Avantages et inconvénients de la formation médicale continue virtuelle : une étude de la portée

Introduction: With the COVID-19 pandemic, most continuing medical education activities became virtual (VCME). The authors conducted a scoping review to synthesize the advantages and disadvantages of VCME to establish the impact of this approach on inequities that physicians face along the intersections of gender, race, and location of practice. Methods: Guided by the methodological framework of Arksey and O’Malley, the search included six databases and was limited to studies published between January 1991 to April 2021. Eligible studies included those related to accredited/non-accredited post-certification medical education, conferences, or meetings in a virtual setting focused on physicians. Numeric and inductive thematic analyses were performed.   Results: 282 studies were included in the review. Salient advantages identified were convenience, favourable learning formats, collaboration opportunities, effectiveness at improving knowledge and clinical practices, and cost-effectiveness. Prominent disadvantages included technological barriers, poor design, cost, lack of sufficient technological skill, and time. Analysis of the studies showed that VCME was most common in the general/family practice specialty, in suburban settings, and held by countries in the Global North. A minority of studies reported on gender (35%) and race (4%).  Discussion: Most studies report advantages of VCME, but disadvantages and barriers exist that are contextual to the location of practice and medical subspecialty. VCME events are largely organized by Global North countries with suboptimized accessibility for Global South attendees. A lack of reported data on gender and race reveals a limited understanding of how VCME affects vulnerable populations, prompting potential future considerations as it evolves. Introduction : Par suite de la pandémie de la COVID-19, la plupart des activités de formation médicale continue ont été offertes en ligne. Les auteurs ont effectué une revue de la portée visant à synthétiser les avantages et les inconvénients de la formation médicale continue en mode virtuel (FMCV) et à examiner les effets de cette approche sur les inégalités qui affectent les médecins en fonction du sexe, de la race et du lieu d’exercice. Méthodes : Suivant le cadre méthodologique d’Arksey et O’Malley, nous avons effectué une recherche dans six banques de données, que nous avons limitée aux études publiées entre janvier 1991 et avril 2021. Les études incluses étaient celles relatives à la formation médicale post-certification, accréditée ou non, aux conférences et aux réunions destinées aux médecins qui se sont déroulées dans un cadre virtuel. Une analyse numérique et une analyse thématique inductive ont été réalisées. Résultats : Au total, 282 articles ont été inclus dans l’étude. Les principaux avantages identifiés sont la commodité, les formats favorables à l’apprentissage, les possibilités de collaboration, l’efficacité pour l’amélioration des connaissances et des pratiques cliniques et le rapport coût-efficacité. Les principaux inconvénients sont les obstacles technologiques, les défauts de conception, le coût, les compétences technologiques insuffisantes et le manque de temps. L’analyse des études a montré que la FMCV était la plus courante dans la spécialité de la médecine générale/familiale, dans les banlieues et dans les pays du Nord. Quelques études considèrent les facteurs sexe (35 %) et race (4 %). Discussion : La plupart des études évoquent les avantages de la FMCV, mais il existe des inconvénients et des obstacles liés au lieu d’exercice et à la sous-spécialité médicale. La plupart des activités de FMCV sont organisées dans les pays du Nord et leur accessibilité n’est pas optimale pour les participants provenant des pays du Sud. Le manque de données sur le sexe et la race pose une limite à notre compréhension de la façon dont la FMCV affecte les populations vulnérables. Ces facteurs seraient à prendre en considération dans les recherches futures sur le sujet et au fur et à mesure que la FMCV évolue.

The effect of interactivity in an online course on behavior change and self-efficacy among health care professionals

Continuing Medical Education (CME) interventions continue to be an important factor in the lifelong learning of health care professionals. Online interventions have become increasingly popular since the inception of the Internet. Many CME courses (traditional and online) are evaluated solely on the knowledge gained and participant reactions. However, this study focused on the instructional design of an online CME course and how the design affected the self-efficacy of the learner and the amount of knowledge transferred to the professionals’ practice. Specifically, this study answered the following research questions: 1) How can one design online instruction that will foster a change in health care professionals’ behavior from the course and into medical practice? 2) How can one design online instruction that will increase health care professionals’ self-efficacy with the presented content? The researcher designed two online CME courses regarding the clinical diagnosis of Lyme disease. One course incorporated very few interactive, instructional elements, while the second course incorporated audio, video, and interactive elements. The researcher collected data using both quantitative and qualitative methods via pre-tests, post-tests, a final survey given to participants three weeks after completing the online course, and four interviews. The findings indicated that the knowledge, self-efficacy, and behavior did improve for the majority of participants. However, interactive, instructional elements were not found to be the sole reason for the increase of knowledge, self-efficacy, and change in behavior. The present study did confirm that the instructional design of online courses was important. These results suggest that future CME designers should continue to investigate elements within online courses to see which elements are found to be the most valuable for learners’ gain in knowledge, self-efficacy, and a change in behavior

Creating a strategy of learning : engaging with mental health : lived experience through the use of media narratives

This commentary examines six of my publications, which collectively create an innovative strategy of learning. It is concerned with engaging mental health practitioners and learners more fully with service user lived experience through guided exposure to selected media narratives. The primary intention of this is to facilitate attitudinal change amongst health care professionals, promoting a greater sense of understanding and connectedness with those experiencing mental health difficulties. My learning strategy is concerned with the following elements: The media narrative Facilitation / guided learning Reflective practice Collaborative learning / co-production The media narrative as a learning resource is critically reviewed and gauged to have huge learning potential where facilitative input is offered at distinct stages of access: before, during and after. It is demonstrated that through engaging with this process over a succession of cycles the development of reflective and reflexive practitioners can be promoted. An essential part of my learning strategy concerns the ‘testing out’ of learning, undertaken through a collaborative inquiry process with service users in practice as well as classroom settings. This fosters empathic understanding, an essential component of professional practice. 9 My learning strategy contributes significantly to the existing knowledge and practice base concerning the educational use of media narratives, service user engagement and lived experience learning. It has much to offer in terms of promoting empathic understanding and emotional intelligence, developing reflective practitioners and creating closer working partnerships with service users. The impact from my work has been verified through widespread adoption of my teaching resources, complimentary reviews, numerous citations, and invitations to present at conferences and community workshops. Future directions involve furthering my collaborative engagement with service users and engaging in coproduction work, as well as facilitating narrative sharing amongst those with communicative restrictions, and extending the educative process beyond the healthcare arena, influencing attitudes through encouraging dialogue and reflection around mental health experience