Knowledge in Context: Successful eLearning

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Knowledge in Context Successful e-Learning
e-Mentoring Strategies

• Dr. Marilynne A. Hebert
• Centre for Innovation in Health Technology
• University of Calgary
• CHPSTP Knowledge Transfer RLE04

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Agenda

• KT in Traditional Settings
• Use of ICTs to Support KT
• E-Mentoring/e-Learning KT Strategies
• Discussion

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1. KT in Traditional Settings

• Seminars Classes Continuing Professional
  Development
• Face-to-face instructor has some understanding
  of context
• More homogeneous learner group
• Locally relevant examples
• Workshop Format Chronic Pain Management
  effective example

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Alberta Chronic Pain Ambassador Program

• Increase clinician awareness of the best evidence
  in chronic pain management
• HTA Ambassador Program
• Face-to-face workshops
• few videoconferences
• Each topic discussed resulted in an Evidence in
  Brief
• http//www.ihe.ca/hta/ambassador/

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Evidence in Brief

• Clinical question
• Evidence from the literature (context free)
• Implications for practice (evidence in context)
• Research evidence what is known/not known
• Recommendations based on evidence and clinical
  expertise

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2. Use of ICTs to Support KT

• Larger, more diverse audience
• Learners in one location may participate in
  education produced in another location
• Evidence drawn from the literature
• Evaluation
• List of topics,
• Number of sessions
• Number of attendees
• Technology successfully implemented and used

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2. Use of ICTs to Support KT

• CHIPP (Canada Health Infostructure Partnerships
  Program)
• 22 projects completed
• 7 - continuing education was one of primary goals
• 6 - education was an outcome secondary to
  clinical activities
• Evaluation focused more on increasing access than
  effect of that access

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2. Use of ICTs to Support KT

• Coming Full Circle in Hospice Palliative Care
  Telelearning A Case Study Approach
• Both formal and anecdotal evidence
• Built on existing relationships networking
• Presented cases that reflected local needs
• Drew on members expertise much like local
  rounds
• Issues around confidentiality of info discussed

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2. Use of ICTs to Support KT

• More is better?? Multimedia, Interactive Learning
  Environments
• Journal of Educational Multimedia and Hypermedia
• Journal of Interactive Learning Research
• International Journal on E-Learning

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2. Use of ICTs to Support KT

• More is better?? Multimedia, Interactive Learning
  Environments
• World Conference on E-Learning in Corporate,
  Government, Healthcare, and Higher Education
  (E-Learn)
• World Conference on Educational Multimedia,
  Hypermedia Telecommunications (ED-MEDIA)

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Hi-tech Escape from the Tower of London

• http//today.reuters.com/tv/videoStory.aspx?storyI
  D08e4c65e64acb971ba48a30e257ab04107d428cd
• Role of Edutainment in making the context come
  alive

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3. E-Mentoring/e-Learning KT Strategies

• Readiness of Health Care Professionals to Adopt
  Point of Care Technology on Ward of the 21st
  Century
• Research Team
• Marilynne Hebert Deb White
• Karen Then Sonja Morrison
• Shandra Kimpton Sharon Strauss

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Conceptual Framework

• Readiness to Use Point of Care Technology (Hebert
  and Benbasat, 1994)
• Diffusion of Innovations (Rogers, 1995)
• Theory of Reasoned Action (Fishbein Ajzen, 1975)

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Conceptual Framework
Actual Use of Technology
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Conceptual Framework
Intent to Use Technology
Actual Use of Technology
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Conceptual Framework
Perceived Voluntariness
Intent to Use Technology
Actual Use of Technology
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Conceptual Framework
Perceived Voluntariness
Intent to Use Technology
Actual Use of Technology
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Conceptual Framework
Perceived Voluntariness
Intent to Use Technology
Actual Use of Technology
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Modified Research Plan
Readiness to Adopt Mobile Technology
Implications for Work Processes
Survey
Survey
2 Focus Groups Same Membership
Technology Usability
Implementation Plan
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Survey Results

• Distributed to all categories of work
• Analysis with respect to demographics,
  experience, effect on work and well-being
• Descriptive data on multiple variables
• To be completed regression analysis

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Focus Group 1 Nov. 7/06

• 8 nurses volunteered
• Range of nursing technology experience

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Qualifications

• experienced
• inexperienced
• love technology
• hate technology
• very knowledgeable
• dont have a clue

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Focus Group 1 Nov. 7/06

• 8 nurses volunteered
• Range of nursing technology experience
• 2 hours scheduled
• Introduction to the concept of point of care or
  mobile technology discussion of current work
  day information access and use

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Focus Group 1 Nov. 7/06

• 8 nurses volunteered
• Range of nursing technology experience
• 2 hours scheduled
• Introduction to the concept of point of care or
  mobile technology discussion of current work
  day information access and use
• Demo of devices/applications

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Samsung Q1 Notebook

• PCIS demo system
• Demo data entry using keyboard
• Record for a patient
• Medication administration
• Vital signs

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Hewlitt Packard iPAC 6900

• iWeb through CHR
• Demo selections using stylus
• Access evidence/ policies
• Admin of a blood product
• Drug interaction

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Palm Tungsten TX

• Demo Knowledge Model Chronic Renal Failure
• Selection with stylus
• MyLibrary
• pdf of relevant evidence for nursing care of
  chronic renal failure

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Focus Group 1 Nov. 7/06

• 8 nurses have volunteered
• Range of nursing technology experience
• 2 hours scheduled
• Introduction to the concept of point of care or
  mobile technology discussion of current work
  day information access and use
• Demo of devices/applications
• Discussion of what work might look like with
  access to mobile devices

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Focus Group 2 Nov. 28/06

• Usability Testing
• Perceptions of technology features
• Actual use of the technology
• Work through clinical scenario enter data
• Videotape responses

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3. e-Mentoring/e-Learning KT Strategies

• Model for e-Mentoring?
• Systematic review of Clinical Decision Support
  Systems (CDSS)
• Identified elements that work
• Elements that dont
• Themes

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Systematic Review of Clinical DSSBMJ.com

• Analysis of 70 RCTs identified 4 features
  strongly associated with a DSSs ability to
  improve clinical practice
• DS auto provided as part of clinical workflow
• DS delivered at time location of decision
  making
• Actionable recommendations provided
• Computer based

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Systematic Review of Clinical DSSBMJ.com

• Common theme of all 4 features
• Make it easier for clinicians to use a clinical
  DSS
• Suggests an effective system must minimize the
  effort required by clinicians to receive and act
  on system recommendations
• Kensaku Kawamoto, Caitlin A Houlihan, E Andrew
  Balas, and David F Lobach Improving clinical
  practice using clinical decision support systems
  a systematic review of trials to identify
  features critical to success BMJ, Apr 2005 330
  765

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3. e-Mentoring/e-Learning KT Strategies

• Philippines
• e-Mentoring Project
• potential solution to support isolated Rural
  Health Practitioners
• professional education, problem-solving with
  colleagues in similar settings, allied health
  worker education and data collection.

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Elluminate Demonstration with Zamboanga Medical
School Faculty Alumni
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3. e-Mentoring/e-Learning KT Strategies

• Alumni survey
• Factors affecting retention included
• absence of continuing professional and
  postgraduate medical education
• travel to urban areas for CPD is expensive
• invitations to attend conferences/training arrive
  late or not at all
• access to professional journals is limited and
  expensive.

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3. e-Mentoring/e-Learning KT Strategies

• Goal to develop a sustainable and effective
  practice based e-mentoring program to support
  Rural Health Practitioners in 4 SE Asian
  countries (Philippines, Laos, Malaysia and
  Vietnam).
• The program is expected to
• Develop infrastructure and capacity to
  support/maintain e-mentoring through web-based
  technology
• Develop continuing professional education
  resources appropriate for rural health practice
  in these contexts and
• Use cell phone/web-based technology to improve
  health data collection (i.e. local evidence)

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4. Discussion

• Can principles used in CDSS successfully guide
  development of KT related e-mentoring?
• Is there a danger the technology may get in the
  way of KT?
• Can e-mentoring/e-learning strategies help move
  KT forward?

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Thanks!