数字化学习对护士在职培训效果的系统评价

目的系统评价数字化学习(Electronic Learning,E-learning)对护士在职培训的效果。方法计算机检索1990年1月1日-2015年5月31日Cochrane Library、Pub Med、MEDLINE、ERIC以及"中国期刊全文数据库"中关于E-learning对护士在职培训效果的随机对照实验(RCT),由双人进行文献筛选及质量评价,以Cochrane系统评价员手册5.1.0为文献质量评价准则。采用Rev Man 5.3对纳入研究的样本情况、干预方式、培训内容及展现形式、交流方式、对照组情况、效果及评价六方面进行数据录入和分析。结果 12篇关于E-learning运用于护士在职培训的RCT中,5篇文献质量等级为A,6篇文献质量等级为B,1篇文献质量等级为C(偏倚风险高,不纳入系统评价)。最终11篇RCT纳入了系统评价,样本总量为2 149人,干预方式涉及网络课程、CD-ROM和计算机辅助程序等Elearning手段。培训内容包括除颤、循证护理、个案管理等11个方面,其展现形式多为文档、图标、情景和教学视频。培训后考核、量表自评、工作表现以及参与者的课程完成度和满意度是评价E-learning效果的常用指标。结论 Elearning能够有效地提高护士的知识、技能水平,其灵活性得到护士的认可,而且不受地域限制,能够有效实现培训资源共享。但其培训效果受多方面因素影响。如何构建护士培训内容及展现形式,提高师生交流程度,是提高Elearning培训效果的关键,值得进一步研究。     

Teaching Breast Cancer Screening via Text Messages as Part of Continuing Education for Working Nurses: A Case-control Study

Introduction: Although continuing education is necessary for practicing nurses, it is very difficult to organizetraditional classes because of large numbers of nurses and working shifts. Considering the increasing developmentof mobile electronic learning, we carried out a study to compare effects of the traditional face to face method withmobile learning delivered as text messages by cell phone. Materials and Methods: Sixty female nurses workingin our hospital were randomly divided into class and short message service (SMS) groups. Lessons concerningbreast cancer screening were prepared as 54 messages and sent in 17 days for the SMS group, while the classgroup participated in a class held by a university lecturer of breast and cancer surgery. Pre- and post-testswere undertaken for both groups at the same time; a retention test also was performed one month later. Forstatistical analysis, the paired T test and the independent sample T test were used with SPSS software version16; p<0.05 was considered significant. Results: Mean age and mean work experience of participants in class andSMS groups was 35.8±7.2, 9.8±6.7, 35.4±7.3, and 11.5±8.5, respectively. There was a significant increase in meanscore post-tests (compared with pre-tests) in both groups (p<0.05). Although a better improvement in scores ofretention tests was demonstrated in the SMS group, the mean subtraction value of the post- and pretests as wellas retention- and pre-tests showed no significant difference between the 2 groups (p=0.3 and p =0.2, respectively).Conclusions: Our study shows that teaching via SMS may probably replace traditional face to face teaching forcontinuing education in working nurses. Larger studies are suggested to confirm this.     

An economic evaluation of a computer-tailored e-learning program to promote smoking cessation counseling guideline adherence among practice nurses

ObjectiveTo conduct an economic evaluation of a tailored e-learning program, which successfully improved practice nurses’ smoking cessation guideline adherence.MethodsThe economic evaluation was embedded in a randomized controlled trial, in which 269 practice nurses recruited 388 smoking patients. Cost-effectiveness was assessed using guideline adherence as effect measure on practice nurse level, and continued smoking abstinence on patient level. Cost-utility was assessed on patient level, using patients’ Quality Adjusted Life Years (QALYs) as effect measure.ResultsThe e-learning program was likely to be cost-effective on practice nurse level, as adherence to an additional guideline step cost €1,586. On patient level, cost-effectiveness was slightly likely after six months (cost per additional quitter: €7,126), but not after twelve months. The cost-utility analysis revealed slight cost-effectiveness (cost per QALY gained: €18,431) on patient level.ConclusionProviding practice nurses with a tailored e-learning program is cost-effective to improve their smoking cessation counseling. Though, cost-effectiveness on patient level was not found after twelve months, potentially resulting from smoking relapse.Practice implicationsWidespread implementation of the e-learning program can improve the quality of smoking cessation care in general practice. Strategies to prevent patients’ smoking relapse should be further explored to improve patients’ long-term abstinence.     

Pharmacy education in Saudi Arabia: Achievements and challenges during the last two decades with a focus on Taif University as a case study

Basic expectation from graduates of any pharmacy program is to be able to provide pharmaceutical care at both patients and community levels, be able to solve problems arising during practice, be able to improve quality and outcomes of the services provided continuously and be able to respond effectively to patients and community changing needs. Pharmacy education in Saudi Arabia established in 1959 by founding the first college in Riyadh (King Saud University) followed by establishing two pharmacy colleges in Jeddah (King Abdulaziz University, 2001) and Abha (King Khalid University, 2001), then a college in Al Ahsa (King Faisal University, 2002), followed by four colleges three-years later in each of Buraydah (Qassim University, 2005), Madinah (Taibah University, 2005), Taif (Taif University, 2005) and Makkah (Umm Al-Qura University, 2005). Up to date the number of pharmacy colleges offering basic degrees in pharmacy are 21 governmental and eight privates. This review describes pharmacy education in Saudi Arabia, the historical perspective, current situation, and the important features. The report focuses on the changes during the last two decades covering three main aspects (1) Clinical education and training, (2) Research output, and (3) Quality and accreditation.     

Teaching general practitioners to activate older patients: The intervening role of changes in perceived communication skills

ObjectiveThis report examined whether a change in the perceived communication behaviour (PeCoBe) of general practitioners (GPs) influenced the effect of the Promoting Active Aging (PRACTA) intervention on activation of older patients as perceived by GPs.MethodsPre- and post-intervention questionnaires were filled out by 225 GPs, who were assigned to three groups, e-learning, pdf-article, and control. GPs self-reported their communication behaviour and their perceptions of the attitudes of older patients toward treatment and health.ResultsParticipation in the e-learning intervention showed an increase in the PeCoBe of GPs, while reading the pdf-article resulted in a decrease of such behaviours. An increase in the PeCoBe of GPs was positively related to an increase in their perception of an active attitude among older patients. The indirect effects observed for e-learning and pdf-article interventions had opposite directions.ConclusionBoth types of PRACTA intervention exerted an impact on GPs’ perception of the attitudes of older patients, and change in PeCoBe of GPs could be considered as a mechanism driving this effect.Practical implicationsThe methods based on a combination of knowledge delivery and modelling of communication skills are strongly recommended forms of teaching for GPs on how to communicate with and activate seniors.     

Interprofessional collaborative practice incorporating training for alcohol and drug use screening for healthcare providers in rural areas

Interprofessional collaborative practice expands resources in rural and underserved communities. This article explores the impact of an online education programme on the perceptions of healthcare providers about interprofessional care within alcohol and drug use screening for rural residents. Nurses, behavioural health counsellors, and public health professionals participated in an evidence-based practice (screening, brief intervention, and referral to treatment—SBIRT) model that targets individuals who use alcohol and other drugs in a risky manner. SBIRT is recommended by the United States Preventive Services Task Force as a universal, evidence-based screening tool. Online modules, case simulation practice, and interprofessional dialogues are used to deliver practice-based learning experiences. A quasi-experimental method with pre-tests and post-tests was utilised. Results indicate increased perceptions of professional competence, need for cooperation, actual cooperation, and role values pre-to-post training. Implications suggest that online interprofessional education is useful but the added component of professional dialogues regarding patient cases offers promise in promoting collaborative practice.