Health literacy education programmes developed for qualified health professionals: a scoping review protocol

Introduction: Health literacy education, for health professionals, has been identified as having the potential to improve patient outcomes and has been recognized as such in policy developments. Health literacy, as a relational concept, encompasses individuals’ skills and how health information is processed in relation to the demands and complexities of the surrounding environment. Focus has been predominantly on the dimension of functional health literacy (reading, writing and numeracy), although increasing emphasis has been placed on interactive and critical domains. Such dimensions often guide the development of health professional education programmes, where the aim is to enhance the patient-practitioner relationship, and ultimately reduce the health literacy burden experienced by patients navigating health services. Currently little is known about qualified health professionals’ education in health literacy and communication skills, and development, implementation or evaluation of such interventions. Aim: To identify and map current educational interventions to improve health literacy competencies and communication skills of qualified health professionals. Methods: A scoping review will be conducted drawing on methods and guidance from the Joanna Briggs Institute, and will be reported according to the Preferred Reporting Items for Systematic Review and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Checklist. This study will retrieve literature on health professional education for health literacy and communication skills through a comprehensive search strategy in the following databases: CINAHL; Medline (Ovid); the Cochrane Library; EMBASE; ERIC; UpToDate; PsycINFO. Grey literature will be searched within the references of identified articles; Lenus; ProQuest E-Thesis Portal; RIAN and OpenGrey. A data charting form will be developed with categories including: article details, demographics, intervention details, implementation and evaluation methods. Conclusion: Little is known about the extent and nature of the current evidence base therefore a scoping review will be conducted, in order to identify programme characteristics in relation to health literacy competencies and communication skills.

Got Skills?

Health professional education is designed to help learners gain the knowledge, skills, and attitudes needed for practice. There has been extensive reform in health professional curriculums to emphasize the teaching, development, and assessment of clinical skills. As medical education continues to evolve due to changes in healthcare, and with the ever-increasing growth of technology, it is important to ensure that health professional students are ready to practice successfully. Many curriculums have incorporated clinical skills laboratories to provide learners a safe and protected environment to practice those skills necessary for their profession. Thus, students must acquire, maintain, and enhance their clinical skills techniques as they progress in their education and be properly assessed before they approach real patients. The emergence of the COVID-19 pandemic required educational transition to a remote platform, providing both challenges and opportunities for health education. This chapter reviews how remote skills-based courses can teach and assess clinical skills effectively.

Health literacy education programmes developed for qualified health professionals: a scoping review protocol

Introduction: Health professional education for health literacy has been identified as having the potential to improve patient outcomes and has been recognized as such in policy developments. Health literacy is an emerging concept encompassing individuals’ skills and how health information is processed in relation to the demands and complexities of the surrounding environment. Focus has been predominantly on the dimension of functional health literacy (reading, writing and numeracy), although increasing emphasis has been placed on interactive and critical domains. Such dimensions can guide the development of health professional education programmes and bridge the gap in the interaction between health professionals and their patients. Currently little is known about qualified health professional’s education for health literacy, its development, implementation or evaluation. Aim: To identify and map current educational interventions to improve health literacy competencies and communication skills of qualified health professionals. Methods: A scoping review will be conducted drawing on methods and guidance from the Joanna Briggs Institute, and will be reported according to the Preferred Reporting Items for Systematic Review and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Checklist. This study will retrieve literature on health professional education for health literacy through a comprehensive search strategy in the following databases: CINAHL; Medline (Ovid); the Cochrane Library; EMBASE; ERIC; UpToDate; PsycINFO and Central Register of Controlled Trials (CENTRAL). Grey literature will be searched within the references of identified articles: Lenus; ProQuest E-Thesis Portal; the HSE health research repository and RIAN. A data charting form will be developed with categories agreed by the research team, including: article details, demographics, intervention details, implementation and evaluation methods. Conclusion: Little is known about the extent and nature of the current evidence base therefore in order to identify programmes and consolidate their demographics and characteristics within health literacy competencies and communication skills, a scoping review is warranted.

Impact of the COVID-19 pandemic on teaching and learning in health professional education: a mixed methods study protocol

Background Due to the complex nature of healthcare professionals’ roles and responsibilities, the education of this workforce is multifaceted and challenging. It relies on various sources of learning from teachers, peers, patients and may focus on Work Integrated Learning (WIL). The COVID-19 pandemic has impacted many of these learning opportunities especially those in large groups or involving in person interaction with peers and patients. Much of the curriculum has been adapted to an online format, the long-term consequence of which is yet to be recognized. The changed format is likely to impact learning pedagogy effecting both students and teachers. This requires a systematic approach to evaluation of online teaching and learning adaptation, in comparison to the previous format, where, in person education may have been the focus. Methods The proposed study is a broad based evaluation of health professional education in a major Australian University. The protocol describes a mixed methods convergent design to evaluate the impact of online education on students and teachers in health professional courses including Medicine, Nursing, Allied Health and Biomedical Science. A framework, developed at the university, using Contribution Analysis (CA), will guide the evaluation. Quantitative data relating to student performance, student evaluation of units, quantity of teaching activities and resource utilization will be collected and subjected to relevant statistical analysis. Data will be collected through surveys (500 students and 100 teachers), focus groups (10 groups of students) and interviews of students and teachers (50 students beyond graduation and 25 teachers, for long term follow up to 12 months). Application of CA will be used to answer the key research questions on the short term and long-term impact of online education on teaching and learning approaches. Discussion The protocol describes the study, which will be widely implemented over the various courses in Health Professional Education and Biomedical Science. It will evaluate how students and teachers engage with the online delivery of the curriculum, student performance, and resources used to implement these changes. It also aims to evaluate longitudinal outcome of student learning attributes and impact on graduate outcomes, which is poorly reported in educational literature.

Identifying and Responding To Anxiety and Depression in Adult Cancer Patients: Development, Acceptability and Uptake of An On-Line Communication Skills Education Program Targeting Challenging Conversations for Oncology Health Professionals

Background: Anxiety and depression screening and management in cancer settings occurs inconsistently in Australia. We developed a clinical pathway (ADAPT CP) to promote standardized assessment and response to affected patients and enhance uptake of psychosocial interventions. Health professional education is a common strategy utilised to support implementation of practice change interventions. Health professional education is a common strategy utilised to support implementation of practice change interventions. We developed an interactive on-line education program to support staff communication and confidence with anxiety/depression screening and referral prior to the ADAPT CP being implemented in 12 oncology services participating in the ADAPT CP cluster randomised controlled trial (CRCT). The aim of this research was to assess acceptability and uptake of the education program.Patient Involvement: Although the wider ADAPT Program included patient consumers on the Steering Committee, in the context of this research consumer engagement included health professionals working in oncology. These consumers contributed to resource development.Methods: Development was informed by oncology and communication literature. The five online modules were pilot tested with 12 oncology nurses who participated in standardised medical simulations. Acceptability and uptake were assessed across the 12 Oncology services participating in the ADAPT CRCT. Results: During pilot testing the online training was reported to be acceptable and overall communication and confidence improved for all participants post training. However, during the ADAPT CRCT uptake was low (7%; n=20). Although those who accessed the training reported it to be valuable, competing demands and online format reportedly limited HPs’ capacity and willingness to undertake training.Conclusions: This interactive on-line training provides strategies and communication skills for front-line staff to guide these important conversations. Building workforce skills, knowledge and confidence is crucial for the successful implementation of practice change interventions. However, despite being acceptable during pilot testing, low uptake in real world settings highlights organisational support and incentivisation for frontline staff to undertake training is critical for wider engagement. A multimodal approach to delivery of training to cater for staff preferences for face to face and/or online staff may maximise training uptake and increase effectiveness of training interventionsTrial Registration: Pilot study ACTRN12616001490460 (27/10/2016). ADAPT RCT ACTRN12617000411347(22/03/2017)

Refining assessment: Rasch analysis in health professional education and research

Educators want to assess learners using assessment processes that provide valid measures of learner ability. An ideal assessment tool would include items that are appropriate for assessing the target attributes. Ideal assessment results would accurately differentiate learners across the spectrum of ability, determine which learners satisfied the required standard and enable comparison between learner cohorts (e.g., across different years). Similar considerations are relevant to researchers who are designing or revising methods used to gather other kinds of assessment data, such as participant responses to surveys or clinical measurements of performance. Analysing assessment scores using Rasch analysis provides information about scores and the nature of each assessment item, and analysis output guides refinement of assessment. However, few health professional educators have published research that includes Rasch modelling methods. It may be that health professional educators find the language used to describe Rasch analysis to be somewhat impenetrable and that this has, to date, limited engagement in exploring applications for Rasch. In this paper, we lay out an overview of the potential benefits of Rasch analysis in health professional education and research.

Discussion Paper: Conceptual thresholds in health professional education research and scholarship

Healthcare professionals (HCPs) are increasingly undertaking health professional education (HPE) research and scholarship. This discussion paper highlights key transition points experienced by HCPs newly engaging in HPE research and scholarship, using conceptual thresholds as a theoretical lens. The identified thresholds are: (1) recognising limits, (2) navigating discourses and (3) negotiating identities, and our paper evidences the epistemic, discursive and existential repositioning underpinning these thresholds. Supporting HCPs to successfully navigate the rich and vibrant world of HPE research and scholarship requires a multi-faceted strategy involving individual upskilling, co-construction of resources and strategies, and enhancing the invitational quality of HPE research activities, environments and communities.