amanda thomas community based education/ practice entry and support program coordinator
DESCRIPTION
East Texas Geriatric Education Center + East Texas AHEC = Successful Health Professions Distance Education Collaborative. Amanda Thomas Community Based Education/ Practice Entry and Support Program Coordinator Brazos Area Health Education Center (AHEC) Tony DiNuzzo, PhD - PowerPoint PPT PresentationTRANSCRIPT
East Texas GEC / East Texas AHEC
East Texas Geriatric Education Center + East Texas AHEC = Successful
Health Professions Distance EducationCollaborative
Amanda ThomasCommunity Based Education/
Practice Entry and Support Program CoordinatorBrazos Area Health Education Center (AHEC)
Tony DiNuzzo, PhDDirector, Easy Texas Geriatric Education Center
East Texas GEC / East Texas AHEC
Objectives
• Provide an overview of the ETAHEC / ETGEC partnership and activities
• Describe the use, strengths and weakness of distance learning (DL) to reach multiple sites
• Describe steps taken to strength the ETGEC-ETAHEC relationship and improve effectiveness of DL
East Texas GEC / East Texas AHEC
ETAHEC
• Helps with Health profession shortage problem
• Health work force development
• Facilitate and plan continuing education events
East Texas GEC / East Texas AHEC
Geriatric Education Centers
• In existence since 1980’s at part of Title VII Program– Funded by Department of Health & Human Services (DHHS) -
Health Resources & Services Administration (HRSA), Bureau of Health Professions (BrHP)
– Program eliminated in 2006 due to HRSA budget cuts
• Massive lobbying effort led to reinstating GEC funding for 2007
• 50 GECs funded in 2007 for 3 yrs (9/07 – 6/30/10)• 2 options:
– consortia ($400,000/yr) single entity ($200,000/yr)
• 3 others funded in Texas – Texas Consortium GEC – Baylor College of Medicine– SWAP-C GEC – UTHSC San Antonio– Houston GEC - UTHSC-Houston School of Medicine
East Texas GEC / East Texas AHEC
Purpose of GECs• Improve training of health professionals in
geriatrics• Develop & disseminate curricula• Provide opportunities for continuing education• Provide geriatric clinical training to students
Required: training involving 4 or more health professions – at least one must be allopathic or osteopathic
East Texas GEC / East Texas AHEC
East Texas GEC / East Texas AHEC
East Texas Geriatric Education Center (ETGEC)
– Single institution• Headquarters in UTMB• East Texas Area Health Education Center (AHEC)
primary partner• Affiliations with other institutions
– Funded by Department of Health & Human Services (DHHS) - Health Resources & Services Administration (HRSA), Bureau of Health Professions (BrHP)
– $200,000/yr. for each of 3 years, supplemented with existing funds
East Texas GEC / East Texas AHEC
Legend:
- MUA whole or partial - HPSA whole or partial - Both HPSA & MUA whole or partial
- University of Texas Medical Branch at Galveston1 – Lamar University2 – Stephen F. Austin University3 – Baylor University4 – Victoria College
ETGEC Service Area
Coastal AHEC Piney Woods AHEC Pecan Valley AHEC Brazos AHEC
East Texas GEC / East Texas AHEC
Administrative Structure
Principal Investigator Tony DiNuzzo, PhD
UTMB
Program Consultant James Goodwin, MD
Project Coordinator East Texas AHEC
Executive Committee
Project Co-coordinator Linda Rounds, PhD
Coastal AHEC Teri Dickerson
Brasos AHEC Amanda Thomas
Piney Woods AHEC Mark Scott
Pecan Valley AHEC Paula Crawford
Discipline Coordinator Medicine
Discipline Coordinator Nursing
Discipline Coordinator Allied Health Sciences
Discipline Coordinator Social Work
Steering Committee
Affiliate consultants:Wilma Cordova, MS, LCSW – SFA
Eileen Durgess Curl, PhD, RN – LamarJames Ellor, PhD – Baylor U.
Barbara Orantes, RN – VictoriaJim Mann, PhD - LamarOma Morey, PhD - OED
East Texas GEC / East Texas AHEC
ETGEC Project /Requirements
• Huge assessment, tracking, dissemination, evaluation and outcome reporting component
• Massive web and distance education presence
• Collaboration w/other Texas and national GECs
• Interprofessional, interprofessional
• Regional collaboration w/ affiliates, AHEC and TDCJ/CMC
East Texas GEC / East Texas AHEC
ETGEC Programmatic Focus
HP Disciplines• Allopathic Medicine• Nursing• Social Work• Allied Health Professions – OT, PT, PA
Special Target Populations• Minority elderly• Rural elderly • Older prisoners
East Texas GEC / East Texas AHEC
ETGEC Programmatic Focus
Program FeaturesNo registration FeesFree CE credits (CME, CNE, CEUs - SW, OT, PT)
Modalities/venues:• Distance learning technologies• Web-based curricula• Clinical training• Multiple ambulatory sites
East Texas GEC / East Texas AHEC
Teleconferencing Sites
Baylor University - Waco Victoria College - Victoria
East Texas GEC / East Texas AHEC
ETGEC Training Focus• 30-hour program in health literacy
– the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions
• Live and on-line Continuing Education credits for CME, CNE, SW, OT & PT
• Convene major symposiums with affiliate institutions– Alzheimer’s Disease– Long Term Care: Residents and Their Families
• On-line Continuing Education
• Establish 3 clinical interdisciplinary training sites in geriatrics
East Texas GEC / East Texas AHEC
Nurturing the Partnership
East Texas GEC / East Texas AHEC
Interactive Video Distance Learning (IVDL)
Compression video involving exchange of audio and video between two or more sites
Characterized by separation of student(s) and teacher by space and/or time
East Texas GEC / East Texas AHEC
Background
• Mid ’90s, K-12 level (Fulford & Zhang, 1993; Klesius, Homan, & Thompson, 1997; Smith, 1996; Zirkin & Sumler, 1995)
• Increasing use and value on IVDL – adopted at many major Universities, medical settings, telemedicine, Interactive Teledermatology (East Carolina University Brody School of Medicine, 2005)
• Becoming more affordable
• Improved technologies – eg. ↑ frame speed
East Texas GEC / East Texas AHEC
IVDL as Effective Learning Tool
Early studies:
– IVDL cannot achieve degree of interaction compared to a non-distance environment
– Smith (1996, May) - 30% of 400 respondents would never choose distance learning (DL) courses compared to face-to-face courses
– Miller and Webster (1997) - no significant difference in assessment of interaction
– Horn (1994); Hirumi and Bermudez (1996) - with proper instructional design, courses using IVDL can be more interactive than traditional ones
East Texas GEC / East Texas AHEC
IVDL at UTMB
• Telemedicine widely used – Pediatrics, Endocrinology, TDCJ, ENT, Family Medicine, Geriatrics, Nursing etc…
• UTMB commitment to establishing DL education
– 2003-06 Institutional Plan for Distance Education and Off-Campus Instruction
• Evaluation of IVDL limited to evaluating system software, hardware setup, operation procedures.
• No formal instruction available developing courses involving IVDL
• Assistance available through UTMB Telehealth Center Distance Education Program
East Texas GEC / East Texas AHEC
Purpose
• Determine which interactive video distance learning (IVDL) activities are most effective for learning
• Provide additional guidelines for developing IVDL-based courses
East Texas GEC / East Texas AHEC
Methods• Survey developed to assess:
– Effectiveness of various learning strategies and activities
– Level of satisfaction with interaction
– Professionalism
• IRB approval of survey instrument
• Distributed to health care providers via e-mail - participants of East Texas Geriatric Education Center (ETGEC) programs:– 2004-05 Scholar of Aging Program
– 2005-06 Lecture and Case Study Series in Advanced Geriatrics
East Texas GEC / East Texas AHEC
Study Sites
• 4 remote sites
– Stephen F. Austin State U. (Nacogdoches)
– Lamar University (Beaumont)
– UTHC at Tyler
– McLennan Community College (Waco)
East Texas GEC / East Texas AHEC
Methods (continued)• Activities queried:
– Didactic lecture (q & a)
– Didactic lectures w/group activities
– Written case studies w/general discussion
– Written case studies w/group discussion
– Video cases w/general discussion
– Video cases w/group discussion
– Pre-session activity - assignments
• Scoring: 5= Very effective - 1=not effective
• ~90 surveys sent - 30 surveys completed -representative of all 4 sites
East Texas GEC / East Texas AHEC
Question #1 What IVDL activities are considered most effective for learning?
East Texas GEC / East Texas AHEC
Survey Results (N=30)
0
0.5
1
1.5
2
2.5
3
3.5
4
4.5
Activity type
Did Q&A
Did group
Case gen
Case group
Video gen
Video group
Prep Assign
Avg
. S
core
Max
=5
Figure 1. Distribution of average effectiveness score by activity type
Avg. score=3.55
East Texas GEC / East Texas AHEC
Question #2 Does the technological level of DL system used by remote sites affect impact of activities?
East Texas GEC / East Texas AHEC
• Frame speed, availability of technician, monitor size, connection difficulties
– Stephen F. Austin State U. (Nacogdoches) – High level
– Lamar University (Beaumont) – Moderate level
– UTHC at Tyler – Low level
– McLennan Community College (Waco) – Low level
• Average effectiveness score for all activities for each subject based on location
System characteristics
East Texas GEC / East Texas AHEC
Survey Results (N=30)
0
0.5
1
1.5
2
2.5
3
3.5
4
4.5
5
Remote site
SFA1
SFA2
SFA3
Lamar1
Lamar2
Lamar3
Tyler1
Tyler2
MCC1
MCC2
To
tal
aver
age
sco
re M
ax=
5
Figure 2. Distribution of total average effectiveness score for each subject by site
East Texas GEC / East Texas AHEC
Survey Comments
• Use of handouts – very helpful
• Interaction – dependent on instructor, involving sites throughout presentation
• Need for professionalism – strong agreement
Major Concern
When should IVDL courses be considered?
- Cost vs. Benefit issues
- Demand for courses not available in specific sites
- Time needed for training, acquiring IVDL techniques, course development
East Texas GEC / East Texas AHEC
Conclusions
Data analyses indicated the use of group, team-based activities and case studies as providing the most effective means for learning.
Learning effectiveness was also impacted by the technical level and system used by remote sites.
East Texas GEC / East Texas AHEC
• Course development & delivery– Incorporate activities that are “active”– Group activities work best (if well planned)– Supply handouts
• Videoconferencing Professionalism– Pay attention to how others will be seeing and
hearing you• Speak clearly & directly; be polite• Establish “eye contact” with remote site• Acknowledge their presence; get them involved• Be kind if something goes wrong• Muting is tricky
Discussion and Suggestions
East Texas GEC / East Texas AHEC
Limitations
• Small sample (n=30)
• Representative, low response (30%)
• Survey reliability and validity
• How do effectiveness scores compare to host site (UTMB)?
East Texas GEC / East Texas AHEC
New Challenges
• Different remote sites, new technical requirements
• Hurricane Ike• Personnel changes• Need for consistent communication• Problems with:
– Consistent connection capacity– Speaker cancellations– Obtaining CE Certificates
East Texas GEC / East Texas AHEC
Addressing New Challenges• Communication
– Regular meetings with AHEC Executives– Develop new processes to assure communication– Test runs to assure connection capability
• Program Fidelity– Improved evaluation methods– Improved participant tracking– Back-up plan if speakers cancel, cancelling activity
(avoid at all cost) – Follow-up measures to determine long term program
impact
East Texas GEC / East Texas AHEC
Contact Information East Texas Geriatric Education Center
c/o Tony DiNuzzo, Ph.D., Program Director Sealy Center on Aging, Route 0460
301 University Blvd. University of Texas Medical Branch
Galveston, TX 77555-0460 Telephone: 409.772.5367
Toll-free number: 800.298.7015 Fax: 409.772.8931
E-mail: [email protected]
Website: http://etgec.utmb.edu