1. Interprofessional Asthma Education: Development of a Comprehensive Asthma Rotation in a Pediatric Residency
Carolyn C Robinson
4/30/2014
xxx00.#####.ppt 11/10/2018

2. Problem Identification
1. Problem Identification and
General Needs Assessment
- Health Care Problem
- Current Approach
- Ideal Approach
1. Problem Identification and
General Needs Assessment
- Health Care Problem
- Current Approach
- Ideal Approach
Importance of asthma
Over 6 million children
4.7 million office visits yearly
700,000 visits to an emergency room; 200,000 hospitalizations
Lack competency in asthma management
Knowledge
Meter Dosed Inhaler (MDI) technique
6. Evaluation and Feedback
- Individual Learners
- Program
6. Evaluation and Feedback
- Individual Learners
- Program
2. Targeted Needs Assessment
- Learners
- Learning Environment
2. Targeted Needs Assessment
- Learners
- Learning Environment * *
Pre-test
Post-test *
5. Implementation
- Obtaining Political
Support
- Securing Resources
- Addressing Barriers
- Introducing the Curriculum
- Administering the Curriculum
5. Implementation
- Obtaining Political
Support
- Securing Resources
- Addressing Barriers
- Introducing the Curriculum
- Administering the Curriculum
3. Goals and Objectives
- Broad Goals
- Specific Measurable Objectives
3. Goals and Objectives
- Broad Goals
- Specific Measurable Objectives
Pre-Test
Post-Test *
Percent Correct
Percent of Residents * *
4. Educational Strategies
- Content
- Methods
4. Educational Strategies
- Content
- Methods
Changes in knowledge after online didactic. p<0.05
Overall assessment before and after instruction. p<0.001
Kim. Journal of Asthma 2009
Hemnes. Journal of Asthma 2009
Kern’s Six Step Approach to Curriculum Development
Kern’s Six Step Approach to Curriculum Development
xxx00.#####.ppt 11/10/2018

3. Needs Assessment Kern’s Six Step Approach to Curriculum Development
1. Problem Identification and
General Needs Assessment
- Health Care Problem
- Current Approach
- Ideal Approach
6. Evaluation and Feedback
- Individual Learners
- Program
2. Targeted Needs Assessment
- Learners
- Learning Environment
Resident n=54
Faculty n=34
Resident n=54
Faculty n=28
5. Implementation
- Obtaining Political
Support
- Securing Resources
- Addressing Barriers
- Introducing the Curriculum
- Administering the Curriculum
3. Goals and Objectives
- Broad Goals
- Specific Measurable Objectives
Percent of responses
Rating
4. Educational Strategies
- Content
- Methods
Faculty and resident response to need for curriculum
Faculty and resident response on location of training
Rating on a Likert Scale 1=Least Needed to 4=Most Needed
Kern’s Six Step Approach to Curriculum Development
xxx00.#####.ppt 11/10/2018

4. Kern’s Six Step Approach to Curriculum Development
Goals and Objectives
1. Problem Identification and
General Needs Assessment
- Health Care Problem
- Current Approach
- Ideal Approach
Goal
Understand key aspects of outpatient asthma care in children.
Objectives
Obtain a comprehensive history of an asthmatic patient
Accurately classify severity based on NHLBI guidelines
Describe the control status according to NHLBI guidelines
Recognize characteristics for increased risk of ICU hospitalization
Recognize indications for referral to pulmonary medicine
Teach the proper MDI and aerochamber technique
Develop a plan for optimal asthma control
6. Evaluation and Feedback
- Individual Learners
- Program
2. Targeted Needs Assessment
- Learners
- Learning Environment
5. Implementation
- Obtaining Political
Support
- Securing Resources
- Addressing Barriers
- Introducing the Curriculum
- Administering the Curriculum
3. Goals and Objectives
- Broad Goals
- Specific Measurable Objectives
4. Educational Strategies
- Content
- Methods
Kern’s Six Step Approach to Curriculum Development
xxx00.#####.ppt 11/10/2018

5. Educational Strategies
1. Problem Identification and
General Needs Assessment
- Health Care Problem
- Current Approach
- Ideal Approach
Interprofessional Education
Asthma Educator, Clinical Pharmacist, Respiratory Therapists
Comprehensive Approach
All aspects of asthma care
Variety of Educational Methods
Different learning styles
Condensed
Short one week block
6. Evaluation and Feedback
- Individual Learners
- Program
2. Targeted Needs Assessment
- Learners
- Learning Environment
5. Implementation
- Obtaining Political
Support
- Securing Resources
- Addressing Barriers
- Introducing the Curriculum
- Administering the Curriculum
3. Goals and Objectives
- Broad Goals
- Specific Measurable Objectives
4. Educational Strategies
- Content
- Methods
Kern’s Six Step Approach to Curriculum Development
xxx00.#####.ppt 11/10/2018

6. Educational Methods Lecture Self Directed Learning Direct Observation
“Empty Outlines”
“Instructor Storytelling”
“Pop culture”
Self Directed Learning
Syllabus of articles
Online asthma modules
Scavenger hunt
Direct Observation
Reflection
“Muddiest Point”
“Harvesting”
“One minute papers”
Patient Interaction
Counseling
Interpretation of Spirometry
Evaluation
Skills instruction

7. Kern’s Six Step Approach to Curriculum Development
Implementation
1. Problem Identification and
General Needs Assessment
- Health Care Problem
- Current Approach
- Ideal Approach
Support
Residency program leadership, chief residents, and medical educators
Pulmonologists, pulmonary fellowship program
Resources
Interprofessional collaborators
Authors of online material
Syllabus of articles
Barriers
Scheduling
Standardization
Curriculum introduced July 2013
6. Evaluation and Feedback
- Individual Learners
- Program
2. Targeted Needs Assessment
- Learners
- Learning Environment
5. Implementation
- Obtaining Political
Support
- Securing Resources
- Addressing Barriers
- Introducing the Curriculum
- Administering the Curriculum
3. Goals and Objectives
- Broad Goals
- Specific Measurable Objectives
4. Educational Strategies
- Content
- Methods
Kern’s Six Step Approach to Curriculum Development
xxx00.#####.ppt 11/10/2018

8. Weekly Schedule Interprofessional Activities Educational Activities
Day 1
Introduction
Didactic Lecture with pulmonary fellow
Online Modules
Reading of Articles
Pre-assessment of asthma knowledge and Meter Dose Inhaler (MDI) skills
Taste testing with clinical pharmacist
Day 2
Direct Patient Care and Physician Modeling with pulmonary attending in After Hospital Asthma and Life Threatening Asthma Clinics
Day 3
Direct Patient Care and Physician Modeling at Health Centers with pulmonary attending
Day 4
Participate with asthma educator
Participate with Pulmonary Diagnostic Lab and respiratory therapists
Day 5
Wrap up lecture with questions
Post-assessment of asthma knowledge and MDI skills
Evaluation
Day 1
Introduction
Didactic Lecture with pulmonary fellow
Online Modules
Reading of Articles
Pre-assessment of asthma knowledge and Meter Dose Inhaler (MDI) skills
Taste testing with clinical pharmacist
Day 2
Direct Patient Care and Physician Modeling with pulmonary attending at After Hospital Asthma and Life Threatening Asthma Clinics
Day 3
Direct Patient Care and Physician Modeling at Health Centers with pulmonary attending
Day 4
Participate with asthma educator
Participate with Pulmonary Diagnostic Lab and respiratory therapists
Day 5
Wrap up lecture with questions
Post-assessment of asthma knowledge and MDI skills
Evaluation
Day 1
Introduction
Didactic Lecture with pulmonary fellow
Online Modules
Reading of Articles
Pre-assessment of asthma knowledge and Meter Dose Inhaler (MDI) skills
Taste testing with clinical pharmacist
Day 2
Direct Patient Care and Physician Modeling with pulmonary attending at After Hospital Asthma and Life Threatening Asthma Clinics
Day 3
Direct Patient Care and Physician Modeling at Health Centers with pulmonary attending
Day 4
Participate with asthma educator
Participate with Pulmonary Diagnostic Lab and respiratory therapists
Day 5
Wrap up lecture with questions
Post-assessment of asthma knowledge and MDI skills
Evaluation
Interprofessional Activities
Educational Activities
xxx00.#####.ppt 11/10/2018

9. Improvement in Knowledge: Written Test
1. Problem Identification and
General Needs Assessment
- Health Care Problem
- Current Approach
- Ideal Approach
Objective
Before
After
p value n
Obtaining a comprehensive history of an asthmatic patient
2.8
4.48
<0.001 25
Indications for the use of different inhaler devices
1.96
4.28
Being able to teach the proper inhaler technique
1.56
4.56
Classifying the severity of asthma per NHLBI guidelines
2.36
4.08
Determining asthma control status per NHLBI guidelines
2.16
4.04
Recognizing patients at risk for ICU hospitalization
2.52
Indications for referral to Pulmonary
2.24
3.92
Developing an outpatient plan for optimal asthma control
4.36
6. Evaluation and Feedback
- Individual Learners
- Program
p=0.001
n=26
2. Targeted Needs Assessment
- Learners
- Learning Environment
p<0.001
n=26
n=24
5. Implementation
- Obtaining Political
Support
- Securing Resources
- Addressing Barriers
- Introducing the Curriculum
- Administering the Curriculum
3. Goals and Objectives
- Broad Goals
- Specific Measurable Objectives
4. Educational Strategies
- Content
- Methods
(at end of rotation)
(did not take rotation)
Self perceived knowledge before and after the rotation.
Likert Scale 1=Not knowledgeable to 5=very knowledgeable
Kern’s Six Step Approach to Curriculum Development
xxx00.#####.ppt 11/10/2018

10. Improvement in Skill: MDI Technique
(at end of rotation)
(did not take rotation)
Based on checklist of items necessary to perform the skill proficiently
xxx00.#####.ppt 11/10/2018

11. Satisfaction 100% of residents Rating Rotation should be offered again
Rotation should be required
Would recommend the rotation to a colleague
Plan to implement what they learned in their future career
Satisfaction with Rotation Components
Rating
Rating on a Likert Scale of usefulness (n=25).
1=Not useful 5=Most useful.
xxx00.#####.ppt 11/10/2018

12. Conclusions Positive learning experience on outpatient asthma care
Benefits of using a structured framework
Uses an innovative, comprehensive approach to teaching of asthma
IPE is an excellent tool
Significant improvement
Written test scores and MDI technique
Framework for other departments
Future Directions: Sustainability and Retainability
xxx00.#####.ppt 11/10/2018

13. Acknowledgements Dr. Jen Rama Dr. Mark Ward Dr. Siby Moonnumakal
Dr. Robert Moore
Dr. Julie Katkin
Pulmonary Diagnostic Lab
Kai Sanders
xxx00.#####.ppt 11/10/2018