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Biomedical subjects

Vernon Curran

Publications and source records attributed to Vernon Curran.

14 recordsLinked to original sources
PubMed2006

The development and testing of a performance checklist to assess neonatal resuscitation megacode skill.

PURPOSE: The purpose of this work was to develop and assess the feasibility, reliability, and validity of a brief performance checklist to evaluate skills during a simulated neonatal resuscitation ("megacode") for the Neonatal Resuscitation Program of the American Academy of Pediatrics. METHODS: A performance checklist of items was created, validated, and modified in sequential phases involving: an expert committee, review, and feedback by Neonatal Resuscitation Program instructors for feasibility and criticality and use of the performance checklist by Neonatal Resuscitation Program instructors reviewing videotaped megacodes. The final 20-item performance checklist used a 3-point scale and was assessed by student and instructor volunteers. Megacode scores, the NRP multiple-choice examination scores, student assessments of their ability and performance, and sociodemographic descriptors for both students and instructors were collected. Data were analyzed descriptively. In addition, we assessed the megacode score internal consistency reliability, the correlations between megacode and multiple-choice examination scores, and the variance in scores based on instructor and student characteristics. RESULTS: A total of 468 students and 148 instructors volunteered for the study. The instrument was reliable and internally consistent. Student's scores were high on most items. There was a significant but low correlation between the megacode score and the written knowledge examination. Instructor and student characteristics had little effect on the variance in scores. CONCLUSIONS: This performance checklist provides a feasible assessment tool. There is evidence for its reliability and validity.

Clinical Competence↗
PubMed2006

Facilitating interpersonal interaction and learning online: linking theory and practice.

INTRODUCTION: An earlier study of physicians' perceptions of interactive online learning showed that these were shaped both by program design and quality and the quality and quantity of interpersonal interaction. We explore instructor roles in enhancing online learning through interpersonal interaction and the learning theories that inform these. METHODS: This was a qualitative study using focus groups and interviews. Using purposive sampling, 50 physicians were recruited based on their experience with interactive online CME and face-to-face CME. Qualitative thematic and interpretive analysis was used. RESULTS: Two facilitation roles appeared key: creating a comfortable learning environment and enhancing the educational value of electronic discussions. Comfort developed gradually, and specific interventions like facilitating introductions and sharing experiences in a friendly, informative manner were helpful. As in facilitating effective small-group learning, instructors' thoughtful use of techniques that facilitated constructive interaction based on learner's needs and practice demands contributed to the educational value of interpersonal interactions. DISCUSSION: Facilitators require enhanced skills to engage learners in meaningful interaction and to overcome the transactional distance of online learning. The use of learning theories, including behavioral, cognitive, social, humanistic, and constructivist, can strengthen the educational design and facilitation of online programs. Preparation for online facilitation should include instruction in the roles and techniques required and the theories that inform them.

Attitude of Health Personnel↗
PubMed2006

Evaluation of learning outcomes in Web-based continuing medical education.

BACKGROUND: There has been significant growth in use of Web-based continuing medical education (CME) by physicians. A number of evaluation and metareview studies have examined the effectiveness of Web-based CME to varying degrees. One of the main limitations of this literature has been the lack of systematic evaluation across different clinical subject matter areas using standardized Web-based CME learning formats. METHOD: One group of pretest-postest designs were used to evaluate knowledge and self-reported confidence change across multiple Web-based courses using a standardized instructional format but comprising distinct clinical subject matter. Participants also completed a participant satisfaction survey and a self-reported retrospective skill/ability change survey. RESULTS: The majority of courses evaluated demonstrated significant pre to post knowledge and confidence effect size change, as well as significant self-reported retrospective practice change. CONCLUSIONS: A Web-based CME instructional format comprising multimedia-enhanced learning tutorials supplemented by asynchronous computer-mediated conferencing for case-based discussions was found to be effective in enhancing knowledge, confidence, and self-reported practice change outcomes across a variety of clinical subject matter areas.

Attitude of Health Personnel↗
PubMed2005

Advances in rural medical education in three countries: Canada, the United States and Australia.

INTRODUCTION: This article documents a number of rural medical education initiatives in Australia, Canada and the United States. A typology is created reflecting the centrality the rural mandate and characterizing different features of each school's program. Interviews with school officials are drawn on to reflect the challenges these schools face. METHOD: Seven schools noted for their rural programs were selected from the three countries and interviews were conducted with senior officials. The interview data was supplemented by published material on the schools. RESULTS: The Typology: Three kinds of school are distinguished: Mixed Urban/Rural Schools (University of Washington, US, the University of British Columbia, Canada and Flinders University, Australia); DeFacto Rural Schools (University of New Mexico, US and Memorial University, Canada) and Stand Alone Rural Schools (James Cook University, Australia and the Northern Ontario School of Medicine, Canada). The Pipeline Approach: All of the schools adopted in varying degrees a pipeline approach to meeting the need for rural doctors focusing on: (a) early recruitment; (b) admissions; (c) locating clinical education in rural settings; (d) rural health focus to curriculum; and (e) support for rural practice. CONCLUSION: The analysis does not strongly favor one model over others, although the Stand-Alone Rural schools had more opportunities to adopt innovative curricula reflecting rural health issues and to foster positive views of rural practice. Government funding targeting rural health needs will remain critical in the development of all these programs.

Australia↗
PubMed2005

Prostate cancer screening attitudes and continuing education needs of primary care physicians.

BACKGROUND: In May 2003, a survey questionnaire was distributed to all licensed primary care physicians in Newfoundland and Labrador. The objective was to examine the attitudes, self-reported practices, and continuing medical education (CME) preferences of primary care physicians as they pertain to prostate cancer screening. METHODS: Data was obtained from 485 primary care physicians using self-reports of prostate cancer screening practices, attitudes towards prostate cancer screening, and CME preferences. Respondents' characteristics were also collected (eg, gender, years of experience). RESULTS: A majority of respondents screen asymptomatic male patients for prostate cancer. Screening behaviour was related to high volume practice settings, fee-for-service and increased with patient age. Most common reasons for screening were family history, age of patient, and patient request. Majority of physicians agreed that prostate screening should be routinely performed on all men beginning at age 50, however half of physicians believe there is lack of evidence to support digital rectal examination (DRE) and one-third of physicians do not believe the prostate-specific antigen (PSA) nor DRE are accurate screening tests. Areas of greatest interest for CME included topics related to prostate cancer screening effectiveness, strategies for prevention, sexual dysfunction, available treatments and their side effects, and management options. CONCLUSION: Physicians are supportive of the value of screening, however the reliability of and evidence to support DRE and PSA as prostate cancer screening tests are in question. CME which addresses issues surrounding prostate screening and areas related to patient education and counselling are of greatest need.

Attitude of Health Personnel↗
PubMed2004

Interactive on-line continuing medical education: physicians' perceptions and experiences.

INTRODUCTION: Although research in continuing medical education (CME) demonstrates positive outcomes of on-line CME programs, the effectiveness of and learners' satisfaction with interpersonal interaction in on-line CME are lower Defined as faculty-learner or learner-learner interpersonal interaction, this study explores physicians' perceptions of and experiences in interactive on-line CME and factors influencing these. METHODS: Focus groups and interviews were undertaken by three Canadian universities. Using purposive sampling, we recruited physicians based on their experiences with interactive on-line CME. Content analysis was applied first, followed by a comparative analysis to confirm themes and findings. RESULTS: Physicians based their perceptions of interactive on-line CME by comparing it with what they know best, face-to-face CME. Although perceptions about access and technical competency remained important, two other themes emerged. The first was the capacity of on-line CME to meet individual learning preferences, which, in turn, was influenced by the quality of the program, the degree of self-pacing or self-direction, opportunity for reflection, and educational design. The second was the quality and quantity of interpersonal interaction, which was shaped by perceptions of social comfort, the educational value of interactions, and the role of the facilitator. Prior experience with on-line CME moderated perceptions. DISCUSSION: The extent that on-line CME programs reflected characteristics of high-quality CME and individual learning preferences appeared to shape perceptions about it. It is important to incorporate the characteristics of effective CME into the design and implementation of interactive on-line programs, considering diverse learning preferences, providing faculty development for on-line facilitators, and grounding this work in learning theory.

Attitude of Health Personnel↗
PubMed2004

The role of medical education in the recruitment and retention of rural physicians.

In many countries the sustainability of rural healthcare systems is being challenged by a shortage of rural physicians and difficulties in recruiting and retaining physicians in rural practice. There are numerous factors that influence efforts in rural physician recruitment and retention, many of which are beyond the scope of the academic medical centre and medical education. Nevertheless, there are strategies that medical schools can adopt to contribute to efforts to recruit and retain physicians in rural communities. Rural student recruitment, admissions policies, rural-oriented medical curriculum, rural practice learning experiences, faculty values and attitudes, and advanced procedural skills training are areas which the medical school has direct control of and which have been shown to influence the likelihood of medical students entering rural primary care practice. The purpose of this paper is to elaborate on some of the key strategies that have been identified in the literature.

Career Choice↗
PubMed2003

Discourse analysis of computer-mediated conferencing in World Wide Web-based continuing medical education.

INTRODUCTION: Computer-mediated conferencing (CMC) is a computer messaging system that allows users to engage in asynchronous text-based communications that are independent of time and place. It has been suggested that CMC is an effective modality for facilitating constructivist learning environments that enable adult learners to engage in a continuous, collaborative process of building and reshaping knowledge and understanding. The goals of this exploratory study were to assess the nature of the interactions and collaborative learning characteristics exhibited in World Wide Web-based continuing medical education courseware programs that used CMC and to examine physicians' satisfaction with on-line CMC discussion as a planned learning activity of Web-based CME. METHOD: The Transcript Analysis Tool (TAT) was used to analyze the nature of the discourse that took place in four different Web-based CME courseware programs. Course evaluation surveys and interviews were also conducted with participants to evaluate their satisfaction with on-line CMC discussion. RESULTS: The results suggest that the nature of participation in the programs consisted primarily of independent messages with a minimal amount of learner-to-learner interaction. Elements of critical reflection, interaction, and debate between participants appeared to be missing from these discussions. As such, these discussions were not characteristic of the principles of constructivist learning environments. DISCUSSION: Interactive participation will not occur just because CMC is being used. The design of Web-based CME learning activities, participant characteristics, and facilitation are key factors that influence the effective use of CMC.

Communication↗
PubMed2003

Application of a responsive evaluation approach in medical education.

INTRODUCTION: This paper reports on the usefulness of a responsive evaluation model in evaluating the clinical skills assessment and training (CSAT) programme at the Faculty of Medicine, Memorial University of Newfoundland, Canada. The purpose of this paper is to introduce the responsive evaluation approach, ascertain its utility, feasibility, propriety and accuracy in a medical education context, and discuss its applicability as a model for medical education programme evaluation. METHODS: Robert Stake's original 12-step responsive evaluation model was modified and reduced to five steps, including: (1) stakeholder audience identification, consultation and issues exploration; (2) stakeholder concerns and issues analysis; (3) identification of evaluative standards and criteria; (4) design and implementation of evaluation methodology; and (5) data analysis and reporting. This modified responsive evaluation process was applied to the CSAT programme and a meta-evaluation was conducted to evaluate the effectiveness of the approach. RESULTS: The responsive evaluation approach was useful in identifying the concerns and issues of programme stakeholders, solidifying the standards and criteria for measuring the success of the CSAT programme, and gathering rich and descriptive evaluative information about educational processes. The evaluation was perceived to be human resource dependent in nature, yet was deemed to have been practical, efficient and effective in uncovering meaningful and useful information for stakeholder decision-making. CONCLUSIONS: Responsive evaluation is derived from the naturalistic paradigm and concentrates on examining the educational process rather than predefined outcomes of the process. Responsive evaluation results are perceived as having more relevance to stakeholder concerns and issues, and therefore more likely to be acted upon. Conducting an evaluation that is responsive to the needs of these groups will ensure that evaluative information is meaningful and more likely to be used for programme enhancement and improvement.

Clinical Competence↗
PubMed2003

Experiences of rural women with breast cancer receiving social support via audioconferencing.

We examined the process of social support for breast cancer survivors in rural Newfoundland and Labrador. The subjects were 11 participants in a social support programme that made use of audioconferencing. The core social psychological process by which women received social support consisted of four distinct but overlapping stages: getting connected to the network; finding a voice; connecting with others; and becoming empowered. The findings suggested that support groups facilitated via audioconferencing can transcend geographical distance and permit women living in rural areas to share experiences with each other and to learn from and teach each other. The use of telephone and audioconferencing technologies should be encouraged for the provision of information and support to people in rural settings, where such services may be especially beneficial.

Adult↗
PubMed2002

Teaching digital rectal examinations to medical students: an evaluation study of teaching methods.

PURPOSE: The digital rectal examination (DRE) is a necessary part of a complete physical examination and evaluation of a patient, yet teaching of this examination to medical students is often inadequate. This study was a comparative evaluation of the effectiveness of the rectal teaching associate (RTA), lecture, role-playing, and simulated models as methods for teaching the DRE procedure to undergraduate medical students at Memorial University of Newfoundland Faculty of Medicine. METHOD: A total of 65 third-year medical students were randomly assigned to either an experimental or control group. Both groups received a lecture and practiced the DRE on a simulated model. The experimental group received further training from an RTA. Students completed a pre- and post-intervention knowledge assessment, an objective structured clinical exam (OSCE) measuring performance of the DRE, and a satisfaction survey. RESULTS: Mean knowledge scores increased significantly for both groups (18.73 to 22.32, p <.0001). The control group scored significantly higher on the post-intervention assessment than did the experimental group (23.11 versus 21.47, p =.025) The experimental group scored higher on the OSCE (27.52 versus 23.80, p =.001) and rated the RTA as a more effective method for learning the DRE. CONCLUSIONS: This first study using RTAs to teach the DRE as a global skill for evaluating the rectum suggests that the RTA method is effective for increasing skills and students' confidence in the procedure.

Curriculum↗
PubMedDate not supplied

[Adapting medical education to meet the physician recruitment needs of rural and remote regions in Canada, the US and Australia].

Australia, Canada and the United States have large land masses containing many sparsely populated regions. Each of these countries has experienced difficulty in meeting the physician recruitment needs of its rural and remote regions. This paper reports on a study of selected Australian, Canadian and American medical education programs designed to meet the health professional needs of rural and remote areas. The study is based on published material from the institutions studies, supplemented by a series of interviews with senior academic officials in the institutions involved. The paper focuses on a range of strategies, from recruitment and admissions policies, to exposure to rural clinical practice and modified curricula, each designed to produce medical graduates with a strong orientation to rural practice. The study highlights the important role played by special government funding targeted at rural medical education initiatives and discusses the challenges that such initiatives face.

Australia↗