scholarly journals A retrospective quantitative implementation evaluation of Safer Opioid Prescribing, a Canadian continuing education program

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Abhimanyu Sud ◽  
Kathleen Doukas ◽  
Katherine Hodgson ◽  
Justin Hsu ◽  
Amber Miatello ◽  
...  
Keyword(s):  
Health Policy ◽  
Complex Interventions ◽  
Family Physicians ◽  
Health Professions ◽  
Health Professions Education ◽  
Categorical Variables ◽  
Opioid Prescribing ◽  
Implementation Evaluation ◽  
Implementation Outcomes ◽  
Participant Responsiveness

AbstractBackgroundContinuing health professions education (CHPE) is an important policy intervention for the opioid epidemic. Besides effectiveness or impact, health policy implementation should be studied to understand how an intervention was delivered within complex environments. Implementation outcomes can be used to help interpret CHPE effects and impacts, help answer questions of “how” and “why” programs work, and inform transferability. We evaluated Safer Opioid Prescribing (SOP), a national CHPE program, using implementation outcomes of reach, dose, fidelity, and participant responsiveness.MethodsWe conducted a retrospective quantitative implementation evaluation of the 2014–2017 cohorts of SOP. To measure reach and dose, we examined participation and completion data. We used Ontario physician demographic data, including regulatory status with respect to controlled substances, to examine relevant trends. To measure fidelity and participant responsiveness, we analyzed participant-provided evaluations of bias, active learning, and relevance to practice. We used descriptive statistics and measures of association for both continuous and categorical variables. We used logistic regression to determine predictors of workshop participation and analysis of covariance to examine variation in satisfaction across different-sized sessions.ResultsReach: In total, there were 472 unique participants, 84.0% of whom were family physicians. Among Ontario physician participants, 90.0% were family physicians with characteristics representative of province-wide demographics. Dose: Webinar completion rate was 86.2% with no differences in completion based on rurality, gender, or controlled substance prescribing status with medical regulatory authorities. Fidelity and participant responsiveness: Nearly all participants rated the three webinars and workshop as balanced, and each element of SOP was also rated as highly relevant to clinical practice.ConclusionsThis evaluation demonstrates that Safer Opioid Prescribing was implemented as intended. Over a short period and without any external funding, the program reached more than 1% of the Ontario physician workforce. This suggests that the program may be a good model for using virtual CHPE to reach a critical mass of prescribers. This study represents a methodological advance of adapting evaluation methods from health policy and complex interventions for continuing health professions education. Future studies will assess effectiveness and impact on opioid prescribing and utilization within evaluation models of complex interventions.

scholarly journals A retrospective quantitative implementation evaluation of Safer Opioid Prescribing, a Canadian continuing education program

2020 ◽  
Author(s):  
Abhimanyu Sud ◽  
Kathleen Doukas ◽  
Katherine Hodgson ◽  
Justin Hsu ◽  
Amber Miatello ◽  
...  
Keyword(s):  
Health Policy ◽  
Complex Interventions ◽  
Family Physicians ◽  
Health Professions ◽  
Health Professions Education ◽  
Categorical Variables ◽  
Opioid Prescribing ◽  
Implementation Evaluation ◽  
Implementation Outcomes ◽  
Participant Responsiveness

Abstract BackgroundContinuing health professions education (CHPE) is an important policy intervention for the opioid epidemic. Besides effectiveness or impact, health policy implementation should be studied to understand how an intervention was delivered within complex environments. Implementation outcomes can be used to help interpret CHPE effects and impacts, help answer questions of “how” and “why” programs work, and inform transferability. We evaluated Safer Opioid Prescribing (SOP), a national CHPE program, along the implementation outcomes of reach, dose, fidelity, and participant responsiveness.MethodsWe conducted a retrospective quantitative implementation evaluation of the 2014-2017 cohorts of SOP. To measure reach and dose, we examined participation and completion data. We used Ontario physician demographic data, including regulatory status with respect to controlled substances, to examine relevant trends. To measure fidelity and participant responsiveness, we analyzed participant-provided evaluations of bias, active learning, and relevance to practice. We used descriptive statistics and measures of association for both continuous and categorical variables. We used logistic regression to determine predictors of workshop participation and analysis of covariance to examine variation in satisfaction across different-sized sessions.ResultsIn total, there were 472 unique participants, 84.0% of whom were family physicians. Among Ontario physician participants, 90.0% were family physicians with characteristics representative of province-wide demographics. Webinar completion rate was 86.2% with no differences in completion based on rurality, gender, or controlled substance prescribing status with medical regulatory authorities. Nearly all participants rated the three webinars and workshop as balanced, and each element of SOP was also rated as highly relevant to clinical practice.ConclusionsThis evaluation demonstrates that Safer Opioid Prescribing was implemented as intended. Over a short period and without any external funding, the program reached more than 1% of the Ontario physician workforce. This suggests that the program may be a good model for using virtual CHPE to reach a critical mass of prescribers to drive population-level opioid utilization changes. This study represents a methodological advance of adapting evaluation methods from health policy and complex interventions for continuing health professions education. Future studies will assess effectiveness and impact on opioid prescribing and utilization within evaluation models of complex interventions.

scholarly journals A multi-year retrospective quantitative implementation evaluation of Safer Opioid Prescribing, an opioid prescribing continuing education program for Canadian healthcare providers

2020 ◽  
Author(s):  
Abhimanyu Sud ◽  
Kathleen Doukas ◽  
Katherine Hodgson ◽  
Justin Hsu ◽  
Amber Miatello ◽  
...  
Keyword(s):  
Health Policy ◽  
Active Learning ◽  
Education Program ◽  
Health Professions ◽  
Health Professions Education ◽  
Categorical Variables ◽  
Opioid Prescribing ◽  
Implementation Evaluation ◽  
Participant Responsiveness ◽  
Short Period

Abstract Background: Continuing health professions education is considered an important policy intervention for the opioid epidemic. Besides examining effectiveness or impact, it is important to also study health policy implementation to understand how an intervention was delivered within complex policy and practice environments. Implementation outcomes can be used to help interpret continuing health profession education effects and impacts, help answer questions of “how” and “why” programs work, and inform transferability.Methods: We conducted a retrospective quantitative implementation evaluation of the 2014–2017 cohort of Safer Opioid Prescribing, a Canadian continuing health professions education program consisting of three synchronous webinars and in-person workshop. To measure reach and dose, we examined participation and completion data. We used Ontario physician demographic data, including regulatory status with respect to narcotics to examine relevant trends. To measure fidelity and participant responsiveness, we analyzed participant-provided evaluations of bias, active learning and relevance to practice. We used descriptive statistics and measures of association for both continuous and categorical variables. We used logistic regression to determine predictors of workshop participation and analysis of covariance to examine variation in satisfaction across different-sized sessions.Results: Eighty four percent of participants were family physicians with representative reach to non-major urban physicians. Webinar completion rate was 86.2% with no differences in completion based on rurality, gender or status with the regulatory college. Participants who had regulatory involvement with respect to opioids were more likely to be male, have been in practice for longer and participate in the workshop. Participants reported no significant bias and highly rated both active learning and relevance to practice regardless of their cohort size.Conclusions: This evaluation demonstrates that Safer Opioid Prescribing was implemented as intended. Over a short period and without any external funding, the program reached more than 1% of the Ontario physician workforce. This suggests that Safer Opioid Prescribing is a good model for using virtual continuing health professions education to reach a critical mass of prescribers to drive population level opioid utilization changes. This study represents a methodological advance of adapting evaluation methods from health policy and complex interventions for continuing health professions education.

A Multifaceted Systems Approach to Addressing Stress Within Health Professions Education and Beyond

2017 ◽  
Vol 7 (1) ◽  
Author(s):  
Darla Spence Coffey ◽  
◽  
Kathrin Elliot ◽  
Elizabeth Goldblatt ◽  
Catherine Grus ◽  
...  
Keyword(s):  
Systems Approach ◽  
Health Professions ◽  
Health Professions Education

'I Teach It Because It Is the Biggest Threat to Health': Integrating a Planetary Health Perspective into Health Professions Education

2020 ◽  
Author(s):  
Gabrielle Brand ◽  
Jorja Collins ◽  
Gitanjali Bedi ◽  
James Bonnamy ◽  
Liza Barbour ◽  
...  
Keyword(s):  
Health Professions ◽  
Health Professions Education ◽  
Planetary Health

The application of virtual reality in health professions� digital education: a narrative review (Preprint)

2018 ◽  
Author(s):  
Lorraine Tudor Car ◽  
Bhone Myint Kyaw ◽  
Josip Car
Keyword(s):  
Virtual Reality ◽  
Professional Education ◽  
Health Professions ◽  
Health Professions Education ◽  
Narrative Review ◽  
Current Evidence ◽  
Future Research ◽  
Educational Content ◽  
Potential Applications

BACKGROUND Digital technology called Virtual Reality (VR) is increasingly employed in health professions’ education. Yet, based on the current evidence, its use is narrowed around a few most applications and disciplines. There is a lack of an overview that would capture the diversity of different VR applications in health professions’ education and inform its use and research. OBJECTIVE This narrative review aims to explore different potential applications of VR in health professions’ education. METHODS The narrative synthesis approach to literature review was used to analyse the existing evidence. RESULTS We outline the role of VR features such as immersion, interactivity and feedback and explain the role of VR devices. Based on the type and scope of educational content VR can represent space, individuals, objects, structures or their combination. Application of VR in medical education encompasses environmental, organ and micro level. Environmental VR focuses on training in relation to health professionals’ environment and human interactions. Organ VR educational content targets primarily human body anatomy; and micro VR microscopic structures at the level of cells, molecules and atoms. We examine how different VR features and health professional education areas match these three VR types. CONCLUSIONS We conclude by highlighting the gaps in the literature and providing suggestions for future research.

scholarly journals A systematic review of school health policy measurement tools: implementation determinants and outcomes

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Gabriella M. McLoughlin ◽  
Peg Allen ◽  
Callie Walsh-Bailey ◽  
Ross C. Brownson
Keyword(s):  
Health Policy ◽  
Policy Implementation ◽  
School Health ◽  
School Policy ◽  
Implementation Processes ◽  
Implementation Outcomes ◽  
Policy Measurement ◽  
Measurement Tools ◽  
School Health Policy ◽  
Health Policy Implementation

Abstract Background Governments in some countries or states/provinces mandate school-based policies intended to improve the health and well-being of primary and secondary students and in some cases the health of school staff. Examples include mandating a minimum time spent per week in programmed physical activity, mandating provision of healthy foods and limiting fat content of school meals, and banning tobacco products or use on school campuses. Although school health researchers have studied whether schools, districts, or states/provinces are meeting requirements, it is unclear to what extent implementation processes and determinants are assessed. The purposes of the present systematic review of quantitative measures of school policy implementation were to (1) identify quantitative school health policy measurement tools developed to measure implementation at the school, district, or state/provincial levels; (2) describe the policy implementation outcomes and determinants assessed and identify the trends in measurement; and (3) assess pragmatic and psychometric properties of identified implementation measures to understand their quality and suitability for broader application. Methods Peer-reviewed journal articles published 1995–2020 were included if they (1) had multiple-item quantitative measures of school policy implementation and (2) addressed overall wellness, tobacco, physical activity, nutrition, obesity prevention, or mental health/bullying/social-emotional learning. The final sample comprised 86 measurement tools from 67 peer-review articles. We extracted study characteristics, such as psychometric and pragmatic measure properties, from included articles based on three frameworks: (1) Implementation Outcomes Framework, (2) Consolidated Framework for Implementation Research, and (3) Policy Implementation Determinants Framework. Results Most implementation tools were developed to measure overall wellness policies which combined multiple policy topics (n = 35, 40%) and were in survey form (n = 75, 87%). Fidelity was the most frequently prevalent implementation outcome (n = 70, 81%), followed by adoption (n = 32, 81%). The implementation determinants most assessed were readiness for implementation, including resources (n = 43, 50%), leadership (n = 42, 49%), and policy communication (n = 41, 48%). Overall, measures were low-cost and had easy readability. However, lengthy tools and lack of reported validity/reliability data indicate low transferability. Conclusions Implementation science can contribute to more complete and rigorous assessment of school health policy implementation processes, which can improve implementation strategies and ultimately the intended health benefits. Several high-quality measures of implementation determinants and implementation outcomes can be applied to school health policy implementation assessment. Dissemination and implementation science researchers can also benefit from measurement experiences of school health researchers.

scholarly journals Creative leaps in theory: the might of abduction

2021 ◽  
Author(s):  
Mario Veen
Keyword(s):  
Health Professions ◽  
Central Place ◽  
Health Professions Education ◽  
Abductive Reasoning ◽  
The Poor ◽  
The World

AbstractThis paper argues that abductive reasoning has a central place in theorizing Health Professions Education. At the root of abduction lies a fundamental debate: How do we connect practice, which is always singular and unique, with theory, which describes the world in terms of rules, generalizations, and universals? While abduction was initially seen as the ‘poor cousin’ of deduction and induction, ultimately it has something important to tell us about the role of imagination and humility in theorizing Health Professions Education. It is that which makes theory possible, because it allows us to ask what might be the case and calls attention to the role of creative leaps in theory. Becoming aware of the abductive reasoning we already perform in our research allows us to take the role of imagination—something rarely associated with theory—seriously.

Facilitators and Barriers to Clinical Pathway Uptake and Utilization among Primary Care Providers in Saskatchewan – A Qualitative Study

2021 ◽  
Author(s):  
Gary Groot ◽  
Shaliny Ollegasagrem ◽  
Mahasti Khakpour ◽  
Adel Panahi ◽  
Donna Goodridge ◽  
...  
Keyword(s):  
Wound Care ◽  
Clinical Pathways ◽  
Complex Interventions ◽  
Family Physicians ◽  
Standardize Patient ◽  
Primary Care Providers ◽  
System Level ◽  
It Services ◽  
Care Providers ◽  
Facilitators And Barriers

Abstract Background: Clinical Pathways (CPWs) are multidisciplinary, evidence based, complex interventions designed to standardize patient care. In Saskatchewan, development, implementation, and evaluation of seven provincial CPWs (Hip & Knee, Spine, Pelvic Floor, Prostate Assessment, Fertility Care, Lower Extremity Wound Care, and Acute Stroke) present significant challenges, leading to lower uptake and utilization. This study aimed to identify facilitators and barriers to CPW uptake and utilization by Family Physicians in Saskatchewan. Methods: A qualitative interpretive approach was used consisting of eight one-on-one key informant (KI) interviews and five focus groups (FG) in identifying the facilitators and barriers to CPWs. KIs had been involved in the design and implementation of CPWs. FGs were held with 30 Family Physicians in two urban and two rural Saskatchewan cities. All interviews were audio recorded and transcribed. Inductive, thematic analysis of the interviews based on the Theoretical Domain Framework (TDF) for behavioral changes was used to identify facilitators and barriers to CPW uptake and utilization by Family Physicians.Results: KI interviews informed the FG interview guide. From 5 FG discussions, 51 themes emerged and were mapped under 14 TDF domains. Family Physicians notably emphasized the barriers for utilizing CPWs. Major barriers were: system-level (knowledge & communication, social/professional identity, Family Physician engagement and education); objective clarification (goals, belief about consequences of implementing CPW) and technical and resource related (administrative, access to local specialists, enforcement and incentives). The most prominent barrier was lack of systematic CPW promotion and inconsistencies in communication between: organization to practitioner; organization to organization; and practitioner to practitioner. Facilitators were recognized to mitigate barriers and ranged from need for optimized and integrated IT services (i.e. Electronic Medical Records), to optimism towards CPW usage and patient outcomes. Conclusions: Informed by data from KIs and FGs, this exploratory study identified specific improvements required to promote uptake of CPWs based on perceived facilitators and barriers. Recommendations are provided to enhance uptake among FPs. These initial findings will inform the creation of a theory-based, province -wide survey instrument to further evaluate CPWs.

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