Douglas Archibald

Validation of the interprofessional collaborative competency attainment survey (ICCAS)

Abstract The purpose of this study was to obtain evidence regarding the validity and reliability of an instrument to measure the self-reported competencies of interprofessional care in interprofessional education programs. Five hundred and eighty-four students and clinicians in Canada and New Zealand who were registered in 15 interprofessional education undergraduate, postgraduate, and continuing professional development programs completed the Interprofessional Collaborative Competency Attainment Survey (ICCAS) using a retrospective pre-test/post-test design. Factor analyses showed the presence of two factors in the pre-program items and one factor in the post-program items. Tests conducted provided evidence in support of the validity and reliability of the ICCAS as a self-assessment instrument for interprofessional collaborative practice. Internal consistency was high for items loading on factor 1 (α = 0.96) and factor 2 (α = 0.94) in the pre-program assessment and for the items in the post-program assessment (α = 0.98). The transition from a two factor solution to a single factor structure suggests interventions influence learners’ understanding of interprofessional care by promoting the recognition of the high degree of interrelation among interprofessional care competencies. Scores on the ICCAS are reliable and predict meaningful outcomes with regard to attitudes toward interprofessional competency attainment.

Building positive relationships in healthcare: Evaluation of the teams of interprofessional staff interprofessional education program

The Teams of Interprofessional Staff (TIPS) project consisted of five healthcare teams from across Ontario, participating in three, two-day face-to-face interprofessional educational (IPE) sessions over an 8-month period. The purpose of TIPS was to explore whether interprofessional team development for practicing healthcare professionals, makes a difference in team functioning, team member satisfaction, ability to work effectively both individually and as a team, and improved patient well-being. A comprehensive formative and summative evaluation revealed that all teams perceived they benefitted from and engaged in successful team development. Success meant different things to each team reflecting the continuum of team development from building a safe, trusted group to becoming leaders of team development for other interprofessional teams. Effective teamwork is crucial to nurses who often take on the role of coordinator of care on a day-to-day basis, or are in managerial roles in interprofessional clinics or clinical program teams.

Residents' and preceptors' perceptions of the use of the iPad for clinical teaching in a family medicine residency program.

BackgroundAs Family Medicine programs across Canada are transitioning into a competency-based curriculum, medical students and clinical teachers are increasingly incorporating tablet computers in their work and educational activities. The purpose of this pilot study was to identify how preceptors and residents use tablet computers to implement and adopt a new family medicine curriculum and to evaluate how they access applications (apps) through their tablet in an effort to support and enhance effective teaching and learning.MethodsResidents and preceptors (n = 25) from the Family Medicine program working at the Pembroke Regional Hospital in Ontario, Canada, were given iPads and training on how to use the device in clinical teaching and learning activities and how to access the online curriculum. Data regarding the use and perceived contribution of the iPads were collected through surveys and focus groups. This mixed methods research used analysis of survey responses to support the selection of questions for focus groups.ResultsReported results were categorized into: curriculum and assessment; ease of use; portability; apps and resources; and perceptions about the use of the iPad in teaching/learning setting. Most participants agreed on the importance of accessing curriculum resources through the iPad but recognized that these required enhancements to facilitate use. The iPad was considered to be more useful for activities involving output of information than for input. Participants’ responses regarding the ease of use of mobile technology were heterogeneous due to the diversity of computer proficiency across users. Residents had a slightly more favorable opinion regarding the iPad’s contribution to teaching/learning compared to preceptors.ConclusionsiPad’s interface should be fully enhanced to allow easy access to online curriculum and its built-in resources. The differences in computer proficiency level among users should be reduced by sharing knowledge through workshops led by more skillful iPad users. To facilitate collection of information through the iPad, the design of electronic data-input forms should consider the participants’ reported negative perceptions towards typing data through mobile devices. Technology deployment projects should gather sufficient evidence from pilot studies in order to guide efforts to adapt resources and infrastructure to relevant needs of Family Medicine teachers and learners.

Mobile technologies in medical education: AMEE Guide No. 105.

Abstract Mobile technologies (including handheld and wearable devices) have the potential to enhance learning activities from basic medical undergraduate education through residency and beyond. In order to use these technologies successfully, medical educators need to be aware of the underpinning socio-theoretical concepts that influence their usage, the pre-clinical and clinical educational environment in which the educational activities occur, and the practical possibilities and limitations of their usage. This Guide builds upon the previous AMEE Guide to e-Learning in medical education by providing medical teachers with conceptual frameworks and practical examples of using mobile technologies in medical education. The goal is to help medical teachers to use these concepts and technologies at all levels of medical education to improve the education of medical and healthcare personnel, and ultimately contribute to improved patient healthcare. This Guide begins by reviewing some of the technological changes that have occurred in recent years, and then examines the theoretical basis (both social and educational) for understanding mobile technology usage. From there, the Guide progresses through a hierarchy of institutional, teacher and learner needs, identifying issues, problems and solutions for the effective use of mobile technology in medical education. This Guide ends with a brief look to the future.

What Do Primary Care Practitioners Want to Know? A Content Analysis of Questions Asked at the Point of Care

Introduction: Assessing physician needs to develop continuing medical education (CME) activities is an integral part of CME curriculum development. The purpose of the present study was to demonstrate the feasibility of identifying areas of perceived greatest needs for continuing medical education (CME) by using questions collected electronically at the point of care. Methods: This study is a secondary analysis of the “Just‐in‐Time” (JIT) information librarian consultation service database of questions using quantitative content analysis methods. The original JIT project demonstrated the feasibility of a real‐time librarian service for answering questions asked by primary care clinicians at the point of care using a Web‐based platform or handheld device. Data were collected from 88 primary care practitioners in Ontario, Canada, from October 2005 to April 2006. Questions were answered in less than 15 minutes, enabling clinicians to use the answer during patient encounters. Results: Description of type and frequency of questions asked, including the organ system on which the questions focused, was produced using 2 classification systems, the “taxonomy of generic clinical questions” (TGCQ), and the International Classification for Primary Care version 2 (ICPC‐2). Of the original 1889 questions, 1871 (99.0%) were suitable for analysis. A total of 970 (52%) of questions related to therapy; of these, 671 (69.2%) addressed questions about drug therapy, representing 36% of all questions. Questions related to diagnosis (24.8%) and epidemiology (13.5%) were also common. Organ systems questions concerning musculoskeletal, endocrine, skin, cardiac, and digestive systems were asked more than other categories. Discussion: Questions collected at the point of care provide a valuable and unique source of information on the true learning needs of practicing clinicians. The TGCQ classification allowed us to show that a majority of questions had to do with treatment, particularly drug treatment, whereas the use of the ICPC‐2 classification illustrated the great variety of questions asked about the diverse conditions encountered in primary care. It is feasible to use electronically collected questions asked by primary care clinicians in clinical practice to categorize self‐identified knowledge and practice needs. This could be used to inform the development of future learning activities.

A scoping review of medical education research in family medicine

BackgroundLittle is known about the state of education research within family medicine. As family medicine education models develop, it is important to develop an understanding of the current state of this research and develop ways to advance the field.MethodsWe conducted a scoping review of family medicine education research to describe 1) research topic areas and 2) the methodologies and methods used to study these topics. MEDLINE, Social Sciences Abstracts and ERIC electronic databases were searched. 817 full text articles from 2002 to 2012 were screened; 624 articles were included in the review.ResultsThe following research topic areas were identified: continuing education, curriculum development, undergraduate education, teaching methods, assessment techniques, selection of entrants, non-clinical skills, professional and faculty development, clinical decision-making and resident well-being. Quantitative studies comprised the large majority of research approaches; overall minimal methodological details were provided.ConclusionsOur review highlights an overall need for increased sophisticated in methodological approaches to education research in family medicine, a problem that could be ameliorated by multiple strategies including better engagement of methodologists throughout the research process. The results provide guidance for future family medicine education research programs.

A development framework for mobile healthcare monitoring apps

Developing healthcare monitoring apps is non-trivial as it requires a balance between simple, easy-to-use interfaces, and powerful business intelligence reporting capabilities, both of which must be integrated into the day-to-day tasks and procedures of clinical practice. This paper presents a development framework for building and deploying mobile healthcare monitoring apps. The framework combines an application development methodology (that ensures adoption and effectiveness of apps when deployed) with an application architecture and component library (to simplify and reduce the development effort needed to implement, deploy and maintain such apps). The development framework is evaluated using a case study of a mobile healthcare monitoring app developed and deployed in collaboration with a team of healthcare researchers and doctors to support the training of residents in family medicine.

Introducing global health into the undergraduate medical school curriculum using an e-learning program: a mixed method pilot study

BackgroundPhysicians need global health competencies to provide effective care to culturally and linguistically diverse patients. Medical schools are seeking innovative approaches to support global health learning. This pilot study evaluated e-learning versus peer-reviewed articles to improve conceptual knowledge of global health.MethodsA mixed methods study using a randomized-controlled trial (RCT) and qualitative inquiry consisting of four post-intervention focus groups. Outcomes included pre/post knowledge quiz and self-assessment measures based on validated tools from a Global Health CanMEDS Competency Model. RCT results were analyzed using SPSS-21 and focus group transcripts coded using NVivo-9 and recoded using thematic analysis.ResultsOne hundred and sixty-one pre-clerkship medical students from three Canadian medical schools participated in 2012–2013: 59 completed all elements of the RCT, 24 participated in the focus groups. Overall, comparing pre to post results, both groups showed a significant increase in the mean knowledge (quiz) scores and for 5/7 self-assessed competencies (p < 0.05). These quantitative data were triangulated with the focus groups findings that revealed knowledge acquisition with both approaches. There was no statistically significant difference between the two approaches. Participants highlighted their preference for e-learning to introduce new global health knowledge and as a repository of resources. They also mentioned personal interest in global health, online convenience and integration into the curriculum as incentives to complete the e-learning. Beta version e-learning barriers included content overload and technical difficulties.ConclusionsBoth the e-learning and the peer reviewed PDF articles improved global health conceptual knowledge. Many students however, preferred e-learning given its interactive, multi-media approach, access to links and reference materials and its capacity to engage and re-engage over long periods of time.

Designing Digital Video to Support Learner Outcomes: A Study in an Online Learning Resource for Healthcare Professionals and Students

This pragmatic, mixed methods study explored how the design and implementation of digital video resources in an online educational environment affected learning outcomes. Forty-five health professionals and students evaluated the digital videos incorporated into ePhysicianHealth.com, the world’s first comprehensive online resource on health and wellness for physicians and medical students. Specifically the participants were to evaluate how digital videos impacted their learning experiences. Quantitative and qualitative data were collected from two sources: surveys and interviews. The findings of the study clearly indicated that the majority of the participants found the digital videos a valuable addition to ePhysicianHealth.com. There were numerous practical conclusions from this study that provided recommendations for the future design and delivery of digital videos in pedagogical settings. They included: the use of personal testimonials and stories; the use of problem-solving scenarios involving modeling and demonstrations; and tailoring modeling scenarios to the specific needs of learners.

A training program designed to improve interprofessional knowledge, skills and attitudes in chronic disease settings

Abstract For over 25 years, The Arthritis Program (TAP) at Southlake Regional Health Centre has worked within a successful interprofessional model. TAP recognized the need to teach its model and developed The Arthritis Program – Interprofessional Training Program (TAP-ITP). This pilot study evaluated perceptions of 22 TAP-ITP participants related to effectiveness and satisfaction. The study employed a longitudinal survey design and data were collected at the baseline (T1), post-program (T2), and at one year (T3) by use of the following instruments: W(e)Learn Program Assessment; Interprofessional (IP) Learner and Team Contracts; Interprofessional Collaborative Competencies Attainment Survey (ICCAS); Bruyère Clinical Team Self Assessment Scale; and Attitudes Toward Health Care Teams (ATHCT). Data analysis included descriptive, non-parametric and parametric tests. Results indicated participants were very satisfied with TAP-ITP. ICCAS scores revealed statistically significant differences (Wilcoxon rank sum tests) from T1 to T2 in perceptions of IPC competencies (p < 0.05). Paired t-tests for each T1 to post (T2 and T3) scores were all significant (p < 0.05) for each Bruyère subscale and overall scores. For ATHCT, paired t-tests for each T1 to T2 were significant for Quality of Care/Process (p = 0.04) and borderline significant for Physician Centrality scale (p = 0.06). At T3, improvement in both scales was maintained. This pilot study suggests that TAP-ITP improves self-assessed scores of knowledge and skills, as well as attitudes in interprofessional care post-program and sustained at one year.