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      E-learning for self-management support: introducing blended learning for graduate students – a cohort study

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          Abstract

          Background

          E-learning allows delivery of education in many diverse settings and researchers have demonstrated it can be as effective as learning conducted in traditional face-to-face settings. However, there are particular practices and skills needed in the area of providing patient self-management support (SMS), that may not be achievable online. The aim of this study was to compare three approaches in the training of university students regarding the preparation of a Chronic Condition Self-Management Care Plan: 1) traditional face-to-face delivery of SMS training, 2) an e-learning approach and 3) a blended approach (combining e-learning and face-to-face teaching).

          Methods

          Graduate entry physiotherapy students and medical students at Flinders University were recruited. Depending on the cohort, students were either exposed to traditional face-to-face training, e-learning or a blended model. Outcomes were compared between the three groups. We measured adherence to care plan processes in the preparation of an assessment piece using the Flinders Program Chronic Care Self Management tools. A total of 183 care plans were included (102 traditional, 52 blended, 29 e-learning,). All students submitted the Flinders Program Chronic Care Plan for university assessment and these were later assessed for quality by researchers. The submission was also assigned a consumer engagement score and a global competence score as these are integral to successful delivery of SMS and represent the patient perspective.

          Results

          The blended group performed significantly better than the traditional group in quality use of the Flinders Program tools: Problem and Goals ( P < 0.0001). They also performed significantly better in the total care plan score ( P < 0.0001) and engagement score ( P < 0.0001). There was no significant difference between the groups for the Partners in Health tool.

          Conclusions

          In this pilot study, the blended learning model was a more effective method for teaching self-management skills than the traditional group, as assessed in the development of a chronic condition self-management care plan. We anticipate that future research with identical groups of students would yield similar results but in the meantime, academics can have confidence that blended learning is at least as effective as traditional learning methods.

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          Most cited references17

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          Chronic disease self-management program: 2-year health status and health care utilization outcomes.

          To assess the 1- and 2-year health status, health care utilization and self-efficacy outcomes for the Chronic Disease Self-Management Program (CDSMP). The major hypothesis is that during the 2-year period CDSMP participants will experience improvements or less deterioration than expected in health status and reductions in health care utilization. Longitudinal design as follow-up to a randomized trial. Community. Eight hundred thirty-one participants 40 years and older with heart disease, lung disease, stroke, or arthritis participated in the CDSMP. At 1- and 2-year intervals respectively 82% and 76% of eligible participants completed data. Health status (self-rated health, disability, social/role activities limitations, energy/fatigue, and health distress), health care utilization (ER/outpatient visits, times hospitalized, and days in hospital), and perceived self-efficacy were measured. Compared with baseline for each of the 2 years, ER/outpatient visits and health distress were reduced (P <0.05). Self-efficacy improved (P <0.05). The rate of increase is that which is expected in 1 year. There were no other significant changes. A low-cost program for promoting health self-management can improve elements of health status while reducing health care costs in populations with diverse chronic diseases.
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            Virtual Reality Training Improves Operating Room Performance

            To demonstrate that virtual reality (VR) training transfers technical skills to the operating room (OR) environment.
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              A review of evaluation outcomes of web-based continuing medical education.

              The Internet and worldwide web have expanded opportunities for the provision of a flexible, convenient and interactive form of continuing medical education (CME). Larger numbers of doctors are accessing and using the Internet to locate and seek medical information. It has been suggested that a significant proportion of this usage is directly related to questions that arise from patient care. A variety of Internet technologies are being used to provide both asynchronous and synchronous forms of web-based CME. Various models for designing and facilitating web-based CME learning have also been reported. The purpose of this study was to examine the nature and characteristics of the web-based CME evaluative outcomes reported in the peer-reviewed literature. A search of Medline was undertaken and the level of evaluative outcomes reported was categorised using Kirkpatrick's model for levels of summative evaluation. The results of this analysis revealed that the majority of evaluative research on web-based CME is based on participant satisfaction data. There was limited research demonstrating performance change in clinical practices and there were no studies reported in the literature that demonstrated that web-based CME was effective in influencing patient or health outcomes. The findings suggest an important need to examine in greater detail the nature and characteristics of those web-based learning technologies, environments and systems which are most effective in enhancing practice change and ultimately impacting patient and health outcomes. This is particularly important as the Internet grows in popularity as a medium for knowledge transfer.
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                Author and article information

                Contributors
                ginnymunro1308@gmail.com
                andrea.morello@flinders.edu.au
                Candice.oster@flinders.edu.au
                christine.redmond@caissa.com.au
                anna.vnuk@flinders.edu.au
                sheila.lennon@flinders.edu.au
                Sharon.lawn@flinders.edu.au
                Journal
                BMC Med Educ
                BMC Med Educ
                BMC Medical Education
                BioMed Central (London )
                1472-6920
                24 September 2018
                24 September 2018
                2018
                : 18
                : 219
                Affiliations
                [1 ]ISNI 0000 0004 0367 2697, GRID grid.1014.4, College of Medicine and Public Health, , Flinders University, ; PO Box 2100, Adelaide, South Australia 5001 Australia
                [2 ]ISNI 0000 0004 0367 2697, GRID grid.1014.4, Flinders Human Behaviour & Health Research Unit, Department of Psychiatry, , Flinders University, ; PO Box 2100, Adelaide, South Australia 5001 Australia
                [3 ]ISNI 0000 0004 0367 2697, GRID grid.1014.4, Discipline of Physiotherapy, School of Nursing & Health Sciences, , Flinders University, ; PO Box 2100, Adelaide, South Australia 5001 Australia
                Article
                1328
                10.1186/s12909-018-1328-6
                6154791
                30249238
                e4f71b04-d127-4062-b1e6-c40b51118a64
                © The Author(s). 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 5 January 2018
                : 16 September 2018
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2018

                Education
                self-management,self-management support,e-learning,blended learning,virtual learning,chronic care,person-centred care

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