Dataset Information

Participant-reported effect of an Indigenous health continuing professional development initiative for specialists.

ABSTRACT:

Background

Health outcomes of Indigenous patients are impacted by culturally unsafe specialty care environments. The 'Educating for Equity (E4E)' program is a continuing professional development (CPD) intervention which incorporates skill-based teaching to improve Indigenous patient experiences and outcomes in healthcare interactions.

Methods

The E4E program was delivered to rheumatologists in two phases, each delivered as experiential learning workshops where participants engaged with and applied course content within an interactive format focusing on real-time feedback. The phase 1 workshop focused on skill development of E4E Framework concepts and principles. Phase 2 concentrated on building capacity for teaching of E4E content. Evaluation of the program's effectiveness was through longitudinal responses to the Social Cultural Confidence in Care Survey (SCCCS), self-reported strategies employed to address social issues and improve therapeutic relationships, engagement with teaching others, and satisfaction with the program.

Results

Two cohorts of participants have participated in the program (n?=?24 Phase 1, n?=?10 Phase 2). For participants completing both phases of training, statistically significant improvements were observed in exploring social factors with patients, gaining knowledge and skills related to cultural aspects of care, improved communication and relationship building, and reflections on held stereotypes. Strategies to address social issues and build therapeutic relationships remained consistent throughout participation, while the training enhanced exploration and confidence to ask about cultural and traditional practices, and stronger communication strategies for exploring beliefs, expectations, social barriers, and residential school impacts on health. Participants reported feeling prepared to teach Indigenous health concepts to others and subsequently lead teaching with residents, fellows, and allied health professionals. Satisfaction with the delivery and content of the workshops was high, and participants valued interactions with peers in learning.

Conclusions

This CPD intervention had a beneficial impact on self-reported confidence and enhanced practice strategies to engage with Indigenous patients.

SUBMITTER: Barnabe C

PROVIDER: S-EPMC7891014 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Participant-reported effect of an Indigenous health continuing professional development initiative for specialists.

Barnabe Cheryl C Kherani Raheem B RB Appleton Tom T Umaefulam Valerie V Henderson Rita R Crowshoe Lynden L

BMC medical education 20210218 1

<h4>Background</h4>Health outcomes of Indigenous patients are impacted by culturally unsafe specialty care environments. The 'Educating for Equity (E4E)' program is a continuing professional development (CPD) intervention which incorporates skill-based teaching to improve Indigenous patient experiences and outcomes in healthcare interactions.<h4>Methods</h4>The E4E program was delivered to rheumatologists in two phases, each delivered as experiential learning workshops where participants engaged ...[more]

PMID: 33602213

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Project description:BackgroundWeb-based continuing professional development (CPD) is a convenient and low-cost way for physicians to update their knowledge. However, little is known about the factors that influence their intention to put this new knowledge into practice.ObjectiveWe aimed to identify sociocognitive factors associated with physicians' intention to adopt new behaviors as well as indications of Bloom's learning levels following their participation in 5 web-based CPD courses.MethodsWe performed a cross-sectional study of specialist physicians who had completed 1 of 5 web-based CPD courses offered by the Federation of Medical Specialists of Quebec. The participants then completed CPD-Reaction, a questionnaire based on Godin's integrated model for health professional behavior change and with evidence of validity that measures behavioral intention (dependent variable) and psychosocial factors influencing intention (n=4). We also assessed variables related to sociodemographics (n=5), course content (n=9), and course format (eg, graphic features and duration) (n=8). Content variables were derived from CanMEDS competencies, Bloom's learning levels, and Godin's integrated model. We conducted ANOVA single-factor analysis, calculated the intraclass correlation coefficient (ICC), and performed bivariate and multivariate analyses.ResultsA total of 400 physicians participated in the courses (range: 38-135 physicians per course). Average age was 50 (SD 12) years; 56% (n=223) were female, and 44% (n=177) were male. Among the 259 who completed CPD-Reaction, behavioral intention scores ranged from 5.37 (SD 1.17) to 6.60 (SD 0.88) out of 7 and differed significantly from one course to another (P<.001). The ICC indicated that 17% of the total variation in the outcome of interest, the behavioral intention of physicians, could be explained at the level of the CPD course (ICC=0.17). In bivariate analyses, social influences (P<.001), beliefs about capabilities (P<.001), moral norm (P<.001), beliefs about consequences (P<.001), and psychomotor learning (P=.04) were significantly correlated with physicians' intention to adopt new behaviors. Multivariate analysis showed the same factors, except for social influences and psychomotor learning, as significantly correlated with intention.ConclusionsWe observed average to high behavioral intention scores after all 5 web-based courses, with some variations by course taken. Factors affecting physicians' intention were beliefs about their capabilities and about the consequences of adopting new clinical behaviors, as well as doubts about whether the new behavior aligned with their moral values. Our results will inform design of future web-based CPD courses to ensure they contribute to clinical behavior change.

Project description:INTRODUCTION:Interprofessional learning (IPL) is increasingly recognized as a promising strategy in addressing the burgeoning challenges in healthcare. Its assessment remains to be perplexing and requires accurate measurements. Thus, this study intended to develop a valid and reliable reflective tool in assessing IPL as a Continuing Professional Development (CPD) outcome. METHODS:A one-group post-posttest pre-experimental design with tool development was employed to establish the validity and reliability of the "Inventory of Reflective Vignette-Interprofessional Learning" (IRV-IPL). This tool was developed from an extensive literature review and designed with three segments to assess interprofessional competencies before, after, and what if scenarios using vignettes. After it was validated by education experts (n = 5) and written consent forms were signed by the participants, the IRV-IPL was pilot tested among healthcare professionals (n = 10) for analysis and improvement. During the actual implementation, it was administered to healthcare professionals (n = 45) who participated in a university-provided CPD event. Collected data underwent validity and reliability testing. RESULTS:IRV-IPL generated excellent internal consistency (α = 0.98), and across all segments of collaboration (α = 0.96), coordination (α = 0.96), cooperation (α = 0.96), communication (α = 0.97), and commendation (α = 0.98). Items exhibited significantly positive large correlations (r > 0.35, p < 0.05) in all segments showing beneficial measures for postdictive validity in recalling prior interprofessional competencies, and predictive validity in estimating interprofessional learning as an outcome of CPD and alternative interventions. CONCLUSION:This study provided a piece of groundwork evidence on the use of IRV-IPL as a reflective assessment tool for interprofessional learning in CPD contexts. Further studies are essential to explore the educational utility of IRV framework in crafting relevant assessments and to establish construct validity of IRV-IPL using exploratory and confirmatory factor analyses.

Project description:BackgroundContinuing professional development (CPD) is essential for physicians to maintain and enhance their knowledge, competence, skills, and performance. Web-based CPD plays an essential role. However, validated theory-informed measures of their impact are lacking. The CPD-REACTION questionnaire is a validated theory-informed tool that evaluates the impact of CPD activities on clinicians' behavioral intentions.ObjectiveWe aimed to review the use of the CPD-REACTION questionnaire, which measures the impact of CPD activities on health professionals' intentions to change clinical behavior. We examined CPD activity characteristics, ranges of intention, mean scores, score distributions, and psychometric properties.MethodsWe conducted a systematic review informed by the Cochrane review methodology. We searched 8 databases from January 1, 2014, to April 20, 2021. Gray literature was identified using Google Scholar and Research Gate. Eligibility criteria included all health care professionals, any study design, and participants' completion of the CPD-REACTION questionnaire either before, after, or before and after a CPD activity. Study selection, data extraction, and study quality evaluation were independently performed by 2 reviewers. We extracted data on characteristics of studies, the CPD activity (eg, targeted clinical behavior and format), and CPD-REACTION use. We used the Mixed Methods Appraisal Tool to evaluate the methodological quality of the studies. Data extracted were analyzed using descriptive statistics and the Student t test (2-tailed) for bivariate analysis. The results are presented as a narrative synthesis reported according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines.ResultsOverall, 65 citations were eligible and referred to 52 primary studies. The number of primary studies reporting the use of CPD-REACTION has increased continuously since 2014 from 1 to 16 publications per year (2021). It is available in English, French, Spanish, and Dutch. Most of the studies were conducted in Canada (30/52, 58%). Furthermore, 40 different clinical behaviors were identified. The most common CPD format was e-learning (34/52, 65%). The original version of the CPD-REACTION questionnaire was used in 31 of 52 studies, and an adapted version in 18 of 52 studies. In addition, 31% (16/52) of the studies measured both the pre- and postintervention scores. In 22 studies, CPD providers were university-based. Most studies targeted interprofessional groups of health professionals (31/52, 60%).ConclusionsThe use of CPD-REACTION has increased rapidly and across a wide range of clinical behaviors and formats, including a web-based format. Further research should investigate the most effective way to adapt the CPD-REACTION questionnaire to a variety of clinical behaviors and contexts.Trial registrationPROSPERO CRD42018116492; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=116492.

Project description:OBJECTIVES: Continuing professional development (CPD) is a novel approach to increase professional knowledge and skills. The aim of this study is to explore participants' characteristics and to understand participants' views on two rapid review courses (RRCs) as part of CPD program, and to assess healthcare providers' views about the use of internet for accessing medical information. METHODS: Data were collected from 150 participants who attended an RRC in Nephrology and Rheumatology as part of an ongoing CME program. RESULTS: Participants' response rate was 92% and 84.4% in Nephrology and Rheumatology RRCs, respectively. Participants' Mean Age±SD were 39±2.1 and 41±2.1 years in the Nephrology and Rheumatology courses, respectively. Demographic variables, i.e., age, gender, and specialization showed a significant (p<0.01) impact on the learning objectives of the program. Further, participants reported that the course material had a significant (p<0.02) impact on their knowledge. Finding new medical information was the primary motive to search the internet among all participants. About half of the subjects reported knowledge of their preferred medical education sites and had access at their clinical setup. Barriers to internet use included lack of specific information, difficulty to download contents, and excessive material. Professional association websites, online journals, and CME programs were the most frequently searched sources of information. Most of the subjects reported significant (p<0.02) barriers to find medical resources on the internet and to adequately utilize the currently available medical search engines available in the healthcare system. CONCLUSION: A discipline specific and integrated CPD program may have provided dual benefit such as accredited CME hours and a significant change in the participants' knowledge. There is a need to increase Internet accessibility and capacity in the current healthcare facilities. Future CPD studies should include measuring participants' knowledge and skills "pre and post" course delivery, and a detailed evaluation of the course program.

Dataset Information

Participant-reported effect of an Indigenous health continuing professional development initiative for specialists.

Background

Methods

Results

Conclusions

Publications

Participant-reported effect of an Indigenous health continuing professional development initiative for specialists.

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