Knowledge transfer for the management of dementia: a cluster-randomised trial of blended learning in general practice

Abstract

BackgroundThe implementation of new medical knowledge into general practice is a complex process. Blended learning may offer an effective and efficient educational intervention to reduce the knowledge-to-practice gap. The aim of this study was to compare knowledge acquisition about dementia management between a blended learning approach using online modules in addition to quality circles (QCs) and QCs alone.MethodsIn this cluster-randomised trial with QCs as clusters and general practitioners (GPs) as participants, 389 GPs from 26 QCs in the western part of Germany were invited to participate. Data on the GPs' knowledge were obtained at three points in time by means of a questionnaire survey. Primary outcome was the knowledge gain before and after the interventions. A subgroup analysis of the users of the online modules was performed.Results166 GPs were available for analysis and filled out a knowledge test at least two times. A significant increase of knowledge was found in both groups that indicated positive learning effects of both approaches. However, there was no significant difference between the groups. A subgroup analysis of the GPs who self-reported that they had actually used the online modules showed that they had a significant increase in their knowledge scores.ConclusionA blended learning approach was not superior to a QCs approach for improving knowledge about dementia management. However, a subgroup of GPs who were motivated to actually use the online modules had a gain in knowledge.Trial registrationCurrent Controlled Trials ISRCTN36550981.

Dementia diagnosis and management: a narrative review of changing practice

“…In studies of the facilitated or small-group educational strategies, qualitative analysis of facilitated learning suggested that it can improve knowledge and self-directed learning, 15 while practicebased workshops and decision-support software appeared to improve the detection rate but not the management, in a trial of Blended learning techniques only demonstrated a significant improvement in knowledge gain when GPs self-reported using the online modules. 20 Among interventions that altered the care pathway, the trial of an in-home assessment of patients' mental wellbeing and functional capacity showed a significant improvement in detection rates. 23 Two studies of case management demonstrated improved management either by providing care more adherent to guidelines, increasing referrals to community services, and increasing anti-cholinesterase prescribing, 24 or by reducing hospital use and consultation rates with physicians, and by decreasing feelings of depression or isolation.…”

“…This found that both 'blended learning' and classical learning methods improved knowledge in these areas, but no significant difference between the groups was found, although a subgroup analysis showed that when GPs self-reported as having used the e-learning modules, their knowledge gain was significantly better than the other group's (an increase in knowledge score of 1.17, 95% confidence interval [CI] = 0.20 to 2.14, P = 0.019). 20 Four of the educational intervention studies investigated facilitated or smallgroup teaching. Facilitated learning can be described as an educational process wherein the learners are actively involved by collaborating and negotiating in all components of their own learning.…”

“…Clinicians/practices were able to review and adapt the prompts to suit their local services and personnel. Vollmar et al 2010; 20 Two interventions: 1. Online learning modules + structured case discussion.…”

A systematic review to compare the effectiveness of face-to-face versus online (including blended learning) delivery of CME/CPD for healthcare practitioners (HCPs)

“…In face-to-face with online learning, and only two studies [98,104], compared blended with face-toface learning. There were no studies comparing blended with online learning only.…”

“…Four studies were from Europe, with one, [103] being conducted amongst general practitioners (GPs) from central London and Scotland, another, [3] with GPs working in the NHS across Spain, the third, [104] through primary care quality circles in Western Germany and the last [105] being conducted with occupational physicians through the Amsterdam University, Netherlands.…”