Limits...
Effectiveness of Web-based versus face-to-face delivery of education in prescription of falls-prevention exercise to health professionals: randomized trial.

Maloney S, Haas R, Keating JL, Molloy E, Jolly B, Sims J, Morgan P, Haines T - J. Med. Internet Res. (2011)

Bottom Line: Outcomes were measured across levels 1 to 3 of Kirkpatrick's hierarchy of educational outcomes, including attendance, adherence, satisfaction, knowledge, and self-reported change in practice.Knowledge test results were comparable between the Web-based and face-to-face groups: median (interquartile range [IQR]) for the Web-based group was 90.00 (70.89-90.67) and for the face-to-face group was 80.56 (70.67-90.00); rank sum P = .07.Practical considerations should arguably drive choice of delivery method, which may favor Web-based provision for its ability to overcome access issues for health professionals in regional and remote settings.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Physiotherapy, Monash University, Frankston, Australia. stephen.maloney@monash.edu

ABSTRACT

Background: Exercise is an effective intervention for the prevention of falls; however, some forms of exercises have been shown to be more effective than others. There is a need to identify effective and efficient methods for training health professionals in exercise prescription for falls prevention.

Objective: The objective of our study was to compare two approaches for training clinicians in prescribing exercise to prevent falls.

Methods: This study was a head-to-head randomized trial design. Participants were physiotherapists, occupational therapists, nurses, and exercise physiologists working in Victoria, Australia. Participants randomly assigned to one group received face-to-face traditional education using a 1-day seminar format with additional video and written support material. The other participants received Web-based delivery of the equivalent educational material over a 4-week period with remote tutor facilitation. Outcomes were measured across levels 1 to 3 of Kirkpatrick's hierarchy of educational outcomes, including attendance, adherence, satisfaction, knowledge, and self-reported change in practice.

Results: Of the 166 participants initially recruited, there was gradual attrition from randomization to participation in the trial (n = 67 Web-based, n = 68 face-to-face), to completion of the educational content (n = 44 Web-based, n = 50 face-to-face), to completion of the posteducation examinations (n = 43 Web-based, n = 49 face-to-face). Participant satisfaction was not significantly different between the intervention groups: mean (SD) satisfaction with content and relevance of course material was 25.73 (5.14) in the Web-based and 26.11 (5.41) in the face-to-face group; linear regression P = .75; and mean (SD) satisfaction with course facilitation and support was 11.61 (2.00) in the Web-based and 12.08 (1.54) in the face-to-face group; linear regression P = .25. Knowledge test results were comparable between the Web-based and face-to-face groups: median (interquartile range [IQR]) for the Web-based group was 90.00 (70.89-90.67) and for the face-to-face group was 80.56 (70.67-90.00); rank sum P = .07. The median (IQR) scores for the exercise assignment were also comparable: Web-based, 78.6 (68.5-85.1), and face-to-face, 78.6 (70.8-86.9); rank sum P = .61. No significant difference was identified in Kirkpatrick's hierarchy domain change in practice: mean (SD) Web-based, 21.75 (4.40), and face-to-face, 21.88 (3.24); linear regression P = .89.

Conclusion: Web-based and face-to-face approaches to the delivery of education to clinicians on the subject of exercise prescription for falls prevention produced equivalent results in all of the outcome domains. Practical considerations should arguably drive choice of delivery method, which may favor Web-based provision for its ability to overcome access issues for health professionals in regional and remote settings.

Trial registration: Australian New Zealand Clinical Trials Registry number: ACTRN12610000135011; http://www.anzctr.org.au/ACTRN12610000135011.aspx (Archived by WebCite at http://www.webcitation.org/63MicDjPV).

Show MeSH

Related in: MedlinePlus

Screenshot of the constructed short-course home page, illustrating the typical integration of learning resources, activities, and supports. The segment of image on the right shows an example of a multimedia resource—in this case, a discussion on measuring quadriceps strength.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC3278102&req=5

figure1: Screenshot of the constructed short-course home page, illustrating the typical integration of learning resources, activities, and supports. The segment of image on the right shows an example of a multimedia resource—in this case, a discussion on measuring quadriceps strength.

Mentions: The other group took part in Web-based delivery of the equivalent educational material over a 4-week period (anticipated to require 7 hours total time commitment over 4 weeks) facilitated by a Web-based tutor who corresponded with participants through Web-based discussions and was available by phone if problems occurred. The Web-based course was constructed within the online learning system Moodle (Moodle.com, Perth, Australia), which uses open source code and is available in the public domain. Figure 1 shows a screenshot of the constructed course home page to illustrate the typical integration of activities and learning resources. Participants were posted a DVD comprising the multimedia used in the Web-based program as a troubleshooting solution if they encountered difficulties viewing the content online. Participants were allowed to progress through the program at their own pace, completing educational activities any time during the 4 weeks. Learning tasks ranged from self-directed reading and formative quizzes to interactive skills-practice sessions with feedback opportunities. For feedback, students uploaded digital footage of their skill mastery, which was viewed by the Web-based tutor. They were then guided through a reflective task by reading the tutor’s comments of typical group performance in the task submissions, and they could view a tutor-selected exemplar of student performance to enable benchmarking of expectations of performance competency.


Effectiveness of Web-based versus face-to-face delivery of education in prescription of falls-prevention exercise to health professionals: randomized trial.

Maloney S, Haas R, Keating JL, Molloy E, Jolly B, Sims J, Morgan P, Haines T - J. Med. Internet Res. (2011)

Screenshot of the constructed short-course home page, illustrating the typical integration of learning resources, activities, and supports. The segment of image on the right shows an example of a multimedia resource—in this case, a discussion on measuring quadriceps strength.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC3278102&req=5

figure1: Screenshot of the constructed short-course home page, illustrating the typical integration of learning resources, activities, and supports. The segment of image on the right shows an example of a multimedia resource—in this case, a discussion on measuring quadriceps strength.
Mentions: The other group took part in Web-based delivery of the equivalent educational material over a 4-week period (anticipated to require 7 hours total time commitment over 4 weeks) facilitated by a Web-based tutor who corresponded with participants through Web-based discussions and was available by phone if problems occurred. The Web-based course was constructed within the online learning system Moodle (Moodle.com, Perth, Australia), which uses open source code and is available in the public domain. Figure 1 shows a screenshot of the constructed course home page to illustrate the typical integration of activities and learning resources. Participants were posted a DVD comprising the multimedia used in the Web-based program as a troubleshooting solution if they encountered difficulties viewing the content online. Participants were allowed to progress through the program at their own pace, completing educational activities any time during the 4 weeks. Learning tasks ranged from self-directed reading and formative quizzes to interactive skills-practice sessions with feedback opportunities. For feedback, students uploaded digital footage of their skill mastery, which was viewed by the Web-based tutor. They were then guided through a reflective task by reading the tutor’s comments of typical group performance in the task submissions, and they could view a tutor-selected exemplar of student performance to enable benchmarking of expectations of performance competency.

Bottom Line: Outcomes were measured across levels 1 to 3 of Kirkpatrick's hierarchy of educational outcomes, including attendance, adherence, satisfaction, knowledge, and self-reported change in practice.Knowledge test results were comparable between the Web-based and face-to-face groups: median (interquartile range [IQR]) for the Web-based group was 90.00 (70.89-90.67) and for the face-to-face group was 80.56 (70.67-90.00); rank sum P = .07.Practical considerations should arguably drive choice of delivery method, which may favor Web-based provision for its ability to overcome access issues for health professionals in regional and remote settings.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Physiotherapy, Monash University, Frankston, Australia. stephen.maloney@monash.edu

ABSTRACT

Background: Exercise is an effective intervention for the prevention of falls; however, some forms of exercises have been shown to be more effective than others. There is a need to identify effective and efficient methods for training health professionals in exercise prescription for falls prevention.

Objective: The objective of our study was to compare two approaches for training clinicians in prescribing exercise to prevent falls.

Methods: This study was a head-to-head randomized trial design. Participants were physiotherapists, occupational therapists, nurses, and exercise physiologists working in Victoria, Australia. Participants randomly assigned to one group received face-to-face traditional education using a 1-day seminar format with additional video and written support material. The other participants received Web-based delivery of the equivalent educational material over a 4-week period with remote tutor facilitation. Outcomes were measured across levels 1 to 3 of Kirkpatrick's hierarchy of educational outcomes, including attendance, adherence, satisfaction, knowledge, and self-reported change in practice.

Results: Of the 166 participants initially recruited, there was gradual attrition from randomization to participation in the trial (n = 67 Web-based, n = 68 face-to-face), to completion of the educational content (n = 44 Web-based, n = 50 face-to-face), to completion of the posteducation examinations (n = 43 Web-based, n = 49 face-to-face). Participant satisfaction was not significantly different between the intervention groups: mean (SD) satisfaction with content and relevance of course material was 25.73 (5.14) in the Web-based and 26.11 (5.41) in the face-to-face group; linear regression P = .75; and mean (SD) satisfaction with course facilitation and support was 11.61 (2.00) in the Web-based and 12.08 (1.54) in the face-to-face group; linear regression P = .25. Knowledge test results were comparable between the Web-based and face-to-face groups: median (interquartile range [IQR]) for the Web-based group was 90.00 (70.89-90.67) and for the face-to-face group was 80.56 (70.67-90.00); rank sum P = .07. The median (IQR) scores for the exercise assignment were also comparable: Web-based, 78.6 (68.5-85.1), and face-to-face, 78.6 (70.8-86.9); rank sum P = .61. No significant difference was identified in Kirkpatrick's hierarchy domain change in practice: mean (SD) Web-based, 21.75 (4.40), and face-to-face, 21.88 (3.24); linear regression P = .89.

Conclusion: Web-based and face-to-face approaches to the delivery of education to clinicians on the subject of exercise prescription for falls prevention produced equivalent results in all of the outcome domains. Practical considerations should arguably drive choice of delivery method, which may favor Web-based provision for its ability to overcome access issues for health professionals in regional and remote settings.

Trial registration: Australian New Zealand Clinical Trials Registry number: ACTRN12610000135011; http://www.anzctr.org.au/ACTRN12610000135011.aspx (Archived by WebCite at http://www.webcitation.org/63MicDjPV).

Show MeSH
Related in: MedlinePlus