Gordon Morris, Chandratilake Madawa, Baker Paul
College of Health and Social Care, University of Salford, UK.
Clin Teach. 2013 Aug;10(4):258-63. doi: 10.1111/tct.12008.
E-learning continues to proliferate as a method to deliver continuing medical education. The effectiveness of e-learning has been widely studied, showing that it is as effective as traditional forms of education. However, most reports focus on whether the e-learning is effective, rather than discussing innovations to allow clinical educators to ask 'how' and 'why' it is effective, and to facilitate local reproduction.
Previous work has set out a number of barriers to the introduction of e-learning interventions. Cost, the time to produce interventions, and the training requirements for educators and trainees have all been identified as barriers. We set out to design an e-learning intervention on paediatric prescribing that could address these issues using a low-fidelity approach, and report our methods so as to allow interested readers to use a similar approach.
Using low-cost, readily accessible tools and applying appropriate educational theory, the intervention was produced in a short period of time. As part of a randomised controlled trial, long-term retention of prescribing skills was demonstrated, with significantly higher prescribing skill scores in the e-learning group at 4 and 12 weeks (p < 0.0001). Feedback was universally positive, with Likert responses suggesting that it was useful, convenient and easy to use.
A low-fidelity approach to designing can successfully overcome many of the barriers to the introduction of e-learning. The design model described is simple and can be used by clinical teachers to support local development. Further research could investigate the experiences of these clinicians using this method of instructional design.
电子学习作为一种提供继续医学教育的方法，仍在不断普及。电子学习的有效性已得到广泛研究，表明其与传统教育形式一样有效。然而，大多数报告关注的是电子学习是否有效，而非探讨如何让临床教育工作者了解其有效的“方式”和“原因”，以及促进其在本地的推广。
先前的工作已经指出了引入电子学习干预措施的一些障碍。成本、制作干预措施的时间以及教育工作者和学员的培训要求都被确定为障碍。我们着手设计一种关于儿科处方的电子学习干预措施，该措施可以采用低保真度的方法来解决这些问题，并报告我们的方法，以便有兴趣的读者能够采用类似的方法。
利用低成本、易于获取的工具并应用适当的教育理论，该干预措施在短时间内就制作完成。作为一项随机对照试验的一部分，证明了处方技能的长期保持情况，电子学习组在4周和12周时的处方技能得分显著更高（p < 0.0001）。反馈普遍积极，李克特量表的回答表明它有用、方便且易于使用。
一种低保真度的设计方法能够成功克服引入电子学习的许多障碍。所描述的设计模型简单，临床教师可以使用它来支持本地开发。进一步的研究可以调查这些临床医生使用这种教学设计方法的体验。
