Gajera Gopi V, Pandey Praveen, Malathesh Barikar C, Nirisha P Lakshmi, Suchandra K Hari Hara, Ibrahim Ferose Azeez, Suhas Satish, Manjunatha Narayana, Kumar Channaveerachari Naveen, Suresha Bada Math, Jain Sumi
Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.
Department of Psychiatry, All India Institute of Medical Sciences, Hyderabad, Telangana, India.
J Neurosci Rural Pract. 2023 Jan-Mar;14(1):91-97. doi: 10.25259/JNRP-2022-4-20. Epub 2022 Dec 15.
We compared effectiveness of blended mode (consisting of traditional classroom teaching and e-learning sessions) and fully digital mode (e-learning sessions alone) of primary care psychiatry training for primary care doctors in Chhattisgarh.
We retrospectively compared the engagement in training, knowledge (K), attitude (A), and practice (P) in primary care psychiatry, and patient identification by primary care doctors ( = 941) from Chhattisgarh region who underwent training through either blended training mode ( = 546) or fully digital training mode ( = 395) for 16 h each, using Clinical Schedules for Primary Care Psychiatry based modules between June 2019 and November 2020 with a tertiary care center (NIMHANS, Bengaluru) as hub.
The Statistical Package for the Social Sciences version 27 was used to analyze the data. Continuous variables were analyzed using the independent samples -test, and discrete variables were analyzed using the Chi-square test. A repeated measures analysis of variance (ANOVA) (two-way mixed design) was used to see the interaction of training type and time of pre- and post-KAP measurement while controlling for years of experience. The number of patients identified by both training groups over 8 months was also compared using the repeated measures ANOVA (two-way mixed design).
Engagement inferred by the number of participants completing pre-KAP forms (75%), post-KAP forms (43%), post-session assessments (37- 47%), case presentation (33.9%), and certification (32.1%) was better in the blended group ( < 0.05). The mean gain in KAP scores was significantly higher in the blended group controlling for the years of experience as primary care doctor (PCD) (F = 30.36, < 0.001). PCDs in the blended training group consistently identified a higher number of patients with mental illness over 8 months of follow-up (F = 6.21, < 0.001).
The blended mode yielded better results in primary care psychiatry training compared to fully digital mode. In-person interactions while provided for a very brief proportion of the training seem to have an unmistakable imprint on the outcomes and seem critical for better consolidation and assimilation of information, which translates into better practice.
我们比较了混合模式（包括传统课堂教学和电子学习课程）与全数字模式（仅电子学习课程）对恰蒂斯加尔邦初级保健医生进行初级保健精神病学培训的效果。
我们回顾性比较了恰蒂斯加尔邦地区接受培训的941名初级保健医生在初级保健精神病学培训中的参与度、知识（K）、态度（A）和实践（P），以及患者识别情况。这些医生在2019年6月至2020年11月期间，以一家三级医疗中心（班加罗尔的国家精神卫生和神经科学研究所）为中心，通过混合培训模式（546人）或全数字培训模式（395人）分别接受了16小时的培训，培训使用基于初级保健精神病学临床时间表的模块。
使用社会科学统计软件包第27版分析数据。连续变量使用独立样本t检验进行分析，离散变量使用卡方检验进行分析。在控制经验年限的同时，使用重复测量方差分析（ANOVA）（双向混合设计）来观察培训类型与KAP测量前后时间的交互作用。两个培训组在8个月内识别的患者数量也使用重复测量ANOVA（双向混合设计）进行比较。
混合组在完成KAP前测表（75%）、KAP后测表（43%）、课后评估（37 - 47%）、病例报告（33.9%）和认证（32.1%）的参与者数量所推断的参与度方面表现更好（P < 0.05）。在控制作为初级保健医生（PCD）的经验年限后，混合组的KAP得分平均增益显著更高（F = 30.36，P < 0.001）。在8个月的随访中，混合培训组的初级保健医生持续识别出更多患有精神疾病的患者（F = 6.21，P < 0.001）。
与全数字模式相比，混合模式在初级保健精神病学培训中产生了更好的效果。虽然面对面互动在培训中所占比例非常小，但似乎对培训结果有着明确无误的影响，并且对于更好地巩固和吸收信息（进而转化为更好的实践）似乎至关重要。
