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There is interest in the potential of internet-delivered programs to cost-effectively increase access to pain management for people with chronic pain. However, few large-scale clinical and economic evaluations have been undertaken. Using a randomised controlled trial design, the current study (n = 659) examined the clinical efficacy, cost-effectiveness and cost-utility of an internet-delivered pain management program for people with mixed chronic pain conditions when delivered with optional clinician support. The treatment group reported significant improvements in disability, depression, anxiety, average pain intensity and quality-adjusted life-years (QALYs), compared to control, and exhibited relatively high levels of treatment engagement and satisfaction. Each additional clinical improvement (defined as ≥ 30% improvement) produced by the intervention, over control, was associated with a cost (AUD) of $48, $27, $38 and $83 for disability, depression, anxiety and average pain intensity, respectively. Gainion period. The findings support the clinical efficacy and cost-effectiveness of internet-delivered programs with 'on demand' clinician support as a way to increase access to pain management. Key limitations of the current study include the use of a waitlist-control group, a short follow-up period, and the focus on governmental healthcare costs. Further evaluation of these programs is necessary if they are scaled up and offered as routine care.
The goal of continuing professional development (CPD) is to improve patient care. However, traditionally, CPD has been planned and taught by clinicians, for clinicians, who tend to be protective of the professional-only environment for learning and are wary of the contributions and participation of patients. Although patients are sometimes included as guest speakers, this role has not typically extended to planning, content development, or serving as key faculty-ultimately excluding the patient perspective from the development and delivery of CPD. The absence of the patient perspective in CPD creates an inadvertent blind spot, hindering the opportunity for clinicians to hone patient-centric skills that are learned and practiced through training. As shared decision-making rises in importance among expected clinician competencies, the involvement of patients is becoming more essential. Patients can be our best teachers, and their inclusion in CPD can engage clinicians' hearts as well as minds and reinforce thnt and delivery of CPD. The absence of the patient perspective in CPD creates an inadvertent blind spot, hindering the opportunity for clinicians to hone patient-centric skills that are learned and practiced through training. As shared decision-making rises in importance among expected clinician competencies, the involvement of patients is becoming more essential. Patients can be our best teachers, and their inclusion in CPD can engage clinicians' hearts as well as minds and reinforce the reasons why our work matters. TGF-beta inhibitor Patients are often more willing to engage in clinician education than we may realize, but educators must take the first step and invite them to participate and collaborate. This article will describe how to create a plan for engaging patients as partners, including guidance for gaining buy-in from leadership and faculty; recruiting, training, and nurturing patients; determining roles and responsibilities; and creating a safe space for patient participation.
Canada's maintenance of certification programs for physicians has evolved to emphasize assessment activities. Our organization recognized the importance of offering more practice assessment opportunities to our members to enhance their practice and help them comply with a regulation from our provincial professional body related to ongoing continuing education. This led us to rethink our annual congress and enrich the program with a curriculum of interdisciplinary simulation sessions tailored to meet the needs of a broad audience of specialists. Our challenges are similar to those of many national specialty societies having limited access to simulation facilities, instructors, and simulation teams that can cover the breadth and scope of perceived and unperceived simulation needs for their specialty. Our innovative solution was to partner with local experts to develop 22 simulation sessions over the past three years. The response was very positive, drawing 867 participants. Over 95% of participants either agrtice or patient outcomes. We were able to centralize offers from organizations that had previously worked in silo to develop simulation sessions meeting the needs of our members. Proposing simulation sessions allowed our organization to establish long-term partnerships and to expend our "educational toolbox" to address skill gaps not usually addressed during annual meetings.
Both patients and providers in the United States (US) suffer from burnout, which can impact the clinical relationship and quality of care. Among providers, burnout is a state of exhaustion including heightened depersonalization; among patients, burnout can negatively affect clinical outcomes. More than half of clinical providers in the United States suffer from burnout; less is known about the magnitude and prevalence among patients. Understanding patient burnout will improve our recognition of treatment barriers, understanding of patient-provider communication, and perceived quality of care. The purpose of the 2019 Stanford University MedicineX Burnout Workgroup was to use a collaborative approach to expand on the National Academy of Medicine (NAM) Wellness and Resilience Model, which does not currently include the patient as an influential member of the care team potentially experiencing burnout. This collaboration among patients, physicians, students, caregivers, technologists, and researchers used a con providers. The design of this workgroup was informed by Everyone Included, a model that recognizes and rejects hierarchical traditions in clinical practice. This approach allowed for the creation of a safe space for the exchange of knowledge between the various stakeholders. The resulting inclusive conceptual model, The Burnout Dyad, describes a cocreated care experience informed by both patient and provider characteristics.
A new multisource feedback (MSF) program was specifically designed to support physician quality improvement (QI) around the CanMEDS roles of Collaborator, Communicator, and Professional. Quantitative ratings and qualitative comments are collected from a sample of physician colleagues, co-workers (C), and patients (PT). These data are supplemented with self-ratings and given back to physicians in individualized reports. Each physician reviews the report with a trained feedback facilitator and creates one-to-three action plans for QI. This study explores how the content of the four aforementioned multisource feedback program components supports the elicitation and translation of feedback into a QI plan for change.
Data included survey items, rater comments, a portion of facilitator reports, and action plans components for 159 physicians. Word frequency queries were used to identify common words and explore relationships among data sources.
Overlap between high frequency words in surveys and rater comments was substantial. The language used to describe goals in physician action plans was highly related to respondent comments, but less so to survey items. High frequency words in facilitator reports related heavily to action plan content.
All components of the program relate to one another indicating that each plays a part in the process. Patterns of overlap suggest unique functions conducted by program components. This demonstration of coherence across components of this program is one piece of evidence that supports the program's validity.
All components of the program relate to one another indicating that each plays a part in the process. Patterns of overlap suggest unique functions conducted by program components. This demonstration of coherence across components of this program is one piece of evidence that supports the program's validity.
Involvement of patients in continuing professional development (CPD) is less developed than in health professional education at undergraduate or postgraduate levels. Although patients are sometimes involved in delivering CPD, they are less likely to be involved in education planning. At our institution, patients have sometimes acted as consultants in the design of CPD. The problem we address is how to engage patients as partners throughout the design process. We applied principles of authentic patient engagement and lessons learned from patient involvement in undergraduate health professional education to the design of CPD for family physicians. We created a partnership between the CPD Office and Patient and Community Partnership for Education, a unit with a history of patient involvement in the education of health professional students. Practices for meaningful involvement were identified through literature review, environmental scan, and interviewing key informants, including patients involved in health per buy-in; mechanisms to identify those patients best able to contribute expertise; ways to facilitate involvement that work for both patients and CPD providers; the importance of feedback mechanisms to patient partners; and recognition for patient contributions. CPD offices should view integration of patient partners in program planning as an opportunity to engage in ongoing quality improvement.
Leveraging online learning tools and encouraging transfer of learning to practice remains a critical challenge to successful continuing professional development (CPD) offerings. Four sets of factors are essential to the transfer of learning from CPD into practice learner characteristics, instructional design, content, and environment. Through incorporating elements of educational theories/frameworks into the planning of online CPD activities, educators can maximize opportunities for learning transfer. In this article, we highlight four educational theories/frameworks that provide useful insight to tackle these interrelated factors in online CPD Self-Determination Theory considers the intrinsic and extrinsic motivation of participants, which can be encouraged through flexibility, customization, and choices available in online formats. Practical Inquiry Model encourages intentionally planning and embedding opportunities for reflection and dialogue in online activities to enhance knowledge application. VirtualCPD to support participants' application of newly acquired knowledge.
Completion of continuing education hours might not guarantee the achievement of new competencies. Influenza vaccination training was provided to pharmacists in the United Arab Emirates (UAE), who had no similar training in their pharmacy degree. The training was developed and conducted at Gulf Medical University, UAE. Influenza vaccine administration is not yet a privilege for pharmacists in the UAE. This study focuses on determining whether a defensible cut score for the influenza vaccination training multiple-choice questions examination is feasible.
Influenza vaccination training and assessment happened on the same day. The Angoff (modified), Beuk, and Hofstee methods were used for standard-setting. Six subject matter experts who were involved in developing and conducting the first influenza vaccination training in the UAE evaluated the cut score using the Angoff method with the Delphi technique.
The criterion-based cut score was 34.23 of 46 questions, with mean 74% and SD 2.24. Inter-rater reliability was 0.
