Evaluation of a faculty development program in substance abuse education

Objective: To determine whether a faculty development program was effective in increasing clinical skills and the amount of substance abuse teaching of individual general medical faculty. Design: Program participants were evaluated with a structured assessment before and several months after participating in a faculty development program in substance abuse education. Participants: Eighty percent were general internal medicine faculty, who on average devoted 25% of their time to teaching. The remainder of the participants were family medicine, psychiatry, or other internal medicine faculty and nonphysician teachers. Intervention: The participants attended a learner-centered, largely experiential faculty development program in substance abuse education to improve their clinical and teaching skills relevant to substance abuse among patients in the general medical setting. Measurements and main results: Eighty-six percent of the participants completed the evaluation. The participants reported increased confidence in their clinical skills in recognizing substance abuse, presenting the problem to the patient, and referring the patient for treatment. The participants also reported improved attitudes toward patients and increased teaching about the management of the primary problem of substance abuse, but not at the expense of teaching about medical complications. Conclusions: Clinically oriented, interactive faculty development courses in substance abuse education can contribute to increased confidence in clinical skills in substance abuse as well as teaching about substance abuse. Received from the Departments of Medicine, Harvard Medical School, Boston, Brigham and Women’s Hospital, Boston, and the Cambridge Hospital, Cambridge, and the Division of General Medicine and Primary Care, Brigham and Women’s Hospital, Boston, Massachusetts. Presented at the annual meeting of the Society of General Internal Medicine, May 1–3, 1991, Seattle, Washington. Supported by funds to the Society of General Internal Medicine from the J.M. Foundation and the Pew Memorial Trusts.     

Evaluation of an audiovisual diabetes education program

A randomized controlled trial was conducted to determine whether an education program specifically designed for patients with non-insulin-dependent diabetes and limited literacy could improve and sustain glucose and weight control. From a referral clinic, 120 obese (>130 per cent of ideal body weight) diabetic patients who were not taking insulin were recruited. Of these, 55 per cent were female and 49 per cent were black; the mean age was 53 years. Mean glycosylated hemoglobin (HbA₁%) was 10.2 per cent. Each subject was assigned to one of three groups: 1) monthly group sessions with videotapes for diabetic persons with low literacy skills; 2) monthly group sessions without videotapes; or 3) no monthly sessions. After seven months, there had been 16 dropouts (13 per cent). Differences in weight changes between groups were significant (p<0.05); group 1 lost a median of 1 kg of weight (p<0.05) compared with a 0.1-kg loss and no change in groups 2 and 3, respectively. This weight loss was not sustained at 11 months. There was no significant change in HbA₁%. Age, education, and compliance beliefs did not predict outcome. The authors conclude that the patient education programs did not result in sustained glucose or weight control. Received from the Division of Endocrinology, St. Thomas’s Hospital and Medical School, London, United Kingdom, and the Division of General Internal Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas. Presented at the meeting of the Southern Section, Society for Research and Education in Primary Care Internal Medicine, January 1986, and at the National Meeting, May 1986. Supported by a grant from Pfizer Pharmaceuticals.     

Evaluation of an inpatient rheumatoid arthritis patient education program

Summary We evaluated an inpatient rheumatoid arthritis patient education program to determine whether patient knowledge improved and whether the improvement persisted after discharge. Patient knowledge was assessed by a multiple choice and true-false test given upon admission, after education, and 4 months following discharge. The treatment group increased their knowledge by 40% (p<.05) on the post-intervention questionnaire and retained most of this knowledge over a 4-month period. A control group of outpatients demonstrated no significant improvement in knowledge. Inpatients particularly demonstrated a marked increase in their knowledge of physical therapy recommendations. This knowledge was acquired and maintained even though the patients were involved in numerous diagnostic and therapeutic interventions that could have distracted from the educational program.     

Evaluation of a continuing education program in rheumatoid arthritis

A continuing medical education (CME) program in rheumatoid arthritis was implemented and evaluated in six community hospitals. It was targeted at primary care physicians and utilized physicians identified by their peers as being educationally influential for the dissemination of content knowledge. Although inpatient and outpatient audits of physician records demonstrated little change in three control communities, substantial improvement in the utilization of diagnostic procedures and patient management was documented in the three intervention communities utilizing the influential physicians. CME delivered through community-based educationally influential physicians is an effective way to change physician behavior in small communities with no prior ongoing educational programs. This approach should improve the primary care given to patients with rheumatoid arthritis and reduce the need for participation of academic faculty in traditional CME programs.     

Evaluation of an education program of patients undergoing oral anticoagulation treatment

OBJECTIVE: To evaluate the therapeutic impact of an education program on patients undergoing oral anticoagulation treatment, within the hospital of Annecy (France). MATERIAL AND METHODS: Groups of 10 patients were invited to participate to two meetings. The education was carried out by two nurses. Thanks to this prospective study, we compare the population before and after education in terms of treatment knowledge and stability. RESULTS: Within 9 months 88 patients have been included, amongst which 55 have attended the two meetings. The average of correct answers to the knowledge evaluation questionnaire distributed before and after 6 months of education were, respectively, 6.63/12, 10.09/12 (P < 0.0001). Through INR controls within the 6 months preceding (424 controls) and the 6 months following the education (619 controls), we observe: an increase of the total INR average in therapeutic zone, from 45% to 61% (P < 0.0001); a decrease of the difference average per patient between the INR value observed and the one targeted: 0.54 before education, 0.40 after education (P = 0.0016); at last, the average phasing per patient under the therapeutic zone increases after education, from 49% to 65% (P < 0.001). CONCLUSION: The education improves objectively the knowledge of patient undergoing AVK. If the size of patient sample is not large enough to prove any consequence on hemorrhagic or thrombotic complications, the education program still improves significantly the treatment stability.     

Continuing education in later adulthood: implications for program development for elderly guest students

While more and more institutions of higher education are offering cost-free continuing education programs to older men and women, the enrollment of this target population is quite low. This study was conducted to identify factors that would positively influence the decisions of individuals over sixty years of age to participate in such programs. Sixty-five white predominantly upper middle-class, highly educated (means = 16.92 years of schooling) women aged sixty years and over (means = 68.80) were given a questionnaire concerning attitudes toward continuing education. The majority (86%) indicated a high level of interest in taking geology, political science, world and art history, music, literature, and language courses. In addition, 85 percent preferred to participate in learning situations that included younger and older individuals; 58 percent reported interest in having a companion enroll with them; 48 percent preferred no specific learning environments (i.e., lecture, discussion, or workshop); and 75 percent reported that family members did not suggest that they enroll in continuing education classes. It is suggested that the high level of interest in taking courses offered by institutions of higher education displayed by the women surveyed is because of personal experience with university level education in young adulthood.     

Evaluation of an education program on the management of rheumatic diseases for physical therapists

An educational program on the management of rheumatic diseases was developed for physical therapists. It was community based and designed to measure changes in patient care and physician behavior in the utilization of physical therapy services. Substantial changes in the utilization of physical therapy services were documented in 3 intervention communities, but not in control communities. In patients undergoing total hip arthroplasty, there was a 1.8 day reduction in the hospitalization, significant increases in the use of preoperative physical therapy and a shift in the use of walking aids. These data suggest that physical therapists can play an important role in physician and patient education, and this may result in lower costs and improved outcomes.     

A problem-based education program for patients with rheumatoid arthritis: Evaluation after three and twelve months

Objective . To develop and evaluate the effect of a new arthritis education program based on a previous study. Methods . One hundred individuals with established rheumatoid arthritis randomized to an intervention group or a control group completed self-report questionnaires, Results . Three months after the education program the patients in the intervention group had increased their knowledge about their disease. They reported increased practice of exercise and joint protection and reduction of disability and pain. After 12 months, increased knowledge and practice of joint protection was maintained. However, there was no longer any difference between the intervention group and the control group regarding reported pain, disability, and practice of exercise. At both intervals the individuals in the intervention group reported an increased ability to handle their pain and a reduction of problems with their disease. The control group remained stable except for a slight increase in pain. Conclusion . A structured patient education program had positive impact for 3 months, and some improvements were maintained for 12 months. We suggest that patient education should become an integrated part of the total management of rheumatoid arthritis.     

Evaluation of an education program for elementary school children with asthma.

To evaluate the effectiveness of a comprehensive asthma management education program for 7- to 12-year-old children with asthma, entitled Roaring Adventures of Puff (RAP), 18 elementary schools in Edmonton were randomized to intervention and control groups. Participating in the program were 76 students with asthma in the intervention schools and 86 in the control schools. Children in the intervention schools had statistically significant improvements in unscheduled doctor visits, missed school days, moderate-to-severe parent rating of severity, severity of shortness of breath, limitations in the kind of play, and correct use of medications. Unscheduled doctor visits and missed school days were the only significant improvements in the control group; however, improvements were about half that of the intervention group. The results showed that a comprehensive, school-based asthma education program is feasible and improves outcomes.     

Evaluation of a Web-based education and counseling pilot program for older heart failure patients

Web-based communication has been reported as a feasible management tool for heart failure (HF) patients and has also been documented to positively impact quality of life (QOL). The feasibility and effectiveness of a Web-based educational and HF management program among older HF patients (60 years and older), however, have not been previously explored. Therefore, a prospective study was conducted. QOL (physical and mental health) and perceived control (PC) scores of 40 participants were measured (baseline and 3 months) and retrospectively compared with an age- and sex-matched control group of 40 patients receiving HF care as usual. Between-group differences over time were statistically significant in the QOL mental health component and PC scores. The authors' findings demonstrate the beneficial effects of a Web-based program on QOL and PC in older patients with HF. This approach may be potentially beneficial in delivering educational and behavioral support to this high-risk group in ways that are affordable and accessible.     

Biliary atresia: a scientometric analysis of the global research architecture and scientific developments

Biliary atresia (BA) is a rare cholangiopathy of largely unknown etiology and unpredictable outcome. There has been an increasing number of BA‐related publications, which may challenge researchers to determine their actual scientific value. This study aimed to evaluate the global research activity and developments relating to BA using a combination of scientometric methodologies and visualization tools. A comprehensive search strategy for the Web of Science? database was designed to obtain bibliographic data on scientific BA publications for the timespan 1900–2018. Research output of countries, institutions, individual authors and collaborative networks was analyzed. Semi‐qualitative research measures including citation rate and h‐index were assessed. Choropleth mapping and network diagrams were used to visualize results. In total, 4,459 publications on BA were identified (88.5% in English), originating from 63 countries. The largest number was published by the USA (n = 991; 22.2%), Japan (n = 667; 15.0%) and the UK (n = 294; 6.6%). The USA combined the highest number of cooperation articles (n = 140). The most productive collaborative network was established between the USA and Canada (n = 17). Scientific papers from the UK received the highest average citation rate (16.7), whereas the USA had the highest country‐specific h‐index (59). Eighty‐eight (2.0%) items were published under the auspices of multicenter consortiums and registries. The most productive institutions and authors were based in the USA, the UK, Japan, France, Canada and Taiwan. BA‐related research has constantly been progressing, becoming more multidisciplinary but with main research endeavors concentrated in a few high‐income countries. Studies into pathogenesis of BA remain uncommon, but are sorely needed to foster true scientific progress with this rare disease. Hence, international collaborative and translational research should be strengthened to allow further evolution in this field.