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Evaluating the impact of an intensive education workshop on evidence-informed decision making knowledge, skills, and behaviours: a mixed methods study.

ABSTRACT: BACKGROUND: Health professionals require a unique set of knowledge and skills in order to meet increasing expectations to use research evidence to inform practice and policy decisions. They need to be able to find, access, interpret, and apply the best available research evidence, along with information about patient preferences, clinical expertise, and the clinical context and resources, to such decisions. This study determined preferences for continuing education following an intensive educational workshop and evaluated the impact of the workshop on evidence informed decision making (EIDM) knowledge, skills, and behaviours. METHODS: An explanatory mixed methods, longitudinal study design was implemented among a convenience sample of various health care professionals attending the workshop. EIDM knowledge, skills, and behaviours were quantitatively measured at baseline and six month follow-up, with EIDM knowledge and skills measured additionally immediately following the educational workshop (post-test measurement). To determine participants preferences for continuing education, data were collected using quantitative survey (post-test measurement) and qualitative (individual telephone interviews after six-month follow-up) methods. RESULTS: EIDM knowledge and skills increased significantly from baseline to immediately following the intervention [5.6, 95% CI (3.7, 7.4), P < 0.001] and from baseline to six-month follow-up [3.7, 95% CI (2.1, 5.3), P < 0.001], with a significant decrease from immediately following the intervention to six-month follow-up [-1.9, 95% CI (-3.5, -0.3), P 0.018]. EIDM behaviours increased, but not significantly, from baseline to six-month follow-up [1.7, 95% CI (-0.3, 3.8), P 0.095]. At baseline and six-month follow-up there was a weak, non-significant positive correlation between EIDM knowledge and skills and EIDM behaviours (r = 0.29, P 0.069 and r = 0.24, P 0.136, respectively). Over time there was a shift in preferences for timing and frequency of online continuing education strategies. Willingness to participate in continuing education, however, remained evident. CONCLUSIONS: An intensive educational workshop shows promise for increasing EIDM knowledge and skills. Increasing EIDM knowledge and skills may promote the capacity of health professionals to use research evidence when making practice and policy decisions and, in turn, lead to positive patient outcomes.

SUBMITTER: Yost J

PROVIDER: S-EPMC3929552 | biostudies-other | 2014

REPOSITORIES: biostudies-other

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Evaluating the impact of an intensive education workshop on evidence-informed decision making knowledge, skills, and behaviours: a mixed methods study.

Yost Jennifer J Ciliska Donna D Dobbins Maureen M

BMC medical education 20140117

<h4>Background</h4>Health professionals require a unique set of knowledge and skills in order to meet increasing expectations to use research evidence to inform practice and policy decisions. They need to be able to find, access, interpret, and apply the best available research evidence, along with information about patient preferences, clinical expertise, and the clinical context and resources, to such decisions. This study determined preferences for continuing education following an intensive ...[more]

PMID: 24433582

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Project description:BackgroundNurses are increasingly expected to engage in evidence-informed decision making (EIDM); the use of research evidence with information about patient preferences, clinical context and resources, and their clinical expertise in decision making. Strategies for enhancing EIDM have been synthesized in high-quality systematic reviews, yet most relate to physicians or mixed disciplines. Existing reviews, specific to nursing, have not captured a broad range of strategies for promoting the knowledge and skills for EIDM, patient outcomes as a result of EIDM, or contextual information for why these strategies "work."AimTo conduct a scoping review to identify and map the literature related to strategies implemented among nurses in tertiary care for promoting EIDM knowledge, skills, and behaviours, as well as patient outcomes and contextual implementation details.MethodsA search strategy was developed and executed to identify relevant research evidence. Participants included registered nurses, clinical nurse specialists, nurse practitioners, and advanced practice nurses. Strategies were those enhancing nurses' EIDM knowledge, skills, or behaviours, as well as patient outcomes. Relevant studies included systematic reviews, randomized controlled trials, cluster randomized controlled trials, non-randomized trials (including controlled before and after studies), cluster non-randomized trials, interrupted time series designs, prospective cohort studies, mixed-method studies, and qualitative studies. Two reviewers performed study selection and data extraction using standardized forms. Disagreements were resolved through discussion or third party adjudication.ResultsUsing a narrative synthesis, the body of research was mapped by design, clinical areas, strategies, and provider and patient outcomes to determine areas appropriate for a systematic review.ConclusionsThere are a sufficiently high number of studies to conduct a more focused systematic review by care settings, study design, implementation strategies, or outcomes. A focused review could assist in determining which strategies can be recommended for enhancing EIDM knowledge, skills, and behaviours among nurses in tertiary care.

Project description:IMPORTANCE:Intensive lifestyle change (e.g., the Diabetes Prevention Program) and metformin reduce type 2 diabetes risk among patients with prediabetes. However, real-world uptake remains low. Shared decision-making (SDM) may increase awareness and help patients select and follow through with informed options for diabetes prevention that are aligned with their preferences. OBJECTIVE:To test the effectiveness of a prediabetes SDM intervention. DESIGN:Cluster randomized controlled trial. SETTING:Twenty primary care clinics within a large regional health system. PARTICIPANTS:Overweight/obese adults with prediabetes (BMI???24 kg/m2 and HbA1c 5.7-6.4%) were enrolled from 10 SDM intervention clinics. Propensity score matching was used to identify control patients from 10 usual care clinics. INTERVENTION:Intervention clinic patients were invited to participate in a face-to-face SDM visit with a pharmacist who used a decision aid (DA) to describe prediabetes and four possible options for diabetes prevention: DPP, DPP ± metformin, metformin only, or usual care. MAIN OUTCOMES AND MEASURES:Primary endpoint was uptake of DPP (??9 sessions), metformin, or both strategies at 4 months. Secondary endpoint was weight change (lbs.) at 12 months. RESULTS:Uptake of DPP and/or metformin was higher among SDM participants (n =?351) than controls receiving usual care (n =?1028; 38% vs. 2%, p <?.001). At 12-month follow-up, adjusted weight loss (lbs.) was greater among SDM participants than controls (-?5.3 vs. -?0.2, p?<?.001). LIMITATIONS:Absence of DPP supplier participation data for matched patients in usual care clinics. CONCLUSIONS AND RELEVANCE:A prediabetes SDM intervention led by pharmacists increased patient engagement in evidence-based options for diabetes prevention and was associated with significantly greater uptake of DPP and/or metformin at 4 months and weight loss at 12 months. Prediabetes SDM may be a promising approach to enhance prevention efforts among patients at increased risk. TRIAL REGISTRATION:This study was registered at clinicaltrails.gov (NCT02384109)).

Project description:In this article, we describe a province-wide collaborative project in which we adapted the Explore Transplant (ET) education program for use in Ontario, Canada, to develop Explore Transplant Ontario (ETO). Kidney transplantation (KT), especially living donor kidney transplantation (LDKT), is the best treatment for many patients with end-stage kidney disease (ESKD), with the best patient survival and quality of life and also reduced health care costs. Yet KT and LDKT are underutilized both internationally and in Canada. Research has demonstrated that patients with ESKD who receive personalized transplant education are more likely to complete the transplant evaluation process and to receive LDKT compared with patients who do not receive this education.Research expertise of the lead authors and Medline search of studies assessing the impact of education interventions on access to KT and LDKT.The ET program, developed by Dr Amy Waterman, has been used in thousands of patients with ESKD in the United States to enhance KT and LDKT knowledge. To adapt this program for use in Ontario, we convened a working group, including patient representatives, nephrologists, transplant coordinators, dialysis nurses, and patient educators from all Ontario KT centers and selected dialysis units. In an iterative process concluding in a consensus workshop, the working group reviewed and edited the text of the original ET program and suggested changes to the videos.The adapted program reflects the Ontario health care environment and responds to the specific needs of patients with chronic kidney disease (CKD) in the province. The videos feature Ontario transplant nephrologists, transplant coordinators, and patients, representative of the ethnic diversity in Ontario, sharing their transplant experience and expertise. Despite the changes, ETO is consistent with the quality and style of the original ET program. At the end of this article, we summarize subsequent steps to test and utilize ETO. Those projects, specifically the ETO pilot study and a multicomponent quality improvement initiative to increase utilization of KT and LDKT across Ontario, will be described in full in future papers.This article describes a provincial initiative; therefore, our findings may not be fully generalizable without further considerations. The adapted education program has not yet been tested in large trial for effectiveness.As a program grounded in the theoretical model of behavior change, ETO places patients with ESKD at the center of a complex process of navigating renal replacement therapy modalities and acknowledges a broad range of patient values, priorities, and states of readiness to pursue KT.

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Evaluating the impact of an intensive education workshop on evidence-informed decision making knowledge, skills, and behaviours: a mixed methods study.

Publications

Evaluating the impact of an intensive education workshop on evidence-informed decision making knowledge, skills, and behaviours: a mixed methods study.

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