Analyse, développement et évaluation d'une formation médicale en ligne

Plante, Patrick; Mendoza, Gustavo Adolfo Angulo; Archambault, Patrick

doi:10.52358/mm.vi2.95

Cited by 3 publications

(1 citation statement)

References 4 publications

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“…We found that EPs' and ACHPs' intention to use wiki-based knowledge tools can be predicted by the three direct TPB constructs-attitude toward the behavior, SN, and PBC. We have also identified the salient beliefs that will help us develop a theory-based training program to promote the use of wiki-based knowledge tools in trauma care centers for EPs and ACHPs [40,73]. These salient beliefs will also inform the development of interventions that support the implementation of future wiki-based knowledge tools for other acute care contexts, such as optimal ED elder care [74] and pandemic knowledge management [75].…”

Section: Principal Findingsmentioning

confidence: 99%

Intention to Use Wiki-Based Knowledge Tools: Survey of Quebec Emergency Health Professionals

et al. 2021

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Background Clinical decision support systems are information technologies that assist clinicians in making better decisions. Their adoption has been limited because their content is difficult to adapt to local contexts and slow to adapt to emerging evidence. Collaborative writing applications such as wikis have the potential to increase access to existing and emerging evidence-based knowledge at the point of care, standardize emergency clinical decision making, and quickly adapt this knowledge to local contexts. However, little is known about the factors influencing health professionals’ use of wiki-based knowledge tools. Objective This study aims to measure emergency physicians’ (EPs) and other acute care health professionals’ (ACHPs) intentions to use wiki-based knowledge tools in trauma care and identify determinants of this intention that can be used in future theory-based interventions for promoting the use of wiki-based knowledge tools in trauma care. Methods In total, 266 EPs and 907 ACHPs (nurses, respiratory therapists, and pharmacists) from 12 Quebec trauma centers were asked to answer a survey based on the theory of planned behavior (TPB). The TPB constructs were measured using a 7-point Likert scale. Descriptive statistics and Pearson correlations between the TPB constructs and intention were calculated. Multiple linear regression analysis was conducted to identify the salient beliefs. Results Among the eligible participants, 57.1% (152/266) of EPs and 31.9% (290/907) of ACHPs completed the questionnaire. For EPs, we found that attitude, perceived behavioral control (PBC), and subjective norm (SN) were significant determinants of the intention to use wiki-based knowledge tools and explained 62% of its variance. None of the sociodemographic variables were related to EPs’ intentions to use wiki-based knowledge tools. The regression model identified two normative beliefs ("approval by physicians" and "approval by patients") and two behavioral beliefs ("refreshes my memory" and "reduces errors"). For ACHPs, attitude, PBC, SN, and two sociodemographic variables (profession and the previous personal use of a wiki) were significantly related to the intention to use wiki-based knowledge tools and explained 60% of the variance in behavioral intention. The final regression model for ACHPs included two normative beliefs ("approval by the hospital trauma team" and "people less comfortable with information technology"), one control belief ("time constraints"), and one behavioral belief ("access to evidence"). Conclusions The intentions of EPs and ACHPs to use wiki-based knowledge tools to promote best practices in trauma care can be predicted in part by attitude, SN, and PBC. We also identified salient beliefs that future theory-based interventions should promote for the use of wiki-based knowledge tools in trauma care. These interventions will address the barriers to using wiki-based knowledge tools, find ways to ensure the quality of their content, foster contributions, and support the exploration of wiki-based knowledge tools as potential effective knowledge translation tools in trauma care.

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Section: Principal Findingsmentioning

confidence: 99%

Intention to Use Wiki-Based Knowledge Tools: Survey of Quebec Emergency Health Professionals

et al. 2021

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Exploring the impact of a context-adapted decision aid and online training about shared decision making about goals of care with elderly patients in the intensive care unit: a mixed-methods study

Plaisance,

Turgeon,

Souza

et al. 2024

Preprint

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Purpose: To explore the impact of a context-adapted decision aid and an online training about shared decision-making (SDM) about goals of care on the level of involvement of elderly patients by intensivists in SDM about goals of care and quality of goals of care discussions (GCD) in an intensive care unit. Methods: This was a three-phase before-after mixed-methods implementation study conducted in an ICU in Lévis, Quebec, Canada. We followed the StaRI and COREQ reporting guidelines. We recruited patients aged ≥ 65 and their attending intensivists. We video-recorded GCD in three phases: Phase I: GCD without a decision aid; Phase II: GCD with a decision aid about goals of care but no online training; and Phase III: GCD with both a decision aid about goals of care following online training about SDM. All GCD recordings were transcribed verbatim. We measured the level of patient engagement by intensivists in SDM about goals of care through the OPTION scale and evaluated GCD quality using the Audit of Communication, Care Planning, and Documentation (ACCEPT) indicators. A qualitative thematic analysis of the encounters transcriptions was also performed. Results: Out of 359 eligible patients, the study included 21 patients (71% males; median age, 77 years; 57% without high school diploma) and 5 intensivists (80% male; median age, 35). Despite completing online training, the decision aid was never used in recorded encounters. We did not perform any tests of statistical significance to compare results in each study phase because of small sample sizes over each phase. OPTION and ACCEPT scores were low in each phase, but physicians did engage in GCD. We found that 76% of the goals of care recorded in medical records after the discussion were consistent with preferences expressed by patients during recorded observations. Several patients expressed confusion about GCD. Barriers identified by intensivists leading GCD include physician attitudes, challenges to performing GCD along with the demands of the intensive care unit, misunderstandings, and lack of training. Facilitators include a patient-centered approach, a clear decision aid, and positive patient attitudes. In future work, an environment that supports physicians in performing GCD, promotes earlier and higher quality patient GCD before admission to the intensive care unit, and encourages meaningful SDM in critical care must be assessed as pathways to successful intensive care unit GCD. Conclusion: A context-adapted decision aid about goals of care was created in addition to a complementary online training module. The online training was completed by all participating physicians but no increased involvement of patients in SDM during intensive care unit GCD was observed, and use of the decision aid was also not observed. We found several communication barriers that will need to be explored to improve intensive care unit GCD.

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Perspectivas actuales de la formación en la era digital

Angulo Mendoza,

Papi

2023

Med. Med.

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Ce numéro compte trois articles de recherche, un article de praticiens et deux articles de discussions et débats offrant une exploration de divers sujets au cœur de la technologie éducative. D’une part, l’hybridation de l’enseignement, une approche complexe intégrant différentes modalités pour offrir des expériences d’apprentissage optimisées. D’autre part, les pratiques d’interaction en contexte de formation à distance, soulignant l’importance de maintenir des connexions significatives malgré les barrières physiques. Ce numéro explore également la télésurveillance, un outil essentiel pour préserver l’intégrité intellectuelle et lutter contre la fraude dans les examens en ligne. De plus, une réflexion approfondie sur le leadership et la stratégie numérique en contexte scolaire émerge de ces pages, mettant en lumière l’importance d’une vision éclairée pour tirer pleinement parti des technologies éducatives. Enfin, l’édition varia 2023 aborde le lien entre la technologie éducative et la formation en santé, explorant la formation thérapeutique des patients ainsi que la littératie médicale.

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Analyse, développement et évaluation d'une formation médicale en ligne

Cited by 3 publications

References 4 publications

Intention to Use Wiki-Based Knowledge Tools: Survey of Quebec Emergency Health Professionals

Intention to Use Wiki-Based Knowledge Tools: Survey of Quebec Emergency Health Professionals

Exploring the impact of a context-adapted decision aid and online training about shared decision making about goals of care with elderly patients in the intensive care unit: a mixed-methods study

Perspectivas actuales de la formación en la era digital

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