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Interactive patient education via an audience response system in cardiac rehabilitation.

ABSTRACT: Objectives:Patient education and compliance play an important role in the success of rehabilitation in cardiovascular diseases. The aim of this study is to analyze whether interactive learning methods, in this study, the audience response system with a "clicker," can improve the learning success of patients during and after their rehabilitation process. Methods:In a randomized, prospective cohort study, a total of 260 patients were randomized to either an interactive training group using Athens audience response system or to a control group without the use of audience response system during the educational sessions. Patients were taught and tested on four different topics concerning their primary disease: heart failure, arterial hypertension, prevention of cardiovascular diseases, and coronary heart disease. After each session, the patients had to answer questions on the previously taught topics via questionnaires. These questions were asked again at the day of discharge, as well as 3 and 12?months after discharge. Additional information on the patients' health, plus their mental status, was gathered with the help of further questionnaires (HADS and SF-12). Results:A total of 260 patients (201 men and 59 women) were recruited. The patients were on average 61.1?±?11?years old. A significant short-term effect on the patients' knowledge about their disease was found immediately after the educational sessions in the intervention group. However, there was no long-term effect in either the intervention or control group. Although there was no statistical significance found in any of the observations, a positive short-term effect on learning capacity as well as positive trends in mental and physical health after discharge could be found in patients after the use of audience response system during their rehabilitation. Conclusion:This study provides interesting and new data on the use of an interactive learning method for patients to gain knowledge about their primary disease and eventually improve their physical and mental health status in a long-term perspective. By implementing different and new ways of teaching and interaction during the hospitalization, not only patients, but also medical staff and caregivers could benefit.

SUBMITTER: Stoevesandt D

PROVIDER: S-EPMC7453440 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Interactive patient education via an audience response system in cardiac rehabilitation.

Stoevesandt Dietrich D Weber Andreas A Wienke Andreas A Bethge Steffi S Heinze Viktoria V Kowoll Simone S Schlitt Axel A

SAGE open medicine 20200825

<h4>Objectives</h4>Patient education and compliance play an important role in the success of rehabilitation in cardiovascular diseases. The aim of this study is to analyze whether interactive learning methods, in this study, the audience response system with a "clicker," can improve the learning success of patients during and after their rehabilitation process.<h4>Methods</h4>In a randomized, prospective cohort study, a total of 260 patients were randomized to either an interactive training grou ...[more]

PMID: 32922784

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Project description:IntroductionAudience response systems (ARS) are increasingly popular; however, their contribution to education is not completely clear. Our study found that scores from review quizzes delivered by an ARS correlate with in-training exam (ITE) scores and are viewed positively by residents. This information may be useful in identifying poor performers early so that targeted educational interventions can be made. The objective was to determine if scores on review quizzes delivered by an ARS correlate with ITE scores and to obtain participant feedback on use of the ARS for ITE preparation.MethodsThis was a prospective observational study of emergency medicine (EM) residents at six accredited EM residency programs. Subjects included residents who had taken previous ITEs. Subjects participated in bimonthly review sessions using an ARS. Twelve review quizzes were administered, each consisting of 10 multiple-choice questions. After the ITE, subjects completed an attitudinal survey consisting of six Likert-scale items and one "yes/no" item. We used a mixed linear model to analyze the data, accounting for prior 2012 ITE scores and nesting due to institution.ResultsAmong 192 participants, 135 (70.3%) completed the ITE in both 2012 and 2013; we analyzed their data for the first objective. Results from the mixed linear model indicate that the total mean score on the review quizzes was a significant [t(127) = 6.68; p < 0.001] predictor of the 2013 ITE after controlling for the 2012 ITE score. One hundred forty-six (76.0%) participants completed the attitudinal survey; 96% of respondents stated that they would like ARS to be used more often in resident education. Respondents felt the sessions aided in learning (mean 7.7/10), assisted in preparation for the ITE (mean 6.7/10), and helped identify content areas of weakness (mean 7.6/10).ConclusionOur results suggest that scores from review quizzes delivered by an audience response system correlate with in-training exam scores and is viewed positively by residents.

Project description:BackgroundThe widespread availability and cost-effectiveness of new-wave software-based audience response systems (ARSs) have expanded the possibilities of collecting health data from hard-to-reach populations, including youth. However, with all survey methods, biases in the data may exist because of participant nonresponse.ObjectiveThe aims of this study were to (1) examine the extent to which an ARS could be used to gather health information from youths within a large-group school setting and (2) examine individual- and survey-level response biases stemming from this Web-based data collection method.MethodsWe used an ARS to deliver a mental health survey to 3418 youths in 4 high schools in the Midwestern United States. The survey contained demographic questions, depression, anxiety, and suicidality screeners, and questions about their use of offline resources (eg, parents, peers, and counselors) and Web-based resources (ie, telemental health technologies) when they faced stressful life situations. We then examined the response rates for each survey item, focusing on the individual- and survey-level characteristics that related to nonresponse.ResultsOverall, 25.39% (868/3418) of youths answered all 38 survey questions; however, missingness analyses showed that there were some survey structure factors that led to higher rates of nonresponse (eg, questions at the end of survey, sensitive questions, and questions for which precise answers were difficult to provide). There were also some personal characteristics that were associated with nonresponse (eg, not identifying as either male or female, nonwhite ethnicity, and higher levels of depression). Specifically, a multivariate model showed that male students and students who reported their gender as other had significantly higher numbers of missed items compared with female students (B=.30 and B=.47, respectively, P<.001). Similarly, nonwhite race (B=.39, P<.001) and higher depression scores (B=.39, P<.001) were positively related to the number of missing survey responses.ConclusionsAlthough our methodology-focused study showed that it is possible to gather sensitive mental health data from youths in large groups using ARSs, we also suggest that these nonresponse patterns need to be considered and controlled for when using ARSs for gathering population health data.

Project description:BackgroundDue to improved treatments and ageing population, many countries now report increasing prevalence in rates of ischemic heart disease and heart failure. Cardiac rehabilitation has potential to reduce morbidity and mortality, but not all patients complete. In light of favourable effects of cardiac rehabilitation it is important to develop patient education methods which can enhance adherence to this effective program. The LC-REHAB study aims to compare the effect of a new patient education strategy in cardiac rehabilitation called 'learning and coping' to that of standard care. Further, this paper aims to describe the theoretical basis and details of this intervention.Methods/designOpen parallel randomised controlled trial conducted in three hospital units in Denmark among patients recently discharged with ischemic heart disease or heart failure. Patients are allocated to either the intervention group with learning and coping strategies incorporated into standard care in cardiac rehabilitation or the control group who receive the usual cardiac rehabilitation program. Learning and coping consists of two individual clarifying interviews, participation of experienced patients as educators together with health professionals and theory based, situated and inductive teaching. Usual care in cardiac rehabilitation is characterised by a structured deductive teaching style with use of identical pre-written slides in all hospital units. In both groups, cardiac rehabilitation consists of training three times a week and education once a week over eight weeks. The primary outcomes are adherence to cardiac rehabilitation, morbidity and mortality, while secondary outcomes are quality of life (SF-12, Health education impact questionnaire and Major Depression Inventory) and lifestyle and risk factors (Body Mass Index, waist circumference, blood pressure, exercise work capacity, lipid profile and DXA-scan). Data collection occurs four times; at baseline, at immediate completion of cardiac rehabilitation, and at three months and three years after the finished program.DiscussionIt is expected that learning and coping incorporated in cardiac rehabilitation will improve adherence in cardiac rehabilitation and may decrease morbidity and mortality. By describing learning and coping strategies the study aims to provide knowledge that can contribute to an increased transparency in patient education in cardiac rehabilitation.Trial registrationIdentifier NCT01668394.

Project description:BackgroundCardiac rehabilitation (CR) is clinically proven to reduce morbidity and mortality; however, many eligible patients do not enroll in treatment. Furthermore, many enrolled patients do not complete their full course of treatment. This is greatly influenced by socioeconomic factors but is also because of patients' lack of understanding of the importance of their care and a lack of motivation to maintain attendance.ObjectiveThis study aims to explore the potential benefits of virtual reality (VR) walking trails within CR treatment, specifically with regard to patient knowledge retention, satisfaction with treatment, and the overall attendance of treatment sessions.MethodsNew CR patients were enrolled and randomized on a rolling basis to either the control group or intervention group. Intervention patients completed their time on the treadmill with VR walking trails, which included audio-recorded education, whereas control patients completed the standard of care therapy. Both groups were assisted by nursing staff for all treatment sessions. Primary outcomes were determined by assessing 6-minute walk test improvement. In addition, secondary outcomes of patients' cardiac knowledge and satisfaction were assessed via a computer-based questionnaire; patient adherence to the recommended number of sessions was also monitored. Cardiac knowledge assessment included a prerehabilitation education quiz, and the same quiz was repeated at patients' final visit and again at the 2-month follow-up. The satisfaction questionnaire was completed at the final visit.ResultsBetween January 2018 and May 2019, 72 patients were enrolled-41 in the intervention group and 31 in the control group. On the basis of the results of the prerehabilitation and postrehabilitation 6-minute walk test, no significant differences were observed between the intervention and control groups (P=.64). No statistical differences were observed between groups in terms of education (P=.86) or satisfaction (P=.32) at any time point. The control group had statistically more favorable rates of attendance, as determined by the risk group comparison (P=.02) and the comparison of the rates for completing the minimum number of sessions (P=.046), but no correlation was observed between the study group and reasons for ending treatment.ConclusionsAlthough no improvements were seen in the VR intervention group over the control group, it is worth noting that limitations in the study design may have influenced these outcomes, not the medium itself. Furthermore, the qualitative information suggests that patients may have indeed enjoyed their experience with VR, even though quantitative satisfaction data did not capture this. Further considerations for how and when VR should be applied to CR are suggested in this paper.Trial registrationClinicalTrials.gov NCT03945201; https://clinicaltrials.gov/ct2/show/NCT03945201.

Project description:This study presents a seminar model for teaching radiographic caries detection and treatment planning at the Faculty of Dentistry, University of Oslo. The seminar is based partly on an audience response system (ARS) and uses patient cases to focus on caries risk assessment and treatment planning. This paper describes the seminar design, implementation, learning outcomes, and observational study of variability in caries registrations and students' attitudes to use of ARS. Dental and dental hygiene students participate in two seminar modules. Module 1 aims to develop and increase individual student skills in radiographic caries lesion detection, scoring, and differential diagnosis. Students perform trial registrations on bitewings using an ARS with anonymous live polling, and scorings are discussed in plenum. Students then perform individual registrations on 12 bitewing pairs. Using digital scoring, students detect and grade caries lesions on all approximal and occlusal tooth surfaces. After the session, students use the ARS to repeat scorings on selected tooth surfaces, and results are again discussed in plenum. Module 2 involves group exercises on 4 patient cases that are later presented with plenary discussions. In total, 1,624 caries registrations performed by 150 students attending the seminar between 2016 and 2018 were assessed for variability between students. As expected, variations in caries registrations were observed between students, mostly related to restored surfaces or tooth surfaces that were otherwise difficult to register. In 2022, 63 dental and dental hygiene students attending the seminar answered a questionnaire about use of ARS. The responses were scored using a five-point Likert scale. Overall, no significant difference in satisfaction with the ARS-based module was observed between dental and dental hygiene students (χ2 test, p > 0.05). The majority of the students were positive toward the use of ARS (94%), but some disagreed on the role of ARS in usefulness for understanding the seminar content (3.2%), and in increasing their confidence in radiographic registration of caries (3.2%). The ARS-based module provides a positive learning environment that ensures student anonymity, interactivity, and engagement, and combined with the other seminar module gives students basic skills in caries detection and treatment planning.

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Interactive patient education via an audience response system in cardiac rehabilitation.

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Interactive patient education via an audience response system in cardiac rehabilitation.

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