Improving education in primary care: development of an online curriculum using the blended learning model

Background  

Standardizing the experiences of medical students in a community preceptorship where clinical sites vary by geography and discipline can be challenging. Computer-assisted learning is prevalent in medical education and can help standardize experiences, but often is not used to its fullest advantage. A blended learning curriculum combining web-based modules with face-to-face learning can ensure students obtain core curricular principles.     

Consumer e-health education in HIV/AIDS: a pilot study of a web-based video workshop

Background  

Members of the HIV/AIDS community are known to use web-based tools to support learning about treatment issues. Initial research indicated components such as message forums or web-based documentation were effectively used by persons with HIV/AIDS. Video has also shown promise as a technology to aid consumer health education. However, no research has been published thus far investigating the impact of web-based environments combining these components in an educational workshop format.     

A web-based Alcohol Clinical Training (ACT) curriculum: Is in-person faculty development necessary to affect teaching?

Background  

Physicians receive little education about unhealthy alcohol use and as a result patients often do not receive efficacious interventions. The objective of this study is to evaluate whether a free web-based alcohol curriculum would be used by physician educators and whether in-person faculty development would increase its use, confidence in teaching and teaching itself.     

Web-based objective structured clinical examination with remote standardized patients and Skype: Resident experience

Objective

Using Skype and remote standardized patients (RSPs), investigators sought to evaluate user acceptance of a web-based objective structured clinical examination (OSCE) among resident physicians.

Methods

After participating in four web-based clinical encounters addressing pain with RSPs, 59 residents from different training programs, disciplines and geographic locations completed a 52-item questionnaire regarding their experience with Skype and RSPs. Open-ended responses were solicited as well.

Results

The majority of participants (97%) agreed or strongly agreed the web-based format was convenient and a practical learning exercise, and 90% agreed or strongly agreed the format was effective in teaching communication skills. Although 93% agreed or strongly agreed they could communicate easily with RSPs using Skype, 80% preferred traditional face-to-face clinical encounters, and 58% reported technical difficulties during the encounters. Open-ended written responses supported survey results.

Conclusion

Findings from this study expose challenges with technology and human factors, but positive experiences support the continued investigation of web-based OSCEs as a synchronous e-learning initiative for teaching and assessing doctor–patient communication. Such educational programs are valuable but unlikely to replace face-to-face encounters with patients.

Practice implications

This web-based OSCE program provides physician learners with additional opportunity to improve doctor–patient communication.     

Non-response to a life course socioeconomic position indicator in surveillance: comparison of telephone and face-to-face modes

Background  

Measurement of socioeconomic position (SEP) over the life course in population health surveillance systems is important for examining differences in health and illness between different population groups and for monitoring the impact of policies and interventions aimed at reducing health inequities and intergenerational disadvantage over time. While face-to-face surveys are considered the gold standard of interviewing techniques, computer-assisted telephone interviewing is often preferred for cost and convenience. This study compared recall of parents' highest level of education in telephone and face-to-face surveys.     

Introducing an online community into a clinical education setting: a pilot study of student and staff engagement and outcomes using blended learning

Background  

There are growing reasons to use both information and communication functions of learning technologies as part of clinical education, but the literature offers few accounts of such implementations or evaluations of their impact. This paper details the process of implementing a blend of online and face-to-face learning and teaching in a clinical education setting and it reports on the educational impact of this innovation.     

Development, implementation and pilot evaluation of a Web-based Virtual Patient Case Simulation environment – Web-SP

Background  

The Web-based Simulation of Patients (Web-SP) project was initiated in order to facilitate the use of realistic and interactive virtual patients (VP) in medicine and healthcare education. Web-SP focuses on moving beyond the technology savvy teachers, when integrating simulation-based education into health sciences curricula, by making the creation and use of virtual patients easier. The project strives to provide a common generic platform for design/creation, management, evaluation and sharing of web-based virtual patients. The aim of this study was to evaluate if it was possible to develop a web-based virtual patient case simulation environment where the entire case authoring process might be handled by teachers and which would be flexible enough to be used in different healthcare disciplines.     

Prospective study of clinician-entered research data in the Emergency Department using an Internet-based system after the HIPAA Privacy Rule

Background  

Design and test the reliability of a web-based system for multicenter, real-time collection of data in the emergency department (ED), under waiver of authorization, in compliance with HIPAA.     

From design to implementation - The Joint Asia Diabetes Evaluation (JADE) program: A descriptive report of an electronic web-based diabetes management program

Background  

The Joint Asia Diabetes Evaluation (JADE) Program is a web-based program incorporating a comprehensive risk engine, care protocols, and clinical decision support to improve ambulatory diabetes care.     

Interactive decision support in hepatic surgery

Background  

Hepatic surgery is characterized by complicated operations with a significant peri- and postoperative risk for the patient. We developed a web-based, high-granular research database for comprehensive documentation of all relevant variables to evaluate new surgical techniques.     

Determinants of engagement in face-to-face and online patient support groups

Background

Although peer-to-peer contact might empower patients in various ways, studies show that only a few patients actually engage in support groups.

Objective

The objective of our study was to explore factors that facilitate or impede engagement in face-to-face and online peer support, using the Theory of Planned Behavior.

Methods

A questionnaire was completed by 679 patients being treated for arthritis, breast cancer, or fibromyalgia at two Dutch regional hospitals.

Results

Our results showed that only a minority of the patients engaged in organized forms of peer support. In total 10% (65/679) of the respondents had engaged in face-to-face meetings for patients in the past year. Only 4% (30/679) of the respondents had contact with peers via the Internet in the past year. Patients were more positive about face-to-face peer support than about online peer support (P < .001). In accordance with the Theory of Planned Behavior, having a more positive attitude (P < .01) and feeling more supported by people in the social environment (P < .001) increased the intention to participate in both kinds of peer support. In addition, perceived behavioral control (P = .01) influenced the intention to participate in online peer support. Nevertheless, the intention to engage in face-to-face and online peer support was only modestly predicted by the Theory of Planned Behavior variables (R ² = .33 for face-to-face contact and R ² = .26 for online contact).

Conclusion

Although Health 2.0 Internet technology has significantly increased opportunities for having contact with fellow patients, only a minority seem to be interested in organized forms of peer contact (either online or face-to-face). Patients seem somewhat more positive about face-to-face contact than about online contact.     

“Conversational Advice”: A mixed-methods analysis of medical residents’ experiences co-managing primary care patients with behavioral health providers

Objective

When integrated behavioral health clinicians (IBHCs) and residents co-manage patients, residents may learn new approaches. We aimed to understand the effect of co-management on residents’ behavioral health (BH) management learning.

Focus groups inform a web-based program to increase fruit and vegetable intake

Objective

To use focus groups to inform a web-based educational intervention for increased fruit and vegetable (FV) consumption.

Methods

Twelve groups (participants = 137, aged 21–65) were recruited from four geographically diverse health systems. Four groups were stratified by gender and eight by race (white and African American) and gender. Questions included perceptions of healthy eating, factors that encourage or serve as barriers to FV consumption and features preferred for a web-based educational intervention.

Results

Though knowledgeable about healthy eating, participants did not know how to achieve or always care about healthy nutritional choices. Motivators for FV consumption included being role models and health concerns. Barriers included: lack of time, expense and FV availability. Website preferences included: visuals, links, tailored materials, menu suggestions, goal setting assistance, printable summaries and built in motivation. The developers incorporated nearly all suggestions.

Conclusion

Focus groups provided needs-based tactical strategies for an online, education intervention targeting factors to improve FV consumption.

Practice implications

Focus groups can provide valuable input to inform interventions. Further, web-based programs’ abilities to offer information without time or geographic constraints, with capacity for tailoring and tracking progress makes them a valuable addition in the arsenal of efforts to promote healthy behaviors.     

Process evaluation of a web-based intervention aimed at empowerment of disability benefit claimants

Background  

The objective of this process evaluation study was to gain insight into the reach, compliance, appreciation, usage barriers, and users' perceived effectiveness of a web-based intervention . This intervention was aimed at empowerment of disability claimants, prior to the assessment of disability by an insurance physician.     

The feasibility of a web-based counselling program for occupational physicians and employees on sick leave due to back or neck pain

Background  

The objective of this feasibility study was to gain insight into occupational physicians' (OPs) and employees' use of, and attitudes towards, 'Snelbeter' (Get Well Fast), a new web-based counselling program for employees on sick leave due to non-specific back or neck pain and their OPs.     

Web-based computer adaptive assessment of individual perceptions of job satisfaction for hospital workplace employees

Background  

To develop a web-based computer adaptive testing (CAT) application for efficiently collecting data regarding workers' perceptions of job satisfaction, we examined whether a 37-item Job Content Questionnaire (JCQ-37) could evaluate the job satisfaction of individual employees as a single construct.     

Proximity morality in medical school – medical students forming physician morality "on the job": Grounded theory analysis of a student survey

Background  

The value of ethics education have been questioned. Therefore we did a student survey on attitudes about the teaching of ethics in Swedish medical schools.