Effectiveness of the spaced education pedagogy for clinicians’ continuing professional development: a systematic review

Article


Phillips, Jane L, Heneka, Nicole, Bhattarai, Priyanka, Fraser, Claire and Shaw, Tim. 2019. "Effectiveness of the spaced education pedagogy for clinicians’ continuing professional development: a systematic review." Medical Education. 53 (9), pp. 886-902. https://doi.org/10.1111/medu.13895
Article Title

Effectiveness of the spaced education pedagogy for clinicians’ continuing professional development: a systematic review

ERA Journal ID20513
Article CategoryArticle
AuthorsPhillips, Jane L, Heneka, Nicole, Bhattarai, Priyanka, Fraser, Claire and Shaw, Tim
Journal TitleMedical Education
Journal Citation53 (9), pp. 886-902
Number of Pages17
YearSep 2019
PublisherJohn Wiley & Sons
Place of PublicationUnited Kingdom
ISSN0308-0110
1365-2923
Digital Object Identifier (DOI)https://doi.org/10.1111/medu.13895
Web Address (URL)https://onlinelibrary.wiley.com/doi/full/10.1111/medu.13895
Abstract

Context: Ensuring clinical practice reflects current evidence is challenging given the rapid proliferation of new knowledge. Changing entrenched clinical behaviours and facilitating the adoption of best practice evidence requires a range of strategies, including affordable, scalable and effective continuing professional development (CPD). Yet, identifying the CPD delivery method most likely to effectively change and improve patient outcomes is difficult given the variability in the evidence for different learning approaches. Although there is moderate level evidence for outreach education, audit and feedback, and face-to-face or online learning, little is known about the capacity of spaced education to change ineffective clinical practice(s). Spaced education harnesses the power of spacing, repetition and testing learning content to increase topic-specific knowledge. Although spaced education is widely used in undergraduate and postgraduate medical programmes, its effectiveness as a CPD delivery method that improves patient outcomes is less certain.

Aim: To determine the effectiveness of the spaced education CPD programmes to change targeted clinical knowledge and practice(s) to improve patient outcomes.

Method: A systematic review, appraising the spaced education CPD evidence generated from searching six specialist medical and psychosocial databases. Studies published in English peer-reviewed journals from 1 January, 2000 to 31 August, 2018 were eligible for inclusion. A modified Kirkpatrick four levels of evaluation framework assisted with appraising the effect of spaced education CPD interventions on clinicians and patients.

Results: Of the 2396 studies identified, 17 met the inclusion criteria, involving 2701 practising clinicians from multiple disciplines and specialties. Five randomised controlled trials generated level II evidence, with the remaining 12 studies generating lower levels of evidence. The majority of studies (n = 14) involved the delivery of online spaced education. All studies were evaluated using the modified Kirkpatrick four levels of evaluation framework with: 10 studies demonstrating significant increases in participants’ knowledge; seven studies reporting significant changes in clinician behaviour; four studies showing significant increases in clinician confidence; and three studies identifying significant and sustained increases in participants’ clinical skills. Only two studies reported positive improvements in patient outcomes.

Conclusion: Spaced education via an online platform offers a scalable CPD format that can increase clinical knowledge and change practice. However, further adequately powered randomised controlled trials are required to confirm that spaced education CPD can impact positively on patients’ reported outcomes.

KeywordsClinical Competence; Education, Medical, Continuing; Health Knowledge, Attitudes, Practice; Humans; Inservice Training; Patient Reported Outcome Measures; Staff Development
ANZSRC Field of Research 2020390110. Medicine, nursing and health curriculum and pedagogy
Public Notes

Files associated with this item cannot be displayed due to copyright restrictions.

Byline AffiliationsUniversity of Technology Sydney
University of Notre Dame Australia
University of Sydney
Permalink -

https://research.usq.edu.au/item/y57z1/effectiveness-of-the-spaced-education-pedagogy-for-clinicians-continuing-professional-development-a-systematic-review

  • 24
    total views
  • 2
    total downloads
  • 2
    views this month
  • 0
    downloads this month

Export as

Related outputs

Acceptability of a virtual prostate cancer survivorship care model in regional Australia: A qualitative exploratory study
Heneka,, Chambers, Suzanne K., Schaefer, Isabelle and Dunn, Jeff. 2023. "Acceptability of a virtual prostate cancer survivorship care model in regional Australia: A qualitative exploratory study ." Psycho-Oncology: journal of the psychological, social and behavioral dimensions of cancer. 32 (4), pp. 569-580. https://doi.org/10.1002/pon.6101
Prostate Cancer Survivorship Essentials for men with prostate cancer on androgen deprivation therapy: protocol of an effectiveness-implementation hybrid (Type 1) randomised trial of a tele-based nurse-led survivorship care intervention (PCEssentials)
Green, Anna, Newton, Robert U, Chambers, Suzanne K, Smith, David P, Tuffaha, Haitham, Galvao, Daniel A, Heathcote, Peter, Patel, Manish I, Christie, David, Egger, Sam, Sara, Sally, Heneka, Nicole and Dunn, Jeff. 2023. "Prostate Cancer Survivorship Essentials for men with prostate cancer on androgen deprivation therapy: protocol of an effectiveness-implementation hybrid (Type 1) randomised trial of a tele-based nurse-led survivorship care intervention (PCEssentials)." ANZUP Annual Scientific Meeting. Melbourne, Australia 09 - 11 Jul 2023
The importance of developing palliative care quality indicators for the prison setting: why now, and next steps
Schaefer, Isabelle, Heneka, Nicole, DiGiacomo, Michelle, Panozzo, Stacey and Phillips, Jane L.. 2023. "The importance of developing palliative care quality indicators for the prison setting: why now, and next steps." BMC Palliative Care. 22 (1). https://doi.org/10.1186/s12904-023-01150-3
Correction: The importance of developing palliative care quality indicators for the prison setting: why now, and next steps
Schaefer, Isabelle, Heneka, Nicole, DiGiacomo, Michelle, Panozzo, Stacey and Phillips, Jane L.. 2023. "Correction: The importance of developing palliative care quality indicators for the prison setting: why now, and next steps ." BMC Palliative Care. 22 (1). https://doi.org/10.1186/s12904-023-01210-8
A Vanguard Approach to the Design and Delivery of Nurse-Led Survivorship Care
Sara, Sally A. M., Chambers, Suzanne K., Briggs, Russell, Heneka, Nicole and Dunn, Jeff. 2023. "A Vanguard Approach to the Design and Delivery of Nurse-Led Survivorship Care." Seminars in Oncology Nursing. 39 (1). https://doi.org/10.1016/j.soncn.2022.151366
Translating the Prostate Cancer Survivorship Essentials Framework into clinical practice: A participatory research process analysis
Heneka, Nicole, Crowe, Helen, Chambers, Suzanne K., Costello, Anthony, Crowe, Jane, Dundee, Phil, Heerey, Rachel, Stijnen, Elles, Bolger, Chris, Schaefer, Isabelle and Dunn, Jeff. 2023. Translating the Prostate Cancer Survivorship Essentials Framework into clinical practice: A participatory research process analysis.
Designing Organisational Management Frameworks to Empower Episodic Volunteering
Dunn, Jeff, Scuffham, Paul, Hyde, Melissa K., Stein, Kevin, Zajdlewicz, Leah, Savage, Anne, Heneka, Nicole, Ng, Shu-Kay and Chambers, Suzanne K.. 2022. "Designing Organisational Management Frameworks to Empower Episodic Volunteering." Voluntas: International Journal of Voluntary and Nonprofit Organizations. 33 (2), pp. 217-228. https://doi.org/10.1007/s11266-020-00226-5
Elements of optimal paediatric palliative care for children and young people: An integrative review using a systematic approach
Virdun, Claudia, Brown, Nicola, Phillips, Jane, Luckett, Tim, Agar, Meera, Green, Anna and Davidson, Patricia M.. 2015. "Elements of optimal paediatric palliative care for children and young people: An integrative review using a systematic approach." Collegian: The Australian Journal of Nursing Practice, Scholarship and Research. 22 (4), pp. 421-431. https://doi.org/10.1016/j.colegn.2014.07.001
Elements of effective palliative care models: a rapid review
Luckett, Tim, Phillips, Jane, Agar, Meera, Virdun, Claudia, Green, Anna and Davidson, Patricia M.. 2014. "Elements of effective palliative care models: a rapid review." BMC Health Services Research. 14, pp. 1-22. https://doi.org/10.1186/1472-6963-14-136
A Multicomponent Nonpharmacological Intervention to Prevent Delirium for Hospitalized People with Advanced Cancer: A Phase II Cluster Randomized Waitlist Controlled Trial (The PRESERVE Pilot Study)
Hosie, Annmarie, Phillips, Jane, Lam, Lawrence, Kochovska, Slavica, Noble, Beverly, Brassil, Meg, Kurrle, Susan, Cumming, Anne, Caplan, Gideon A., Chye, Richard, Ely, Eugene Wesley, Lawlor, Peter G., Bush, Shirley H., Davis, Jan Maree, Lovell, Melanie, Parr, Cynthia, Williams, Sally, Hauser, Katherine, McArdle, Susan, ..., Agar, Meera. 2020. "A Multicomponent Nonpharmacological Intervention to Prevent Delirium for Hospitalized People with Advanced Cancer: A Phase II Cluster Randomized Waitlist Controlled Trial (The PRESERVE Pilot Study)." Journal of Palliative Medicine. 23 (10), pp. 1314-1322. https://doi.org/10.1089/jpm.2019.0632
Development of a cancer pain self-management resource to address patient, provider, and health system barriers to care
Luckett, Tim, Davidson, Patricia M., Green, Anna, Marie, Natalie, Birch, Mary-Rose, Stubbs, John, Phillips, Jane, Agar, Meera, Boyle, Frances and Lovell, Melanie. 2019. "Development of a cancer pain self-management resource to address patient, provider, and health system barriers to care." Palliative and Supportive Care. 17 (4), pp. 472-478. https://doi.org/10.1017/S1478951518000792
Virtual models of care for people with palliative care needs living in their own home: A systematic meta-review and narrative synthesis
Disalvo, Domenica, Agar, Meera, Caplan, Gideon, Murtagh, Fliss EM, Luckett, Tim, Heneka, Nicole, Hickman, Louise, Kinchin, Irina, Trethewie, Susan, Sheehan, Caitlin, Urban, Kat, Cohen, Joshua, Harlum, Janeane, Long, Brian, Parker, Tricia, Schaefer, Isabelle and Phillips, Jane. 2021. "Virtual models of care for people with palliative care needs living in their own home: A systematic meta-review and narrative synthesis." Palliative Medicine. 35 (8), pp. 1385-1406. https://doi.org/10.1177/02692163211024451
Quality of online self-management resources for adults living with primary brain cancer, and their carers: a systematic environmental scan
Schaefer, Isabelle, Heneka, Nicole, Luckett, Tim, Agar, Meera R., Chambers, Suzanne K., Currow, David C., Halkett, Georgia, Disalvo, Domenica, Amgarth-Duff, Ingrid, Anderiesz, Cleola and Phillips, Jane L.. 2021. "Quality of online self-management resources for adults living with primary brain cancer, and their carers: a systematic environmental scan." BMC Palliative Care. 20 (1), pp. 1-11. https://doi.org/10.1186/s12904-021-00715-4
The Health Professionals Guide to Delivering Psychological Care for Men with Prostate Cancer
Chambers, Suzanne K, Heneka, Nicole and Dunn, Jeff. 2021. The Health Professionals Guide to Delivering Psychological Care for Men with Prostate Cancer. Australia. Australian Academic Press.
Mitigating opioid errors in inpatient palliative care: A qualitative study
Heneka, Nicole, Bhattarai, Priyanka, Shaw, Tim, Rowett, Debra, Lapkin, Samuel and Phillips, Jane L.. 2020. "Mitigating opioid errors in inpatient palliative care: A qualitative study." Collegian: The Australian Journal of Nursing Practice, Scholarship and Research. 27 (3), pp. 304-312. https://doi.org/10.1016/j.colegn.2019.09.005
A psychosocial care model for men with prostate cancer
Chambers, Suzanne K., Galvao, Daniel A., Green, Anna, Lazenby, Mark, Newton, Robert U., Oliffe, John L., Phillips, Jane L., Phillips, Rachel, Ralph, Nicholas, Sara, Sally, Heathcote, Peter and Dunn, Jeff. 2019. A psychosocial care model for men with prostate cancer. Sydney, Australia. Prostate Cancer Foundation of Australia.
Risk of opioid misuse in people with cancer and pain and related clinical considerations: a qualitative study of the perspectives of Australian general practitioners
Luckett, Tim, Newton-John, Toby, Phillips, Jane, Holliday, Simon, Giannitrapani, Karleen, Powell-Davies, Gawaine, Lovell, Melanie, Liauw, Winston, Rowett, Debra, Pearson, Sallie-Anne, Raymond, Bronwyn, Heneka, Nicole and Lorenz, Karl. 2020. "Risk of opioid misuse in people with cancer and pain and related clinical considerations: a qualitative study of the perspectives of Australian general practitioners." BMJ Open. 10 (2), pp. 1-11. https://doi.org/10.1136/bmjopen-2019-034363
Clinicians’ perceptions of opioid error–contributing factors in inpatient palliative care services: A qualitative study
Heneka, Nicole, Bhattarai, Priyanka, Shaw, Tim, Rowett, Debra, Lapkin, Samuel and Phillips, Jane L.. 2019. "Clinicians’ perceptions of opioid error–contributing factors in inpatient palliative care services: A qualitative study." Palliative Medicine. 33 (4), pp. 430-444. https://doi.org/10.1177/0269216319832799
A phase III wait-listed randomised controlled trial of novel targeted interprofessional clinical education intervention to improve cancer patients’ reported pain outcomes (The Cancer Pain Assessment (CPAS) Trial): study protocol
Phillips, Jane L., Heneka, Nicole, Lovell, Melanie, Lam, Lawrence, Davidson, Patricia, Boyle, Frances, McCaffrey, Nikki, Fielding, Sally and Shaw, Tim. 2019. "A phase III wait-listed randomised controlled trial of novel targeted interprofessional clinical education intervention to improve cancer patients’ reported pain outcomes (The Cancer Pain Assessment (CPAS) Trial): study protocol." Trials. 20. https://doi.org/10.1186/s13063-018-3152-z
Self-Perceived Pain Assessment Knowledge and Confidence (Self-PAC) Scale for Cancer and Palliative Care Nurses: A Preliminary Validation Study
Phillips, Jane L., Heneka, Nicole, Hickman, Louise and Lam, Lawrence. 2018. "Self-Perceived Pain Assessment Knowledge and Confidence (Self-PAC) Scale for Cancer and Palliative Care Nurses: A Preliminary Validation Study." Pain Management Nursing. 19 (6), pp. 619-626. https://doi.org/10.1016/j.pmn.2018.07.008
Clinicians’ perceptions of medication errors with opioids in cancer and palliative care services: a priority setting report
Heneka, N., Shaw, T., Azzi, C. and Phillips, J. L.. 2018. "Clinicians’ perceptions of medication errors with opioids in cancer and palliative care services: a priority setting report." Supportive Care in Cancer. 26 (10), pp. 3315-3318. https://doi.org/10.1007/s00520-018-4231-0
Exploring Factors Contributing to Medication Errors with Opioids in Australian Specialist Palliative Care Inpatient Services: A Multi-Incident Analysis
Heneka, Nicole, Shaw, Tim, Rowett, Debra, Lapkin, Samuel and Phillips, Jane L.. 2018. "Exploring Factors Contributing to Medication Errors with Opioids in Australian Specialist Palliative Care Inpatient Services: A Multi-Incident Analysis." Journal of Palliative Medicine. 21 (6), pp. 825-835. https://doi.org/10.1089/jpm.2017.0578
Opioid errors in inpatient palliative care services: a retrospective review
Heneka, Nicole, Shaw, Tim, Rowett, Debra, Lapkin, Samuel and Phillips, Jane L.. 2018. "Opioid errors in inpatient palliative care services: a retrospective review." BMJ Supportive and Palliative Care. 8 (2), pp. 175-179. https://doi.org/10.1136/bmjspcare-2017-001417
Identifying systems barriers that may prevent bereavement service access to bereaved carers: A report from an Australian specialist palliative care service
Phillips, Jane L., Lobb, Elizabeth, Mohacsi, Paula, Heneka, Nicole and Currow, David. 2018. "Identifying systems barriers that may prevent bereavement service access to bereaved carers: A report from an Australian specialist palliative care service." Collegian: The Australian Journal of Nursing Practice, Scholarship and Research. 25 (1), pp. 39-43. https://doi.org/10.1016/j.colegn.2017.03.004
Can A Complex Online Intervention Improve Cancer Nurses’ Pain Screening and Assessment Practices? Results from a Multicenter, Pre-post Test Pilot Study
Phillips, Jane L., Heneka, Nicole, Hickman, Louise, Lam, Lawrence and Shaw, Tim. 2017. "Can A Complex Online Intervention Improve Cancer Nurses’ Pain Screening and Assessment Practices? Results from a Multicenter, Pre-post Test Pilot Study." Pain Management Nursing. 18 (2), pp. 75-89. https://doi.org/10.1016/j.pmn.2017.01.003
Quantifying the burden of opioid medication errors in adult oncology and palliative care settings: A systematic review
Heneka, Nicole, Shaw, Tim, Rowett, Debra and Phillips, Jane L.. 2016. "Quantifying the burden of opioid medication errors in adult oncology and palliative care settings: A systematic review." Palliative Medicine. 30 (6), pp. 520-532. https://doi.org/10.1177/0269216315615002
Identifying Opioid Medication Error Types, Incidence and Patient Impact in Adult Oncology and Palliative Care Settings: A Systematic Review
Heneka, Nicole, Phillips, Jane L., Rowett, D. and Shaw, Tim. 2015. "Identifying Opioid Medication Error Types, Incidence and Patient Impact in Adult Oncology and Palliative Care Settings: A Systematic Review." 42nd COSA Annual Scientific Meeting. Hobart, Australia 17 - 19 Nov 2015 United Kingdom.
Australian survey of current practice and guideline use in adult cancer pain assessment and management: The community nurse perspective
Phillips, Jane L., Lovell, Melanie, Luckett, Tim, Agar, Meera, Green, Anna and Davidson, Patricia. 2015. "Australian survey of current practice and guideline use in adult cancer pain assessment and management: The community nurse perspective." Collegian: The Australian Journal of Nursing Practice, Scholarship and Research. 22 (1), pp. 33-41. https://doi.org/10.1016/j.colegn.2013.11.002
Multi-Centre Pre-Post Test Trial of a Complex QStream (c) Pain Assessment Intervention on Cancer Nurses' Pain Screening and Assessment Practices
Phillips, Jane, Heneka, Nicole, Lam, Lawrence and Shaw, Tim. 2014. "Multi-Centre Pre-Post Test Trial of a Complex QStream (c) Pain Assessment Intervention on Cancer Nurses' Pain Screening and Assessment Practices." Asia Pacific Journal of Clinical Oncology. 10, pp. 206-206.
A Complex QStream (R) Pain Assessment Intervention on Cancer Nurses' Pain Screening and Assessment Practices: Results from a Quasi-Experimental Study
Phillips, Jane, Heneka, Nicole, Lam, Lawrence and Shaw, Tim. 2014. "A Complex QStream (R) Pain Assessment Intervention on Cancer Nurses' Pain Screening and Assessment Practices: Results from a Quasi-Experimental Study." Asia Pacific Journal of Clinical Oncology. 10, pp. 136-136.
Impact of a novel online learning module on specialist palliative care nurses’ pain assessment competencies and patients’ reports of pain: Results from a quasiexperimental pilot study
Phillips, Jane L., Heneka, Nicole, Hickman, Louise, Lam, Lawrence and Shaw, Tim. 2014. "Impact of a novel online learning module on specialist palliative care nurses’ pain assessment competencies and patients’ reports of pain: Results from a quasiexperimental pilot study." Palliative Medicine. 28 (6), pp. 521-529. https://doi.org/10.1177/0269216314527780
Exploring opiate errors in the specialist cancer and palliative care setting: perceptions of key stakeholders
Phillips, Jane, Heneka, Nicole and Shaw, Tim. 2013. "Exploring opiate errors in the specialist cancer and palliative care setting: perceptions of key stakeholders." COSA Annual Scientific Meeting 2013. Adelaide, Australia 12 - 14 Nov 2013 Australia.
Mapping cancer pain screening, assessment and reassessment practices within one Australian health district: results from a baseline chart audit
Phillips, Jane, Heneka, Nicole and Shaw, Tim. 2013. "Mapping cancer pain screening, assessment and reassessment practices within one Australian health district: results from a baseline chart audit." COSA Annual Scientific Meeting 2013. Adelaide, Australia 12 - 14 Nov 2013 Australia.
Impact of a Qstream Online Learning Module on Palliative Care Nurses’ Pain Assessment Competencies and Patients’ Reports of Pain: Results from a Quasi-Experimental Pilot Study
Phillips, Jane, Heneka, Nicole, Hickman, Louise, Lam, Lawrence and Shaw, Tim. 2013. "Impact of a Qstream Online Learning Module on Palliative Care Nurses’ Pain Assessment Competencies and Patients’ Reports of Pain: Results from a Quasi-Experimental Pilot Study." COSA Annual Scientific Meeting 2013. Adelaide, Australia 12 - 14 Nov 2013 Australia.