Posts Tagged ‘based’
Project GreenVax Announced By Texas-Based Consortium
Leaders of the Texas Plant-Expressed Vaccine Consortium have announced a biotherapeutic manufacturing initiative designed to show proof of concept for a landmark new technology that could dramatically increase the nation’s capability to produce vaccines for infectious diseases, including influenza…
Training of patient and consumer representatives in the basic competencies of evidence-based medicine: a feasibility study
Background:Evidence based medicine (EBM) has become standard approach in medicine. Patients and health authorities increasingly claim active patient roles in decision making. Education to cope with these roles might be useful. We investigated the feasibility, acceptability and possible impact of EBM training courses for patient and consumer representatives.Methods:We designed a generic one week EBM course based on previous experience with EBM courses for non medical health professionals. A course specific competence test has been developed and validated to measure EBM skills. Formative and summative evaluation of the course comprised: 1) EBM skills; 2) individual learning goals; 3) self reported implementation after six months using semi-structured interviews; 4) group based feedback by content analysis. EBM skills’ achievement was compared to results gathered by a group of undergraduate University students of Health Sciences and Education who had attended a comparable EBM seminar.Results:Fourteen EBM courses were conducted including 161 participants without previous EBM training (n=54 self-help group representatives, n=64 professional counsellors, n=36 patient advocates, n=7 others); 71% had a higher education degree; all but five finished the course. Most participants stated personal learning goals explicitly related to practicing EBM such as acquisition of critical appraisal skills (n=130) or research competencies (n=67). They rated the respective relevance of the course on average with 80% (SD 4) on a visual analogue scale ranging from 0 to 100%.Participants passed the competence test with a mean score of 14.7 (SD 3.0, n=123) out of 19.5 points. The comparison group of students achieved a mean score of 14.4 (SD 3.3, n=43). Group based feedback revealed increases of self confidence, empowerment through EBM methodology and statistical literacy, and acquisition of new concepts of patient information and counselling. Implementation of EBM skills was reported by 84 of the 129 (65%) participants available for follow-up interviews. Barriers included lack of further support, limited possibilities to exchange experiences, and feeling discouraged by negative reactions of health professionals.Conclusions:Training in basic EBM competencies for selected patient and consumer representatives is feasible and accepted and may affect counselling and advocacy activities. Implementation of EBM skills needs support beyond the training course.
Internet-based medical education: a realist review of what works, for whom and in what circumstances
Background:Educational courses for doctors and medical students are increasingly offered via the Internet. Despite much research, course developers remain unsure about what (if anything) to offer online and how. Prospective learners lack evidence-based guidance on how to choose between the options on offer. We aimed to produce theory driven criteria to guide the development and evaluation of Internet-based medical courses.Methods:Realist review – a qualitative systematic review method whose goal is to identify and explain the interaction between context, mechanism and outcome. We searched 15 electronic databases and references of included articles, seeking to identify theoretical models of how the Internet might support learning from empirical studies which (a) used the Internet to support learning, (b) involved doctors or medical students; and (c) reported a formal evaluation. All study designs and outcomes were considered. Using immersion and interpretation, we tested theories by considering how well they explained the different outcomes achieved in different educational contexts.Results:249 papers met our inclusion criteria. We identified two main theories of the course-in-context that explained variation in learners’ satisfaction and outcomes: Davis’s Technology Acceptance Model and Laurillard’s model of interactive dialogue. Learners were more likely to accept a course if it offered a perceived advantage over available non-Internet alternatives, was easy to use technically, and compatible with their values and norms. ‘Interactivity’ led to effective learning only if learners were able to enter into a dialogue – with a tutor, fellow students or virtual tutorials – and gain formative feedback.Conclusions:Different modes of course delivery suit different learners in different contexts. When designing or choosing an Internet-based course, attention must be given to the fit between its technical attributes and learners’ needs and priorities; and to ways of providing meaningful interaction. We offer a preliminary set of questions to aid course developers and learners consider these issues.
A comparative evaluation of the effect of internet-based CME delivery format on satisfaction, knowledge and confidence
Background:Internet-based instruction in continuing medical education (CME) has been associated with favorable outcomes. However, more direct comparative studies of different Internet-based interventions, instructional methods, presentation formats, and approaches to implementation are needed. The purpose of this study was to conduct a comparative evaluation of two Internet-based CME delivery formats and the effect on satisfaction, knowledge and confidence outcomes.Methods:Evaluative outcomes of two differing formats of an Internet-based CME course with identical subject matter were compared. A Scheduled Group Learning format involved case-based asynchronous discussions with peers and a facilitator over a scheduled 3-week delivery period. An eCME On Demand format did not include facilitated discussion and was not based on a schedule; participants could start and finish at any time. A retrospective, pre-post evaluation study design comparing identical satisfaction, knowledge and confidence outcome measures was conducted.Results:Participants in the Scheduled Group Learning format reported significantly higher mean satisfaction ratings in some areas, performed significantly higher on a post-knowledge assessment and reported significantly higher post-confidence scores than participants in the eCME On Demand format that was not scheduled and did not include facilitated discussion activity.Conclusions:The findings support the instructional benefits of a scheduled delivery format and facilitated asynchronous discussion in Internet-based CME.
Medicare, Consumers Face Challenges When Trying To Make Choices Based On Value
News outlets report on concerns about Medicare costs and the difficulties consumers face when trying to find value in their health services. Jacksonville Business Journal reports on concerns about proposals to base Medicare pay on rewarding quality and notes that variation in hospital performance often occurs because of the amount of charity cases, Medicaid and uninsured patients…
Job requirements compared to medical school education: differences between graduates from problem-based learning and conventional curricula
Background:Problem-based Learning (PBL) has been suggested as a key educational method of knowledge acquisition to improve medical education. We sought to evaluate the differences in medical school education between graduates from PBL-based and conventional curricula and to what extent these curricula fit job requirements.Methods:Graduates from all German medical schools who graduated between 1996 and 2002 were eligible for this study. Graduates self-assessed nine competencies as required at their day-to-day work and as taught in medical school on a 6-point Likert scale. Results were compared between graduates from a PBL-based curriculum (University Witten/Herdecke) and conventional curricula.Results:Three schools were excluded because of low response rates. Baseline demographics between graduates of the PBL-based curriculum (n=101, 49% female) and the conventional curricula (n=4720, 49% female) were similar. No major differences were observed regarding job requirements with priorities for “Independent learning/working” and “Practical medical skills”. All competencies were rated to be better taught in PBL-based curriculum compared to the conventional curricula (all p<0.001), except for "Medical knowledge" and "Research competence". Comparing competencies required at work and taught in medical school, PBL was associated with benefits in "Interdisciplinary thinking" (Delta +0.88), "Independent learning/working" (Delta +0.57), "Psycho-social competence" (Delta +0.56), "Teamwork" (Delta +0.39) and "Problem-solving skills" (Delta +0.36), whereas "Research competence" (Delta -1.23) and "Business competence" (Delta -1.44) in the PBL-based curriculum needed improvement.Conclusion:Among medical graduates in Germany, PBL demonstrated benefits with regard to competencies which were highly required in the job of physicians. Research and business competence deserve closer attention in future curricular development.
Validity of cost-effectiveness models based on randomized clinical trials
Cost-effectiveness studies are widely used to guide prescribing policy in many countries, as part of health technology assessment programs. However, a new study suggests that cost-effectiveness analyses based on data from randomized controlled trials may not be realistic enough to accurately inform policy.
More Insurance-Based Discrimination During Pregnancy, Delivery Reported By Lower Income Women
According to an analysis of statewide data taken from 1998-2001, women in Oregon who made less than $50,000 a year were more than three times likely to report they were discriminated against by health providers because of their insurance status during pregnancy and delivery…
School-based H1N1 Influenza Clinics To Begin For K-3 Students, Alabama
The Alabama Department of Public Health will begin offering nasal mist flu vaccine to kindergarten through third grade students in Alabama schools at voluntary H1N1 influenza vaccination clinics. A few clinics will begin the week of Nov. 23, but the majority will be held beginning the week of Nov. 30-Dec. 5. “Vaccination is the best way to protect your children from this potentially serious disease,” said State Health Officer Dr. Donald Williamson.
Implementation fidelity of packaged teen smoking cessation treatments delivered in community-based settings
Efficacious ‘packaged’ teen smoking cessation treatment programs, those developed by national organizations, are widely disseminated to local communities to help teens quit smoking. The implementation fidelity of these programs in community settings has not been documented. The efficacy of these programs could be lessened if they are not implemented as intended. Data from Helping Young Smokers Quit describe the frequency and types of modifications made to packaged teen cessation treatment programs for community delivery. A national sample of 591 community-based teen tobacco cessation treatment programs was profiled and 59% used a single packaged treatment program. Bivariate analyses found that 63% of program administrators reported implementing their program as planned; 37% modified their selected program. The most frequently reported modifications were made to the length and format of the program. Of those who modified their programs, >90% reported multiple program modifications (e.g. length and content). Administrators modified their programs to accommodate implementation barriers, such as time constraints and low participant enrollment, and to address the needs of participants with multiple risk behaviors that are co-morbid with tobacco use.
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