Designing Tailored Web-Based Instruction to Improve Practicing Physicians' Preventive Practices

Division of Continuing Medical Education, University of Alabama School of Medicine, Birmingham, AL 35294-4551, USA.
Journal of Medical Internet Research (Impact Factor: 4.67). 09/2003; 5(3):e20. DOI: 10.2196/jmir.5.3.e20
Source: PubMed

ABSTRACT The World Wide Web has led to the rapid growth of medical information and continuing medical educational offerings. Ease of access and availability at any time are advantages of the World Wide Web. Existing physician-education sites have often been designed and developed without systematic application of evidence and cognitive-educational theories; little rigorous evaluation has been conducted to determine which design factors are most effective in facilitating improvements in physician performance and patient-health outcomes that might occur as a result of physician participation in Web-based education. Theory and evidence-based Web design principles include the use of: needs assessment, multimodal strategies, interactivity, clinical cases, tailoring, credible evidence-based content, audit and feedback, and patient-education materials. Ease of use and design to support the lowest common technology denominator are also important.
Using these principles, design and develop a Web site including multimodal strategies for improving chlamydial-screening rates among primary care physicians.
We used office-practice data in needs assessment and as an audit/feedback tool. In the intervention introduced in 4 phases over 11 months, we provided a series of interactive, tailored, case vignettes with feedback on peer answers. We included a quality-improvement toolbox including clinical practice guidelines and printable patient education materials.
In the formative evaluation of the first 2 chlamydia modules, data regarding the recruitment, enrollment, participation, and reminders have been examined. Preliminary evaluation data from a randomized, controlled trial has tested the effectiveness of this intervention in improving chlamydia screening rates with a significant increase in intervention physicians' chlamydia knowledge, attitude, and skills compared to those of a control group.
The application of theory in the development and evaluation of a Web-based continuing medical education intervention offers valuable insight into World Wide Web technology's influence on physician performance and the quality of medical care.

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    ABSTRACT: Andragogy is as old as man itself, but its individualization as a learning theory only emerged in the late XX century. In the medical field, there is a significant experience regarding its use on pre-graduate teaching; however, the studies regarding its use in continuing medical education are still relatively scarce, and mainly address issues related with gestures teaching. We designed this study with the purpose of understanding the motivations that impel physicians to continue studying, which are their most frequently adopted teaching/learning methods and how do they evaluate the formations they attend to. For that purpose, we built and validated three different questionnaires (motivations, preferred learning methods and formations assessment), that were presented altogether to a group of 95 physicians from several medical specialties, selected according to a convenience criteria. The results revealed that, in fact, physicians do study in a continuous way, mainly for their own personal satisfaction, and to satisfy their update needs. They study mainly to be able to respond to daily clinical problems, and, although they initially give preference to acquire knowledge in a passive approach (reading books and scientific magazines), they give primacy to more active methods (discussion with fellows and practical knowledge application) for structuring, consolidating or updating previous knowledge. Most physicians do not seek scientific meetings as a learning method, although they acknowledge the importance of such meetings for knowledge acquisition and practise improvement. The place where meeting formations take place is not relevant in the learning process, but as far as timing is concerned, extra-labour programs are more motivating. The most frequently attended formation activities were based on expositive methods, and met initial expectations for more than half of the responders. Less than half of the responders acknowledged the formers importance in the learning process.
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