E. Ozturk1, M. Van Iersel5, K. Van Loon2, C. Den Rooyen2, J. Klaasse4, R. De Lind Van Wijngaarden3, H. Van Goor1 1Radboud University Nijmegen Medical Center,General Surgery,Nijmegen, GELDERLAND, Netherlands 2KNMG,Utrecht, UTRECHT, Netherlands 3Hart Long Centrum Leiden,Cardiothoracic Surgery,Leiden, ZUID-HOLLAND, Netherlands 4Medisch Spectrum Twente,Enschede, OVERIJSSEL, Netherlands 5Radboud University Nijmegen Medical Center,Geriatrics,NIjmegen, GELDERLAND, Netherlands
Introduction: Surgical specialists and those in training lack knowledge to adequately diagnose and treat the frail older patient before, during and after the operation.As part of a national initiative to increase competency of residents to deal with the elderly perioperatively, a six weeks open interactive online course was developed and broadly promoted among physicians (in training) involved in operations of elderly patients.The aim of this study was to evaluate the attitude, self confidence and knowledge after taking this course.
Methods: Multiple educators followed the participants in their process and supported them in the discussions.Attitude (Ageing Semantic Differential, ASD), self confidence (validated questionnaire of self-perceived knowledge) and knowledge in 5 different domains (multiple choice exam) were obtained before and after the course.Correlations between these three outcomes and with demographics e.g. profession,gender,experience were explored. Participants gave written consent for using the data for research before start of the course .
Results:260 physicians applied for the course.206 (79%) actually started and in 174 (67%) participants ASD and self confidence were available for analysis.Complete knowledge scores were available in 125 participants (60%).Professions with the highest percentage of participants were (residents in), anesthesiology (23.1%),gynecology (22.3%) and surgery (21.5%).Of these, 81.7%,60.3% and 46.4% were residents.Mean age was 35 years and 68% were women.Dropout for the knowledge exams was 40 percent,in the majority these were surgical interns and emergency department physicians.Knowledge in 5 different categories improved significantly, mean scores of correct answers increased from 49 to 65 percent (p<0.005).Participants of surgery and gynecology felt more secure (p=0.012 and p=0.01) in the treatment of the older patient after completing the course.Gynecologists (in training) also had a better attitude after the six-week course (p=0.036).A significant correlation was found between the ASD and the total knowledge score for surgeons (in training) (p=0.02).Discussions and exchange of best practices were many via the forum included in the course.
Conclusion:An interactive open online course on peri-operative care for the elderly increases knowledge in a mix group of surgeons,anesthetists,gynecologists and other physicians involved in the perioperative care of elderly.Thereby selfconfidence increases in surgeons and gynecologists and trainees in these specialties, with a significant attitude improvement in gynecologists (in training).More knowledge improves attitude, although this was only apparent for the surgical specialty.Drop out is high, however, the 60% completion rate is high compared to a 10% completion rate of massive open online courses in general.The next research steps are to measure the retention in knowledge and to explore the value of this courses for daily practice in the participating departments.