ABSTRACT
BACKGROUND: Patient-reported outcome (PRO) measures have been used widely to screen for depression, anxiety, and symptoms in cancer patients. Computer-based applications that collect patients' responses and transfer them to the treating health professional in real time have the potential to improve patient well-being and cancer outcomes. OBJECTIVE: This study will test the feasibility and acceptability of a newly developed eHealth system which facilitates PRO data capture from cancer patients, data linkage and retrieval to support clinical decisions and patient self-management, and data retrieval to support ongoing evaluation and innovative research. METHODS: The eHealth system is being developed in consultation with 3 overarching content-specific expert advisory groups convened for this project: the clinical advisory group, technical advisory group, and evaluation advisory group. The following work has already been completed during this phase of the study: the Patient-Reported Outcome Measures for Personalized Treatment and Care (PROMPT-Care) eHealth system was developed, patient-reported outcomes were selected (distress, symptoms, unmet needs), algorithms to inform intervention thresholds for clinical and self-management were determined, clinician PRO feedback summary and longitudinal reports were designed, and patient self-management resources were collated. PROsaiq, a custom information technology system, will transfer PRO data in real time into the hospital-based oncology information system to support clinical decision making. The PROMPT-Care system feasibility and acceptability will be assessed through patients completing PROMPT-Care assessments, participating in face-to-face cognitive interviews, and completing evaluation surveys and telephone interviews and oncology staff participating in telephone interviews. RESULTS: Over the course of 3 months, the system will be pilot-tested with up to 50 patients receiving treatment or follow-up care and 6 oncology staff at 2 hospitals in New South Wales, Australia. Data will be collected to determine the accuracy and completeness of data transfer procedures, extent of missing data from participants' assessments, acceptability of the eHealth system and usefulness of the self-management resources (via patient evaluation surveys and interviews), and acceptability and perceived usefulness of real-time PRO reporting (via oncology staff interviews) at the completion of the pilot phase. CONCLUSIONS: This research investigates implementation of evidence into real world clinical practice through development of an efficient and user-friendly eHealth system. This study of feasibility and acceptability of the newly developed eHealth system will inform the next stage of larger scale testing and future implementation of the system as part of routine care. CLINICALTRIAL: Australian New Zealand Clinical Trials Registry ACTRN1261500135294; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=369299&isReview=true (Archived by WebCite at http://www.webcitation.org/6lzylG5A0).
ABSTRACT
BACKGROUND: There is an apparent disjuncture between the requirements of the medical spiral curriculum and the practice of replacing previous online material in undergraduate courses. This paper investigates the extent to which students revisit previous online material for the purposes of building the educational spiral, and the implications for the implementation of a Faculty's Learning Management System implementation. METHODS: At the University of Cape Town, medical students' last date of access to 16 previous online courses was determined. Students completed a survey to determine their reasons for revisiting this material and the perceived benefits of this availability. RESULTS: 70% of the students revisited their previous online courses. The major reasons were to review lecture presentations, lectures notes, and quizzes. The perceived benefits were for understanding new material, preparation for assessments, and convenience. Although student comments were not always in line with the concept of the spiral curriculum, most referred to processes of building on previous work, and some mentioned the spiral curriculum specifically. CONCLUSION: This study suggests that the practice of replacing previous online courses may hinder rather than support student learning. Although students visit previous material for ranges of reasons, a large number are aware of the spiral curriculum, and use the online environment to build upon previous material. Any practice, which entails replacing material and redesigning curricula content may be detrimental to the students' future learning needs, and such activities may need revision.
