Telehealth Presntation AB PS

1. Teaching healthcare professionals Telehealth Dr Arin Basu Dr Philippa Seaton Associate Professor Ray Kirk Health Sciences Centre University of Canterbury Presented at the HIC 2010, Melbourne, Australia

2. Outline of this presentation • The Issue • Why we wanted to do the study • What did we hope to find • How did we do the study • What did we find • What does it mean

3. The Issue • Telehealth (TH) is important for NZ • Telehealth practice scope is expanding • Yet TH uptake is low (best estimate 25%) • TH is not part of undergraduate health professional curricula • TH is unique in medical care: • Popular and needed • Fast, rapid development • Yet little formal training available to practitioners

4. What did we want to study? • We == a multidisciplinary team (physician, nurse, health sciences professor, educator, social scientist) • What pedagogical and professional teaching and learning models were being followed in teaching TH to health professionals? • Conduct a systematic review of the available literature • Build models based on TH training practices

5. What was done?

6. Study Question • What specific teaching programmes aimed at teaching healthcare professionals to practice Telehealth are reported in peer-reviewed literature? • Wherever available, what is the relative effectiveness of one training method over another?

7. Databases Searched • Databases in the UC libray • Pubmed • CINAHL • Google and Google Scholar • Specialist telehealth journals • Hand searches

8. Inclusion Criteria • The study was published between 1999-2009, • The study was peer reviewed prior to publication, • The study was published in an English language journal, and • The objective or primary goal of the study was about teaching Telehealth to health care professionals in practice. • The inclusion criteria were relaxed

9. Exclusion Criteria • If they did not meet inclusion criteria • Descriptive alone • Websites only • No evaluation

10. Search Terms Used (Student* OR resident OR intern* OR “house officer*”OR pgy* OR nurs* OR train*) AND (teach* OR curr* OR pedagog* OR syllab*) AND tele*

11. Review Workflow

12. Data Analysis • Two steps • Stage I: Review of titles and abstract and removed studies that did not meet criteria • Stage II: Reviewed full text articles and extracted data • Used Interpretive data analysis techniques using NVivo 8 • Developed and defined emergent pedagogical themes

13. Summary Table

14. List of included Studies • Amarasaikhan et al (2007) rural physician training in Mongolia • Asprey et al (2001) physician assistants at Iowa • Atack (2004) about Team teaching for nurses in USA • Blignault (1999) about Queensland Telemedicine Network • Brebner et al (2003) about A & E programme in UK • Giansanti et al (2008) about training Path Technicians in Italy • Glinkowski (2007) about teaching anatomy to medical students and preparing them • Kobb (2008) about evaluation of web based materials in USA • Seifert (2004) about Telepharmacy project in Texas • Zafar (2008) about Telemedicine programme in Pakistan

15. Emergent Theme - context • Role of context • What resources were available • Availability of the equipment • Internet connection and facilities • Speed and bandwidth • What was the context and work climate that had to happen? • Work context • Do physicians understand?

16. Emergent theme - readiness • Are the learners ready for the lessons? • Are they computer literate? • Can they handle the equipment? • Lesson: Prepare the learners in using the appropriate technology

17. Emergent theme - content • Careful selection of content and planning is necessary for success • Use a participatory design approach (enable “hands-on” learning) • Use the learning styles (recall, reflect, build) • Prepare for practice, not just knowledge acquisition • Promote interprofessional communication • Build effective communication skills

18. Dynamic Linkages of the Theme

19. The significance of the findings • Telehealth education is practice learning in the workplace • Formal needs assessment from the learner perspective helps • Going beyond didactic approach (non-didactic) • Videoconferencing, posters, product flyers, hands on helpful • Learning transfer depends on context and work climate

20. Lessons from the project • TH related learning is workplace practice skill acquisition • Immediate quality of experience (“Outward Bound Model”) works • The role of apprenticeship models in Telehealth • Role of the coach • Role of apprentice modeling the master in chunks of lessons • Give the learners a conceptual model to observe before the task • Scaffold the learner as he or she learns to master the task • Fade gradually and promote the learner proficiency

21. Conceptual Model on TH

22. In summary … • A project to identify what are the existing practices in Telehealth • Did not find a whole lot • We could use the existing literature to build a beginning model • There is a scope for doing educational research and identifying best practices in TH • The results are based on student ratings, so open to questions

23. Acknowledgment and Team • Ako Aotearoa Southern Hub funded the project • Health Sciences Centre, UC where the work was done • Jane Mountier as Research Assistant • Team members • Dr Arindam Basu • Associate Professor Ray Kirk • Dr Philippa Seaton • Dale Sheehan • Elizabeth Hanley • Dr Billy O Steen • Dr Mary Allan