Online Educational Intervention Research Articles

Effect of online education on use of molecular markers to guide treatment selection for advanced gastric or gastroesophageal (GE) cancer.

111 Background: Trastuzumab in combination with chemotherapy is recommended for advanced gastric cancer positive for human epidermal growth factor receptor 2 (HER2) overexpression. Despite this recommendation, an informal pilot survey suggested that many oncologists do not include HER2 testing as part of routine practice to identify patients most likely to benefit from adding trastuzumab to chemotherapy. Methods: An interactive online educational activity was developed to provide expert guidance on HER2 testing and use of HER2-targeted agents in gastric or GE cancer. Pre- and post-education surveys were administered as part of the activity to measure changes in participant competence. In addition, 3 months after completing the educational activity, participants were sent another follow-up survey by email to assess changes in practice. Results: To date, pre-and post-education surveys have been obtained for 122 oncologists and 3-month follow-up surveys obtained from 14 oncologists. In the pre-education survey, only 46% said they were testing all of their patients with advanced gastric or GE cancer for HER2 overexpression. However, immediately after participating in the educational intervention, this proportion increased to 93%. Importantly, a follow-up survey indicated that HER2 testing of all patients with advanced gastric or GE cancer was now part of routine practice for 79% of those surveyed. A final analysis of pre- and post-education and 3-month follow-up surveys will be presented. Conclusions: Expert guidance on HER2 testing and use of HER2-targeted agents in gastric or GE cancer provided through an interactive online educational intervention substantially improved oncologist competence and practice patterns.

Heating up Coaching Education: What Coaches Need to Know

Background:The National Standards for Sport Coaches (2006) acknowledges that differences exist in athletes’ ability to tolerate heat. As such, Domain 2: Safety and Injury Prevention (S7-10), Domain 3: Physical Conditioning (S12-13), and Domain 7: Organization and Administration (S34) list expectations for coaches’ ability to recognize and respond to heat illness. However, only the American Red Cross of Greater Indianapolis (Domain 2 specific) and 13 programs are accredited by NCACE. Moreover, on-line trainings frequently used to educate novice interscholastic and recreational sport coaches provide only a cursory review of heat illness precautions, symptoms, and remedies.Objective:The purpose of this exploratory study is to identify changes in coaches’ actual and perceived knowledge after an on-line educational intervention, as well as determine whether the educational intervention will decrease the knowledge gap.Research Design:A pre-test/post-test design was used to identify the effect of an educational intervention on perceived and actual knowledge of sport coaches.Participants:Coaches (n=19; male=14, female=5) were solicited via email made available by the Indiana High School Athletic Association and the Indiana Youth Soccer Association – Olympic Development Program.Instrumentation:The Perceived Knowledge Questionnaire (five-item survey) and an actual knowledge assessment (two versions of 19-item quiz) were used to measure the coaches’ perceived and actual knowledge about the prevention, recognition, and treatment of exertional heat illnesses. Participants completed the “Beat the Heat: Be a Better Coach in Extreme Environmental Conditions” educational intervention.Procedures:Coaches completed the on-line educational module including pre-test and post-tests evaluations of actual and perceived knowledge.Statistical Analysis:Researchers performed three separate paired t-tests to identify the effect of the educational intervention on the dependent variables: actual knowledge, perceived knowledge, and knowledge gap. Significance was set a-prior at p<0.05.Results:Participants demonstrated a significant 18.1% improvement (t18=-4.877, p<0.001, ES=0.62) in actual knowledge scores. Perceived knowledge also significantly improved (t18=-2.585, p=0.019, ES=0.25). Knowledge gap, the difference between actual knowledge and perceived knowledge, became significantly smaller (t18=4.850, p<0.001, ES=0.63).Conclusions:Results indicate the on-line educational intervention improved actual knowledge, perceived knowledge, and decreased the knowledge gap. Additional large scale study of this intervention is warranted.

Innovative online smoking prevention education for pediatric providers, 'tween' girls, and their families

Now more than ever, technology use by pediatricians and family physicians and their patients has redefined the traditional patient–provider relationship with greater communication and exchange of health information. Pediatrics in Practice and the No Smoking Room offer a powerful online strategy to address gaps in pediatric and family physician practice and patient education in smoking prevention. This online educational model — empowering both provider and patient in smoking prevention information — is a one-of-a-kind program in the tobacco counseling field. With the rise of new technology and rapid adoption of its use as a tool for improved healthcare practice and patient education, providers and patients are in a position to forge a renewed path of meaningful partnership, effective communication, and trust for the improved health of children and their families. In order to showcase technology's dynamic role in the professional development of today's pediatricians and family physicians and in patient education, this paper demonstrates the value of an innovative, online educational intervention in delivering comprehensive smoking prevention counseling skills for busy health professionals and its companion smoking prevention program for young 8–11-year-old females, known as the 'tween' market.

Innovative online smoking prevention education for pediatric providers, 'tween' girls, and their families

Now more than ever, technology use by pediatricians and family physicians and their patients has redefined the traditional patient–provider relationship with greater communication and exchange of health information. Pediatrics in Practice and the No Smoking Room offer a powerful online strategy to address gaps in pediatric and family physician practice and patient education in smoking prevention. This online educational model — empowering both provider and patient in smoking prevention information — is a one-of-a-kind program in the tobacco counseling field. With the rise of new technology and rapid adoption of its use as a tool for improved healthcare practice and patient education, providers and patients are in a position to forge a renewed path of meaningful partnership, effective communication, and trust for the improved health of children and their families. In order to showcase technology's dynamic role in the professional development of today's pediatricians and family physicians and in patient education, this paper demonstrates the value of an innovative, online educational intervention in delivering comprehensive smoking prevention counseling skills for busy health professionals and its companion smoking prevention program for young 8–11-year-old females, known as the 'tween' market.

Professional Practice-Computer Software Applications

This prospective educational intervention research study identifies the existing knowledge base of a sample of 416 practicing acute care nurses regarding skin tears and evaluates the efficacy of an educational program designed to improve these nurses' knowledge regarding skin tears including: (1) predisposing factors; (2) identification and assessment of skin tears using the Payne Martin Classification System; and (3) preventive care, treatment and documentation regarding skin tears. A pretest baseline measurement of acute care nurses' skin tear knowledge and a postintervention posttest measurement of changes in these nurses' skin tear knowledge were obtained following an online educational intervention. The Web-based skin tear educational program was effective in delivering new knowledge to these nurses. Study results indicate a highly significant (P = .001) improvement between pre- and posttest scores for all three categories of skin tear knowledge studied: (1) identification and assessment of skin tears (97.1% to 99.1%); (2) the Payne Martin Classification system (83.4% to 94.9%); and (3) skin tear treatment (73.8% to 93.7%). The results of this study demonstrate that there is a need to have a consistent skin tear identification tool and treatment protocol in place for standardized evidence-based practice among nurses in an acute care setting. We recommend: (1) uniform skin tear education for all acute care staff nurses; (2) that the Payne Martin Skin Tear Classification System be used for skin tear documentation on all medical/surgical units; and (3) that product availability for the standardized treatment skin tears and a skin tear treatment protocols be available for nurses to follow. Additionally, educational support should be readily available for staff nurses and patient care technicians regarding prevention strategies for skin tears.

Medical Residents’ Knowledge of Dietary Supplements

The widespread use of complementary and alternative medicine modalities such as dietary supplements has prompted many medical schools to offer courses covering such topics. To date, little is known about the impact of these courses on medical graduates' knowledge. This study was designed to evaluate resident physicians' level of understanding of popular dietary supplement regulation and to determine whether an interactive online curriculum could aid in improving such knowledge. A multicenter online educational intervention was developed and administered to physicians at 15 internal medicine residency programs throughout the United States, between March 1, 2006 and June 30, 2006. Pretest performance was used to measure baseline knowledge of commonly used dietary supplements. Posttest performance compared with pretest performance measured the effectiveness of the educational intervention. A total of 335 physicians completed the module. Baseline knowledge of dietary supplements was low (average pretest score 59.7%). More than one-third of respondents were unaware of the reasons for use of saw palmetto and black cohosh. Results for questions on safety and drug-supplement interactions were similarly low. Only 57% of physicians knew that kava kava has been associated with hepatitis. Only 15% were aware that St. John's Wort can lower cyclosporine levels. With regards to knowledge of efficacy, only 36% were aware that fish oil has been shown to lower triglyceride levels. After completion of the curriculum, scores improved significantly (P < 0.001) in all question/content areas. Residents' knowledge of dietary supplements is poor. An online didactic module may improve knowledge and potentially enhance patient-physician communication regarding the use of such products.

Physicians' Understanding of the Regulation of Dietary Supplements

After passage of the Dietary Supplement Health and Education Act, herbs and other supplements were allowed to be sold to the public without Food and Drug Administration (FDA) approval or premarket evaluation. Data suggest that many people are unaware of this lack of governmental oversight and may rely on their physicians for education in this arena. This study was designed to evaluate physicians' level of understanding of dietary supplement regulation and the adverse event reporting process and to determine whether an interactive online curriculum could aid in improving knowledge. A multicenter online educational intervention was developed and administered to physicians at 15 internal medicine residency programs throughout the United States between March 1, 2006, and June 30, 2006. Pretest performance was used to measure baseline knowledge, while posttest performance compared with pretest performance measured the effectiveness of the educational intervention. A total of 335 physicians completed the module. Ninety percent of those completing the module were residents, while 10% were attending physicians. Baseline knowledge of dietary supplement regulatory issues was poor. The total average pretest score was only 59% (986/1675). The average score rose to 91% (1526/1675) after completion of the curriculum (P<.001). With regard to specific content areas, about one third of physicians were unaware that dietary supplements did not require FDA approval or submission of safety and efficacy data before being marketed. Similar percentages believed that there are regulations in place to ensure supplement quality. Most physicians were unaware that serious adverse events due to the use of supplements should be reported through the FDA MedWatch system. Physician knowledge of dietary supplement regulation and adverse event reporting is poor. An online didactic module may improve knowledge and potentially enhance patient-physician communication regarding the use of such products.

Ability of Physicians to Diagnose and Manage Illness Due to Category A Bioterrorism Agents

Early recognition of a terrorist attack with biologic agents will rely on physician diagnosis. Physicians' ability to diagnose and care for patients presenting after a bioterror event is unknown. The role of online case-based didactics to measure and improve knowledge in the diagnosis and treatment of these patients is unknown. A multicenter online educational intervention was completed by 631 physicians at 30 internal medicine residency programs in 16 states and Washington, DC, between July 1, 2003, and June 10, 2004. Participants completed a pretest, assessing ability to diagnose and manage potential cases of smallpox, anthrax, botulism, and plague. A didactic module reviewing diagnosis and management of these diseases was then completed, followed by a posttest. Pretest performance measured baseline knowledge. Posttest performance compared with pretest performance measured effectiveness of the educational intervention. Results were compared based on year of training and geographic location of the residency program. Correct diagnoses of diseases due to bioterrorism agents were as follows: smallpox, 50.7%; anthrax, 70.5%; botulism, 49.6%; and plague, 16.3% (average, 46.8%). Correct diagnosis averaged 79.0% after completing the didactic module (P<.001). Correct management of smallpox was 14.6%; anthrax, 17.0%; botulism, 60.2%; and plague, 9.7% (average, 25.4%). Correct management averaged 79.1% after completing the didactic module (P<.001). Performance did not differ based on year of training (P = .54) or geographic location (P = .64). Attending physicians performed better than residents (P<.001). Physician diagnosis and management of diseases caused by bioterrorism agents is poor. An online didactic module may improve diagnosis and management of diseases caused by these agents.

Exploring organizational characteristics associated with practice changes following a mentored online educational module

Studies of health professionals' perceptions of barriers to and facilitators of research utilization in clinical practices suggest that structural and resource characteristics of service provider organizations are key determinants of the capacity of individual practitioners to provide evidence-based practices. In this pilot study, we compare health professionals' self-reported practice changes with characteristics of the structures and resources available to support research use at 4 hospitals. Data on the self-reported practice changes of stroke rehabilitation professionals at Ontario hospitals were analyzed following their participation in a mentored online educational intervention, the Rehabilitation Education Program for Stroke (REPS). In-depth interviews with a purposefully drawn subsample of REPS mentors and managers of stroke rehabilitation programs examined the participating hospitals' structural and resource characteristics. The interview data on hospital characteristics were coded descriptively and thematically, quantified, and then compared with the percentage of individual REPS participants who reported positive practice changes in each hospital. Hospitals with higher percentages of participants reporting improved practices following REPS provided better computer access, paid time to participate in REPS, had established specialized units of stroke care, strong teamwork, and were previously committed to implementing best practices. They also conducted program audits or evaluations and engaged in "bottom-up" program decision making. Continuing educators should consider the capacity of hospitals to support practice changes when planning educational interventions for rehabilitation professionals. Larger studies employing objective measures are needed to examine relationships between practice improvements and organizational characteristics following educational interventions.