scholarly journals Knowledge of physicians regarding the management of Type two Diabetes in a primary care setting: the impact of online continuous medical education

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Zahra Emami ◽  
Azam Kouhkan ◽  
Alireza Khajavi ◽  
Mohammad E. Khamseh
Keyword(s):  
Primary Care ◽  
Medical Education ◽  
Primary Care Physicians ◽  
Diabetes Management ◽  
Glycosylated Hemoglobin ◽  
Oral Glucose ◽  
Significant Difference ◽  
Post Test ◽  
Type Two Diabetes ◽  
The Impact

Abstract Background To explore the impact of an online continuing medical education (CME) program on physicians’ knowledge about the management of type two diabetes. Methods An online CME program was designed and uploaded in the CME platform, Department of Education, Ministry of health, Iran. A 28-item questionnaire was used for the assessment. In the beginning, a case scenario was introduced. Then, participants were asked to follow and answer to a pretest assessment. Details of the educational content were provided afterward. Finally, the participants took part in the same post-test exam 4 weeks later. The Wilcoxon matched-pairs signed-ranks test was used to compare the measurements. In addition, the Mann-Whitney test was applied to compare knowledge indices between the general practitioners (GPs) and internists. Results Five hundred twenty-six primary care physicians participated in this study. There was a significant positive effect regarding diagnosis confirmation (10.3% difference, P = 0.0001). Moreover, a smaller effect was observed in relation to the importance of glycosylated hemoglobin (HbA1c) at diagnosis (5.2% difference, P = 0.0006). The effect was positive in relation to the self-reported HbA1c testing frequency: more than 90% of the participants answered correctly in the post-test exam (7.6% difference, P = 0.0001). Considering improved knowledge in the treatment of diabetes, there was a very significant difference in response to questions targeting advice on a healthy diet, and physical activity; 27.7% (P = 0.000), and 18.7% (P = 0.000), respectively. In addition, the program had a positive impact on various aspects of treatment with oral glucose-lowering drugs (OGLDs). Moreover, the intervention difference was 25, and 34.4% for the questions targeting the appropriate type of insulin, and insulin initiation regimen after OGLD failure. Subgroup analyses revealed that the intervention increased the rate of correct responses among the GPs in various domains of knowledge in diagnosis and treatment. The initial differences between the GPs and internists no longer remained significant after the intervention. Conclusion Knowledge of Iranian primary health care professionals in diabetes management has significant shortcomings. This is concerning because they are at the front line of patient care. We demonstrate the effectiveness of online CME on improving GPs knowledge in the management of type 2 diabetes.

scholarly journals Developmental Trial of Maternity Education Control Cards

2018 ◽  
Vol 1 (2) ◽  
pp. 10
Author(s):  
Adolfina Nilasari ◽  
Mora Claramita ◽  
Shinta Prawitasari ◽  
Lisa Soldat
Keyword(s):  
Primary Care ◽  
Pregnant Women ◽  
Primary Care Physicians ◽  
Care Center ◽  
Control Card ◽  
Health Care Center ◽  
Significant Difference ◽  
Post Test ◽  
Level Of Knowledge ◽  
Validated Instrument

Background: The behavior of a pregnant woman in maintaining her health during pregnancy is influenced by her knowledge of pregnancy. The greater the knowledge of pregnant women about pregnancy, the better the attitude of pregnant women in maintaining their pregnancy. Consequently, a primary care physician who is a health manager of pregnant women needs to pay attention to this knowledge aspect. Primary care physicians should be able to quickly identify the level of knowledge of pregnant women about pregnancy and determine whether that knowledge is sufficient. For that purpose, primary care physicians need to have the right measurement instruments.Objectives: This study aimed to develop, validate and test the instruments that primary care physicians can use to identify and add to pregnant women’s level of knowledge about pregnancy.Methods: This study involved research and development of a validated instrument that consisted of several stages, namely development, validation and testing. Validation was done through two stages, specifically content validation by experts and face validation by 7 doctors. The experimental phase was a quasi-experimental research with 35 pregnant women who presented for antenatal examination at the Puskesmas Banguntapan I (Community and Primary Health Care Center). T-tests were used to determine whether there was a significant difference between the knowledge of pregnant women before and after using the Maternity Education Control Cards.Results: The validated instrument called the Maternity Education Control Card developed by primary care physicians can be used to identify and increase the level of knowledge of pregnant women about pregnancy. The Maternity Education Control Card was validated by several experts, including communication experts, obstetricians and the Maternal and Child Health Program Coordinator at Bantul Regency. Layout, style, accessibility, and feasibility were assessed by a team of validators at the Puskesmas Banguntapan I (7 doctors and 1 midwife coordinator). The data analysis showed that there was a significant difference between pre-test and post-test scores (p = 0.000). This value was not influenced by age variables, educational level, number of pregnancies nor previous antenatal care frequency, but the level of education did affect the post-test value. The duration required for education was between 9 - 20 minutes, with an average of 14.63 minutes (± 2.61). The duration required for education related to the delta of pre and post-test values. The greater the delta, the longer time required for education.Conclusions: Maternity Education Control Card has been successfully established, validated and proven to significantly increase pregnant women’s knowledge about pregnancy.

Innovation in capacity building of primary-care physicians in diabetes management in India: a new slant in medical education

2016 ◽  
Vol 4 (3) ◽  
pp. 200-202 ◽  
Author(s):  
Sandeep Bhalla ◽  
Ranjit Unnikrishnan ◽  
Rahul Srivastava ◽  
Nikhil Tandon ◽  
Viswanathan Mohan ◽  
...  
Keyword(s):  
Primary Care ◽  
Medical Education ◽  
Capacity Building ◽  
Primary Care Physicians ◽  
Diabetes Management

scholarly journals 1114. Identifying and Addressing Knowledge Gaps in Influenza Management with Targeted Continuing Medical Education

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S587-S588
Author(s):  
Katie Robinson ◽  
Jennifer Frederick ◽  
Kevin Lester ◽  
Robert A Esgro
Keyword(s):  
Primary Care ◽  
At Risk ◽  
Medical Education ◽  
Influenza Infection ◽  
Primary Care Providers ◽  
Care Providers ◽  
Knowledge Gaps ◽  
Post Test ◽  
Baseline Knowledge ◽  
The Impact

Abstract Background Influenza represents a year-round disease burden. Despite CDC recommendations, providers do not always effectively test for and treat influenza. To address identified knowledge gaps regarding the care of patients with or at-risk for influenza infection, a series of continuing education (CE) initiatives were implemented for distinct specialty audiences, and the impact of the education on provider knowledge was measured. Methods Between July 2018 and June 2020, Vindico Medical Education provided 35 CME programs (19 web, 14 live, and 2 print) targeted primarily to any of 4 specialty audiences – ID specialists, pulmonologists, emergency medicine providers, or primary care providers (PCPs). Baseline knowledge and educational impact were assessed via pre-and post-test, respectively, across 3 primary topics – testing, mechanisms of therapeutic agents, and treatment. Results As of June 1, 2020, 39,677 healthcare providers participated in the education and 19,209 had obtained CE credit. Baseline knowledge was lowest regarding testing (44%) and antiviral mechanisms (43%), particularly among all but the pulmonology specialists. Average post-test scores were highest among pulmonology (85%) and primary care (85%) providers. The average relative increase in knowledge across all topics and specialties was 69%. A total of 17,480 providers who see on average 8.5 patients per month presenting with flu-like symptoms committed to practice improvements, resulting in approximately 150,000 patients per month who are more likely to receive the latest evidence-based care. Moreover, three months following the education, 68% of providers reported implementing practice improvements, including applying the latest clinical guidelines and recommendations. Conclusion As data regarding new options for the treatment of influenza continues to emerge, CE education on these topics will be needed. This study highlights the efficacy of multimodal CE to address knowledge gaps among providers who see patients with or at-risk for influenza infection. Disclosures All Authors: No reported disclosures

Implicit and explicit corrective feedback and feedback exposure conditions

2020 ◽  
Vol 4 (1) ◽  
pp. 3-48
Author(s):  
Takehiro Iizuka ◽  
Kimi Nakatsukasa
Keyword(s):  
Explicit Knowledge ◽  
Corrective Feedback ◽  
Significant Difference ◽  
Oral Corrective Feedback ◽  
Post Test ◽  
Picture Description ◽  
Potential Factors ◽  
Implicit And Explicit ◽  
Instructional Settings ◽  
The Impact

This exploratory study examined the impact of implicit and explicit oral corrective feedback (CF) on the development of implicit and explicit knowledge of Japanese locative particles (activity de, movement ni and location ni) for those who directly received CF and those who observed CF in the classroom. Thirty-six college students in a beginning Japanese language course received either recast (implicit), metalinguistic (explicit) or no feedback during an information-gap picture description activity, and completed a timed picture description test (implicit knowledge) and an untimed grammaticality judgement test (explicit knowledge) in a pre-test, immediate post-test and delayed post-test. The results showed that overall there was no significant difference between CF types, and that CF benefited direct and indirect recipients similarly. Potential factors that might influence the effectiveness of CF, such as instructional settings, complexity of target structures and pedagogy styles, are discussed.

Primary care physician services and the frequency of comorbidities in patients with acute myocardial infarction

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
R King ◽  
D Giedrimiene
Keyword(s):  
Myocardial Infarction ◽  
Primary Care ◽  
Acute Myocardial Infarction ◽  
Primary Care Physician ◽  
Care Physician ◽  
Adverse Outcomes ◽  
Coronary Syndrome ◽  
Number Of Patients ◽  
Significant Difference ◽  
The Impact

Abstract Funding Acknowledgements Type of funding sources: None. Background The management of patients with multiple comorbidities represents a significant burden on healthcare each year. Despite requiring regular medical care to treat chronic conditions, a large number of these patients may not receive proper care. Significant disparities have been identified in patients with multiple comorbidities and those who experience acute coronary syndrome or acute myocardial infarction (AMI). Only limited data exists to identify the impact of comorbidities and utilization of primary care physician (PCP) services on the development of adverse outcomes, such as AMI. Purpose The primary objective was to analyze how PCP services utilization can be associated with comorbidities in patients who experienced an AMI. Methods This study was based on retrospective data analysis which included 250 patients admitted to the Hartford Hospital Emergency Department (ED) for an AMI. Out of these, 27 patients were excluded due to missing documentation. Collected data included age, gender, medications and recorded comorbidities, such as hypertension, hyperlipidemia, diabetes mellitus (DM), chronic kidney disease (CKD) and previous arrhythmia. Each patient was assessed regarding utilization of PCP services. Statistical analysis was performed in order to identify differences between patients with documented PCP services and those without by using the Chi-square test. Results The records allowed for identification of documented PCP services for 172 out of 223 (77.1%) patients. The most common comorbidities were hypertension and hyperlipidemia: in 165 (74.0%) and 157 (70.4%) cases respectively. The most frequent comorbidity was hypertension: 137 out of 172 (79.7%) in pts with PCP vs 28 out of 51 (54.9%) without PCP, and significantly more often in patients with PCP, p< 0.001. Hyperlipidemia was the second most frequent comorbidity: in 130 out of 172 (75.6%) vs 27 out of 51 (52.9%) accordingly, and also significantly more often (p< 0.002) in patients with PCP services. The number of comorbidities ranged from 0-5, including 32 (14.3%) patients without comorbidities: 16 (9.3%) with a PCP and 16 (31.4%) without PCP services. The majority of patients - 108 (48.5% of 223), had 2-3 documented comorbidities: 89 (51.8%) had two and 19 (34.6%) had three. The remaining 40 (17.9%) patients had 4-5 comorbidities: 37 (21.5%) of them with a PCP and 3 (10.3%) without, with a significant difference (p < 0.001) found for patients with a higher number of comorbidities who utilized PCP services. Conclusions Our study shows that the majority of patients who presented with an AMI had one or more comorbidities. Furthermore, patients who did not utilize PCP services had fewer identified comorbidities. This suggests that there may be a significant number of patients who experienced AMI with undiagnosed comorbidities due to not having access to PCP services.

Establishment of Primary Care Continuity Experiences in Community Pediatricians' Offices: Nuts and Bolts

PEDIATRICS ◽  
1993 ◽  
Vol 91 (6) ◽  
pp. 1185-1189
Author(s):  
Janice R. Sargent ◽  
Lucy M. Osborn ◽  
Kenneth B. Roberts ◽  
Thomas G. DeWitt
Keyword(s):  
Primary Care ◽  
Medical Education ◽  
Professional Education ◽  
Primary Care Physicians ◽  
Clinical Training ◽  
Clinical Teaching ◽  
Tertiary Care ◽  
Ambulatory Training ◽  
Lengths Of Stay ◽  
Tertiary Care Centers

During the past 30 years, there has been an increasing awareness of the importance of ambulatory care training in medical education. The discrepancy between education and practice was pointed out in the General Professional Education Panel report that indicated training was based largely in hospital settings even though the vast majority of doctor-patient encounters do not result in hospitalization.1 Perkoff,2 noting changes in hospital care such as shorter lengths of stay, increased outpatient care, and the need for well-trained primary care physicians, stated that programs need to make a major effort to emphasize clinical teaching in outpatient settings. Recognizing the need for these changes, the Accreditation Council on Graduate Medical Education (ACGME) has increased dramatically the requirement in primary care specialties for clinical ambulatory training.3 For pediatrics, these requirements have progressed from the suggestion that clinical training should be obtained in outpatient clinics (1961) to requiring clinical training in primary care clinics weekly for 3 years (1985). The problems in providing good training in ambulatory settings have been well described.2-4 In comparison inpatient teaching, training students and residents in an outpatient clinic is inefficient and costly. One of the methods suggested to address these problems has been to move ambulatory training out of tertiary care centers to community sites.5-9 Many pediatric programs are now using community sites for at least a portion of resident education.10 Alpert et al10 and Greenberg et al,11 although encouraging the use of these sites to reduce the gap between pediatric education and the service delivery system, pointed out that there are no standards for use of community sites.

A Randomized Study to Assess the Impact of Pharmacist Counseling of Employer-Based Health Plan Beneficiaries With Diabetes

2011 ◽  
Vol 25 (2) ◽  
pp. 169-179 ◽  
Author(s):  
Dale F. Kraemer ◽  
Wayne A. Kradjan ◽  
Theresa M. Bianco ◽  
Judi A. Low
Keyword(s):  
Diabetes Management ◽  
Statistical Significance ◽  
Glycosylated Hemoglobin ◽  
Randomized Study ◽  
Intervention Group ◽  
Control Group ◽  
Counseling Intervention ◽  
Care Plans ◽  
Pharmacist Counseling ◽  
The Impact

Objective: To assess the impact of pharmacist counseling on empowering people with diabetes to better self-care. Introduction: Community-based pharmacists can play a key role in educating and empowering people in such programs. Methods: A randomized trial compared the effects of pharmacist counseling (intervention group) with printed materials (control group) in diabetic beneficiaries of several employer-based health care plans. All participants also received waiver of out-of-pocket expenses for diabetic-related medications and supplies. Clinical, humanistic, and claim outcomes were evaluated at baseline and at 1 year follow-up. Results: Sixty-seven beneficiaries participated in this study. The 0.50% decrease from baseline in glycosylated hemoglobin (A1c) was statistically significant ( P = .0008) in the intervention group and the difference between the groups approached statistical significance ( P = .076). Beneficiaries in both groups had greater claim costs for diabetic-related medications and supplies during the study year. Both groups also improved in ability to manage their diabetes with the counseling group showing a significantly better understanding of diabetes ( P = .0024). Conclusion: There was a trend toward improvement in A1c in patients counseled by pharmacist with an increased utilization of diabetes-related medications and supplies. Counseling also improved diabetes knowledge and empowered patients to better diabetes management.

The impact of a program to enhance the competencies of primary care physicians in caring for patients with AIDS

1986 ◽  
Vol 1 (5) ◽  
pp. 287-294 ◽  
Author(s):  
Charles E. Lewis ◽  
Howard E. Freeman ◽  
Sherrie H. Kaplan ◽  
Christopher R. Corey
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
The Impact

scholarly journals Using Language Games for Vocabulary Retention in a Rural Primary School in Sarawak

2020 ◽  
Vol 4 (2) ◽  
pp. 101
Author(s):  
Lydia Zeta Donald Stavy ◽  
Frankie Subon ◽  
Norseha Unin
Keyword(s):  
English Language ◽  
Teaching Method ◽  
Language Games ◽  
Text Book ◽  
Vocabulary Retention ◽  
New Words ◽  
Conventional Teaching ◽  
Significant Difference ◽  
Post Test ◽  
The Impact

This study seeks to examine the impact of using language games on students’ vocabulary retention. Six language games were chosen for this study; (1) describe it, (2) matching pairs, (3) jigsaw puzzle, (4) board rush,(5) ball games and (6) true or false. The rationale for choosing six different games is based on the understanding that students require at least five to sixteen exposures to learn a new word (Nation’s, 2001) foreffective vocabulary retention. For this study, vocabulary retention is the ability to keep or retain the new words that are taught for the duration of two weeks. The Pre-test and post-test were used to measure the vocabularyretention of the students. Prior to the pre-test, all 64 participants were taught for two weeks using the conventional teaching method by getting students to look words up in the dictionary, write definitions, and use the words in sentences (Basurto, 2004).For this traditional teaching, the eight new words were chosen from unit 10 of the text book for grade three of Malaysian elementary schools. For the next stage, the students weretaught eight new words from unit 11 of the same text book. After two weeks of teaching using the above six games, the students were given the posttest. The findings revealed that there was a significant difference invocabulary retention between the pre-test and post-test. The participants were able to retain significantly more words in the post-test than in the pre-test. In fact, they achieved better results in the post-test (M=63.45) than in the pre-test (M=58.71). This study reveals that language games can help to boost the students’ vocabulary retention if they are given a chance to learn and practice English language in a fun learning environment.

scholarly journals The Effect of IELTS Listening Strategy Use on the Reduction of IELTS Listening Test Anxiety and on IELTS Listening Performance

2017 ◽  
Vol 7 (11) ◽  
pp. 1025 ◽  
Author(s):  
Ali Reza Nemat Tabrizi ◽  
Mahnaz Ranjbar
Keyword(s):  
Test Anxiety ◽  
Pearson Correlation ◽  
Strategy Instruction ◽  
Strategy Use ◽  
Control Group ◽  
Listening Test ◽  
Significant Difference ◽  
Post Test ◽  
The Impact ◽  
Experimental Group

The study investigates the impact of IELTS listening strategy use on the reduction of listening test anxiety and on the listening performance of the IELTS test takers in light of the data of 80 participants on the pretest and post-test IELTS listening along with the participants' score on pre-anxiety and post anxiety scale. So, drawing on the instruments including a proficiency test, pre/post-test, anxiety questionnaire, materials for strategy instruction, the participants were randomly divided into two groups: Control Group and Experimental Group, each including 40 participants. As per the procedure, after tackling their pre-listening performance and pre-anxiety score, one group was treated with IELTS-Listening related strategies and the other group was not treated, but both were administered listening test. The results of the study indicated that those treated with IELTS strategy outperformed ( t (78) = 4.57, p = .000, r = .460 ) those receiving no listening-related strategy. Furthermore, the results of a t-test run on the post-test of the groups anxiety arrived at a statistically significant difference (t (78) = 5.77, p = .000, r = .547), representing that the control group outperformed the experimental group. Also, Pearson Correlation done for finding out a potential relationship between anxiety and listening performance indicated a negative and weak to moderate relationship ((r (78) = -.26, p = .020). The pedagogical implications of the study are in detailed argued.

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