Interactive Training and Electronic Web Resource as Method to Increase the Level of Family Physicians Knowledge Concerning Implementation of Evidence-based Recommendations for Cardiovascular Risks Screening into Clinical Practice

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Ivanna Shushman
Pavlo Kolesnyk

Abstract

Cardiovascular disease is one of the leading causes of death worldwide, and Ukraine is not an exception. The mortality rate due to cardiovascular diseases among non-communicable diseases in our country today is 63%. In the nine months of 2021, 487.9 thousand citizens died in Ukraine, most of them – from cardiovascular diseases.


To perform specific and effective preventive actions among the population, it is necessary to have complete and reliable information about the prevalence of risk factors in the population. Epidemiological research, by providing this information, makes it possible to assess the extent of the problem and determine the priorities for action in medical science and practice. There is a need to optimize the continuous medical education of doctors in this problem. It is known that the classical lecture and presentation of information gives the lowest level of assimilation by the audience. Therefore, one of the modern forms of education is interactive training, which successfully combines various forms of activating the attention of trainees and attracting them to the practical actions.


The objective: to evaluate the effectiveness of training sessions using the special web resource to increase the level of knowledge of family doctors regarding the implementation of cardiovascular risk screening into their clinical practice.


Materials and methods. A 6-hour interactive training “Principles of evidence-based screening in the family doctors’ practice” was held for 95 family doctors from the Transcarpathian region, among whom 70 (74%) worked in rural areas and 25 (26%)– in urban areas. The level of knowledge of the training participants was assessed using 12 test tasks at the beginning, immediately after the training and 3 months after the training. The test was consisted of theд identical questions at all stages of the survey.


All participants were divided into two groups: group 1 (n=45) – those who learned the topic only at training; group 2 (n=50) – those who, in addition to the training, received free personal access to the web resource “Recommendations for Prevention and Screening”. The Prevention and Screening Recommendations web resource was developed on the basis of the USPTFS evidence-based program and the generalized recommendations from the European screening protocols; the resource gives list of the needed evidence-based screening recommendations depending on the given to the system patient’s personal data.


Results. According to the test results, the average level of knowledge of the participants at the beginning of the training was 6 (5.7) points. Immediately after the training the level increased to 9 (8, 10) points (p<0.001). After 3 months, the average level of knowledge of family doctors decreased to 8 (7.9) points, however, it was statistically higher compared to the average level of knowledge of respondents before training (p<0.001). In addition, the average level of knowledge in 3 months after the training of group 2 participants who had access to the web resource was statistically significantly higher compared to group 1, whose participants got only training (7 vs. 9) (p<0.001) .


Conclusions. Interactive training is an effective method of learning which should be implemented into clinical practice, it creates the prerequisites for the active and widespread use of this method in training of medical workers during their continuous professional development. Having access to a web resource helps to improve the learninf results and maintain the proper level of knowledge for a long time.

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How to Cite
Shushman, I., & Kolesnyk, P. (2021). Interactive Training and Electronic Web Resource as Method to Increase the Level of Family Physicians Knowledge Concerning Implementation of Evidence-based Recommendations for Cardiovascular Risks Screening into Clinical Practice. Family Medicine, (5-6), 21–25. https://doi.org/10.30841/2307-5112.5-6.2021.252998
Section
Topical issues
Author Biographies

Ivanna Shushman, Uzhhorod National University

Ivanna V. Shushman,

Department of Family Medicine and Outpatient Care

Pavlo Kolesnyk, Uzhhorod National University

Pavlo O. Kolesnyk,

Department of Family Medicine and Outpatient Care

References

Unified clinical protocol of primary, secondary (specialized) and tertiary (highly specialized) medical care. Prevention of cardiovascular diseases [Internet]. 2016. Order of the Ministry of Health of Ukraine № 564, dated 13.06.2016. Available from: https://www.dec.gov.ua/wp-content/uploads/2019/11/2016_564_ykpmd_pssz.pdf.

GBD 2019 Diseases and Injuries Collaborators T, Lim SS, Abbafati C, Abbas KM, Abbasi M, Abbasifard M, et al. Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet (London, England). 2020;396(10258):1204-22. doi: 10.1016/S0140-6736(20)30925-9.

National Institute for Health and Care Excellence. Cardiovascular disease: risk assessment and reduction, including lipid modification [Internet]. London: Guideline NICE; 2014. 40 p. Available from: https://www.nice.org.uk/guidance/cg181.

Centers of Medicare and Medicaide Services. Comprehensive Primary Care Initiative [Internet]. Baltimore: CMS; 2017. Available from: https://innovation.cms.gov/innovation-models/comprehensive-primary-care-initiative.

Hoffmann TC, Del Mar C. Clinicians’ Expectations of the Benefits and Harms of Treatments, Screening, and Tests: A Systematic Review. JAMA Intern Med. 2017;177(3):407-19. doi: 10.1001/jamainternmed.2016.8254.

Hoffmann TC, Del Mar C. Patients’ expectations of the benefits and harms of treatments, screening, and tests: a systematic review. JAMA Intern Med. 2015;175(2):274-86. doi: 10.1001/jamainternmed.2014.6016.

Gray JAM, Patnick J, Blanks RG. Maximising benefit and minimising harm of screening. BMJ. 2008;336(7642):480-3. doi: 10.1136/bmj.39470.643218.94.

Mansouri M, Lockyer J. A meta-analysis of continuing medical education effectiveness. J Contin Educ Health Prof. 2007;27(1):6-15. doi: 10.1002/chp.88.

Kastaun S, Leve V, Hildebrandt J, Funke C, Becker S, Lubisch D, et al. Effectiveness of training general practitioners to improve the implementation of brief stop-smoking advice in German primary care: study protocol of a pragmatic, 2-arm cluster randomised controlled trial (the ABCII trial). BMC Fam Pract. 2019;20(1):107. doi: 10.1186/s12875-019-0986-8.

Ahmadi S-F, Baradaran HR, Ahmadi E. Effectiveness of teaching evidence-based medicine to undergraduate medical students: a BEME systematic review. Med Teach. 2015;37(1):21-30. doi: 10.3109/0142159X.2014.971724.

Shushman I, Kolesnyk P, Schonmann Y, Harris M, Frese T. Training Family Doctors and Primary Care Nurses in Evidence-based Prevention, Screening and Management of Cardiovascular Risks in Western Ukraine: A Longitudinal Study. Zdr Varst. 2020;59(4):227-35. doi: 10.2478/sjph-2020-0029.

Sinclair P, Kable A, Levett-Jones T. The effectiveness of internet-based e-learning on clinician behavior and patient outcomes: a systematic review protocol. Int J Nurs Stud. 2015;13(1):52-64. doi: 10.1016/j.ijnurstu.2016.01.011.

Miller CJ, McNear J, Metz MJ. A comparison of traditional and engaging lecture methods in a large, professional-level course. Adv Physiol Educ. 2013;37(4):347-55. doi: 10.1152/advan.00050.2013.

Shushman IV, Kolesnik PO. Internet program «Evidence Prevention and Screening Advisor» as a tool to raise awareness and commitment of patients to evidence screening. Pilot study project. The achievements of the wedge and experimental honey. 2020; (2): 202-5. doi 10.11603/1811-2471.2020.v.i2.11344.