Beal Tiffany, Kemper Kathi J, Gardiner Paula, Woods Charles
Physican Assistant Program, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA.
BMC Med Educ. 2006 Aug 7;6:39. doi: 10.1186/1472-6920-6-39.
Previous research has shown that internet education can lead to short-term improvements in clinicians' knowledge, confidence and communication practices. We wished to better understand the duration of these improvements and whether different curriculum delivery strategies differed in affecting these improvements.
As previously described, we conducted a randomized control trial comparing four different strategies for delivering an e-curriculum about herbs and other dietary supplements (HDS) to clinicians. The four strategies were delivering the curriculum by: a) email over 10 weeks; b) email within one week; c) web-site over 10 weeks; d) web-site within one week. Participants were surveyed at baseline, immediately after the course and 6-10 months after completing the course (long-term). Long-term outcomes focused on clinicians' knowledge, confidence and communication practices.
Of the 780 clinicians who completed the course, 385 (49%) completed the long-term survey. Completers and non-completers of the long-term survey had similar demographics and professional characteristics at baseline. There were statistically significant improvements from baseline to long-term follow-up in knowledge, confidence and communication practices; these improvements did not differ by curriculum delivery strategy. Knowledge scores improved from 67.7 +/- 10.3 at baseline to 78.8 +/- 12.3 at long-term follow-up (P < 0.001). Confidence scores improved from 53.7 +/- 17.8 at baseline to 66.9 +/- 12.0 at long term follow-up (P < 0.001); communication scores improved from 2.6 +/- 1.9 at baseline to 3.6 +/- 2.1 (P < 0.001) at long-term follow-up.
This e- curriculum led to significant and sustained improvements in clinicians' expertise about HDS regardless of the delivery strategy. Future studies should compare the impact of required vs. elective courses and self-reported vs. objective measures of behavior change.
先前的研究表明，网络教育可使临床医生的知识、信心和沟通实践在短期内得到改善。我们希望更好地了解这些改善的持续时间，以及不同的课程传授策略在影响这些改善方面是否存在差异。
如前所述，我们进行了一项随机对照试验，比较了向临床医生传授关于草药和其他膳食补充剂（HDS）的电子课程的四种不同策略。这四种策略分别是：a）在10周内通过电子邮件发送课程；b）在一周内通过电子邮件发送课程；c）在10周内通过网站提供课程；d）在一周内通过网站提供课程。在基线、课程结束后立即以及完成课程6至10个月后（长期）对参与者进行调查。长期结果聚焦于临床医生的知识、信心和沟通实践。
在完成课程的780名临床医生中，385名（49%）完成了长期调查。长期调查的完成者和未完成者在基线时的人口统计学和专业特征相似。从基线到长期随访，知识、信心和沟通实践均有统计学上的显著改善；这些改善在课程传授策略方面没有差异。知识得分从基线时的67.7±10.3提高到长期随访时的78.8±12.3（P<0.001）。信心得分从基线时的53.7±17.8提高到长期随访时的66.9±12.0（P<0.001）；沟通得分从基线时的2.6±1.9提高到长期随访时的3.6±2.1（P<0.001）。
无论采用何种传授策略，该电子课程都能使临床医生在HDS方面的专业知识得到显著且持续的改善。未来的研究应比较必修课程与选修课程的影响，以及自我报告与行为改变的客观测量方法。
