Focused educational intervention improves but may not sustain knowledge regarding falls management

Kempegowda, Punith; Chandan, Joht Singh; Hutton, Richard; Brown, L. Neville; Madden, Wendy; Webb, June; Doyle, Alison; Treml, Jonathan

doi:10.1136/bmjoq-2017-000222

Cited by 13 publications

(14 citation statements)

References 23 publications

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“…Four studies reported using trained interventionists to deliver the education, including change agents and falls ‘champions’ [ 44 , 45 , 71 , 79 ]. Research team members (including project representatives) were the educators in around one-quarter [ 43 , 46 , 48 , 51 , 52 , 54 , 64 , 68 , 69 , 76 ]. Geriatrician clinical educators were the educators in two studies [ 67 , 73 ], and where the study was carried out in a simulation centre, the simulation centre staff were the educators [ 60 , 72 ].…”

Section: Resultsmentioning

confidence: 99%

Education interventions for health professionals on falls prevention in health care settings: a 10-year scoping review

2020

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Background Falls in hospitals are a major risk to patient safety. Health professional education has the potential to be an important aspect of falls prevention interventions. This scoping review was designed to investigate the extent of falls prevention education interventions available for health professionals, and to determine the quality of reporting. Method A five stage scoping review process was followed based on Arksey and O’Malley’s framework and refined by the Joanna Briggs Institute Methodology for JBI Scoping Reviews. Five online databases identified papers published from January 2008 until May 2019. Papers were independently screened by two reviewers, and data extracted and analysed using a quality reporting framework. Results Thirty-nine publications were included. Interventions included formal methods of educational delivery (for example, didactic lectures, video presentations), interactive learning activities, experiential learning, supported learning such as coaching, and written learning material. Few studies employed comprehensive education design principles. None used a reporting framework to plan, evaluate, and document the outcomes of educational interventions. Conclusions Although health professional education is recognised as important for falls prevention, no uniform education design principles have been utilised in research published to date, despite commonly reported program objectives. Standardised reporting of education programs has the potential to improve the quality of clinical practice and allow studies to be compared and evaluated for effectiveness across healthcare settings.

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Section: Resultsmentioning

confidence: 99%

Education interventions for health professionals on falls prevention in health care settings: a 10-year scoping review

2020

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“…In addition to the figures cited above, it is apparent that 2018 shows a further increase in the number of articles citing the Pyramid. In the brief time that this paper was under review, at least six new medical education articles citing the Pyramid and its variations were published, ensuring that 2018 will be well represented in entrenching this myth.…”

Section: Discussionmentioning

confidence: 99%

Edgar Dale's Pyramid of Learning in medical education: Further expansion of the myth

Masters

2019

Medical Education

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Introduction A mythical Pyramid of Learning, usually attributed to Edgar Dale (or the National Training Laboratories [NTL]) and giving student learning retention rates, has been cited in a wide range of educational literature. A 2013 literature review indicated that medical education literature similarly cites this Pyramid. It was hoped that highlighting this myth in that review would reduce references to the Pyramid in future medical education literature. This study aimed at determining what change in Pyramid citation has occurred in the past 5 years. Methods A documented literature review, following the same process as the original review, was conducted. The search dates were September 2012 to April 2018, and the databases were Academic Search Complete, CINAHL, Medline and Google Scholar. Sources were from peer‐reviewed journals or conferences, in English. Results From an initial search result of 992 documents, 41 were found to match the criteria. Trends discovered are: the number of Pyramid citations in medical education literature is increasing dramatically, new sources of the Pyramid are now being used, refutations of the Pyramid are being used to support it, and even researchers who acknowledge the weakness of the Pyramid still cite it. Discussion and Conclusion In spite of the 2013 review, the situation has become worse. One possible reason is that refutations use too polite academic wording, and other researchers then consider the Pyramid to be merely “disputed” or “debated.” To kill the myth of the Pyramid, it is necessary for this article's Abstract to state unequivocally: The Pyramid is rubbish, the statistics are rubbish, and they do not come from Edgar Dale. Until the NTL can provide details about the original research, their version must also be treated as rubbish.

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“…This is particularly relevant where DRUJ congruity is being assessed and specifically when comparing studies which may have been obtained in different positions. 13 Previous studies have examined the use of educational interventions to improve compliance with clinical practice standards, [29][30][31][32] particularly medication administration errors, 33 although radiography examples are limited. 34,35 It is recognised that quality assurance processes are used within imaging departments and improvement strategies are employed, but these appear to be focussed at a local level.…”

Section: Discussionmentioning

confidence: 99%

“…Lecture-based education has limitations, including poor retention of information, in addition to challenges of attendance and delivery patterns. 29 As educational posters also are available over an extended period of time, it was also hoped that it could serve as a reminder for staff, supporting retention of knowledge. Although the overall improvement was initially significant, the impact was seen to vary across hospital sites; however, the reason for this was not investigated further.…”

Section: Discussionmentioning

confidence: 99%

Improving wrist imaging through a multicentre educational intervention: The challenge of orthogonal projections

et al. 2020

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Introduction In relation to wrist imaging, the accepted requirement is two orthogonal projections obtained at 90°, each with the wrist in neutral position. However, the literature and anecdotal experience suggests that this principle is not universally applied. Method This multiphase study was undertaken across eight different hospitals sites. Compliance with standard UK technique was confirmed if there was a change in ulna orientation between the dorsi-palmar (DP) and lateral wrist projections. A baseline evaluation for three days was randomly identified from the preceding three months. An educational intervention was implemented using a poster to demonstrate standard positioning. To measure the impact of the intervention, further evaluation took place at two weeks (early) and three months (late). Results Across the study phases, only a minority of radiographs demonstrated compliance with the standard technique, with an identical anatomical appearance of the distal ulna across the projections. Initial compliance was 16.8% ( n = 40/238), and this improved to 47.8% ( n = 77/161) post-intervention, but declined to 32.8% ( n = 41/125) within three months. The presence of pathology appeared to influence practice, with a greater proportion of those with an abnormal radiographic examination demonstrating a change in ulna appearances in the baseline cohort ( p < 0.001) and the late post-intervention group ( p = 0.002) but not in the examinations performed two weeks after staff education ( p = 0.239). Conclusion Assessment of image quality is critical for diagnosis and treatment monitoring. Yet poor compliance with standard anatomical principles was evident. A simple educational intervention resulted in a transient improvement in wrist positioning, but the impact was not sustained over time.

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Focused educational intervention improves but may not sustain knowledge regarding falls management

Cited by 13 publications

References 23 publications

Education interventions for health professionals on falls prevention in health care settings: a 10-year scoping review

Education interventions for health professionals on falls prevention in health care settings: a 10-year scoping review

Edgar Dale's Pyramid of Learning in medical education: Further expansion of the myth

Improving wrist imaging through a multicentre educational intervention: The challenge of orthogonal projections

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