Search

ObjectivesObjective structured clinical examinations (OSCEs) are common for formative assessment. We developed an Online Smart Communicative Education System and aimed to explore the factors that affect the perceptions of both teachers and students for teaching and learning.Methods and AnalysisA two-year cross-sectional cohort study was undertaken. The program includes three parts. Part I Pre-OSCE: an online flipped class in preparation for task-related knowledge and skills. Part II OSCE-day: 10 tasks in one track formative OSCE. Part III Post-OSCE: extended online feedback for participants with further questions after the exam and raters with more feedback after reviewing their performance online. Principal component analysis with varimax rotation was performed to analyze the perceptions of students and teachers to the Online System by means of questionnaires.ResultsSeventy-six pharmacy students (male 32.9%) took the exam and 24 raters (male, 25%) participated in the scoring during the OSCEs. The mean G coefficient was 0.88. Seventy-six questionnaires from the students were obtained for the analysis. Results explained the cumulative variance of 73.9% for component (1) “Effects of extended online feedback”: 40% and (2) “Facilitation of learning”: 33.9%. Thirty-nine questionnaires from the raters who experienced the Online System were obtained for the analysis (male 23.1%). Results explained a cumulative variance of 77.3% for component (1) “Effects of extended online feedback”: 36.6%, (2) “Facilitation of scoring and feedback”: 24.5%, and (3) “Feasibility of online platform”: 16.2%, respectively.ConclusionWe demonstrated good reliability for digitizing the scoring system with educational support to facilitate teaching. “Effects of extended online feedback” was the major aspect in explaining the variance from the perceptions of students and raters by factor analysis. In comparison with traditional formative OSCEs, extended online feedback is a novel approach, which extends the process of learning and teaching among the learners and raters and overcomes the barriers of time limitation and distance.

Objectives: To determine the effect of implementing health information technology in an outpatient setting on reduction of duplicate prescriptions among patients with multiple chronic diseases. Methods: Adult patients with at least 2 refillable prescriptions for multiple chronic diseases at a medical center in southern Taiwan between 1 October 2012 and 30 June 2013 were enrolled in the current study. The key design principles in the ambulatory pharmaceutical care model included (1) using the SAS Enterprise Guide to systematically screen potential duplicate prescription orders using pre-specified criteria, (2) hospital pharmacists performed medication reviews and provided electronic alerts for duplicate medications to physicians, and (3) medical alerts and recommendations were integrated into the natural workflow of practice to correct duplicate medications. Patient characteristics and patterns of duplicate medications were assessed using descriptive statistical analyses. Results: Of 572 notifications (n=483), the most common duplicate prescriptions occurred in patients > 65 years of age, had > 3 outpatient specialist visits, and were treated with > 10 medications. The correction rate for duplicate prescriptions was high for cardiovascular diseases, endocrinopathies, and Parkinson disease. Among patients who had corrected duplicate medications (n=283), the average monthly medication cost decreased 47,325 TWD during the most recent 6 months when compared to the 6 months preceding the correction. Furthermore, the outpatient clinic, emergency room, and hospitalization person-visits decreased 5.8%, 18.3%, and 13.8%, respectively. Conclusions: Implementation of advancing health information technology in the outpatient setting for a group of patients with multiple chronic diseases revealed a high propensity to successfully reduce duplicate medications in a large population. [ABSTRACT FROM AUTHOR]