1. Review of the Flinders Model: Chronic Condition Self Management online module Lauren CampbellTed de’Lisle-TarrSupervisor: Rene Pols
2. Project summary The Flinders Model of Chronic Condition Management is an ongoing education program aimed at reforming the way health professionals interact and manage patients with chronic conditions. This course was originally, solely taught via a two-day workshop The online course was developed and incepted late last year to allow health professionals to teach themselves the Flinders Model in their own time
3. Flinders Model of Chronic Condition Management - Classic A 10-15 hour online course divided into 19 lessons, each with a specific focus Material is conveyed via text, linked readings, A/V PowerPoint presentations with handouts, and some video-examples from educational DVDs Participants pair up to learn the new material and practice a series of role-plays that exercise covered topics Assessment is in the form of forum-questions and 3 care-plans submitted within the due-dates
4. Summary Reviewing the FM for possible use in the GEMP course Both of have been taught the FM in TCP, 2nd year. Some of us remember that teaching better than others! :-S
5. Methods Completed the online course as a participant, completing the readings and the forums Also made notes of things that weren’t working Then once completed, with time recorded, we went back through it a second time and looked at it with a critical eye. Thought about parts of the course that didn’t seem logical, that were difficult, that didn’t flow.
6. Methods Considered from the position of a GEMP student using this to learn the FM as part of their GEMP studies Although this presentation makes many recommendations for alterations to the existing project it wouldn’t be feasible to list them all Hence Lauren solved this problem by compiling an example FM-online workshop that we hope illustrates many of the points we raise
7. Overall Effective at reinforcing the previous teaching I have had with the FM Got it’s message across effectively The online format is second nature to both of us – We think this aspect will function perfectly with GEMP students
8. General Maintenance Page 4: The ‘next’ button on the third screen of the lesson does not advance to the next page (references page). The reference page- link to the WHO document was broken Page 5: There are 7 Principles of self management in K, I, C, MR, I, L, S. Lesson 5 states there are 6 in the lesson-text, and 7 in the PowerPoint from screen 4. Page 9: The text on the lesson pages states that discussion on a score is indicated for 4 and above. The powerpoint states 4 and below (which we know to be true)
9. General Maintenance Page 11: Goal Statement forum, ‘What [why] do you think it is important for your client to identify a goal to address their problem?’ Page 13: When accessing ‘Case study “Tom” Forum’ from screen 6 of the lesson, we find the link is broken. The forum can still be accessed via the other routes.
10. General Maintenance Page 16: Motivational interviewing text by Rollnick and Moyers linked on the ‘Reading’ page is broken, with is because the URL has ‘www’ inserted when it should not be. You can still access the text from the ‘References’ page however.Correct address: http://pegasus.cc.ucf.edu/~drbryce/Motivational%20Interviewing%20and%20Resistance.pdf
11. Questions we asked ourselves The context of the review was based on several questions we asked ourselves… (some of which we did not have answers for) How would a student perceive this? What would they want? How would it work practically?
12. Questions we wish to ask the faculty Where in the GEMP course was this online module intended to be inserted? Will it be in conjunction with the established teaching? What aspects of this course are to be emphasised to the students?
13. Perceived directions GEMP students could graduate with the certification in place – WHO text justifies this Insert the FM-online workshop into late first year, because PBL groups provide small manageable teams. Students would complete a lesson of the revised FM workshop each week, with maybe an additional week added for lessons that require the completion of the various tools. A large block of teaching can become a bit daunting.
14. Perceived directions Each lesson will more-or-less be the same as the current lessons: stick with what works Lesson-text should remain more or less the same, that summarises the objectives and main points. Readings for the students to complete, both mandatory and optional. Finally, the forum as an assessment tool at the end of each lesson to gauge the student’s comprehension of each lesson’s material. To check they have completed the readings.
15. Perceived Directions - Readings The readings, in general were quite good. Those would transfer over quite nicely. ?? A few of your own studies in hyperlink to make them more accessible The WHO one should probably have an assessment forum concerning its main points, Lauren and I felt it was quite important, if long
16. Perceived Directions – The PowerPoint and videos Although its always good to have information in several formats… the PPs attached to the online module were repetitive, and a bit stale. They offered little more than what was on the lesson-pages If they contained blow-by-blow worked examples, such as PIH scores and C&R and problem statement goals and Careplan- forms filled out then this would be more informative Some of the diagrams were unintelligible Maybe a more interesting commentary than reading the slides Additionally the videos were also a bit stale. Students will likely lose interest quite quickly in these resources and it would be a shame to waste them.
17. Perceived directions – Assessment of completion The forums provide the opportunity for assessment of a student’s performance during a given lesson Additionally, telling the students it will be examined is a good incentive… the forums should be similar to the PBLs in respect to exam revision. The system would have an electronic ‘completion-counter’ that logs when a student has posted on a forum and marks that requirement as completed
18. Perceived directions - Forums Idea that forum questions could be changed a little. Many of the existing forums are reflection type questions. Students may not be too impressed with these questions and may prefer more comprehension type questions. Especially those pertaining to a case study eg ‘Tom case study-style’ (students like right and wrong answers) Work on a timed system of 1 lesson per week Each lesson forum question is allotted to one student to complete for the group, as though they were explaining or presenting this answer Each other member of the group will then reflect on this answer, prompted by a separate reflection question in the forum
19. Perceived Directions – Discussing the types of forum questions Examples of good questions were those relating to case study Tom: The motivational interviewing question for example: What are the major advantages of utilising Motivational Interviewing with clients? How does Motivational Interviewing differ from counselling? Where in the process has there been some implicit use of Motivational Interviewing techniques. How does the Flinders Program support clients and health professionals to utilise Motivational Interviewing strategies?
20. More examples of good questions Using the “Level of Confidence Scale” you ask Tom (client from "Structured Problem Solving" and "Change") to rate his answer on a scale of 1 – 10, with 1 being not very confident at all and 10 being very confident: “How confident are you with quitting smoking?” Tom tells you that his confidence scale is “5” . You then ask Tom: “How much do you believe that quitting will benefit you?” and he replies that he thinks that the benefits of quitting would be “10”. What questions could you ask to determine why Tom doesn’t feel more confident? What strategies could you use to boost his confidence score to > 7?
21. Perceived directions - Moderating Forum moderating very labour intensive Instead randomly moderate a few groups per week Have a flagging-system in place, where students can anonymously flag their forum for review if they are unsure or unsatisfied by their posts Have an electronic system that registers when the whole group have posted on their forum and marks that forum as posted
22. Our Perceived directions Is it possible for the three care plans to be split up to better fit the teaching: Eg: At the end of first year, at the end of second year with the TCP teaching and during COC in third year. This way the FM is constantly reviewed by students, rather than ‘done and forgotten’ the online workshop would also provide a revision-aid
23. The history of the FM, while useful for GPs runs the risk of being glossed over by students Conjoining the PIH and C&R lessons together, as the PIH lesson as it stands is 2 pages long Do we want students to role-play on each other? Or would we prefer them to use patients on the wards?
