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Canadian Respiratory Journal
Volume 20, Issue 6, Pages 435-441
Original Article

Development and Pretesting of an Electronic Learning Module to Train Health Care Professionals on the Use of the Pediatric Respiratory Assessment Measure to Assess Acute Asthma Severity

Anab R Lehr,1,2 Martha L McKinney,3 Serge Gouin,3 Jean-Guy Blais,4 MV Pusic,5 and Francine M Ducharme1,2,6

1University of Montreal, Montreal, Quebec, Canada
2Research Centre, CHU Sainte-Justine, University of Montreal, Montreal, Quebec, Canada
3Department of Pediatrics, University of Montreal, Montreal, Quebec, Canada
4Département d’administration et fondements de l’éducation, University of Montreal, Montreal, Quebec, Canada
5Department of Pediatrics, New York University School of Medicine, New York, New York, USA
6Department of Social and Preventive Medicine, University of Montreal, Montreal, Quebec, Canada

Copyright © 2013 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


BACKGROUND: Severity-specific guidelines based on the Pediatric Respiratory Assessment Measure (PRAM), a validated clinical score, reduce pediatric asthma hospitalization rates.

OBJECTIVE: To develop, pretest the educational value of and revise an electronic learning module to train health care professionals on the use of the PRAM.

METHODS: The respiratory efforts of 32 children with acute asthma were videotaped and pulmonary auscultation was recorded. A pilot module, composed of a tutorial and 18 clinical cases, was developed in French and English. Health care professionals completed the module and provided feedback. The performance of participants, case quality and difficulty, and learning curve were assessed using the Rasch test; quantitative and qualitative feedback served to revise the module.

RESULTS: Seventy-two participants (19 physicians, 22 nurses, four respiratory therapists and 27 health care trainees) with a balanced distribution across self-declared expertise (26% beginner, 35% competent and 39% expert) were included. The accuracy of experts was superior to beginners (OR 1.79, 1.15 and 2.79, respectively). Overall performance significantly improved between the first and latter half of cases (P<0.001). Participants assessed the module to be clear (96%), relevant (98%), realistic (94%) and useful (99%) to learn the PRAM. The qualitative/quantitative analysis led to the deletion of three cases, modification of remaining cases to further enhance quality and reordering within three levels of difficulty.

DISCUSSION: Using rigorous educational methods, an electronic module was developed to teach health care professionals on use of the PRAM score. Using the back-translation technique, both French and English versions were developed and validated simultaneously. The pilot module comprised a tutorial and three case-scenario sections, and was tested on a target audience of physicians, nurses, respiratory therapists and medical trainees.

CONCLUSION: The final electronic learning module met the clarity and quality requirements of a good teaching tool, with a demonstrated learning effect and high appreciation by health care professionals. Available in French and English, it is offered to facilitate implementation of PRAM-based acute pediatric asthma guidelines.