Performance Assessment Through Pre- and Post-training Evaluation of Continuing Medical Education Courses in Prevention and Management of Cardio-Vascular Diseases in Primary Health Care Facilities of Armenia

Abstract

To assess the difference of pre- and post-training performance evaluation of continuing medical education (CME) courses in cardio-vascular diseases (CVD) management among physicians at primary health care facilities of Armenian regions we conducted an evaluation survey. 212 medical records were surveyed on assessment of performance before and after the training courses through a self-employed structured questionnaire. Analysis of survey revealed statistically significant differences (p < 0.05) in a number of variables: threefold increased recording of lipids and body mass index (p = 0.001); moderate increased recording of comorbidities and aspirin prescription (p < 0.012); eightfold increased recording of dyslipidemia management plan, twofold increased recording for CVD management plan and fivefold increased recording for CVD absolute risk (p = 0.000). Missing records of electrocardiography and urine/creatinine analyses decreased statistically significantly (p < 0.05). Statistically significant decrease was observed in prescription of thiazides and angiotensin receptor blockers/angiotensin converting enzyme inhibitors (p < 0.005), while prescription of statins and statins with diet for dyslipidemia management showed increased recording (p < 0.05). Similarly, we observed increased records for counseling of rehabilitation physical activity (p = 0.006). In this survey most differences in pre- and post-evaluation of performance assessment may be explained by improved and interactive training modes, more advanced methods of demonstration of modeling. Current findings may serve a basis for future planning of CME courses for physicians of remote areas facing challenges in upgrading their knowledge, as well as expand the experience of performance assessment along with evaluation of knowledge scores.

Interventions to Improve Clinical Coordination between Levels: Participatory Experience in a Public Healthcare Network in Xalapa, Mexico

“…Participants noted improved trust and knowledge among primary care and secondary care physicians, according to the reflexive methods implemented in the joint training meetings, which are factors that influence care coordination by promoting the interest of professionals in collaborating and communicating with others levels of care [ 2 51 ]. Therefore, it is important to spread this type of intervention in order to improve clinical coordination by promoting agreement on treatments and establishing joint reference criteria, resulting in more appropriate and timely referrals [ 52 53 ], which occurred during the joint training meetings on maternal health, compared to conventional training [ 54 55 56 57 ]. This aspect is especially relevant for the Veracruz context, in which the results of the baseline study showed low values for mutual trust (11.5%) and personal knowledge (49.9%) among physicians in the healthcare network [ 3 4 ].…”

Strategies to address non-communicable diseases in the Commonwealth of Independent States countries: a scoping review

“…Coexistence of specialists in PHC facilities does not motivate family doctors to learn more, because it is easier to refer them to specialists (Asadov and Aripov, 2009;Oleszczyk et al, 2012). Therefore, it is important to prepare health professionals for PHC with a focus on prevention and early detection of diseases at undergraduate, postgraduate, and continuous medical education levels (Lilit Khachatryan, 2013;Krzton-Krolewiecka et al, 2013;Gruzeva et al, 2016aGruzeva et al, , 2016b. A study conducted in 30 European countries and some CIS countries confirmed that building General Practice/Family Medicine in academic discipline comprising teaching and research was essential to strengthen the PHC system (Zarbailov et al, 2017;Kasimova, 2018;Akhmedov and Jarylkasynova, 2010).…”

Medical Education in the Former Soviet Union: Opportunities in Armenia

“…The vast majority of Armenian citizens believe that the diaspora is a positive force in the development of the country [ 8 ]. The Armenian diaspora has made numerous healthcare contributions to the country: Short-term mission trips to various villages, conferences between diaspora and local healthcare professionals, collaborations with local physicians on conducting research and organizing continuing medical education courses [ 15 ]. However, these efforts tend to focus on short-term interventions, they are largely uncoordinated, and their impact is rarely measured.…”