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Best practices in Web-based courses: generational differences across undergraduate and graduate nursing students.

The demand for online courses is greatly increasing across all levels of the curriculum in higher education. With this change in teaching and learning strategies comes the need for quality control to determine best practices in online learning communities. This study examines the differences in student perceptions of the use of technology, educational practices, and outcomes between undergraduate and graduate students enrolled in Web-based courses. The multisite study uses the benchmarking process and the Flashlight Program Evaluating Educational Uses of the Web in Nursing survey instrument to study best practices and examine generational differences between the two groups of students. The outcomes of the study establish benchmarks for quality improvement in online learning. The results support the educational model for online learning and postulates about generational differences for future study.

Adult↗

[The effect of preoperative teaching on the emotional attitude of patients undergoing coronary bypass surgery].

It appears that the emotions of patients in the process of undergoing coronary artery bypass graft surgery have an influence on the rate of mortality. The purpose of this study is to determine if the life-style functioning of the patients can be improved by means of a pre-operative rehabilitative educational programme introduced by the professional nurse. A conceptual framework of reference was compiled after completion of the literature review. This served as the preliminary structure of the pre-operative educational programme. The programme consists of three components, viz. an educational booklet, an educational evaluating model and the educationist. A quasi-experimental study was performed on 4 groups (2 experimental groups and 2 control groups) to determine the effect of the structured pre-operative educational programme on the following three factors: satisfaction with self, others and life; safe-guarding hope and anticipation of a future. An analysis of the data indicated a significant difference between the groups that followed the programme and the groups that did not follow the programme. The primary recommendation of the study is that all patients in the process of undergoing coronary artery bypass graft surgery should follow a pre-operative educational programme. This programme has a positive influence on the life-style functioning of the patient and will thus promote the process of rehabilitation.

Adult↗

When science and politics listen to each other: good prospects from a new school breakfast program in Peru.

This article provides an overview of a school breakfast program implemented in 1993 in the Peruvian Andes. The program, designed by the Instituto de Investigación Nutricional in Lima and supported by the government of Peru, constitutes a clear departure from previous school feeding programs, which were heavily politicized and poorly documented. From the program's inception, nutritionists, managers, and social scientists have collaborated to produce a sound nutritional design, efficient distribution mechanisms, and effective evaluation methods. During the program's first year, controlled evaluations conducted in several Andean regions documented improved dietary intake and a significant decline in the prevalence of anemia. An educational evaluation also found improved verbal skills, higher school attendance, and lower dropout rates among recipients of the school breakfast. The results have prompted the Peruvian government to continue supporting the program, thus setting a new standard for the effective management of social expenditure in the context of economic adjustment.

Anemia↗

Planning, implementation, and evaluation of AIDS education programs for dentists.

Because many dentists were trained before HIV disease was recognized and its implications for dentistry understood, there is a need for effective continuing education programs about the disease for health professionals. Unfortunately, much of the continuing professional education about AIDS in the last few years has been poorly evaluated and the value of continuing education itself has increasingly been called into question. In order to clarify how continuing educational efforts can be designed and evaluated, we report on our continuing educational projects and research which culminated in research on a nationwide educational intervention about AIDS for dentists. We outline and evaluate the steps taken in designing both the intervention and the research. The strengths and weaknesses of the design are discussed and suggestions made about how the design could be improved.

Acquired Immunodeficiency Syndrome↗

Patient education for preventing diabetic foot ulceration. A systematic review.

OBJECTIVE: Ulceration of the feet, which can result in loss of limbs and death, is a major health problem for people with diabetes mellitus. The objective of this review is to assess the effectiveness of patient education to prevent diabetic foot ulcers. RESEARCH DESIGN AND METHODS: We conducted a systematic review of randomized controlled trials (RCTs) that evaluated educational programmes for the prevention of foot ulcers in people with diabetes mellitus. We used standard search methods of the Cochrane "Wounds Groups". Two reviewers working independently extracted data and assessed study quality. RESULTS: The methodologic quality of the 8 included RCTs was poor. The internal validity score (range 0-10) of individual RCTs ranged from 2 to 4. Four trials compared the effect of intensive with brief educational interventions; 2 of these reported clinical endpoints. One study involving high-risk patients reported a reduction in ulcer incidence (OR 0.28, 95% confidence interval [CI] 0.13-0.59) and amputation rate (OR 0.32, 95% CI 0.14-0.71) after 1 year. The other RCT did not find an effect after 7 years of follow-up. Two trials showed that participants' foot care knowledge significantly improved with education. In one trial, foot care knowledge was significantly worse at 6 months, although foot care behavior improved significantly. One RCT, that compared patient foot care education as part of a general diabetes education program to usual care, showed no reduction in the risk of foot ulceration. In one RCT, patient education as part of a complex intervention targeted at both people with diabetes and doctors reduced the prevalence of serious foot lesions at 1 year (OR 0.41, 95% CI 0.16-1.00) and improved foot care behavior. Evidence from two RCTs comparing the effect of patient-tailored education in addition to usual care was conflicting. SUMMARY: Evidence, limited by poor methodologic quality and conflicting results, suggests that patient education may have positive but short-lived effects on foot care knowledge and behavior of patients and may reduce foot ulceration and amputations, especially in high-risk patients. High-quality randomized controlled trials are needed to establish the efficacy of patient education to prevent diabetic foot ulcerations.

Diabetic Foot↗

[Evaluation of medical education at the McMaster University, Canada, based on the case method concept].

Students of three different levels and the chairman of the MD-Program evaluated the educational system of McMaster University, Canada, using the six criteria of the case method as defined by Renschler. This analysis provided a very differentiated evaluation of the McMaster curriculum, demonstrating a systematic progress of learning methods from the second to the last phase. The instrument showed differences in the ratings of the demonstrative lectures between the chairman and the students. Free access to patients and responsibility, gradually growing during the 3-year program, are important features of the educational system. The problem-based system provides a unique integration of acquiring theoretical knowledge in the basic sciences through clinical problem solving which was highly rated in all analysed phases. Ratings given by the interviewed students for evaluation of documented work were lower than expected by the chairman and the authors. The results are discussed in relationship to the McMaster Philosophy and to the conditions of studying medicine in America and in Germany.

Attitude of Health Personnel↗

Community health behavior change through computer network health promotion: preliminary findings from Stanford Health-Net.

Computer-based health education has been employed in many settings. However, data on resultant behavior change are lacking. A randomized, controlled, prospective study was performed to test the efficacy of Stanford Health-Net (Stanford, CA, U.S.A.) in changing community health behaviors. Graduate and undergraduate students (N = 1003) were randomly assigned to treatment and control conditions. The treatment group received access to Health-Net, a health promotion computer network emphasizing specific self-care and preventive strategies. Over a 4-month intervention period, 26% of the treatment group used Health-Net an average of 6.4 times each (range 1-97). The most commonly cited reasons for use were curiosity, general health education, evaluation of current symptoms and anonymity of information. Users rated Health-Net favorably. The most commonly reported reasons for non-use were related to lack of health problems, limited time and lack of access to computer facilities. The mean number of ambulatory medical visits decreased 22.5% more in the treatment group than in the control group (P less than 0.05), while hospitalizations did not differ significantly between groups. In addition, perceived self-efficacy for preventing the acquisition of a sexually transmitted disease (STD) and herpes increased 577% (P less than 0.05) and 261% (P less than 0.01) more, respectively, in the treatment group than in the control group. These findings suggest that access to Stanford Health-Net can result in significant health behavior change. The advantages of the network approach make it a potential model for other communities.

Adult↗

Studies in geriatric education: I Developing educational objectives.

This study reports on the development of a comprehensive set of objectives for the education of undergraduates, graduates, and fellows in geriatric medicine. The objectives were derived from reviews of available educational materials and programs, and their significance was validated through consensus techniques that included over 100 workers with special expertise in geriatrics and gerontology from the United States. Canada, and the United Kingdom. A related and supplementary investigation, which also used consensus methods, uncovered ten general and disease-specific objectives considered to be essential outcomes of the education of geriatric fellows. Academic departments and specialty and subspecialty organizations should find the total set of objectives useful for planning and evaluating educational programs in geriatrics.

Canada↗

Evaluation of an education program for elementary school children with asthma.

To evaluate the effectiveness of a comprehensive asthma management education program for 7- to 12-year-old children with asthma, entitled Roaring Adventures of Puff (RAP), 18 elementary schools in Edmonton were randomized to intervention and control groups. Participating in the program were 76 students with asthma in the intervention schools and 86 in the control schools. Children in the intervention schools had statistically significant improvements in unscheduled doctor visits, missed school days, moderate-to-severe parent rating of severity, severity of shortness of breath, limitations in the kind of play, and correct use of medications. Unscheduled doctor visits and missed school days were the only significant improvements in the control group; however, improvements were about half that of the intervention group. The results showed that a comprehensive, school-based asthma education program is feasible and improves outcomes.

Adolescent↗

Sex education: more is not enough.

Increasing demands for sex education have been associated with a plethora of recommendations, regulations and resources with resulting variability of content, strategy, quality and outcome. While numerous studies confirm that the health behaviour of teenagers is not altered by the teaching of facts alone, other data suggest that appreciation of personal risk and learned assertiveness skills are associated with changes in population behaviours. Peer led teaching is a powerful and probably essential component of school health and sex education. Evaluated interventions with agreed purpose and acceptable methodologies are essential if there is to be any real expectation of health benefit from sex education.

Adolescent↗

Models for evaluating teaching in consultation-liaison psychiatry: I. An overview.

In this paper two useful models are introduced for evaluation of teaching in consultation-liaison psychiatry: decision-oriented and conclusion-oriented research. These models, based on previous studies of educational evaluation, are defined here in terms of their purpose for liaison psychiatry. To clarify the models' usefulness, the methodologic requirements for each model are presented while the unique characteristics of the liaison environment are described in terms of their effect on conclusion-oriented evaluation.

Attitude of Health Personnel↗

Evaluating ethics competence in medical education.

We critically evaluate the ways in which competence in medical ethics has been evaluated. We report the initial stage in the development of a relevant, reliable and valid instrument to evaluate core critical thinking skills in medical ethics. This instrument can be used to evaluate the impact of medical ethics education programmes and to assess whether medical students have achieved a satisfactory level of performance of core skills and knowledge in medical ethics, within and across institutions.

Clinical Competence↗

Evaluation of an educational programme for telephone advisers in primary health care.

Telephone advisers, usually registered nurses, have a very important role in the Swedish primary health care service. In order to improve this service, a special educational programme has been worked out for registered nurses working at a Swedish health centre. The purpose of this paper is to evaluate this educational programme at one of the health centres. The quality of the telephone advice was evaluated by a blind observer. After the educational programme the quality of advice was improved. Among the participating nurses, the confidence and the satisfaction with the work increased after the educational programme.

Attitude of Health Personnel↗

The effect of education on hypothetical and actual oxygen administration decisions.

AIM: This study examined the effect of an education intervention on emergency nurses' decisions related to oxygen administration. METHOD: A controlled pre-test/post-test quasi-experimental design was used. The intervention was a written self directed learning package. Outcome measures were (i) factual knowledge measured using parallel form multiple choice questions (MCQs) and (ii) clinical decisions measured using parallel form MCQs, parallel form patient scenarios and clinical practice observation. RESULTS: Eighty-eight nurses from 4 Melbourne EDs participated in the study (control group: n=37 and experimental group: n=51). Subgroups of nurses from the experimental group also participated in the patient scenarios (n=20) and clinical practice observation (n=10). Emergency nurses' knowledge increased as a function of education. Both patient scenario data and clinical practice observation showed decreased selection of nasal cannulae, increased selection of air entrainment masks and a trend towards selection of higher oxygen flow rates following education. CONCLUSIONS: Evaluation of educational interventions in nursing should focus on identifying strategies that enhance learning in a clinical environment, are valid in terms of the clinical context and culture in which they are being used and most importantly, produce sustained improvements in actual clinical practice.

Attitude of Health Personnel↗

How to use education as an intervention in osteoarthritis.

Definitions of health education and patient education form the starting point for an overview of patient education interventions for people with osteoarthritis (OA). Recipients, tutors and the key messages that education can deliver are considered, followed by a review of the methods used and the typical content of current educational provision for OA. The theoretical and empirical basis for interventions is illustrated using examples from the somewhat limited field. The outcomes used to evaluate education and the evidence for effectiveness is presented. The issues of which patients benefit most, adherence, length of interventions, optimal timing and frequency are raised. The chapter concludes with a brief discussion of the best health care system is needed to underpin educational provision and suggestions for a research agenda that will go some way towards addressing the many questions that remain unanswered.

Delivery of Health Care↗

Emergency department pelvic examination and Pap testing: addressing patient misperceptions.

OBJECTIVES: Failure to obtain cervical cancer screening can be precipitated by limited knowledge. This study describes understanding of Papanicolaou (Pap) smear testing among women undergoing emergency department (ED) pelvic examination and tests the feasibility of educating patients in the ED. METHODS: Patients undergoing pelvic examination in an urban, tertiary care ED were surveyed about Pap smear screening. Among the initial cohort, no education was provided prior to survey administration. Subsequently, a pilot study of scripted information provided by physicians alone or both physicians and counselors was conducted. RESULTS: There were 81 patients in the non-intervention cohort and 32 patients in the intervention cohort. Of the 32 intervention patients, 16 received physician-administered intervention, and 16 received reinforced counseling (physician + counselor). Of 113 total patients, 90 (82%) were African American; mean age was 26 years (SD +/- 7.7 years). Of the 81 non-intervention patients, six (7%; 95% CI = 3% to 15%) said they were told that a Pap test was not done, and 60 (74%; 95% CI = 64% to 82%) mistakenly believed they had a Pap test. Sixty-six (81.5%; 95% CI = 72% to 88%) patients stated they knew the purpose of a Pap test; only 17 (26%; 95% CI = 17% to 37%) of these correctly identified the Pap test as a test for cervical cancer. All 32 intervention patients were surveyed after physician counseling. Compared with the non-intervention group, fewer (56%; 95% CI = 39% to 72%) thought they had a Pap test, and more (31%; 95% CI = 18% to 49%) said they were told they did not receive a Pap test. All 16 reinforced intervention patients correctly denied receiving a Pap test after counselor education. CONCLUSIONS: Knowledge of Pap testing among women undergoing ED pelvic examination is poor; most mistakenly believe they receive a Pap test during ED evaluation. Educating patients may be feasible and effective in the ED setting.

Adult↗