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Participant and educator feedback informs delivery of an interprofessional inflammatory arthritis education program using telemedicine in rural communities
Participant and educator feedback informs delivery of an
interprofessional inflammatory arthritis education program using
telemedicine in rural communities in Ontario Rashmi Bhide, BSc, MHA
Telemedicine Program, St. Michaels Hospital
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Disclosures This study is funded by CIORA (Canadian Initiative
for Outcomes in Rheumatology Care)
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St. Michaels Hospital Academic health sciences centre, fully
affiliated with the University of Toronto Home to the Li Ka Shing
Knowledge Institute
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Martin Family Centre for Arthritis Care and Research
Multidisciplinary comprehensive care for patients with arthritis
Serving over 28 000 patients/year Positions the hospital is a
leader in arthritis education at the University of Toronto Ongoing
research in arthritis outcomes and education effectiveness
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The Martin Family Centre An Interprofessional Approach
Rheumatologists Nurses Dietitians Occupational therapists
Physiotherapists Pharmacists Chaplains
Prescription for Education (RxEd) One day education session
delivered by interprofessional team Program format Didactic, panel
& small group discussions, case studies Integrated
self-management strategies Wait-listed controlled study showed RxEd
improved health-related outcomes (Kennedy, J Rheum 2011) Arthritis
self-efficacy Arthritis knowledge Coping efficacy Illness
intrusiveness (daily impact)
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Even with RxEd, a problem remains Thunder Bay Sudbury Sault
Ste. Marie Orangeville Toronto
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The Solution Increasing access to arthritis education in rural
Ontario communities using telemedicine.
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Study Objectives To evaluate the feasibility of using
telemedicine (TM) to deliver RxEd. a)To explore the process of
delivering an interprofessional program via TM. b)To explore
participants perceptions of the RxEd program delivered using TM
technology.
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1. Planning Consult with RxEd educators to: a)Review the
current format/content b)Determine educators learning needs
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Meeting Educators Learning Needs: Videoconferencing 101 for
Patient Educators Format: One hour multi-point videoconference
Delivered by St. Michaels Patient Education Specialist &
Telemedicine Team Held several weeks prior to RxEd Participants:
Local St. Michaels RxEd Educators Co-facilitators at participating
rural sites
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Videoconferencing 101 Learning Objectives Participants should
be able to: 1) Identify important factors in facilitating effective
patient education. 2) Modify slides and oral presentations for a
patient education session delivered via videoconferencing. 3)
Outline strategies to optimize interactivity during
videoconferencing.
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Videoconferencing 101 Content
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2. Implementation RxEd Telemedicine Workshop October 19,
2012
*Telemedicine sites only I could hear the presenter
clearly*
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I could hear the discussion between participants at different
sites clearly*
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I could see who was speaking at the remote sites*
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Interaction between sites was adequately facilitated*
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The information presented was clear (including presenters
speed, volume & language) All sites
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I understood the slides and I found them helpful
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Overall, todays session met my expectations
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I would recommend this program to other people with
inflammatory conditions
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Post-Workshop Feedback (Educators & Co-facilitators)
Quality of videoconference: Easy to use, it helped to have the
telemedicine learning session prior to the education day. The tips
that were provided were helpful and allowed for more comfort with
the technology and hopefully a more successful day for the
participants.
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Quality of education via videoconferencing: [Only one]
presenter flipped back and forth between themself and the slides.
We watched the slides for the duration of each presentation. This
makes for a boring presentation The camera was pointed a the side
of their head...it didnt feel like they were speaking to us.
Post-Workshop Feedback (Educators & Co-facilitators)
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Small group learning and activities: It was easy to interact
with the other sites. I was impressed with the level of interaction
and how smoothly the videoconference seemed to function
Post-Workshop Feedback (Educators & Co-facilitators)
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Additional comments and suggestions: More interactivity
throughout the workshop Slide modifications for better visibility
on screen Large, clear diagrams Less text Post-Workshop Feedback
(Educators & Co-facilitators)
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Conclusions It is feasible to deliver the one day RxEd workshop
via telemedicine. There is value in offering the RxEd workshop to
remote sites. The Videoconferencing 101 Patient Education workshop
accomplished its overall objectives. Data and feedback will be used
to make improvements for future RxEd sessions.
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The Future Evaluating the effectiveness of TM delivery of RxEd:
1) Explore remote participants perceptions of the program
(telephone interviews) 2) Compare health-related outcomes in remote
vs. local participants Arthritis self-efficacy Arthritis knowledge
Coping efficacy Illness intrusiveness
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Acknowledgements Co-authors: Carol Flewelling, BSc, MEd Carol
Kennedy, BScPT, MSc Kelly Warmington, MEd, PMP Rachel Shupak, MD
Angelo Papachristos, BScPT Caroline Jones, BScPT Mark Kinach, BA
Denise Linton, HBSc Dorcas Beaton, BScOT, MSc, PhD Collaborators:
Educators and co-facilitators The Arthritis Society