Professional Documents
Culture Documents
In the context of continuing health professional education What evidence is there to support educational techniques, timing (single vs. repetitive), setting, and media used to deliver instruction? What evidence exists about the outcomes (knowledge, skills, attitudes, provider behaviors, patient outcomes) of continued health professional education?
Julia Bluestone, MS Peter Johnson, PhD Judith Fullerton, PhD Catherine Carr, DrPH Jessica Alderman, MPH James BonTempo, MS
Inclusion/Exclusion Process
Titles and Abstract Review
Journal Database
244
133
Grade One
Grade Two
61
First Tier
69
First Tier
37
Systematic Reviews
32
Randomized Control Trials
Timing
Setting
10 20 30 40
10 20
10 20 30
10 20 30 40
5
Techniques for 10 Points techniques and providing printed materials alone clustered in the range of no-to-low effects, whereas all interactive programs exhibited mostly moderate-tohigh beneficial effects. The most commonly used techniques, thus, generally were found to have the least benefit (Bloom)
Didactic
Techniques for 30 Points Which of the following has the strongest evidence for skill development outcomes? a) Demonstration b) Using a checklist c) Practice and feedback Dose-response, or providing sufficient practice and feedback was identified as important for skill-related outcomes (McGaghie, Moores, ONeil)
9
10
11
12
Timing for 10 points And the winner is. Repetitive RCTs: Better knowledge acquisition, better retention and some evidence of improved practice behaviors (Kerfoot articles) Systematic reviews: better learning outcomes (Marinopoulos, et al)
13
Timing for 20 Points Repetitive, short learning interventions have been shown to increase retention by how much? a) 2-fold b) 4-fold c) 8-fold
14
15
Setting for 10 Points In one randomized clinical controlled trial focused on emergency obstetrical skills, a classroom setting, simulation center and workplace all resulted in similar knowledge outcomes, true or false?
TRUE
16
Simulation Center
Workplace Learning
18
19
Setting 30 Points
Educational psychology literature reinforces that situated learning Faculty for 10 Pts results in easier transfer into practice, true or false? TRUE
20
21
23
24
25
Research Agenda
Evaluate promising practices in LMICs Test with lower-level cadres Ethiopia: Post-BeMONC SMS MCHIP MNH Champions
28
29
Recommendations: Techniques
Select techniques that help the learner process and integrate information More case-based, problem-based and simulation, less didactic instruction Prioritize simulation for emergency skills Increased feedback and interaction = positive learning outcomes Avoid passive techniques, choose case-based approaches & simulations
Recommendations: Timing
Leverage technology to provide short, repeated exposures Aggressively explore the use of spacing and testing Shorter, repeated workplace based trainings for skills practice
Recommendations: Setting
Select setting based on if it will support effective techniques, and
Reduce absenteeism Address workplace quality assurance Reduce costs and increase productivity
Increase use of mentored, facility-based approach for skills-practice and feedback portion of training
Recommendations: Media
Select media based on if it will support effective techniques, and more effective learning Use appropriate technology to deliver instruction efficiently