[Show abstract][Hide abstract] ABSTRACT: To evaluate the acceptability and relevance of the Maximizing your Patient Education Skills (MPES) course and to determine whether it significantly improved knowledge regarding patient education (PE) theory, self-assessed PE competencies, and PE skills using case based vignettes.
1-Group, multi-site, pre-post-intervention. Participants completed a pre-assessment (T1), participated in the 4-h MPES course, and then a 3-month post-assessment (T2). A focus group was conducted with sub-set of participants.
98 (75%) of participants completed both time points. Participants were highly satisfied with MPES and found it to be relevant. Results showed that MPES had a significant impact on all of our outcome measures.
Findings from this study show that oncology HCPs knowledge of patient education theory, self-assessed competencies and skills can improve after participating in a brief problem-focused and interactive workshop.
Given the evidence that well-planned education and support can contribute to a number of positive health outcomes and the evidence that HCPs may lack the skills to teach and support patients and their families effectively, these results suggest that MPES course may be of value to oncology professionals. Efforts to further develop this course include exploring alternative funding models and using different learning platforms.
Patient Education and Counseling 08/2011; 84(2):176-84. · 2.60 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The present analyses were conducted to examine demographic and clinical variables associated with mood and health-related distress in a sample of 440 women completing primary treatment for early-stage breast cancer. The authors' aim was to test the hypothesis that higher levels of self-efficacy and perceived preparedness for the end of treatment--the reentry phase--are associated with better mood and lower health-related distress in this sample. Women who had received chemotherapy and who were younger (<50 years) had significantly higher mood disturbance and health-related distress scores. Younger age, preparedness, and self-efficacy predicted 36% of the variance in mood disturbance scores. Self-efficacy and age predicted 26% of the variance in health-related distress. Although further research is needed, our findings suggest that self-efficacy and perceived preparedness represent important constructs to target in the development of interventions for women at the reentry transition.
Journal of Psychosocial Oncology 05/2010; 28(3):269-90. · 1.04 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The introduction of a transformative technology into practice settings can affect the functioning of interprofessional teams, placing stress on interprofessional relationships, thus slowing adoption and change. This study explored the potential of an interprofessional education (IPE) approach to mediate this stress and facilitate the adoption of a transformative technology- Image Guided Radiation Therapy (IGRT). Oncologists, physicists, and therapists in radiation medicine who attended an interprofessional IGRT Education Course were interviewed about perceived benefits and stressors to IPE and to interprofessional practice (IPP) in the IGRT context. A modified grounded theory approach was used to conduct 14 interviews, with 200 minutes of interview time recorded. In introducing IGRT, participants noted interprofessional stress in understanding and adopting new technology. IPE offered common terminology, appreciation for others' knowledge, and a holistic framework for practice. Outcomes were thought to foster collaboration, efficiency, and improved professional role definition. Time constraints and power relations were noted to be residual stressors exacerbated by IPE, but were thought to be transient. IPE can thus be of benefit in the implementation of transformative technologies such as IGRT, through mediation of interprofessional stress inherent in change. Interprofessional knowledge, collaboration, and efficiency in practice facilitate the development and adoption of a new practice model.
Journal of Interprofessional Care 04/2010; 24(6):710-21. · 1.48 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Breast cancer survivors experience a wide range of survivorship issues that are not always adequately addressed. This study is an assessment of the Survivorship Consult (SC), a one-to-one clinician-led reflective interview used to capture a comprehensive summary of the survivor experience, to determine its impact on self-efficacy and the perceived likelihood that it initiates behavior change. Using a pre-test/post-test design, data were collected from participants (N = 40) using validated instruments and opened-ended questions to evaluate the SC. Participants found the SC to be a useful tool for planning and goal setting and improved self-efficacy as measured by the Cancer Behavior Inventory with an increase of 2.0 (p = 0.03). The SC demonstrates promise in improving the ability and confidence of breast cancer survivors to manage their care, but further research is required to understand the optimal implementation of this intervention and its impact on the delivery of survivorship services.
Journal of Cancer Education 04/2010; 25(3):457-63. · 0.88 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Personal health records (PHR) offer great promise in transforming the patient experience, but a number of support issues must be addressed to ensure that patients have appropriate access to their health information. Two hundred and fifty breast cancer patients registered to use a portal providing access to personal health information over a six-week period. All support calls were directed to a research triage centre and redirected either to technical, clinical or psychosocial support. Log files were coded and analyzed. Two hundred and thirty-nine support contacts were logged by 122 participants. The majority was referred to technical support; the remaining contacts were directed to clinical support. Seven categories of technical support were identified: registration problems, site access, login issues, password reset, activation key issues, result access and other difficulties. In accessing their test results, patients required support in a number of technical domains, but educational and psychosocial support were not heavily utilized.
Journal of healthcare information management: JHIM 01/2010; 24(1):57-63.
[Show abstract][Hide abstract] ABSTRACT: Personal health records (PHRs) provide patients with access to personal health information (PHI) and targeted education. The use of PHRs has the potential to improve a wide range of outcomes, including empowering patients to be more active participants in their care. There are a number of widespread barriers to adoption, including privacy and security considerations. In addition, there are clinical concerns that patients could become anxious or distressed when accessing complex medical information. This study assesses the implementation of a PHR, and its impact on anxiety levels and perceptions of self-efficacy in a sample of breast cancer patients.
A quasi-experimental pre-test/post-test design was used to collect data from participants to evaluate the use of the PHR. Study participants completed background and pre-assessment questionnaires and were then registered into the portal. By entering an activation key, participants were then able to review their lab results and diagnostic imaging reports. After six weeks, participants completed post-assessment questionnaires and usability heuristics. All data were collected using an online survey tool. Data were cleaned and analyzed using SAS v9.1.
A total of 311 breast cancer patients completed demographic and pre-assessment questionnaires, 250 registered to use the online intervention, and 125 participants completed all required study elements. Matching the pre- and post-anxiety scores demonstrated a decrease in mean anxiety scores (-2.2, p = 0.03); the chemotherapy sub-group had a statistically insignificant mean increase (1.8, p = .14). There was no mean change in self-efficacy scores.
Participants generally found the portal easy to use; however, the perceived value of improved participation was not detected in the self-efficacy scores. Having access to personal health information did not increase anxiety levels. While these results suggest that the use of this PHR may be of benefit for informing patients, further research is required to investigate the impact on the patients experiences, their participation in their care, their relationships with the health care team, and their health outcomes.
BMC Medical Informatics and Decision Making 01/2010; 10:46. · 1.60 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Determining admission criteria that will predict successful student outcomes is a challenging undertaking for newly established health professional programs. This study examined data from the students who entered a medical radiation sciences program in September 2002. By analyzing the correlation between undergraduate GPA, grades in undergraduate science courses, performance in program coursework, and post-graduation certification examination results, the authors determined admission criteria that were linked to successful student outcomes for radiological technology and radiation therapy students.
[Show abstract][Hide abstract] ABSTRACT: Part two of this two-part series presents the results of a departmental initiative implemented in 2003 at a large urban cancer centre, Princess Margaret Hospital (PMH) in Toronto, Ontario, Canada. This new model for radiation therapists was called Advanced Integrated Practice (AIP) and was developed, in part, to encourage and promote scholarship within radiation therapy. The AIP model incorporated integrated clinical specialty roles designed to blend exemplary clinical practice with focused academic activities. This paper discusses an evaluation of the AIP model undertaken to obtain a formal measure of how the model had evolved, how the radiation therapists and other stakeholders were responding to the new model, whether the initial outcomes were realized and to create plans for further development of the design. The evaluation utilized a mixture of traditional qualitative research methodologies such as focus groups, quantitative surveys and a variety of other available measurable outcomes. Outcomes from the model included increased opportunities for diverse roles that incorporated an element of academic practice and augmented career choice and scope for radiation therapists. In addition, academic output and research work also increased within the department. Lessons learned from the implementation and evaluation of the model are shared, and the authors offer some suggestions to increase scholarly activity within the profession.
Journal of Radiotherapy in Practice 05/2008; 7(02):105 - 111.
[Show abstract][Hide abstract] ABSTRACT: As radiation therapy practice evolves with advancing treatment and planning technologies, merging of imaging modalities, changing working models and the advancement to higher education, radiation therapists are frequently finding themselves on the frontline of translating new knowledge into practice. To a large degree, this growing involvement in self-directed original research, with associated dissemination of completed results, has led to an increasing number of therapists being encouraged to pursue an academic path in addition to a clinical career. In Canada, radiation therapists are being appointed as faculty to university departments for the first time. It is heartening that such opportunities are increasing; therapists are able to play a profound role in developing an evidence-based professional body of knowledge while at the same time being recognised for scholarly endeavours. However, despite these many positive steps, barriers and challenges to the development of a scholarly culture for radiation therapists still exist. Part one of this two-part series explores the history of the profession and the subsequent development of a scholarly culture.
Journal of Radiotherapy in Practice 05/2008; 7(02):99 - 104.
[Show abstract][Hide abstract] ABSTRACT: Academic difficulty can often be a significant problem for students in health professional programmes. Students in difficulty are often identified late in their training and run the risk of dismissal if remediation is not successful. Since the inception of the Medical Radiation Sciences Program (MRSP) at the University of Toronto, Faculty of Medicine, and the Michener Institute (MI) in 1999, a number of students have required remediation due to problems in the didactic or clinical component of their training. Not all remediation was successful, and a number of students have been dismissed. There is relatively sparse evidence in the educational literature regarding the nature of academic difficulties that health professional students encounter, and what constitutes appropriate remedial education. The purpose of this research was to evaluate the incidence and prevalence of remediation in the MRSP and the nature of the academic problems. In addition, this study looked at the type of remedial instruction that the Radiation Sciences Board of Examiners (BOE) recommended for these students as well as the effectiveness of these recommendations.
This study consisted of a review of the academic records of students who failed one or more courses and underwent pre-clinical or clinical remediation, and who were presented at the Medical Radiation Sciences Board of Examiners at the University of Toronto between September 1999 and December 2004. Data extraction forms were developed to obtain demographic information, the nature of the academic problems, the remedial recommendation, and their outcomes.
This study identified 69 students who were presented to the BOE 95 times. Forty-four students (44/69, 64%) were from the Radiation Therapy stream, 16 students (16/69, 23%) were from the Nuclear Medicine stream and 9 students (9/69, 13%) were from the Radiographic Technology stream. Most of the remediation occurred due to pre-clinical 50 (50/69, 72%), clinical 15 (15/69, 22%) and both preclinical and clinical problems 4 students (4/69, 6%). Out of 54 students who required pre-clinical remediation, 40 (74%) were promoted. Out of 19 students who required clinical remediation, 10 (10/19, 53%) passed their remediation. Six students (6/69, 9%) were dismissed from the programme due to unsuccessful remediation; 2 due to pre-clinical and 4 due to clinical problems. Based on these results, the remediation process at the MRSP was successful; however, 6 students (6/69, 9%) were dismissed from the programme during the last 4 years despite lengthy unsuccessful remediation.
Our study provided an important perspective about the remediation process at the MRSP at the Michener Institute for Applied Health Sciences. Despite its retrospective methodology, it attempted to identify the magnitude of learning problems that lead to remediation, and identified the efficacy of the remedial programmes.
Annals of the Academy of Medicine, Singapore 10/2007; 36(9):725-34. · 1.36 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To conduct a needs assessment to identify patient and provider perceptions about providing patients with access to their electronic health record in order to develop an online system that is appropriate for all stakeholders.
Malignant hematology patients were surveyed and health care providers were interviewed to identify issues and validate concerns reported in the literature. Based on the analysed data, a prototype will be designed to examine the feasibility and efficacy of providing patients with access to their electronic health record and tailored information.
61% of patients reported using the internet to find health information; 89% were interested in accessing their electronic health record and 79% stated they would benefit from educational material along with the results. Staff members viewed patient online access to the record favourably, but expressed the importance of providing the necessary patient support and education. A Web-based prototype was developed for patients to review their registration data and blood results.
Hematology oncology patients are more interested in using the internet to monitor their clinical information than to find health information. Using the constructed prototype, the feasibility of this project is currently being tested.
Canadian oncology nursing journal = Revue canadienne de nursing oncologique 02/2006; 16(3):154-64.
[Show abstract][Hide abstract] ABSTRACT: This study assessed cancer patients' knowledge and attitudes towards clinical trials (CTs).
A survey was administered to 100/141 cancer outpatients.
82% respondents had heard of CTs, but many could only provide limited definitions and perceived them as high risk. About half had previously been approached to participate in a trial, and 67% had agreed to participate. Factors influencing participation in trials, barriers to recruitment, and suggestions for increased recruitment in clinical trials were identified.
The findings suggest general support of CTs. Education programs are needed to raise awareness, reduce fears, and dispel myths about CT participation.
Journal of Cancer Education 02/2006; 21(4):237-42. · 0.88 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The study evaluated the effectiveness of a two-day continuing education (CE) course developed to increase multidisciplinary oncology professionals' awareness of psychosocial issues and to equip them with the skills and knowledge necessary to identify psychosocial issues and intervene effectively.
Attendees (n = 120) were asked to complete a pre- and 6-month postcourse questionnaire assessing psychosocial orientation using the Physician Belief Scale and the ability to identify psychosocial issues; they were also asked to suggest appropriate interventions based on five case vignettes.
Sixty-nine (56%) participants returned the precourse questionnaire, and 42 (35%) returned the postcourse questionnaire. Psychosocial orientation increased significantly from precourse to postcourse (P = .03). Based on the five case vignettes, participants were able to identify significantly more psychosocial issues (10.5 vs. 7.7, P = .005) and suggest more interventions (12.6 vs. 8.7, P < .001) 6 months following the course.
These findings support the effectiveness of a two-day CE course to improve oncology professionals' psychosocial orientation and ability to identify psychosocial issues and interventions.
Journal of Cancer Education 02/2004; 19(3):161-4. · 0.88 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Introduction Volunteerism is a fertile field for research (Ellis, 1985; Independent Sector, 2002; Institute for Volunteering Research, 1997; Hall et al., 2001), and investigating relevant issues is not only of academic interest, it is also immediately useful to practitioners in volunteer programs. The purpose of this paper is to highlight significant administrative issues within the volunteer program of the Patient Education Program in Princess Margaret Hospital (PMH), a comprehensive care oncology hospital within the University Health Network (UHN) located in Toronto, Canada. PMH has created a highly useful and successful volunteer system for patient education (PE), in which volunteers can make an effective and personally fulfilling contribution to the education and support of patients and their families. Such volunteer activities can be crucial in empowering those dealing with cancer (see also Fusco-Karman and Tamburini,. Administrative support is an essential component of any program development effort (Diamond, 1989), and volunteer administration is a crucial and continually evolving component of our PE program. A variety of volunteer administration models exist (Culp, et al., 1998), and our administrative model of volunteer recruitment, training and support is presented here, with the understanding that the strategies and principles that we have developed are transferable to other situations, including those beyond healthcare. While we recognize that no one formula exists for a volunteer program, we describe our model for the management and use of volunteers for PE in our context in the hope that others will benefit from our understandings and programs. What follows is a discussion of the key points we identified as important in our developing PE program. We describe the PE program at PMH and the role of volunteers in its success. We then detail the formalized volunteer management systems and procedures in our program. Specifically, we consider the role of the Director of Patient Education, the necessity of collaboration in the development, and design of our volunteer curriculum, and finally issues around volunteer motivation, satisfaction, support and recognition.