E‐Learning Module on Chronic Low Back Pain in Older Adults: Evidence of Effect on Medical Student Objective Structured Clinical Examination Performance

Abstract

The Institute of Medicine has highlighted the urgent need to close undergraduate and graduate educational gaps in treating pain. Chronic low back pain (CLBP) is one of the most common pain conditions, and older adults are particularly vulnerable to potential morbidities associated with misinformed treatment. An e-learning case-based interactive module was developed at the University of Pittsburgh Center of Excellence in Pain Education, one of 12 National Institutes of Health–designated centers, to teach students important principles for evaluating and managing CLBP in older adults. A team of six experts in education, information technology, pain management, and geriatrics developed the module. Teaching focused on common errors, interactivity, and expert modeling and feedback. The module mimicked a patient encounter using a standardized patient (the older adult with CLBP) and a pain expert (the patient provider). Twenty-eight medical students were not exposed to the module (Group 1) and 27 were exposed (Group 2). Their clinical skills in evaluating CLBP were assessed using an objective structured clinical examination (OSCE). Mean scores were 62.0 ± 8.6 for Group 1 and 79.5 ± 10.4 for Group 2 (P < .001). Using an OSCE pass–fail cutoff score of 60%, 17 of 28 Group 1 students (60.7%) and 26 of 27 Group 2 students (96.3%) passed. The CLBP OSCE was one of 10 OSCE stations in which students were tested at the end of a Combined Ambulatory Medicine and Pediatrics Clerkship. There were no between-group differences in performance on eight of the other nine OSCE stations. This module significantly improved medical student clinical skills in evaluating CLBP. Additional research is needed to ascertain the effect of e-learning modules on more-advanced learners and on improving the care of older adults with CLBP.

Undergraduate nursing students' subjective attitudes to curriculum for Simulation-based objective structured clinical examination

“…Sharing various methods for systematic self-study, as structured by students themselves, might be helpful to attenuate these feelings, and encouraging self-study using e-learning modules consisting of PowerPoint slides and video and audio recordings (Weiner et al, 2014) is an alternative learning method to lessen these feelings. These subjects typically highlighted Q statement 38 (try to understand nursing skills rather than memorizing).…”

“…These subjects typically highlighted Q statement 38 (try to understand nursing skills rather than memorizing). The development of an evidencebased e-learning module (Weiner et al, 2014) is useful to improve the understanding of nursing knowledge and skills.…”

“…OSCE enables students to practice evidence-based nursing methods, including both skills and knowledge, and also provides an opportunity for professors to identify and remediate undesirable nursing performance in their students (Alinier, 2003;Beckham, 2013;Weiner et al, 2014). The OSCE assessment instrument uses formative or summative evaluations to test students' clinical skills, knowledge and attitudes in an objective and equitable manner (O'Connor et al, 2014;Selim et al, 2012;Turner and Dankoski, 2008).…”

“…It is also important to produce reliable checklists and to properly educate evaluators (Jones et al, 2010;McWilliam and Botwinski, 2010). However, such procedures are expensive, labor intensive, time consuming, and require substantial effort and input by all faculty involved (El-Nemer and Kandeel, 2009;Nulty et al, 2011;Rushforth, 2007;Weiner et al, 2014). In addition, the desired OSCE/SOSCE learning outcomes may not be achieved if a nursing student is stressed, anxious, nervous, or intimidated, as evidenced by symptoms that include shaking hands and a quivering voice.…”

Improving Residents' Safe Opioid Prescribing for Chronic Pain Using an Objective Structured Clinical Examination

“…OSCEs utilize principles of cognitive apprenticeship 16 through coaching, feedback, and allowing learners to reflect on their skills. 17 They have been used to assess trainees' pain and addiction management practices, 18,19 yet we are not aware of prior reports of using OSCEs to teach safe opioid prescribing skills.…”