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The impact of a hybrid online and classroom-based course on palliative care competencies of family medicine residents

Division of Palliative Care, University of Ottawa; Division of Palliative Medicine, University of Calgary, Calgary jpereira{at}scohs.on.ca

M Palacios

Division of Palliative Medicine, Centre for Distance Education and Research in Palliative Care, Tom Baker Cancer Centre, Calgary

T Collin

Division of Palliative Medicine, Centre for Distance Education and Research in Palliative Care, Tom Baker Cancer Centre, Calgary

R Wedel

Department of Family Medicine, University of Calgary, Calgary; Palliative Care Program, Chinook Health Region, Alberta

L Galloway

Division of Palliative Medicine, University of Calgary, Calgary

A Murray

Division of Palliative Medicine, University of Calgary, Calgary

C Violato

Medical Education Unit, Department of Community Health Science, University of Calgary, Calgary

J Lockyer

Medical Education Unit, Department of Community Health Science, University of Calgary, Calgary

The University of Calgary offers a palliative care course that involves both classroom- and web-based learning for rural-based family medicine residents. This study assessed the impact of the course on palliative care-related competencies for two classes: 2004 and 2005. Instruments were developed to evaluate pre- versus post-course changes in knowledge (15-item quiz), attitudes (12-item survey), self-perceived comfort levels (19-item survey) and skills (3 long Objective Structured Clinical Examination stations (OSCEs), with accompanying standardised score sheets). In all, 16 and 20 residents participated in the 2004 and 2005 classes, respectively. Internal reliability values were acceptable to very good (Knowledge Quiz, Kuder-Richardson 20 = 0.5; Attitude Scale,  = 0.68–0.78; OSCE score sheets,  = 0.63–0.89; Self-Perceived Comfort Survey,  = 0.89–0.92). Inter-rater reliability values of the OSCE score sheets were  = 0.87 to 0.92. There was a significant improvement in the pre- versus post-course performances in OSCE 2 for 2004 and 2005 (P = 0.01; P = 0.01; d = 1.42 and 1.94, respectively). Despite statistically insignificant changes in the other OSCEs, acceptable to large effect sizes were noted (d = 0.4–1.34) for OSCE 1 in 2004 and OSCEs 3 in 2004 and 2005. Knowledge improved significantly pre-versus post-course in 2004 and 2005 (t = 4.44 and 8.99; d = 2.29 and 2.24, respectively). Significant improvements and large effect sizes were noted in the comfort scales, but a ceiling effect was noted in the communication subscale. This hybrid course resulted in significant improvements across four domains, knowledge, attitudes, self-perceived comfort scale, and skills, in 2 consecutive classes.

Key Words: education • internet • OSCE • palliative • web learning

This version was published on December 1, 2008

Palliative Medicine, Vol. 22, No. 8, 929-937 (2008)
DOI: 10.1177/0269216308094561


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