development of an Internet-based course on dyslipidemias: A new form of continuing education for pharmacists, The

American Journal of Pharmaceutical Education, Spring 2001 by Olson, Kari L, Schindel, Terri, Geissler, Colin, Tsuyuki, Ross T

The purpose of this project was to create a Internet-based course and evaluate the impact of the course on pharmacists' knowledge, application of learning to practice and confidence in caring for patients. The ADDIE (Assessment, Design, Development, Implementation, and Evaluation) was used to systematically develop the course. The team assembled to develop the course consisted of content experts, an expert in developing adult CE, an instructional designer, and programmers. PHARMALearn-Cholesterol utilizes an interactive, problem-based approach. It provides information on the management of dyslipidemias, and practical information of which can be applied in clinical practice. The course is completely referenced and, where available, links to sources of primary literature are provided. There are graphic and media elements which help explain concepts regarding atherosclerosis. Based upon preliminary results, the course significantly improved pharmacists' knowledge and confidence towards managing patients with dyslipidemias. Numerous studies suggest that patients at high risk for cardiovascular disease are sub-optimally managed and that alternative methods for improving care is required. PHARMALearn-Cholesterol is a unique method of delivering education to pharmacists and can be used to assist pharmacists to become better involved in the care of patients with dyslipidemias

INTRODUCTION

Continuing pharmacy education (CE) is intended to keep practicing pharmacists abreast of new therapies, assist with integrating the results from clinical trials into practice, enhance clinical performance, and ultimately improve patient outcomes. Despite the widespread utilization of CE, numerous studies suggest there are gaps between the available clinical evidence and the application of this evidence into practice(14). Furthermore, despite the use of CE to inform clinicians of current treatment guidelines, there is often little difference in performance compared to groups not receiving CE(1). These data suggest that the current methods of CE development and delivery are neither changing practice nor patient outcomes. More effective strategies are necessary to narrow the gap between learning and the application of learning to practice. Currently, there are numerous methods used to deliver CE. The most commonly utilized forms of traditional CE are live events such as meetings, conferences, workshops, and print-based courses. Numerous reviews of the literature have determined that while the aforementioned methods of education delivery can improve knowledge, there is often little impact on clinical performance or patient outcomes(5-11).

An emerging option for CE delivery is through the use of Internet technology. The Internet offers the following advantages: it is easily and widely accessible, allows the learner to proceed in the learning process at their own pace and at their own convenience, allows the learner to focus on areas which they feel are particularly important, and allows for the use of active learning strategies(12). Despite the potential for the Internet to provide engaging instruction, most Internet pharmacy education courses are merely print-based courses online and thus do not take full advantage of the medium(13). Furthermore, few have been evaluated on their impact on knowledge and application to practice(14).

To address the limitations of traditional CE and the opportunities for developing innovative educational strategies, the following project was undertaken to develop a Internet-based educational course for pharmacists. The course focused on the management of patients with dyslipidemias. Additionally, an evaluation of pharmacists' needs and the impact of the project on pharmacists' knowledge, application of learning to practice, and confidence in caring for patients with dyslipidemias was conducted. This paper presents the methods used in developing the educational course, highlights of the final course, and preliminary results of the evaluation component.

PROJECT DEVELOPMENT

The project began in August 1999 and was completed in May 2000. A team-based approach was used in the development of the course. The team members consisted of (i) an instructional designer, experienced in the design of general educational web-sites, responsible for determining the optimal method of delivering the educational content in order to meet the needs of the user; (ii) Internet programmers responsible for creating the user-interface and course database, configuring the server, and integrating the graphic art and multi-media elements; (iii) two content experts, who were clinical pharmacists experienced in managing dyslipidemias, responsible for developing the content for the course; and (iv) the director of continuing pharmacy education for the province of Alberta.

The ADDIE (Assessment, Design, Development, Implementation, and Evaluation) approach was used to systematically develop the learning course(15). Development occurred in three overlapping phases: Phase 1: Need assessments and instructional design, Phase 2: Development and implementation, and Phase 3: Evaluation.