Fran Kirby

A comparative evaluation of the effect of internet-based CME delivery format on satisfaction, knowledge and confidence

BackgroundInternet-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.MethodsEvaluative 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.ResultsParticipants 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.ConclusionsThe findings support the instructional benefits of a scheduled delivery format and facilitated asynchronous discussion in Internet-based CME.

The Nature of the Interaction Between Participants and Facilitators in Online Asynchronous Continuing Medical Education Learning Environments

Background: MDcme.ca offers an online asynchronous continuing medical education (CME) environment for family physicians. The nature of participation in online CME using computer-mediated conferencing (CMC) discussion systems and the characteristics of interaction between participants and facilitators is not well understood. Purpose: To examine the association between participant and facilitator participation in online asynchronous CME learning environments. Methods: We analyzed registration and participation data including participant and facilitator postings to an asynchronous CMC discussion system for CME programs offered through MDcme.ca using frequency counts. Pearson r correlation was used to assess the association between numbers of participants and participant postings, facilitator postings and participant postings, and the number of discussion items accessed and participant postings. Results: MDcme.ca offered 25 programs to 327 registrants, of whom 180 actually participated by accessing course materials and online discussion postings. Pearson r correlations showed a significant association between the number of participants and the number of postings, the number of facilitator postings and the number of participant postings, and the mean number of discussion items accessed by participants and the overall number of participant postings. Discussion: Both the number of facilitator postings and the number of discussion items accessed by participants appeared to be important determinants of the amount of interaction that will occur in asynchronous online CME. Curriculum planners and facilitators of asynchronous CME need to be aware of the importance of fostering interactive, stimulating discussions if the potential of asynchronous learning for physicians is to reach its potential in supporting higher levels of critical, reflective, practice-based learning.

Evaluation Outcomes Resulting from an Internet-Based Continuing Professional Development (CPD) Asthma Program: Its Impact on Participants' Knowledge and Satisfaction

Introduction. Previous studies have focused on the evaluation of Internet-based continuing professional development (CPD), but few have focused on the clinical area of asthma. Our purpose was to examine the evaluation outcomes related to knowledge and satisfaction that resulted from the provision of an Internet-based CPD program focusing on this clinical area. Methods. Evaluation methodologies included a pre-/post-knowledge assessment (multiple choice) and a satisfaction survey. Completion of all assessments was voluntary, with the exception of the post-knowledge assessment for which completion was required for credit claim. Results. There were a total of N = 457 unique registrants in the course over 1 year. A total of N = 125 course participants completed both pre- and post-knowledge assessments. An overall mean pre-knowledge score of 11.54 and a post-knowledge score of 16.04 were reported. Paired samples t-test analyses indicated a significant pre- to post-knowledge gain overall and for the majority of professions; 95.8% of the N = 46 satisfaction survey respondents reported that the program addressed their learning needs; 89.1% reported that it was relevant to practice. Discussion. Recent studies focusing specifically on asthma were non-Canadian pilot studies with small sample sizes. The study findings highlight a similar initiative in Canada, which provided health professionals who care for patients with asthma access to relevant CPD with a Canadian perspective. The findings show that course participants were extremely satisfied and that they increased their knowledge in this clinical area. Further development of such Internet-based programs may encourage health professionals to improve their knowledge in a variety of therapeutic areas.

A Mixed Learning Technology Approach for Continuing Medical Education

abstract Introduction: Distance learning technologies have been used for many years to provide CME to rural physicians. The purpose of this study was to evaluate the utility and acceptability of a mixed learning technology approach for providing distance CME. The approach combined audio teleconferencing instruction with a Web-based learning system enabling the live presentation and archiving of instructional material and media, asynchronous computer conferencing discussions, and access to supplemental online learning resources. Methodology: The study population was comprised of physicians and nurse practitioners who participated in audio teleconference sessions, but did not access the Web-based learning system (nonusers); learners who participated in audio teleconferences and accessed the Web-based system (online users); and faculty. The evaluation focused upon faculty and learners’ experiences and perceptions of the mixed learning technology approach; the level of usage; and the effectiveness of the approach in fostering non-mandatory, computer-mediated discussions. Results and Discussion: The users of the Web-based learning system were satisfied with its features, ease of use, and the ability to access online CME instructional material. Learners who accessed the system reported a higher level of computer skill and comfort than those who did not, and the majority of these users accessed the system at times other than the live audio teleconference sessions. The greatest use of the system appeared to be for self-directed learning. The success of a mixed learning technology approach is dependent on Internet connectivity and computer access; learners and faculty having time to access and use the Web; comfort with computers; and faculty development in the area of Web-based teaching.

The Characteristics of Continuing Professional Education Systems in the Health Professions in Canada

Mandatory continuing education (MCE) has become widely accepted across many professions and jurisdictions in Canada as a re-credentialing mechanism. MCE is defined as continuing professional education (CPE) courses and/or programs, beyond the entry-level educational requirements, required by a licensure board, professional organization, or the workplace in order to maintain competence or retain licensure, certification, and/or employment. The purpose of this paper is to summarize the nature and characteristics of the CPE systems of the major health care professions in Canada. Overall, mandatory systems of CPE are increasing among allied health professional groups in Canada. This introduces significant opportunities for providers of CPE for the health professions. Important trends appear to include an increase in distance education formats, an increase in collaborative arrangements between providers, and an increase in the use of CPE to regulate practice.