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Join the 2014 Medbiq Conference with David Topps & others to explore effective KT interventions for chronic pain. Discover interactive webinars, scenarios, and forum discussions to improve physician behavior and patient outcomes, all designed to combat professional isolation and promote learning in rural practices.
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Dynia: combining webinars, virtual patients & forums for KT in chronic pain David Topps, Heather Armson, Paul Taenzer, Eloise Carr, Ashi Mehta, Rachel Ellaway Medbiq Conference, 2014 No conflict of interest to declare
The Problem • Poor uptake of CPGs despite great effort • Well-written • Well-publicized as part of TOP guidelines • Knowledge translation • KT interventions incorporating interactive education in chronic noncancer pain led to positive effects on patients' function and knowledge about pain (Ospina et al, 2013) • Measurable change in physician behavior • Potential professional isolation for rural practices
Approach • Webinars for small group learning • Distributed rural sites • Highly interactive sessions • No ‘sage-on-stage’ effect • Virtual patients with SCT • More tuned to experienced docs • Detailed metrics • Online forums • Pre & post webinar discussions
Two SCT Designs • Traditional Script Concordance Testing • Stem, hypothesis given, then does data confirm…? • Avoids best-of-five; all answers reasonable • Better correlation with experience • Modified SCT Design • Stem as usual • Prioritized choice of hypotheses, + data confirm…? • Rapid Reporting Real-time Responses (4R)
Scenario Based Design • ‘Scenario-Based eLearning Design’ – R Colvin Clark • Based on SBL workshop from Medbiq 2013 • Blended PBL & other activities • Subject matter experts • For case design & webinar presentation • Cases authored by VP experts • based on SME content • mini-series to illustrate changed thinking
OLab3 as SBL Design tool • Use Visual Editor map to link cases & activities • Similar to LAMS • www.lamscommunity.org • but simpler and more flexible
Scenario Manager: control over who gets to play what when Scenario Manager in OLab3
Scenario Manager: view progress during play Scenario Manager in OLab3
Secure Forum • To guard against confidentiality lapses • Only 3 data points to make a case identifiable • Single sign-on • Tight linking with cases and nodes • Very useful for collaborative authoring • IMS-LTI integration with Entrada • Considered at that point • Timeline constraints
Results • Very high engagement • Despite being conceptually demanding • Few technical glitches • Echo with many machines in same room • Quotes and comments • Esp from SME about doing the cases so quickly • Low traffic on Forums • Did not have critical mass
Results • Example of 4R report graph • Failure on 2nd webinar was big disappointment
SCT Results • Concordance lower than other SCT papers • But cases designed to be challenging & controversial rather than an exam
PARTICIPANT PHA TE YUAN REFERENCE
Exploring ADL-xAPI • Manual data analysis very time consuming • Experience API very applicable • Export to Learning Record Store • Detailed analysis of metrics through 3rd party tools
Conclusions • Highly engaging combination • SCT approach preferred by docs in practice • Subtle shift in practice over series • Not as great as expected • But purposively sampled highly-updated sites