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The Impact of E-Learning on Adherence to Guidelines for Acute Gastroenteritis: A Single-Arm Intervention Study.

Nicastro E, Lo Vecchio A, Liguoro I, Chmielewska A, De Bruyn C, Dolinsek J, Doroshina E, Fessatou S, Pop TL, Prell C, Tabbers MM, Tavares M, Urenden-Elicin P, Bruzzese D, Zakharova I, Sandhu B, Guarino A - PLoS ONE (2015)

Bottom Line: Primary outcome measures included the proportion of participants fully adherent to CPG and number of patients managed with full adherence.The course improved knowledge scores (pre-course 8.6 ± 2.7 versus post-course 12.8 ± 2.1, P < 0.001), average adherence (from 87.0 ± 7.7% to 90.6 ± 7.1%, P = 0.001) and the number of patients managed in full adherence with the guidelines (from 33.6 ± 31.7% to 43.9 ± 36.1%, P = 0.037).E-learning is effective in increasing knowledge and improving clinical practice in paediatric AGE and is an effective tool for implementing clinical practice guidelines.

View Article: PubMed Central - PubMed

Affiliation: Department of Translational Medical Science, Sector of Pediatrics. University Federico II, Naples, Italy; Paediatric Hepatology Gastroenterology and Transplantation Unit, Hospital Papa Giovanni XXIII, Bergamo, Italy.

ABSTRACT

Objective: E-learning is a candidate tool for clinical practice guidelines (CPG) implementation due to its versatility, universal access and low costs. We aimed to assess the impact of a five-module e-learning course about CPG for acute gastroenteritis (AGE) on physicians' knowledge and clinical practice.

Study design: This work was conceived as a pre/post single-arm intervention study. Physicians from 11 European countries registered for the online course. Personal data, pre- and post-course questionnaires and clinical data about 3 to 5 children with AGE managed by each physician before and after the course were collected. Primary outcome measures included the proportion of participants fully adherent to CPG and number of patients managed with full adherence.

Results: Among the 149 physicians who signed up for the e-learning course, 59 took the course and reported on their case management of 519 children <5 years of age who were referred to their practice because of AGE (281 and 264 children seen before and after the course, respectively). The course improved knowledge scores (pre-course 8.6 ± 2.7 versus post-course 12.8 ± 2.1, P < 0.001), average adherence (from 87.0 ± 7.7% to 90.6 ± 7.1%, P = 0.001) and the number of patients managed in full adherence with the guidelines (from 33.6 ± 31.7% to 43.9 ± 36.1%, P = 0.037).

Conclusions: E-learning is effective in increasing knowledge and improving clinical practice in paediatric AGE and is an effective tool for implementing clinical practice guidelines.

No MeSH data available.


Related in: MedlinePlus

Changes in inappropriate interventions for acute gastroenteritis in children <5 years managed before (Pre) and after (Post) e-learning.
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pone.0132213.g003: Changes in inappropriate interventions for acute gastroenteritis in children <5 years managed before (Pre) and after (Post) e-learning.

Mentions: The proportion of patients managed in full adherence with the guidelines (i.e., no inappropriate interventions or only one minor violation) increased from 33.6 ± 31.7% to 43.9 ± 36.1% (P = 0.037). Similarly, the average adherence score increased from 87.0 ± 7.7% to 90.6 ± 7.1% (P = 0.001) (Fig 2). The proportion of patients who received inappropriate interventions in each domain was calculated. The most common violations to the CPG were orders for stool cultures in the absence of appropriate indications. Unnecessary dietary changes and inconsistent estimates of dehydration compared to objective parameters were also frequently observed. As shown in Fig 3, the e-learning course reduced inappropriate interventions in all of these domains. We also observed a non-significant trend toward a reduction in inappropriate nutritional interventions (P = 0.055). In all, 22% of patients in the PreEG were inappropriately admitted to the hospital, compared to 15% in the PostEG (P = 0.200) patients. The proportion of hospitalized children with moderate or severe dehydration (indicated by >5% weight gain at discharge) was similar in both groups (25% in the PreEG and 26.5% in the PostEG; P = 0.841).


The Impact of E-Learning on Adherence to Guidelines for Acute Gastroenteritis: A Single-Arm Intervention Study.

Nicastro E, Lo Vecchio A, Liguoro I, Chmielewska A, De Bruyn C, Dolinsek J, Doroshina E, Fessatou S, Pop TL, Prell C, Tabbers MM, Tavares M, Urenden-Elicin P, Bruzzese D, Zakharova I, Sandhu B, Guarino A - PLoS ONE (2015)

Changes in inappropriate interventions for acute gastroenteritis in children <5 years managed before (Pre) and after (Post) e-learning.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4493016&req=5

pone.0132213.g003: Changes in inappropriate interventions for acute gastroenteritis in children <5 years managed before (Pre) and after (Post) e-learning.
Mentions: The proportion of patients managed in full adherence with the guidelines (i.e., no inappropriate interventions or only one minor violation) increased from 33.6 ± 31.7% to 43.9 ± 36.1% (P = 0.037). Similarly, the average adherence score increased from 87.0 ± 7.7% to 90.6 ± 7.1% (P = 0.001) (Fig 2). The proportion of patients who received inappropriate interventions in each domain was calculated. The most common violations to the CPG were orders for stool cultures in the absence of appropriate indications. Unnecessary dietary changes and inconsistent estimates of dehydration compared to objective parameters were also frequently observed. As shown in Fig 3, the e-learning course reduced inappropriate interventions in all of these domains. We also observed a non-significant trend toward a reduction in inappropriate nutritional interventions (P = 0.055). In all, 22% of patients in the PreEG were inappropriately admitted to the hospital, compared to 15% in the PostEG (P = 0.200) patients. The proportion of hospitalized children with moderate or severe dehydration (indicated by >5% weight gain at discharge) was similar in both groups (25% in the PreEG and 26.5% in the PostEG; P = 0.841).

Bottom Line: Primary outcome measures included the proportion of participants fully adherent to CPG and number of patients managed with full adherence.The course improved knowledge scores (pre-course 8.6 ± 2.7 versus post-course 12.8 ± 2.1, P < 0.001), average adherence (from 87.0 ± 7.7% to 90.6 ± 7.1%, P = 0.001) and the number of patients managed in full adherence with the guidelines (from 33.6 ± 31.7% to 43.9 ± 36.1%, P = 0.037).E-learning is effective in increasing knowledge and improving clinical practice in paediatric AGE and is an effective tool for implementing clinical practice guidelines.

View Article: PubMed Central - PubMed

Affiliation: Department of Translational Medical Science, Sector of Pediatrics. University Federico II, Naples, Italy; Paediatric Hepatology Gastroenterology and Transplantation Unit, Hospital Papa Giovanni XXIII, Bergamo, Italy.

ABSTRACT

Objective: E-learning is a candidate tool for clinical practice guidelines (CPG) implementation due to its versatility, universal access and low costs. We aimed to assess the impact of a five-module e-learning course about CPG for acute gastroenteritis (AGE) on physicians' knowledge and clinical practice.

Study design: This work was conceived as a pre/post single-arm intervention study. Physicians from 11 European countries registered for the online course. Personal data, pre- and post-course questionnaires and clinical data about 3 to 5 children with AGE managed by each physician before and after the course were collected. Primary outcome measures included the proportion of participants fully adherent to CPG and number of patients managed with full adherence.

Results: Among the 149 physicians who signed up for the e-learning course, 59 took the course and reported on their case management of 519 children <5 years of age who were referred to their practice because of AGE (281 and 264 children seen before and after the course, respectively). The course improved knowledge scores (pre-course 8.6 ± 2.7 versus post-course 12.8 ± 2.1, P < 0.001), average adherence (from 87.0 ± 7.7% to 90.6 ± 7.1%, P = 0.001) and the number of patients managed in full adherence with the guidelines (from 33.6 ± 31.7% to 43.9 ± 36.1%, P = 0.037).

Conclusions: E-learning is effective in increasing knowledge and improving clinical practice in paediatric AGE and is an effective tool for implementing clinical practice guidelines.

No MeSH data available.


Related in: MedlinePlus