University professor, researcher and educational leader in medical/health sciences and adult/post-secondary education. Senior leadership experience in educational development in medical and health sciences education. Professional experience as manager of tele-education/tele-health programming, manager of staff training and development and coordinator of community-based educational and outreach programming. University teaching experience in medical education theory and practice, educational scholarship and research in medical education, digital learning, adult learning theory, interprofessional education (IPE) and collaboration in health professions. Key research contributions: program evaluation in medical and health professions education, tele-education and digital learning in medical education, continuing medical education/continuing professional development (CME/CPD), interprofessional education, assessment and adult and continuing education. Research program has included a focus on: distance, digital and e-learning in medical education
Over the years, a variety of distance learning technologies have been used to address the continu... more Over the years, a variety of distance learning technologies have been used to address the continuing medical education (CME) needs of rural and remote physicians. Some of these have included audio teleconferencing, video conferencing, and slow scan imaging. Although the CME literature has documented these initiatives in detail, it is deficient of evaluative information which could advise key decisions regarding the effectiveness of these instructional technologies in providing CME. In recent times, the emergence and growth of the World Wide Web and CD-ROM technologies have introduced new prospects for delivering continuing education to the rural medical practitioner. Consequently, the rationale for this study was to develop and fieldtest a model for evaluating the effectiveness of computer-mediated instructional courseware. This is a response to the need for comprehensive and systematic evaluation approaches to inform decision-makers, program developers, and future efforts in computer-mediated CME delivery. An eclectic evaluation planning matrix was designed by selecting various elements and concepts from evaluation approaches identified in the literature. This planning matrix was used in developing the evaluation model. The model was then field tested by evaluating a computer-mediated courseware program “Dermatological Office Procedures” using a modified pretest-posttest control group study design. Evaluation was performed at formative and summative levels, and numerous methods were used to collect antecedent, reaction, cognitive, behavioral, and instructional transaction data. A metaevaluation was formulated and conducted to assess the effectiveness of the fieldtest of the evaluation model. An evaluator self-report, a focus group with program developers, and interviews of stakeholders and decision-makers were used to gather data about the effectiveness of the courseware evaluation model. The main conclusion of the study was that the CME Courseware Evaluation Model was useful in collecting evaluative data to inform decision making and improve the instructional product. Recommendations for further research are presented, implications for educational practice are discussed, and a modified version of the evaluation model is provided reflecting the results of the study. Incidentally, the results of the fieldtest revealed that computer-mediated instruction was an effective means for delivering CME at a distance.
The impact of breast cancer on the emotional and social health of women and their families is an ... more The impact of breast cancer on the emotional and social health of women and their families is an important issue for the cancer field. Nevertheless, many patients do not avail themselves of support programmes. In rural communities there is often a lack of services, which, for many, leads to a perception of 'being alone' in the struggle to become better. This paper reports an evaluation of a pilot project to facilitate a self-help peer support group network: an extensive provincial audio teleconferencing network for rural breast cancer survivors, established by the Telemedicine Centre of the Memorial University of Newfoundland. A satisfaction questionnaire was distributed to participants in the pilot programme. Responses suggested that they were very satisfied with the use of audio teleconferencing for the facilitation of a social support programme. The programme appeared to help bridge the isolation gap that rural women with breast cancer often experience. The results have implications for the provision of self-help social support services through audio teleconferencing, as well as for the quality of life and wellbeing of rural women.
Introduction Virtual care has expanded during COVID-19 and enabled continued access to healthcare... more Introduction Virtual care has expanded during COVID-19 and enabled continued access to healthcare services. As with the introduction of any new technology in healthcare delivery, the preparation of healthcare providers for adopting and using such systems is imperative. The purpose of this qualitative study was to explore experts’ ascribed opinions on healthcare providers’ continuing professional development (CPD) needs in virtual care. Methods Semistructured interviews were conducted with a purposive sample of key informants representing Canadian provincial and national organizations with expertise in virtual care delivery. Results Three main areas of knowledge, skills, and abilities that would be most helpful for healthcare providers in preparing to adopt and use virtual care were identified. The use of technology necessitates knowledge of how to integrate technology and virtual care in the practice workflow. This includes knowing how to use the technology and the privacy and secur...
ABSTRACT Interprofessional education (IPE) in health and human services educational and clinical ... more ABSTRACT Interprofessional education (IPE) in health and human services educational and clinical settings has proliferated internationally. The use of information and communication technologies (ICTs) in the facilitation of interprofessional learning is also growing, yet reviews of the effectiveness of ICTs in the delivery of pre- and/or post-licensure IPE have been limited. The current study's purpose was to review the evaluation outcomes of IPE initiatives delivered using ICTs. Relevant electronic databases and journals from 1996 to 2013 were searched. Studies which evaluated the effectiveness of an IPE intervention using ICTs were included and analyzed using the Barr et al. modified Kirkpatrick educational outcomes typology. Fifty-five studies were identified and a majority reported evaluation findings at the level 1 (reaction/satisfaction). Analysis revealed that learners react favorably to the use of ICTs in the delivery of IPE, and ICT-mediated IPE can lead to positive attitudinal and knowledge change. A majority of the studies reported positive evaluation outcomes at the learner satisfaction level, with the use of web-based learning modalities. The limited number of studies at other levels of the outcomes typology and deficiencies in study designs indicate the need for more rigorous evaluation of outcomes in ICT-mediated IPE.
This study reports on an evaluation of the usefulness of the Simulated Clinical Examination (SCE)... more This study reports on an evaluation of the usefulness of the Simulated Clinical Examination (SCE) method as a means of assessing the clinical-skill competencies of entering Postgraduate year 1 (PGY1) family-medicine residents. PGY1 family-medicine residents participated in a SCE encompassing clinical encounters with standardized patients. Residents were asked to complete pre-evaluation and post-evaluation surveys, and faculty and residents participated in separate focus groups. The SCE was perceived as a useful method during the early phases of postgraduate training for assessing clinical-skill competencies, providing constructive feedback to residents, enhancing self-awareness, and enhancing confidence. This exploratory study suggests that the SCE, as an assessment method, can have beneficial effects on learning and the fostering of clinical-skill competencies during postgraduate training.
The digital rectal examination (DRE) is a necessary part of a complete physical examination and e... more The digital rectal examination (DRE) is a necessary part of a complete physical examination and evaluation of a patient, yet teaching of this examination to medical students is often inadequate. This study was a comparative evaluation of the effectiveness of the rectal teaching associate (RTA), lecture, role-playing, and simulated models as methods for teaching the DRE procedure to undergraduate medical students at Memorial University of Newfoundland Faculty of Medicine. A total of 65 third-year medical students were randomly assigned to either an experimental or control group. Both groups received a lecture and practiced the DRE on a simulated model. The experimental group received further training from an RTA. Students completed a pre- and post-intervention knowledge assessment, an objective structured clinical exam (OSCE) measuring performance of the DRE, and a satisfaction survey. Mean knowledge scores increased significantly for both groups (18.73 to 22.32, p <.0001). The control group scored significantly higher on the post-intervention assessment than did the experimental group (23.11 versus 21.47, p =.025) The experimental group scored higher on the OSCE (27.52 versus 23.80, p =.001) and rated the RTA as a more effective method for learning the DRE. This first study using RTAs to teach the DRE as a global skill for evaluating the rectum suggests that the RTA method is effective for increasing skills and students' confidence in the procedure.
Problem addressed There is a lack of consensus around the optimal way to train family medicine re... more Problem addressed There is a lack of consensus around the optimal way to train family medicine residents to care for children. Objective of program Evaluation of an ambulatory versus an inpatient pediatrics rotation for family medicine residents. Program description A 4-week pediatrics rotation for second-year family medicine residents was introduced involving half-day ambulatory pediatric clinics. A nonequivalent control group evaluation study design was followed. Patient logbook entries, as well as residents' satisfaction, knowledge, and self-reported confidence outcomes were compared between family medicine residents completing the new ambulatory rotation and those completing a traditional inpatient-ambulatory pediatrics rotation. Conclusion An ambulatory rotation in pediatrics is a feasible option for facilitating family medicine resident learning in child health care. Residents report exposure to more patient cases that reflect a family practice office setting and the same level of knowledge and confidence as residents completing an inpatient-ambulatory rotation. Intraprofessional collaboration, flexibility in scheduling, and the support of pediatric preceptors are key factors in the organization and implementation of an ambulatory rotation.
Purpose: Self-directed learning (SDL) activities are a recognized type of informal adult learning... more Purpose: Self-directed learning (SDL) activities are a recognized type of informal adult learning across many continuing professional development systems. The expansive growth of DSMTs has created new opportunities for connecting with information and colleagues. The purpose of this survey is to explore adult learners’ perceptions and experiences with SDL and continuing professional education (CPE).
Over the years, a variety of distance learning technologies have been used to address the continu... more Over the years, a variety of distance learning technologies have been used to address the continuing medical education (CME) needs of rural and remote physicians. Some of these have included audio teleconferencing, video conferencing, and slow scan imaging. Although the CME literature has documented these initiatives in detail, it is deficient of evaluative information which could advise key decisions regarding the effectiveness of these instructional technologies in providing CME. In recent times, the emergence and growth of the World Wide Web and CD-ROM technologies have introduced new prospects for delivering continuing education to the rural medical practitioner. Consequently, the rationale for this study was to develop and fieldtest a model for evaluating the effectiveness of computer-mediated instructional courseware. This is a response to the need for comprehensive and systematic evaluation approaches to inform decision-makers, program developers, and future efforts in computer-mediated CME delivery. An eclectic evaluation planning matrix was designed by selecting various elements and concepts from evaluation approaches identified in the literature. This planning matrix was used in developing the evaluation model. The model was then field tested by evaluating a computer-mediated courseware program “Dermatological Office Procedures” using a modified pretest-posttest control group study design. Evaluation was performed at formative and summative levels, and numerous methods were used to collect antecedent, reaction, cognitive, behavioral, and instructional transaction data. A metaevaluation was formulated and conducted to assess the effectiveness of the fieldtest of the evaluation model. An evaluator self-report, a focus group with program developers, and interviews of stakeholders and decision-makers were used to gather data about the effectiveness of the courseware evaluation model. The main conclusion of the study was that the CME Courseware Evaluation Model was useful in collecting evaluative data to inform decision making and improve the instructional product. Recommendations for further research are presented, implications for educational practice are discussed, and a modified version of the evaluation model is provided reflecting the results of the study. Incidentally, the results of the fieldtest revealed that computer-mediated instruction was an effective means for delivering CME at a distance.
The impact of breast cancer on the emotional and social health of women and their families is an ... more The impact of breast cancer on the emotional and social health of women and their families is an important issue for the cancer field. Nevertheless, many patients do not avail themselves of support programmes. In rural communities there is often a lack of services, which, for many, leads to a perception of 'being alone' in the struggle to become better. This paper reports an evaluation of a pilot project to facilitate a self-help peer support group network: an extensive provincial audio teleconferencing network for rural breast cancer survivors, established by the Telemedicine Centre of the Memorial University of Newfoundland. A satisfaction questionnaire was distributed to participants in the pilot programme. Responses suggested that they were very satisfied with the use of audio teleconferencing for the facilitation of a social support programme. The programme appeared to help bridge the isolation gap that rural women with breast cancer often experience. The results have implications for the provision of self-help social support services through audio teleconferencing, as well as for the quality of life and wellbeing of rural women.
Introduction Virtual care has expanded during COVID-19 and enabled continued access to healthcare... more Introduction Virtual care has expanded during COVID-19 and enabled continued access to healthcare services. As with the introduction of any new technology in healthcare delivery, the preparation of healthcare providers for adopting and using such systems is imperative. The purpose of this qualitative study was to explore experts’ ascribed opinions on healthcare providers’ continuing professional development (CPD) needs in virtual care. Methods Semistructured interviews were conducted with a purposive sample of key informants representing Canadian provincial and national organizations with expertise in virtual care delivery. Results Three main areas of knowledge, skills, and abilities that would be most helpful for healthcare providers in preparing to adopt and use virtual care were identified. The use of technology necessitates knowledge of how to integrate technology and virtual care in the practice workflow. This includes knowing how to use the technology and the privacy and secur...
ABSTRACT Interprofessional education (IPE) in health and human services educational and clinical ... more ABSTRACT Interprofessional education (IPE) in health and human services educational and clinical settings has proliferated internationally. The use of information and communication technologies (ICTs) in the facilitation of interprofessional learning is also growing, yet reviews of the effectiveness of ICTs in the delivery of pre- and/or post-licensure IPE have been limited. The current study's purpose was to review the evaluation outcomes of IPE initiatives delivered using ICTs. Relevant electronic databases and journals from 1996 to 2013 were searched. Studies which evaluated the effectiveness of an IPE intervention using ICTs were included and analyzed using the Barr et al. modified Kirkpatrick educational outcomes typology. Fifty-five studies were identified and a majority reported evaluation findings at the level 1 (reaction/satisfaction). Analysis revealed that learners react favorably to the use of ICTs in the delivery of IPE, and ICT-mediated IPE can lead to positive attitudinal and knowledge change. A majority of the studies reported positive evaluation outcomes at the learner satisfaction level, with the use of web-based learning modalities. The limited number of studies at other levels of the outcomes typology and deficiencies in study designs indicate the need for more rigorous evaluation of outcomes in ICT-mediated IPE.
This study reports on an evaluation of the usefulness of the Simulated Clinical Examination (SCE)... more This study reports on an evaluation of the usefulness of the Simulated Clinical Examination (SCE) method as a means of assessing the clinical-skill competencies of entering Postgraduate year 1 (PGY1) family-medicine residents. PGY1 family-medicine residents participated in a SCE encompassing clinical encounters with standardized patients. Residents were asked to complete pre-evaluation and post-evaluation surveys, and faculty and residents participated in separate focus groups. The SCE was perceived as a useful method during the early phases of postgraduate training for assessing clinical-skill competencies, providing constructive feedback to residents, enhancing self-awareness, and enhancing confidence. This exploratory study suggests that the SCE, as an assessment method, can have beneficial effects on learning and the fostering of clinical-skill competencies during postgraduate training.
The digital rectal examination (DRE) is a necessary part of a complete physical examination and e... more The digital rectal examination (DRE) is a necessary part of a complete physical examination and evaluation of a patient, yet teaching of this examination to medical students is often inadequate. This study was a comparative evaluation of the effectiveness of the rectal teaching associate (RTA), lecture, role-playing, and simulated models as methods for teaching the DRE procedure to undergraduate medical students at Memorial University of Newfoundland Faculty of Medicine. A total of 65 third-year medical students were randomly assigned to either an experimental or control group. Both groups received a lecture and practiced the DRE on a simulated model. The experimental group received further training from an RTA. Students completed a pre- and post-intervention knowledge assessment, an objective structured clinical exam (OSCE) measuring performance of the DRE, and a satisfaction survey. Mean knowledge scores increased significantly for both groups (18.73 to 22.32, p <.0001). The control group scored significantly higher on the post-intervention assessment than did the experimental group (23.11 versus 21.47, p =.025) The experimental group scored higher on the OSCE (27.52 versus 23.80, p =.001) and rated the RTA as a more effective method for learning the DRE. This first study using RTAs to teach the DRE as a global skill for evaluating the rectum suggests that the RTA method is effective for increasing skills and students' confidence in the procedure.
Problem addressed There is a lack of consensus around the optimal way to train family medicine re... more Problem addressed There is a lack of consensus around the optimal way to train family medicine residents to care for children. Objective of program Evaluation of an ambulatory versus an inpatient pediatrics rotation for family medicine residents. Program description A 4-week pediatrics rotation for second-year family medicine residents was introduced involving half-day ambulatory pediatric clinics. A nonequivalent control group evaluation study design was followed. Patient logbook entries, as well as residents' satisfaction, knowledge, and self-reported confidence outcomes were compared between family medicine residents completing the new ambulatory rotation and those completing a traditional inpatient-ambulatory pediatrics rotation. Conclusion An ambulatory rotation in pediatrics is a feasible option for facilitating family medicine resident learning in child health care. Residents report exposure to more patient cases that reflect a family practice office setting and the same level of knowledge and confidence as residents completing an inpatient-ambulatory rotation. Intraprofessional collaboration, flexibility in scheduling, and the support of pediatric preceptors are key factors in the organization and implementation of an ambulatory rotation.
Purpose: Self-directed learning (SDL) activities are a recognized type of informal adult learning... more Purpose: Self-directed learning (SDL) activities are a recognized type of informal adult learning across many continuing professional development systems. The expansive growth of DSMTs has created new opportunities for connecting with information and colleagues. The purpose of this survey is to explore adult learners’ perceptions and experiences with SDL and continuing professional education (CPE).
Uploads