Question

Online versus Live Delivery of Education to Pharmacists in a Large Multicentre Health Region: A Non-inferiority Assessment of Learning Outcomes.

Taylor, Robert; Jung, Joanne; Loewen, Peter; Spencer, Carrie; Dossa, Anar; de Lemos, Jane

BSc(Biol), BSc(Pharm), ACPR, is a Clinical Pharmacist at the Richmond Hospital, Richmond, British Columbia

Canadian Journal of Hospital Pharmacy (CAN J HOSP PHARM), 2013 Jul; 66 (4): 233-40.

BACKGROUND: The prevalence of online modules for continuing education in the health professions has been increasing in recent years. However, the effectiveness of online modules for pharmacist learning has not been thoroughly studied. OBJECTIVES: The primary aim of this study was to determine if providing education to pharmacists through a self-paced enhanced online module was non-inferior to a face-to-face learning module with respect to knowledge application on the topic of postoperative insulin dosing. Secondary aims were to determine pharmacists' knowledge gain and retention, as well as their satisfaction with the modules. METHODS: The participants in this prospective, randomized, parallel-group non-inferiority trial were pharmacists in a large multicentre health region. Outcomes were measured by comparing scores obtained on pre- and post-module knowledge-assessment questionnaires. A between-group difference in change on knowledge application scores of less than 25 percentage points was the predetermined non-inferiority margin. RESULTS: A total of 74 pharmacists consented to participate, 38 randomly assigned to use the enhanced online module and 36 to attend the face-to-face learning session. For questions examining knowledge application, the mean improvement achieved by the online learning group was 26 percentage points greater than that achieved by the face-to-face learning group (95% confidence interval [CI] 25 to 27; p < 0.001). For questions testing knowledge gain, the improvement achieved by the online learning group was 7 percentage points less than that achieved by the face-to-face learning group (95% CI 2 to 12; p = 0.008). Therefore, the enhanced online module was deemed to be non-inferior to the face-to-face learning session in terms of knowledge application and knowledge gain. Insufficient data were available to analyze the secondary outcome of knowledge retention over time. Participant satisfaction was similar for the 2 groups (p = 0.62). CONCLUSION: The self-paced enhanced online module was non-inferior to facilitated face-to-face learning in terms of improving application and knowledge of insulin dosing. Pharmacists had similar levels of satisfaction with the 2 modes of learning.

1. What are the independent variable(s) in this study?

2. What are the dependent variables in this study?

3. What type of research approach was used in the study?

        Is it quantitative and qualitative, Why?

4. Is the study prospective or retrospective in nature? Why?

5. Is the study experimental or non-experimental in design? Why? What type of research is this study?

Answer 1

Introduction:The dependent variable is defined as the effect of the independent variable on the responses of the participants in a well designed experimental study. This is a non inferiority study which is designed to determine the non inferiority of an enhanced online education module to the face-to-face module in the education of the pharmacists with respect to understanding the effect it has on -

1. the knowledge application and the knowledge gain of the pharmacists with respect to the post operative dosage of insulin(primary outcome)

2.knowledge retention over time

3. participant satisfaction with the learning modules.(2 and 3 secondary outcomes)

TABLE 1.

	Dependent variable(s)	Independent variable(s)
1.	This is the variable under study in an experimental design which is measured.	This is the manipulation brought out by the researcher in the experimental study.
2.	The dependent variable is the one that changes because of the change brought on by the experimenter,it is the effect in simple terms.	The independent variable is the change factor brought on by the experimenter;it is the cause in simple words.
3.	answer 2: The dependent variables in this study are; primary1.the knowledge application and knowledge gain of post-operative insulin dosing among pharmacists. secondary2.knowledge retention over time. secondary3.participant satisfaction rates with the modules.	answer 1.The independent variables in this study are the two learning mechanisms 1.the self paced enhanced online learning module for pharmacists. 2.face to face learning module for pharmacists.

Answer 1 The independent variables in In this study : Please refer table 1 under independent variables

Answer 2: The dependent variables in this study: please refer table 1 under dependent variables.

Answer 3 the type of research approach in the study:quantitative approach,experimental design with randomization.

A true experiment is a kind of Research Design in which the researcher does the manipulation using independent variables on the dependent variables to obtain the pre testing and the post testing results in order to test the hypothesis and there is random allocation of the individuals to the two groups in order to control the other external factors that can modify the result.

This is a quantitative study as the data that has been collected has been quantified after a randomized experiment on the pharmacists. 38 pharmacists were subjected to enhanced online training module randomly while 36 were subjected to face to face training module the data was collected and statistical analysis of the data was done to calculate the p-value. This is in line with the design of the quantitative analysis where data is collected objectively and subjected to the statistical analysis to come to a conclusion by obtaining the p-value.

Answer 4 This is a prospective study because this is a study ahead in time and completed using a randomized group allocation of the pharmacists,performing an experiment. Any study which is conducted by subjecting the subject to an experiment and the results are obtained after that is a prospective study.Retrospective studies are the ones which which collect the information using data sheets or recollections of events that have happened back in time. Here the study has been done by subjecting the pharmacists to enhanced online and face to face education module and obtaining feedback from them via questionnaires. This is an ahead in time and hence this is a prospective study.

Answer 5 This is an experimental study because 74 pharmacists are randomly assigned to two groups one of which is subjected to a face-to-face education module and the other is subjected to an enhanced online education module and their effects of these two different exposures on their knowledge application and knowledge gain of  post-operative insulin dosage, their satisfaction rates with the modules and their knowledge retention over time are analyzed using statistical analysis. There are two groups here which are randomly assigned to study the effect of the independent variables on the dependent variables,hence this is an example of an experimental study design .