Digital Education for Health Professions on Smoking Cessation Management: Systematic Review by the Digital Health Education Collaboration

Semwal, Monika; Whiting, Penny; Bajpai, Ram; Bajpai, Shweta; Kyaw, Bhone Myint; Car, Lorainne Tudor

doi:10.2196/13000

Cited by 42 publications

(29 citation statements)

References 44 publications

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“…The online educational program and web-based resources had a significant impact on nurses self-reported intervention with patients, confirming what others have found in clinical trials 29 . Additionally, it created a network of nurse champions who are poised to become leaders in tobacco control in their countries.…”

Section: Discussionsupporting

confidence: 87%

Building capacity in tobacco control by establishing the Eastern Europe Nurses’ Center of Excellence for Tobacco Control

Bialous

Nohavová

Králíková

et al. 2020

Tob. Prev. Cessation

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INTRODUCTION Properly educated nurses delivering evidence-based tobacco dependence treatment could contribute to improving health and reducing regional disparities in tobacco-related disease and death in Central and Eastern Europe. The aims of this study are to describe development of the Eastern European Nurses’ Centre of Excellence for Tobacco Control (COE) and evaluate its online educational program on tobacco dependence treatment using the 5As framework. METHODS The online education evaluation followed a prospective, single group, pre- and post-assessment of changes in nurses’ self-reported tobacco cessation interventions. Leaders from five Eastern European countries (Hungary, Czech Republic, Romania, Slovakia, Slovenia) developed protocols for in-country tobacco control education. Nurses responded to a baseline survey, accessed an online nursing educational program, and completed a follow-up survey at 3 months, in the period December 2015 to June 2016. A total of 695 nurses from five countries answered questions on cessation interventions at baseline and of these 507 (73%) completed a follow-up survey at 3 months. RESULTS At the follow-up at 3 months, the 507 nurses self-reported a significant increase in providing all 5A components, i.e. nurses were significantly (p<0.0001) more likely to always /usually advise a patient to quit, assess interest in quitting (p=0.002), assist with a quit plan, review barriers to quitting and recommend a smoke-free home post-discharge (all p<0.0001). They were also significantly more likely (p=0.01) to agree or strongly agree that nurses have an obligation to advise patients on the risks of smoking. There was a significant increase (p<0.0001) in nurses’ estimate of the number of patients they provided a cessation intervention the previous week. Nurses who smoked were 60% more likely to assist and arrange compared to nurses who never smoked. CONCLUSIONS Coordinating multi-country activities through a COE was successful in engaging a network of nurses to use an online educational program and participate in other tobacco control activities.

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Section: Discussionsupporting

confidence: 87%

Building capacity in tobacco control by establishing the Eastern Europe Nurses’ Center of Excellence for Tobacco Control

Bialous

Nohavová

Králíková

et al. 2020

Tob. Prev. Cessation

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“…We are also aware of recent reviews, which reached similar conclusions [55-62]. For example, digital education seems to be at least as effective (and sometimes more effective) as traditional education in improving dermatology, diabetes management, or smoking cessation–related skills and knowledge [58,61,62]. Most of these reviews, however, stressed the inconclusiveness of overall findings mainly because of the low certainty of the evidence.…”

Section: Discussionmentioning

confidence: 84%

Offline Digital Education for Postregistration Health Professions: Systematic Review and Meta-Analysis by the Digital Health Education Collaboration

Posadzki¹,

Bała²,

Kyaw³

et al. 2019

J Med Internet Res

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Background The shortage and disproportionate distribution of health care workers worldwide is further aggravated by the inadequacy of training programs, difficulties in implementing conventional curricula, deficiencies in learning infrastructure, or a lack of essential equipment. Offline digital education has the potential to improve the quality of health professions education. Objective The primary objective of this systematic review was to evaluate the effectiveness of offline digital education compared with various controls in improving learners’ knowledge, skills, attitudes, satisfaction, and patient-related outcomes. The secondary objectives were (1) to assess the cost-effectiveness of the interventions and (2) to assess adverse effects of the interventions on patients and learners. Methods We searched 7 electronic databases and 2 trial registries for randomized controlled trials published between January 1990 and August 2017. We used Cochrane systematic review methods. Results A total of 27 trials involving 4618 individuals were included in this systematic review. Meta-analyses found that compared with no intervention, offline digital education (CD-ROM) may increase knowledge in nurses (standardized mean difference [SMD]=1.88; 95% CI 1.14 to 2.62; participants=300; studies=3; I2=80%; low certainty evidence). A meta-analysis of 2 studies found that compared with no intervention, the effects of offline digital education (computer-assisted training [CAT]) on nurses and physical therapists’ knowledge were uncertain (SMD 0.55; 95% CI –0.39 to 1.50; participants=64; I2=71%; very low certainty evidence). A meta-analysis of 2 studies found that compared with traditional learning, a PowerPoint presentation may improve the knowledge of patient care personnel and pharmacists (SMD 0.76; 95% CI 0.29 to 1.23; participants=167; I2=54%; low certainty evidence). A meta-analysis of 4 studies found that compared with traditional training, the effects of computer-assisted training on skills in community (mental health) therapists, nurses, and pharmacists were uncertain (SMD 0.45; 95% CI –0.35 to 1.25; participants=229; I2=88%; very low certainty evidence). A meta-analysis of 4 studies found that compared with traditional training, offline digital education may have little effect or no difference on satisfaction scores in nurses and mental health therapists (SMD –0.07; 95% CI –0.42 to 0.28, participants=232; I2=41%; low certainty evidence). A total of 2 studies found that offline digital education may have little or no effect on patient-centered outcomes when compared with blended learning. For skills and attitudes, the results were mixed and inconclusive. None of the studies reported adverse or unintended effects of the interventions. Only 1 study reported costs of interventions. The risk of bias was predominantly unclear and the certainty of the evidence ranged from low to very low. Conclusions There is some evidence to support the effectiveness of offline digital education in improving learners’ knowledge and insufficient quality and quantity evidence for the other outcomes. Future high-quality studies are needed to increase generalizability and inform use of this modality of education.

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“…For the purpose of this review, digital education can be defined as “an approach to teaching and learning, representing all or part of the educational model applied, that is based on the use of electronic media and devices as tools for improving access to training, communication and interaction, that facilitates the adaptation of new ways of understanding and developing learning” [33]. Digital education encompasses a variety of learning modalities including computer-based online/offline digital education (online/offline digital education), high-fidelity mannequins, virtual reality environments, virtual patient scenarios, serious gaming and gamification, and mobile learning, etc [15,20,27,34-36]. It is often combined with traditional nondigital learning, known as blended learning.…”

Section: Methodsmentioning

confidence: 99%

“…The potential benefits of digital education for health professions education have been evaluated in previous reviews and acknowledged by the World Health Organization [12-14,24-27]. While there are reviews on the use of digital education in specific pediatric fields (eg, emergency or rehabilitation care) and for undergraduate education [28-30], we are unaware of any systematic review assessing the effectiveness of digital education in the field of pediatrics for postregistration health professionals.…”

Section: Introductionmentioning

confidence: 99%

Digital Health Professions Education in the Field of Pediatrics: Systematic Review and Meta-Analysis by the Digital Health Education Collaboration

Brusamento¹,

Kyaw²,

Whiting³

et al. 2019

J Med Internet Res

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BackgroundReducing childhood morbidity and mortality is challenging, particularly in countries with a shortage of qualified health care workers. Lack of trainers makes it difficult to provide the necessary continuing education in pediatrics for postregistration health professionals. Digital education, teaching and learning by means of digital technologies, has the potential to deliver medical education to a large audience while limiting the number of trainers needed.ObjectiveThe goal of the research was to evaluate whether digital education can replace traditional learning to improve postregistration health professionals’ knowledge, skills, attitudes, and satisfaction and foster behavior change in the field of pediatrics.MethodsWe completed a systematic review of the literature by following the Cochrane methodology. We searched 7 major electronic databases for articles published from January 1990 to August 2017. No language restrictions were applied. We independently selected studies, extracted data, and assessed risk of bias, and pairs of authors compared information. We contacted authors of studies for additional information if necessary. All pooled analyses were based on random effects models. We included individually or cluster randomized controlled trials that compared digital education with traditional learning, no intervention, or other forms of digital education. We assessed the quality of evidence using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) criteria.ResultsTwenty studies (1382 participants) were included. Participants included pediatricians, physicians, nurses, and midwives. Digital education technologies were assessed including high-fidelity mannequins (6 studies), computer-based education (12 studies), mobile learning (1 study), and virtual reality (1 study). Most studies reported that digital education was either as effective as or more effective than the control intervention for outcomes including skill, knowledge, attitude, and satisfaction. High-fidelity mannequins were associated with higher postintervention skill scores compared with low-fidelity mannequins (standardized mean difference 0.62; 95% CI 0.17-1.06; moderate effect size, low-quality evidence). One study reported physician change in practicing behavior and found similar effects between offline plus online digital education and no intervention. The only study that assessed impact on patient outcome found no difference between intervention and control groups. None of the included studies reported adverse or untoward effects or economic outcomes of the digital education interventions. The risk of bias was mainly unclear or high. The quality of evidence was low due to study inconsistencies, limitations, or imprecision across the studies.ConclusionsDigital education for postregistration health professions education in pediatrics is at least as effective as traditional learning and more effective than no learning. High-fidelity mannequins were found to be more effective at improving skills than tradit...

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Digital Education for Health Professions on Smoking Cessation Management: Systematic Review by the Digital Health Education Collaboration

Cited by 42 publications

References 44 publications

Building capacity in tobacco control by establishing the Eastern Europe Nurses’ Center of Excellence for Tobacco Control

Building capacity in tobacco control by establishing the Eastern Europe Nurses’ Center of Excellence for Tobacco Control

Offline Digital Education for Postregistration Health Professions: Systematic Review and Meta-Analysis by the Digital Health Education Collaboration

Digital Health Professions Education in the Field of Pediatrics: Systematic Review and Meta-Analysis by the Digital Health Education Collaboration

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