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      Extension for Community Healthcare Outcomes Based Telementoring of Physicians for Dementia–Effectiveness in India

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          Abstract

          Objective

          The study aimed to evaluate the effectiveness of a program based on the telementoring model [Extension for Community Healthcare Outcomes (ECHO)] for primary care physicians in diagnosing and treating patients with dementia.

          Method

          The ECHO model was adapted through 12 live sessions of 2 h every 2 weeks consisting of a didactic presentation by the expert, peer-led new case discussions, and follow-up discussions. In addition, there were 10 h of self-paced e-learning and interim assignments. The impact was examined by noting participation, session ratings, monthly clinical reports, and comparing knowledge and competency scores before and after the course.

          Results

          Among the 63 participants, 39.7% attended at least 80% of the sessions; completing the program successfully. The ratings for all sessions ranged from “good” to “excellent.” The paired sample t-test revealed a statistically significant improvement ( p < 0.001) in self-rated skills and confidence in diagnosing and treating dementia with an effect size of 1.25 and 1.37, respectively. No change in the knowledge score was observed throughout the course. A considerable increase in dementia-related clinical practice was observed during four monthly summary of clinical cases. Due to the limited data of monthly reports during the COVID pandemic, no statistical analysis was attempted.

          Conclusion

          The ECHO model appears to have a positive immediate impact on the clinical ability of primary care physicians to diagnose and treat dementia. Its direct impact on patient health and at the community level should be aimed at in future studies.

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          Most cited references26

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          The Impact of Project ECHO on Participant and Patient Outcomes: A Systematic Review.

          Project Extension for Community Healthcare Outcomes (ECHO) uses tele-education to bridge knowledge gaps between specialists at academic health centers and primary care providers from remote areas. It has been implemented to address multiple medical conditions. The authors examined evidence of the impact of all Project ECHO programs on participant and patient outcomes.
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            Achieving desired results and improved outcomes: integrating planning and assessment throughout learning activities.

            Most physicians believe that to provide the best possible care to their patients, they must commit to continuous learning. For the most part, it appears the learning activities currently available to physicians do not provide opportunities for meaningful continuous learning. At the same time there have been increasing concerns about the quality of health care, and a variety of groups within organized medicine have proposed approaches to address issues of physician competence and performance. The authors question whether CME will be accepted as a full partner in these new approaches if providers continue to use current approaches to planning and assessing CME. A conceptual model is proposed for planning and assessing continuous learning for physicians that the authors believe will help CME planners address issues of physician competence, physician performance, and patient health status.
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              Medical Education During the COVID-19 Pandemic: Learning From A Distance

              As paradigms of clinical care delivery have been significantly impacted by the novel coronavirus disease 2019 (COVID-19) pandemic, so has the structure, delivery, and future of medical education. Both undergraduate and graduate medical education have seen disruptions ranging from fully virtual delivery of educational content and limited clinical care for medical students to increased clinical demands with redeployment for residents and fellows. Adherence to social distancing has led to the adoption and implementation of already available technologies in medical education, including video conferencing softwares and social media platforms. Efficient and effective use of these technologies requires an understanding not only of these platforms and their features, but also of their inherent limitations. During a time of uncertainty and increased clinical demands, the approach to medical education must be thoughtful with attention to wellness of both the educator and learner. In this review, we discuss the influence of the pandemic on the existing medical education landscape, outline existing and proposed adaptations to social distancing, and describe challenges that lie ahead.
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                Author and article information

                Contributors
                Journal
                Front Psychiatry
                Front Psychiatry
                Front. Psychiatry
                Frontiers in Psychiatry
                Frontiers Media S.A.
                1664-0640
                23 May 2022
                2022
                : 13
                : 869685
                Affiliations
                Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS) , Bengaluru, India
                Author notes

                Edited by: Gianfranco Spalletta, Santa Lucia Foundation (IRCCS), Italy

                Reviewed by: Kristin Sohl, University of Missouri, United States; Lisa Shook, Cincinnati Children’s Hospital Medical Center, United States

                *Correspondence: Preeti Sinha, preetisinha@ 123456nimhans.ac.in

                This article was submitted to Aging Psychiatry, a section of the journal Frontiers in Psychiatry

                Article
                10.3389/fpsyt.2022.869685
                9168648
                464edbb1-7413-48ab-ad30-f584fc168be3
                Copyright © 2022 Nair, Sinha, Chand, Sahu, Gorthi, Varghese and Sivakumar.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 04 February 2022
                : 04 April 2022
                Page count
                Figures: 3, Tables: 1, Equations: 0, References: 27, Pages: 8, Words: 5621
                Categories
                Psychiatry
                Original Research

                Clinical Psychology & Psychiatry
                echo,telementoring,dementia,training,primary care
                Clinical Psychology & Psychiatry
                echo, telementoring, dementia, training, primary care

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