasts) (P = 0.027). Furthermore, compared with a control group with similar baseline characteristics that received only standard didactics without a podcast, those in the podcast group had greater increases in mean EEG evaluation scores between baseline and after 10 EEG interpretations.
CONCLUSIONS:
In reviewing the improvement in EEG evaluation after a podcast education module, those with more podcast experience achieved greater gains in EEG evaluation scores. For EEG education, those receiving the podcast education module showed greater increases in scores compared with those receiving didactic teaching without podcasting, as measured by change in a mean EEG evaluation scores.

via Prior Podcast Experience Moderates Improvement in Electroencephalography Evaluation After Educational Podcast Module. – PubMed – NCBI.

MANUSCRIPT: The social media index: measuring the impact of emergency medicine and critical care websites.

NTRODUCTION:
The number of educational resources created for emergency medicine and critical care (EMCC) that incorporate social media has increased dramatically. With no way to assess their impact or quality, it is challenging for educators to receive scholarly credit and for learners to identify respected resources. The Social Media index (SMi) was developed to help address this.
METHODS:
We used data from social media platforms (Google PageRanks, Alexa Ranks, Facebook Likes, Twitter Followers, and Google+ Followers) for EMCC blogs and podcasts to derive three normalized (ordinal, logarithmic, and raw) formulas. The most statistically robust formula was assessed for 1) temporal stability using repeated measures and website age, and 2) correlation with impact by applying it to EMCC journals and measuring the correlation with known journal impact metrics.
RESULTS:
The logarithmic version of the SMi containing four metrics was the most statistically robust. It correlated significantly with website age (Spearman r=0.372; p<0.001) and repeated measures through seven months (r=0.929; p<0.001). When applied to EMCC journals, it correlated significantly with all impact metrics except number of articles published. The strongest correlations were seen with the Immediacy Index (r=0.609; p<0.001) and Article Influence Score (r=0.608; p<0.001).
CONCLUSION:
The SMi’s temporal stability and correlation with journal impact factors suggests that it may be a stable indicator of impact for medical education websites. Further study is needed to determine whether impact correlates with quality and how learners and educators can best utilize this tool.

via The social media index: measuring the impact of emergency medicine and critical care websites. – PubMed – NCBI.