A review of methods to assess the economic impact of distributed medical education (DME) in Canada

Lemky, Kim; Gagné, Pierre; Stobbe, Karl; Fearon, Gervan; Blom, Sylvia; Lapointe, G

doi:10.36834/cmej.43343

Cited by 2 publications

(9 citation statements)

References 16 publications

(20 reference statements)

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“…First, there is a shift from delivery of medical education in large urban academic centers toward distributed medical education. Technologies such as video conferencing and digital library collections have enabled this advancement and are tied to social, health, and economic benefits [42,43]. There is potential for the MTU concept to play a role in this area, and further research is needed to determine how best to incorporate this concept into practice.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of a Mobile Telesimulation Unit to Train Rural and Remote Practitioners on High-Acuity Low-Occurrence Procedures: Pilot Randomized Controlled Trial

Jewer¹,

Parsons²,

Dunne³

et al. 2019

J Med Internet Res

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Background The provision of acute medical care in rural and remote areas presents unique challenges for practitioners. Therefore, a tailored approach to training providers would prove beneficial. Although simulation-based medical education (SBME) has been shown to be effective, access to such training can be difficult and costly in rural and remote areas. Objective The aim of this study was to evaluate the educational efficacy of simulation-based training of an acute care procedure delivered remotely, using a portable, self-contained unit outfitted with off-the-shelf and low-cost telecommunications equipment (mobile telesimulation unit, MTU), versus the traditional face-to-face approach. A conceptual framework based on a combination of Kirkpatrick’s Learning Evaluation Model and Miller’s Clinical Assessment Framework was used. Methods A written procedural skills test was used to assess Miller’s learning level— knows —at 3 points in time: preinstruction, immediately postinstruction, and 1 week later. To assess procedural performance (shows how), participants were video recorded performing chest tube insertion before and after hands-on supervised training. A modified Objective Structured Assessment of Technical Skills (OSATS) checklist and a Global Rating Scale (GRS) of operative performance were used by a blinded rater to assess participants’ performance. Kirkpatrick’s reaction was measured through subject completion of a survey on satisfaction with the learning experiences and an evaluation of training. Results A total of 69 medical students participated in the study. Students were randomly assigned to 1 of the following 3 groups: comparison (25/69, 36%), intervention (23/69, 33%), or control (21/69, 31%). For knows, as expected, no significant differences were found between the groups on written knowledge (posttest, P=.13). For shows how, no significant differences were found between the comparison and intervention groups on the procedural skills learning outcomes immediately after the training (OSATS checklist and GRS, P=1.00). However, significant differences were found for the control versus comparison groups (OSATS checklist, P<.001; GRS, P=.02) and the control versus intervention groups (OSATS checklist, P<.001; GRS, P=.01) on the pre- and postprocedural performance. For reaction, there were no statistically significant differences between the intervention and comparison groups on the satisfaction with learning items (P=.65 and P=.79) or the evaluation of the training (P=.79, P=.45, and P=.31). Conclusions Our results demonstrate that simulation-based training delivered remotely, applying our MTU concept, can be an effective way to teach procedural skills. Participants trained remotely in the MTU had comparable learning outcomes (shows how) to those trained face-to-face. Both groups received statistically significant higher procedural performance scores than those in the control group. Participants in both instruction groups were equally satisfied with their learning and training (reaction). We believe that mobile telesimulation could be an effective way of providing expert mentorship and overcoming a number of barriers to delivering SBME in rural and remote locations.

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Section: Discussionmentioning

confidence: 99%

Evaluation of a Mobile Telesimulation Unit to Train Rural and Remote Practitioners on High-Acuity Low-Occurrence Procedures: Pilot Randomized Controlled Trial

Jewer¹,

Parsons²,

Dunne³

et al. 2019

J Med Internet Res

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“…11 This paper builds on the authors' previous publication and recommends creating an accessible and reliable method to measure the economic impact of distributed medical education through the RMC to provide information for regional and rural community development, policy development, and return on investment. 8 These new RMCs not only increase capacity to existing medical programs, but also generate economic benefits in smaller centres and can help boost small community economies.…”

Section: Literature Reviewmentioning

confidence: 99%

“…The model data includes estimates of spending by students and visitors found on websites, and institutional financial records. 8 The facilities used for training in RMCs range from a full regional medical campus with fit-for-purpose buildings in a mid-size city to a single clinic in a small community (longitudinal integrated clerkships). 1 Programs may include classroom teaching and video conferencing from the main campus.…”

Section: Literature Reviewmentioning

confidence: 99%

“…This data helps to support the securing of needed investment and increases to operating budgets. 8 As well, economic information accounts for the spillover benefits extending beyond students graduating from the program. RMCs have significant public and community health benefits and regional development benefits, beyond any monetary amount tabulated in this paper.…”

Section: Introductionmentioning

confidence: 99%

“…RMCs have significant public and community health benefits and regional development benefits, beyond any monetary amount tabulated in this paper. 1,2,[4][5][6][7][8] These benefits warrant further study, and the authors recognize that the economic impact analysis shared in this paper only partially captures the benefits, but is still essential in assuring the development and perpetuity of RMCs.…”

Section: Introductionmentioning

confidence: 99%

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Step-by-Step Process for Assessing the Economic Impact of Regional Medical Campuses in Canada

Lapointe

Lemky

Gagné³

et al. 2023

JRMC

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Background: Regional medical campuses (RMCs) create positive economic impacts in communities and small cities. RMCs increase educational capacity, medical services, and address the shortage or maldistribution of physicians in rural areas. Our paper answers the question: How do you assess the economic impact of a RMC? Methods: The Canadian Input-Output (I-O) model and the Simplified American Council on Education (ACE) model are adapted to assess the economic impact of an individual RMC using a step-by-step process. The models are tested using data from three Canadian RMCs. Results: A comparison of the two models found similarities with data requirements and spreadsheet calculations. However, the Canadian I-O model spreadsheet is linked to Statistics Canada multipliers and calculations are more complex. Outputs are calculated for multiple economic variables. The Simplified ACE model, in contrast, uses a single multiplier and provides a single number by input category and a cumulative total of all impacts. Conclusion: Both models successfully assess economic impacts of RMC. The step-by-step process allows RMC administrators and others to understand the limitations of each model, but also facilitates an in-house economic assessment of RMC. The authors provide guidance on choosing the best model.

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A review of methods to assess the economic impact of distributed medical education (DME) in Canada

Cited by 2 publications

References 16 publications

Evaluation of a Mobile Telesimulation Unit to Train Rural and Remote Practitioners on High-Acuity Low-Occurrence Procedures: Pilot Randomized Controlled Trial

Evaluation of a Mobile Telesimulation Unit to Train Rural and Remote Practitioners on High-Acuity Low-Occurrence Procedures: Pilot Randomized Controlled Trial

Step-by-Step Process for Assessing the Economic Impact of Regional Medical Campuses in Canada

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