Evaluation of a home study continuing education program on patient teaching skills

Abstract

Key Words: Evaluation, home study, patient teaching skills Patient education is an essential component of health care. However, at the end of a clinic visit or hospitalization, patients recall only about 50% of the recommendations given by the health care team.'-' Perhaps recall is no greater because health care professionals (HCPs) fail to use teaching skills known to improve instructional effectiveness and to enhance patient recall and satisfaction.'-' In addition, health care providers have identified lack of training in how to teach as one barrier to providing effective patient education. Although undergraduate and graduate cumcula may address the theoretical basis for teaching, h o p t s to teach is often overlooked or minimized."-' Practicing HCPs report that formal training is not readily available.The "Effective Patient Teaching" (EPT) program was developed to help HCPs improye their patient teaching and adherence counseling skills. The 3-day workshop consists of demonstration or modeling, practice, and feedback on use of operationally defined skills. Careful evaluations of EPT have shown significant gains in the teaching skills of medical and nursing students, as well as practicing HCPs.h."' In addition, surrogate patient recall was significantly greater when taught by EPT participants than that achieved by an untrained, matched, comparison group.. Moreover, improvements in participants' teaching skills have been shown to translate to the clinical setting 1 week and 1 month after EPT." This article describes the development and formative evaluation of a home study version of the Effective Patient Teaching course.We started out with considerable optimism about making use of the home study approach. For one thing, both telephone and written inquiries about the EPT workshop course often contained requests that EPT be taught in a selfstudy format. as did evaluations received from participants in the workshop EFT course. In addition, two thirds of the respondents to the 1988 Needs Assessment Survey of the American Association of Diabetes Educators (the AADE is a national organization fostering both professional growth and quality education 156 Boswell et al.for patients with diabetes'*) cited self-study modules as their favored method of continuing education (personal communication).We were especially impressed by a review of the literature, which indicates that programs offered as self-study courses are in demand, are feasible, and are cost-effective. Commonly cited reasons for requesting self-study programs include the lack of study time because of ever-increasing work demands, the convenience of being able to learn at one's own pace, and constraints on workshopkonference attendance because of tight budgets.l3-I5The literature also reports that completion rates for self-learning programs are generally acceptable. One self-study on the management of pressure woundsi6 showed a completion rate of 72% (compared with a 56% rate for nurses studying the same topic as an in-service program). Another study that exam...

Web-based continuing medical education (II): Evaluation study of computer-mediated continuing medical education

“…[6][7][8] Other distance learning technologies such as correspondence and home-study print-based materials, videoconferencing, and interactive television to provide CME were also reported. [9][10][11][12][13][14][15] Recently, the growth and development of the Internet, World Wide Web (Web), and interactive multimedia compact disk read-only memory Abstract Background: Over the years, various distance learning technologies and methods have been applied to the continuing medical education needs of rural and remote physicians. They have included audio teleconferencing, slow scan imaging, correspondence study, and compressed videoconferencing.…”

Can distance learning improve smoking cessation advice in family practice? A randomized trial

“…First, although our sample size was comparable with other evaluations of distance learning, 28,[35][36][37] our study may not have had sufficient power to detect important changes in educational outcomes had they occurred. Second, our assumption that those who did not complete the post-test questionnaire had not changed from baseline also may have biased the findings toward a null result.…”

Improving the skills of health professionals in engaging patients in diabetes-related problem solving

“…It is the successor to "EPT," which, from 1983 to 1996, was offered to undergraduate medical, nursing, and dietetic students 14,15 and to practicing health professionals. [16][17][18] Evaluations of the original EPT program demonstrated that participants' didactic teaching skills changed, 14,19 changes translated to the practice environment, 20 changes persisted for at least several months, 21 and EPT could be effectively disseminated at other institutions. [22][23][24] Despite these successes, evaluations also showed that EPT did not result in meaningful improvement in participants' use of teaching techniques thought to help patients make lifestyle changes.…”

“…We reached two conclusions: direct instruction skills useful for accomplishing goals suggested by the left half of the continuum had been well defined and could be taught, [14][15][16][17][18][19][20][21][22][23][24]35,36 but specific, operationally defined skills for engaging patients in problem solving had not. Defining those skills was accomplished via a systematic process of literature review, solicitation of advice from experts who had published research articles about problem solving in diabetes, and statistical analysis of professional judgments about the skills (The process will be described in detail elsewhere.)…”