Post-assessment Scores Research Articles

Interprofessional Competency Toolkit for Internationally Educated Health Professionals: Evaluation and Pilot Testing.

Internationally Educated Health Professionals (IEHPs) constitute a major health care workforce in Canada. Interprofessional education is particularly important for IEHPs to integrate into the Canadian health care system. We designed an online interprofessional education curriculum for IEHPs. The curriculum is designed to cover the six interprofessional competency domains defined in the Canadian Interprofessional Health Collaborative National Interprofessional Competency Framework. In this article, we are presenting findings from the pilot testing of the curriculum with a cohort of IEHPs and educators. We conducted surveys and interviews with IEHPs and educators from four provinces (British Columbia, Alberta, Saskatchewan, and Manitoba). We aimed to include seven healthcare professionals: licensed practical nurses, registered nurses, registered psychiatric nurses, pharmacists, physicians, occupational therapists, and physical therapists. We also used a pre- post- self-assessment tool and a set of reflective questions to measure the effectiveness of the curriculum. Thirty IEHPs and five educators reviewed the online curriculum and participated in this evaluation. Postintervention confidence scores for all items under the role clarification and patient-centered care domains increased significantly (P = <0.01) after module completion. The scores also increased for most questions in team functioning, collaborative leadership, and communication domains. The postassessment scores increased for only half of the questions in conflict management domains. Participants agreed with the appropriateness of the content in terms of language, scenarios, and cultural aspects covered in the online curriculum on interprofessional education. The content of the curriculum improved IEHPs' understanding of interprofessional collaboration in Canada. The interprofessional curriculum is a creative and useful resource to improve collaborative practice among internationally educated health professionals in Canada.

An Experimental Study of the Effects of Psychological Interventions on Adult Patients with Dental Anxiety

Dental anxiety is a common problem and is considered an obstacle to providing quality dental care to patients. The present study was conducted to determine the prevalence of dental anxiety among patients under going restorative procedures in a university dental clinic, to determine the effect of a combination of psychological interventions (psychoeducation, relaxation therapy, and modeling technique) in reducing dental anxiety within and between experimental and control groups, and to identify differences in concern or anxiety towards dental procedures between pre-assessment, post-assessment, and follow-up assessment of experimental and control groups. Corah’s Dental Anxiety Scale, Revised (DAS-R) measured dental anxiety prevalence, and the Dental Concerns Assessment (DCA) identified factors causing dental anxiety. Patients experiencing dental anxiety were randomly assigned into an experimental or control group. Experimental group patients (n=15) received a 45-minute session of a combination of psychological interventions to reduce dental anxiety, whereas control group patients (n=15) received dental treatment as usual from general dental practitioners. A t-test and One-way analysis of variance were used for analyses. Results show that out of 65 patients, 41 had dental anxiety (prevalence 63.1%). Experimental group patients showed significant reduction in the post-assessment and follow-up DAS-R scores (F=18.85, P=&lt;0.01) compared with pre-assessment scores. Significant reductions in post-assessment DCA scores were found for extraction, injection, and sound or vibration of the drill for the experimental group compared with pre-assessment scores (P&lt;0.03). Over all, the combination of psychoeducation, relaxation therapy and modeling technique was effective at reducing dental concern and anxiety of dental procedures.

Successfully Managing IBD in Children: Can Medical Education Improve Knowledge and Competence of Physicians?

Introduction: It is estimated that 25% of patients with IBD are diagnosed within the pediatric age group, and that approximately 50,000 children in the United States have IBD. IBD in children is different than in adults with respect to distribution of disease and thus requires pediatric-specific considerations to confirm diagnosis and select appropriate therapy. This study assessed whether online continuing medical education (CME) - a 15-minute video lecture - can impact knowledge and competence of gastroenterologists and primary care physicians (PCPs) who care for children with IBD. Methods: An online survey was administered to assess the educational effect of the CME program focused on management goals for IBD in children, by comparing the same participant's responses to 4 identical pre- and post-CME assessment questions. A paired 2-tailed t-test was used to assess whether the mean post-assessment score was different from the mean pre-assessment score. McNemar's chi-squared statistic was used to determine statistical significance. Effect size was calculated using Cramer's V by determining the change in proportion of participants who answered questions correctly from pre- to post- assessment. Survey data were collected from September 24 to November 24, 2015. Results: Data were collected for 64 gastroenterologists and 71 PCPs, each of whom answered all assessment questions during the study period. Gastroenterologists who participated in the CME activity demonstrated statistically significant improvements in knowledge/competence (n=64; P<.05; V=0.238, medium educational effect). While 25% answered all 4 questions correctly on preassessment, 63% answered them all correctly on post-CME assessment. PCPs who participated in the CME activity demonstrated statistically significant improvements in knowledge/competence (n=71; P<.05; V=0.245, medium educational effect). While 3% answered all 4 questions correctly on preassessment, 32% answered them all correctly on post-CME assessment. Significant improvements occurred in physicians' ability to recognize epidemiologic differences between pediatric and adult IBD, recognize appropriate approaches to vaccinations, and in knowledge of clinical trial data for pediatric IBD. Conclusion: CME in the format of a video lecture on IBD in children led to improvements in clinicallyrelevant knowledge of gastroenterologists and PCPs, and may be a suitable method for further education of clinicians in this space.

Student-generated e-learning for clinical education.

Within clinical education, e-learning facilitates a standardised learning experience to augment the clinical experience while enabling learner and teacher flexibility. With the shift of students from consumers to creators, student-generated content is expanding within higher education; however, there is sparse literature evaluating the impact of student-developed e-learning within clinical education. The aim of this study was to implement and evaluate a student-developed e-learning clinical module series within ambulatory care clinical pharmacy experiences. Three clinical e-learning modules were developed by students for use prior to clinical experiences. E-learning modules were created by fourth-year professional pharmacy students and reviewed by pharmacy faculty members. A pre-/post-assessment was performed to evaluate knowledge comprehension before and after participating in the e-learning modules. Additionally, a survey on student perceptions of this educational tool was performed at the end of the clinical experience. There is sparse literature evaluating theimpact ofstudent-developed e-learning within clinical education RESULTS: Of the 31 students eligible for study inclusion, 94per cent participated in both the pre- and post-assessments. The combined post-assessment score was significantly improved after participating in the student-developed e-learning modules (p=0.008). The student perception survey demonstrated positive perceptions of e-learning within clinical education. Student-generated e-learning was able to enhance knowledge and was positively perceived by learners. As e-learning continues to expand within health sciences education, students can be incorporated into the development and execution of this educational tool.

The California Tri-pull Taping Method in the Treatment of Shoulder Subluxation After Stroke: A Randomized Clinical Trial.

Background:Shoulder subluxation is a frequent occurrence in individuals following a stroke. Although various methods of treatment are available, none of them address all possible consequences of the subluxation pain, limited range of motion, the subluxation, and decreased functional use of the arm.Aims:The purpose of this study was to evaluate the effectiveness of California tri-pull taping (CTPT) method on shoulder subluxation, pain, active shoulder flexion, and upper limb functional recovery after stroke.Materials and Methods:This was a randomized control study on 30 participants. All participants received conventional neurorehabilitation 5 days a week over 6 weeks. Half of the participants also received the CTPT. Pre- and post-assessment scores were taken on all participants for the amount of shoulder subluxation, pain, active shoulder flexion, and functional recovery.Results:The CTPT method demonstrated a significant reduction of pain in the treatment group from baseline, a significant improvement in active shoulder flexion and a significant improvement in proximal arm function as measured on the proximal subscale on the Fugl-Meyer upper extremity functional Scale but not the distal or total Fugl-Meyer subscales. Shoulder subluxation was not statistically significant.Conclusions:The CTPT method is an effective treatment for the hemiplegic subluxed shoulder.

The Effects of Utilizing High Element Ropes Courses as a Treatment Intervention on Self-Efficacy

Adventure-Based Therapy (ABT) is a treatment intervention in Recreational Therapy (RT) that has the capacity to produce a variety of physical, psychological, cognitive, and social outcomes. While there is research on the potential benefits of ABT and ropes course experiences, there is a lack of research on which course types lead to specific results, which may result in inconsistent programming. The purpose of this mixed-methods study was to determine the impact of a static belay high ropes course experience on self-efficacy and to explore the different parts of the course experience that were beneficial in developing self-efficacy. Assessments reflected a significant increase in self-efficacy following the ropes course experience. Focus groups and follow-up interviews reflected the different factors of ropes course experiences that led to the differences between pre- and postassessment scores. These results supported that high ropes course programming can impact self-efficacy development, including mastery experiences, vicarious experiences, verbal persuasion, and emotional and physiological arousal. Based on these findings, recreational therapists should consider the use of the high ropes course as a tool to improve self-efficacy. Additional implications for practice and future research are included.

Patient activation and outcome in pulmonary rehabilitation

BackgroundThis respiratory service improvement project explored the relationship between patient activation and outcome in pulmonary rehabilitation.Method: Activation was assessed using the Patient Activation Measure (PAM), as part of pre– and post–assessment questionnaires. Measures of depression (PHQ–9) and anxiety (GAD–7) routinely given were also included. Baseline scores for those that completed pulmonary rehabilitation were compared with those that did not.FindingsResults showed a significant difference in pre– and post–assessment PAM scores for patients completing (p&lt;0.001). However, there were no significant differences between those completing and those who did not. Significant differences were found for pre– and post–assessment scores for depression (p&lt;0.001) and anxiety (p&lt;0.05), and those not completing were significantly more depressed (p&lt;0.005) and anxious (p&lt;0.05) than those completing the programme.DiscussionThis project, therefore, found that completion of pulmonary rehabilitation can improve outcomes for patient activation, depression and anxiety. The PAM was not able to predict whether a patient will complete pulmonary rehabilitation, but currently used measures for depression and anxiety were. Further research is needed to understand the mechanisms of action, but this project could help inform the development of targeted psychological interventions to support respiratory patients.

Study of effectiveness of brief cognitive behavioral therapy for auditory hallucinations in schizophrenia

Introduction A growing body of evidence supports the use of cognitive behavioral therapy (CBT) for the treatment of schizophrenia. Auditory hallucinations are a common feature in schizophrenia that persists as a distressing symptom even after adequate pharmacotherapy regimen. Combining pharmacotherapy with brief CBT may reduce the severity of symptoms through decreasing the distress caused by the hallucinations. Aim The aim of this study was to evaluate the effectiveness of brief individual CBT for auditory hallucinations combined with treatment as usual (TAU) compared with TAU only in a sample of Egyptian schizophrenic patients referred to the Outpatient Clinic of El Hadara University Hospital. Patients and methods A total of 40 patients diagnosed with schizophrenia referred to the outpatient clinic of El Hadara University Hospital were randomly assigned into two groups: group I received brief CBT for auditory hallucinations combined with TAU, and group II received TAU only. Brief CBT for auditory hallucinations was delivered on eight sessions of 45 min each with a frequency of once per week. Positive and Negative Syndrome Scale (PANSS) was assessed before and after therapy in both groups and outcome was compared. Results On comparing the pre-assessment scores with the post-assessment scores of group I after 8 weeks of brief CBT for auditory hallucinations, a significant symptom reduction was observed for the PANSS positive (−18.31%, P < 0.001), negative (−16.67%, P < 0.001), general symptoms (−16.53%, P < 0.001), and total (−16.53%, P < 0.001) scores. Moreover, on comparing group I with group II after 8 weeks of brief CBT for auditory hallucinations, a significant symptom reduction was observed for the PANSS positive (P < 0.001), negative (P = 0.008), general symptoms (P < 0.001), and total (P < 0.001) scores. Conclusion Brief CBT for auditory hallucinations was found to be effective in reducing symptom severity in schizophrenia

Improving Hematologist/Oncologist Knowledge and Confidence in Managing Hemophilia through Online Educational Interventions

The field of hemophilia has advanced tremendously over the past few decades leading to significant improvements to a patient's life expectancy. However, gaps in clinician's knowledge about appropriate tailored management of hemophilia can result in suboptimal patient outcomes. A study was conducted to determine if a series of online educational interventions on hemophilia could improve the knowledge and confidence of hematologists/oncologists in treating patients with hemophilia.The Perelman School of Medicine at the University of Pennsylvania, Office of CME, the National Hemophilia Foundation and Medscape, LLC, in partnership with an expert steering committee, developed a global, accredited educational curriculum (http://www.medscape.org/sites/advances/hemophilia-management) focused on the advances in the management of hemophilia. Six activities, including text and video formats, within the curriculum were evaluated using a pre-assessment/post-assessment study design comparing participants' responses to knowledge and case-based multiple choice questions before exposure to educational content (pre-assessment measurement) with the same participants' responses after participation in the educational activity (post-assessment measurement). Outcomes assessment questions focused on current evidence-based recommendations for the management of hemophilia. For all questions combined, paired 2-tailed t-test was used to assess whether the mean pre-assessment score was different from the mean post-assessment score. The effect size (Cohen's d) was calculated by comparing pre-assessment means and post-assessment means of linked learners to show the effect of educational intervention. Effect size of >0.8 and 0.4-0.8 are considered a large and medium effect size, respectively.A total of 256 hematologist/oncologist participants who completed all pre- and post- assessment questions for each assessment were included in the evaluation across the 6 interventions. An increase in knowledge and performance was demonstrated as a result of participation in each of the 6 interventions with effect sizes of 0.25, 0.559, 0.618, 0.721, 1.26, and 2.275. Topics that demonstrated the largest statistically significant increases in correct post-assessment compared with pre-assessment answers included: mechanism of action of Fc fusion technology (63% relative increase, p<.001), patient counseling when switching to an extended half-life factor replacement (100%, P=.008), joint health in hemophilia (340% relative increase, P<.05), and incidence of inhibitors (227% relative increase, p<.05).Confidence in when to use prophylaxis increased post-educational exposure (7.3% mean confidence shift using a 7-point Likert scale) as measured in 3 of the 6 activities. Areas where knowledge gaps remained, as evidenced by >15% incorrect answers post-education, included: adherence with prophylaxis, outcomes for children and adults with severe hemophilia A receiving prophylaxis vs episodic treatment, clinical data from recent studies with new extended half-life factor products in terms of efficacy, tolerability, and risk of inhibitor development in persons of different ages and risk settings, and the potential place of extended half-life factor products in the strategy for the care of individuals with hemophilia A and B.This study demonstrates the success of a targeted online hemophilia educational curriculum using text and video formats in improving the knowledge and confidence of hematologists/oncologists who treat patients with hemophilia, while also identifying remaining educational needs for future education. DisclosuresVan Laar:Medscape LLC: Employment. Pipe:CSL Behring: Consultancy; Bayer: Consultancy; American Thrombosis and Hemostasis Network: Other: Chair of the Board of Directors; National Hemophilia Foundation: Other: member of the Medical and Scientific Advisory Committee; Novo Nordisk: Consultancy; Baxter: Consultancy; Biogen Idec Inc: Consultancy.

Success of Online Curriculum-Based Education in the Management of Multiple Myeloma and Continuing Gaps Among Hematologists/Oncologists

Driven by ever-increasing access to diagnostic/prognostic tools and new therapies, the treatment and management of multiple myeloma (MM) is rapidly evolving. This in turn leads to a direct clinical need for updated, timely, and effective education approaches for clinicians to ensure they have access to the latest knowledge, allowing them to provide the best possible care for patients with MM. However, given the time constraints of a busy practice and the large amount of updates in the field, hematologists/oncologists who manage MM often are challenged with integrating new information into clinical practices. A study was conducted to determine if a series of online educational interventions on MM could improve the knowledge and competence of hematologists/oncologists.A series of 9 online continuing medical education interventions targeting US-based hematologists/oncologists was developed to address specific education gaps identified by comprehensive needs assessment in MM (http://www.medscape.org/sites/advances/multiple-myeloma). To assess changes in knowledge and competence, a pre/post outcomes assessment was performed on a subset of 4 video or text-based activities whose focus included: management of transplant-eligible, transplant-ineligible, elderly patients, and differentiating between therapies. The outcomes survey method included knowledge- and case-based, multiple-choice questions focused on current evidence-based recommendations for the management of MM. The effect size (Cohen's d) was calculated by comparing pre-assessment means and post-assessment means of linked learners to show effect of the educational interventions. Effect size of >0.8 and 0.4-0.8 are considered a large and medium effect size, respectively. A Chi square test was used to assess whether the mean pre-assessment score was different from the mean post-assessment score.549 hematologist/oncologist who completed all pre- and post- assessment questions were evaluated. Statistically significant effect on gain in knowledge and competence was demonstrated in each of the 4 interventions (P < .05) with effect sizes of d = 0.4, 0.778, 0.966, and 1.408. Topics that demonstrated significant improvement in learning included: awareness of emerging data/trial design (23% mean increase, 95% CI: 10.4-35.6; P<.001), appropriately tailoring therapy for elderly patients with MM (37% mean increase, 95% CI: 17-57%; P<.001), and use of consolidation/maintenance therapy in MM (35% mean increase, 95% CI: 9.6-59.4%; P<.001). Despite improvements in learning, education gaps remain, as evidenced by the percent of incorrect answers post education, specifically in the areas of: understanding benefits of continuous lenalidomide plus dexamethasone (Rd) therapy (59% incorrect), evaluating clinical trial data for assessing tailored therapy for elderly patients with MM (43% incorrect), and key clinical considerations such as age, performance status, medical history, and comorbidities that could affect treatment of elderly patients with MM (36% incorrect).Knowledge gaps permeate clinical practice specific to MM, with the potential to impact patient outcomes. This study demonstrated the success of a targeted online MM educational curriculum using video and text-based activities as evidenced by improvement in knowledge and competence relative to integrating new clinical trial data, tailoring MM therapy, and supportive care measures. The study also revealed additional areas requiring further education. DisclosuresVan Laar:Medscape LLC: Employment. Landgren:Onyx: Research Funding; International Myeloma Foundation: Research Funding; Onyx: Honoraria; Celgene: Honoraria; Bristol-Myers Squibb: Honoraria; Medscape: Honoraria; BMJ Publishing: Honoraria; Celgene: Consultancy; BMJ Publishing: Consultancy; Medscape: Consultancy; Bristol-Myers Squibb: Consultancy; Onyx: Consultancy.

The Effects of Vocabulary Learning Strategies in Mathematical Instruction on Ninth-Grade Students' Coordinate Algebra Achievement

The purpose of this study was to investigate if adding the vocabulary learning strategies of an interactive word wall and graphic organizers to mathematical instruction was an effective method to increase student achievement in mathematics for two ninth-grade coordinate algebra classes. The 45 participants in the study were members of two co-taught ninth grade coordinate algebra classes in the Southeastern United States. This study used a quasi-experimental design with a pre-assessment/post assessment. An analysis of covariance (ANCOVA) was used to compare the achievement levels of the two classes, as measured by the post assessment. The results did not show a significant difference between the post assessment scores of the experimental class using graphic organizers and an interactive word wall compared to the control class that did not. The results of this study may be important to teachers as they implement the Common Core State Standards, the Common Core Georgia Performance Standards, and the Mathematical Practice Standards.

Optimizing inhaler use by pharmacist-provided education to community-dwelling elderly

ObjectiveTo assess, using a standard observational tool, the ability of patients to demonstrate and maintain proper inhaled medication administration techniques following pharmacist education. DesignSix-month observational study. SettingPatients' homes or adult day health center. ParticipantsPatients in a Program for All-inclusive Care for the Elderly (PACE) prescribed one or more inhaled medications used at least once daily. InterventionInstruction by on-site clinical pharmacist. MeasurementsHickey's Pharmacies Inhaler Technique assessment (score range: 0–20, higher better). ResultsForty-two patients were evaluated at baseline, taught proper techniques for using inhaled medications, assessed immediately following the education, and re-assessed 4–6 weeks later. The mean pre-assessment score was 14 (SD 4.5, range 0–20), the initial post-assessment score increased to 18 (SD 3, range 10–20). The second post-assessment (4–6 weeks later) score mean was 17.7 (SD 3, range 10–20). Both follow-up scores were significantly improved from baseline (p < 0.05). Multivariable analysis indicated the strongest predictors of second post-training score were: score after initial pharmacist training and being subscribed to auto-refill. These characteristics predicted ∼70% of the variance in the second score (p < 0.001). ConclusionsThese results indicate that education by a pharmacist combined with an auto-refill program can improve and sustain appropriate inhaler use by community-dwelling elders in a PACE program. The improved score was maintained 4–6 weeks later indicating a sustained benefit of medication administration education. Optimal inhaler use ensures optimal dosing and supports appropriate inhaler treatment in lieu of oral agents.

Interactive Web-based Learning Modules Prior to General Medicine Advanced Pharmacy Practice Experiences

To implement and evaluate interactive web-based learning modules prior to advanced pharmacy practice experiences (APPEs) on inpatient general medicine. Three clinical web-based learning modules were developed for use prior to APPEs in 4 health care systems. The aim of the interactive modules was to strengthen baseline clinical knowledge before the APPE to enable the application of learned material through the delivery of patient care. For the primary endpoint, postassessment scores increased overall and for each individual module compared to preassessment scores. Postassessment scores were similar among the health care systems. The survey demonstrated positive student perceptions of this learning experience. Prior to inpatient general medicine APPEs, web-based learning enabled the standardization and assessment of baseline student knowledge across 4 health care systems.

Effect of California Tri-Pull Taping Method on Shoulder Subluxation, Pain, Active Range of Motion and Upper Limb Functional Recovery After Stroke – A Pretest Post Test Design

Objective: The primary objective of the study was to evaluate the effect of California tri-pull taping (CTPT) method on post stroke shoulder subluxation, pain, active range of motion and upper limb functional recovery. Design: Pretest post test design. Setting: Study was conducted ininpatient and outpatient department of MM hospital Mullana- Ambala. Participants: 10 subjects with post stroke shoulder subluxation were included into the study. (7 male , 3 female). Intervention: For taping, two types of tape was used, cotton pre-tape and rigid post-tape. Tape was applied to subjects for thrice a week, for six weeks and conventional neuro rehabilitation programmewas also given to the subjects, five days a week for six weeks. Main outcome measures: Pre, and post assessment scores were taken from each subject by using, Digital Vernier caliper, visual analogue scale (VAS), Goniometer, and Fuglmeyer scale (FUG). Results: The CTPT method produced significant reduction on inferior subluxation from pre intervention to post intervention, pain. There was also significant improvement of AROM, and FUG. Conclusion: This intervention is a promising adjunct to the management of the hemiplegic subluxed shoulder. The main limitation of the study was, small sample size and no control group was used.

Using Evidence to Inform Risk or Harm Decisions

OPEN ACCESSDecember 19, 2014Using Evidence to Inform Risk or Harm Decisions Laurel Murrow, MD, MSc, Gerald Crites, MD, MEd, Donald Goggans, MD, Julie Gaines, MLIS, Jennifer Stowe, MS, W. Scott Richardson, MD Laurel Murrow, MD, MSc GRU/UGA Medical Partnership Google Scholar More articles by this author , Gerald Crites, MD, MEd Medical College of Georgia at Georgia Regents University Google Scholar More articles by this author , Donald Goggans, MD Medical College of Georgia at Georgia Regents University Google Scholar More articles by this author , Julie Gaines, MLIS Medical College of Georgia at Georgia Regents University Google Scholar More articles by this author , Jennifer Stowe, MS Medical College of Georgia at Georgia Regents University Google Scholar More articles by this author , W. Scott Richardson, MD Medical College of Georgia at Georgia Regents University Google Scholar More articles by this author https://doi.org/10.15766/mep_2374-8265.9990 SectionsAbout ToolsDownload Citations ShareFacebookTwitterEmail Abstract Introduction: Numerous studies have demonstrated that many physicians lack fundamental skills in interpreting and using clinical care evidence. We hypothesized that building a foundation for evidence-based medicine (EBM) prior to the clinical years would provide an initial scaffold that could be integrated during clinical training. Many schools have interpreted LCME standard ED-17 as synonymous with instruction in EBM. Methods: This was one of nine modules in EBM skills for first-year and second-year medical students, who were novices in EBM knowledge. The two-part module began with a 2-hour, in-class didactic covering the fundamental features of risk and harm studies, including internal study validity, and study results. Between 1 and 14 days later, students then participated in a 2-hour interactive large-group EBM exercise during which they applied their knowledge and practiced forming judgments for overall study validity. The large-group exercise is based on principles of team-based learning (TBL), but does not follow them exactly. Results: We performed a pre-post assessment of alternative items (10 pre, 12 post) covering the same objectives. The preassessment scores were 175 correct and 215 incorrect (difficulty 44.87%). Postassessment scores were 421 correct and 47 incorrect (difficulty 89.96%). Discussion: The mode of instruction is highly adaptable. In previous years, the module followed strict TBL pedagogy for the application exercise, and this EBM exercise can easily be converted back to a traditional TBL by having teams simultaneously report answers using whiteboards or flipcharts and then debating their choices. In addition, the initial didactic session can be prerecorded for students to review before class. Educational Objectives By the end of the didactic session, learners will be able to: List examples of why we need evidence for risk or harm.Define the following terms: cause/causality, etiology, diagnosis, confounding variables, contributing factors, association, risk, harm, risk factor, prognostic factor, and protective factor.Given an example of a factor, differentiate between a risk factor and a protective factor.Describe and compare the characteristics, design features, and strengths of the two study designs for risk or harm studies (i.e., cohort and case-control). By the end of the interactive large-group EBM exercise, learners will be able to: Correctly identify whether confounders are present in a given clinical study for risk/harm.Correctly identify if a given clinical study for risk/harm possesses any risk for surveillance or recall bias effects.Identify whether a given cohort study had inappropriate length of follow-up or incomplete follow-up (using the 5/20 rule for the latter).Demonstrate how to use three of the four rules of causation (biological sense excluded from demonstration) for a given clinical study for risk/harm.Judge whether a study's overall (i.e., internal) validity is enough to recommend using it in risk decisions.Correctly interpret a table or figure of results for statistical significance (p values, confidence intervals), odds ratios, and relative risks. Sign up for the latest publications from MedEdPORTAL Add your email below FILES INCLUDEDReferencesRelatedDetails FILES INCLUDED Included in this publication: Instructor's Guide.pdf Facilitator's Copy.pdf Template-Risk Module.pdf Using Evidence for Risk or Harm Decisions.pptx Completed Application Exercise Worksheet.pdf Practice Problems for Results.pdf To view all publication components, extract (i.e., unzip) them from the downloaded .zip file. Download editor’s noteThis publication may contain technology or a display format that is no longer in use. CitationMurrow L, Crites G, Goggans D, Gaines J, Stowe J, Richardson WS. Using Evidence to Inform Risk or Harm Decisions. MedEdPORTAL. 2014;10:9990. https://doi.org/10.15766/mep_2374-8265.9990 Related Using Evidence to Inform Risk or Harm Decisions Using Evidence to Inform Prognosis Decisions Using Randomized Controlled Trials for Treatment Decisions Copyright & Permissions© 2014 Murrow et al. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-No Derivatives license.KeywordsHarmCohortStudy ValidityEBMCase-Control StudiesTeam-Based LearningCase-ControlRiskEvidence-Based MedicineTBL Disclosures None to report. Funding/Support None to report. Loading ...

Capacity building for evidence-based decision making in local health departments: scaling up an effective training approach.

BackgroundThere are few studies describing how to scale up effective capacity-building approaches for public health practitioners. This study tested local-level evidence-based decision making (EBDM) capacity-building efforts in four U.S. states (Michigan, North Carolina, Ohio, and Washington) with a quasi-experimental design.MethodsPartners within the four states delivered a previously established Evidence-Based Public Health (EBPH) training curriculum to local health department (LHD) staff. They worked with the research team to modify the curriculum with local data and examples while remaining attentive to course fidelity. Pre- and post-assessments of course participants (n = 82) and an external control group (n = 214) measured importance, availability (i.e., how available a skill is when needed, either within the skillset of the respondent or among others in the agency), and gaps in ten EBDM competencies. Simple and multiple linear regression models assessed the differences between pre- and post-assessment scores. Course participants also assessed the impact of the course on their work.ResultsCourse participants reported greater increases in the availability, and decreases in the gaps, in EBDM competencies at post-test, relative to the control group. In adjusted models, significant differences (p < 0.05) were found in ‘action planning,’ ‘evaluation design,’ ‘communicating research to policymakers,’ ‘quantifying issues (using descriptive epidemiology),’ and ‘economic evaluation.’ Nearly 45% of participants indicated that EBDM increased within their agency since the training. Course benefits included becoming better leaders and making scientifically informed decisions.ConclusionsThis study demonstrates the potential for improving EBDM capacity among LHD practitioners using a train-the-trainer approach involving diverse partners. This approach allowed for local tailoring of strategies and extended the reach of the EBPH course.

Use of web-based learning modules for a general medicine advanced pharmacy practice experience

ObjectiveTo implement and assess web-based learning modules on baseline pharmacy student knowledge prior to a general medicine advanced pharmacy practice experience (APPE). MethodsThree web-based learning modules were developed for use prior to a general medicine APPE. Students completed pre- and post-assessments specific to each learning module. Additionally, students completed perception surveys at the conclusion of the APPE to determine the utility of these modules and the impact on student learning experiences. ResultsUse of the web-based training (WBT) modules resulted in a statistically significant improvement in post-assessment scores for two of the three modules (p < 0.001). Student participants found the modules easy to use and helpful in APPE preparation. ConclusionsUtilization of a WBT module prior to a general medicine APPE improves baseline knowledge among pharmacy students.

Fall 2020 Fully Online Semester and Maintaining Wellness in College Student Physical Education

With instructional formats changing due to COVID, it is essential to examine the effect of a physical activity (PA) and wellness course on college student wellness and motivation when courses had to be delivered fully online. This research examines the effect of an online PA and wellness course on wellness and motivation during the COVID-19 pandemic. Pre- and post-test surveys were utilized to measure changes in wellness and motivation among college students enrolled in a PA and wellness course. There were significant increases between the pre- and post-assessment scores for all dimensions of wellness and motivation.Including whole-person wellness and motivation content in college-level IPAP curriculum may enhance students’ overall well-ness and motivation for wellness-promoting behaviors even during an atypical semester.

Effectiveness of URTI Preventive Education Programme on Recovery of children and Practice of caregivers

A quasi-experimental study was conducted to assess the predisposing factors of URTI, effectiveness of teaching programme on the recovery of children and on the practice of their caregivers. This study was conducted in a child nursing home at district Haridwar, Uttarakhand. Total 51 children and their caregivers who met the selection criteria were selected by convenient sampling technique. Pretest was taken by using structured questionnaire, practice checklist and rating scale followed by URTI preventive education programme. After five days post test was taken. The mean post test practice score (9.8±1.27) was higher than the mean pretest practice score (5.8±1.43) and 't' value was 15.3. The mean post test assessment score (22.01±1.03) was higher than the mean pretest assessment score (16.03± 1.43) and 't' value was 24.9. The difference between pretest practice score and posttest practice score was 4 and between pretest assessment score and posttest assessment score was 5.98. It means practice and assessment score improved after implementation of education programme. The finding of the study reveals that the education had a vital role in improving the practice of caregivers and recovery of the children.

An Active-Learning Laboratory on Immunizations

To implement and evaluate an active-learning laboratory activity to teach pharmacy students about influenza, pneumococcal, and shingles vaccines. The laboratory session was divided into 6 immunization stations: 3 stations on influenza including a pediatrics station, and 1 station each for pneumococcal, shingles, and anaphylaxis. Although 118 of 123 (95.9%) students had completed an immunization training certificate prior to attending the laboratory, the average score on a pre-assessment to measure immunization knowledge and confidence was 56%. The post-assessment score was 87.4%. Students' confidence improved by 18.7% to 51.2% in each of the 5 areas assessed. Most respondents rated the activity overall as good or excellent on a post-activity evaluation. An active-learning approach to teaching immunizations allowed students to gain knowledge in simulated real-world experiences and reinforced key concepts on influenza, pneumococcal, and shingles vaccines.