Editor’s Note: This paper provides competent and focused concepts, research and implementation of the Webinar Distance Learning format for continuing education in pharmacology. This study provides excellent guidance for application of webinars in other medical related fields.
Online Webinars for Continuing Medical Education:
An Effective Method of Live Distance Learning
Kristine M. Zaragoza-Anderson
Continuing education for the medical professions has long been held in traditional face-to-face classrooms. However, special populations such as those located in rural and remote areas may not have access to these live events. This study sought to identify an effective online delivery method using instructional methodology to offer accredited education.
In this study, the courses developed were examined by the affective response of students that participated. In addition, a literary research was completed to determine the qualities that make a good candidate for this distance education, identify topics that are in need of additional training, and assess the techniques and methodology to provide continuing distance education.
In 1965, the state of Florida was the first to implement mandatory continuing education for pharmacists and pharmacy technicians. Today, all 50 states except for Hawaii requIn 1965, the state of Florida was the first to implement mandatory continuing education for pharmacists and pharmacy technicians. Today, all 50 states except for Hawaii require them to participate in accredited continuing education (Driesen, Verbeke, Simoens, & Laekeman, 2007). The Accreditation Council for Pharmacy Education (ACPE) sets accreditation standards and accredits continuing education providers, rather than individual continuing education activities (ACPE, 2008). This study extends to measure the effectiveness of its programming by conducting affective assessments to determine the quality and potential of each program, the instructional methodology implemented, and the delivery format utilized.
The study focused on the design and delivery of pharmaceutical distance education. This was selected as the subject matter of the study because pharmacists and pharmacy technicians are required by state law to participate in continuing education to maintain their medical license. All of the courses in the study were developed and approved in conjunction with ACPE guidelines. ments to be released in the pharmaceutical market. A team of student matter experts, instructional designers, and multimedia production specialists developed the online programs. Pharmacists and pharmacy technicians world-wide then studied the programs. The students in the study included retail, corporate (managed care), health care facilities (hospital, skilled nursing facility, etc.), research institutes, marketing firms, and members of the military.
Instructional Design Process
The implementation of distance learning technologies requires careful planning. The figure below (Figure 1) illustrates the major phases in the implementation process.
Figure 1. Instructional Design Model
The Florida Center for Instructional Technology recommends the following steps for proper techniques of implementing distance education (Barron, 1999). The first step is to conduct a needs assessment. The needs assessment identified the topics to be taught, the requirements and forms to be competed to receive ACPE accreditation for each course. The analysis also identified the technical requirements of the webinar format.
The needs analysis was to determine the pharmaceutical topics and concerns which pharmacists requested training in. A review of public health issues of concern in the media was air pollution (e.g.: emissions and diesel fuel). Air pollution can affect health in many ways with both short-term and long-term effects. The United States Environmental Protection Agency (EPA) reports that national average air quality continues to improve as emissions decline through 2006 (EPA, 2008). Therefore it is important to continue efforts to improve the quality of the air to help prevent chronic illnesses like asthma. The asthma webinar was developed to address these environmental concerns and the short-term and long-term effects they can have on people. Additionally, research of national health data shows an increasing trend of chronic diseases. The Centers for Disease Control and Prevention (CDC) report of Behavioral Risk Factor Surveillance System (BRFSS) is the world's largest telephone survey that tracks health risks in the United States. The data show an increasing trend of diabetes, hypertension, and lack of patient management skills to control their disease (CDC, 2005). Finally, pharmacy focus groups and survey questions asking what other educational programs they would like to be offered identified the remaining educational courses in the study.
The next step was to outline instructional goals and objectives and produce the instructional materials. A well-structured distance learning course must place instructional objectives foremost (Barron, 1999). The objectives for each course were established and subject matter experts developed the content for the webinars. All of the materials were approved by a licensed medical doctor before being released to the students.
The technology should be as invisible as possible, just another tool that instructors can use to effectively convey the content and interact with students (Barron, 1999). The technical requirements to produce and deliver the content were established. The webinars consisted of a pre-recorded audio lecture and PowerPoint presentation that was hosted online. At a certain time, students would login to the website to participate. The website also had a chat room and discussion area to ask the instructor questions or to request technical support.
The third step of the process provided training and practice for instructors in the webinar courses. The live webinars required an instructor to participate in the question and answer sessions. Many of the techniques and skills used in a classroom teaching situation do not translate directly into a distance education approach. Instructor training programs are important to acquaint the instructor with the use of technology as well as to help with the re-design of the instructional strategies. The course instructor was trained in understanding distance education and how to operate the webinar software. The instructor improved his delivery and instructional methods with each webinar.
The final step is to implement the program. After the training is complete and a pilot test has been conducted to ensure the technology is functioning, the programs were implemented. The feedback from students was collected and accreditation paperwork was filed. The ACPE paperwork included the letter of agreements, faculty review, and beta testing to determine the amount of continuing education units to assign to each course of study.
During this whole process a constant, on-going evaluation was conducted to provide quality assurance. This process extended to the delivery of courses that are medically correct, technically savvy, and provided a constant stream of student feedback to address concerns as they occurred.
Research in distance learning has produced several methods of distribution for online learning. This study had to meet the need of the accreditation body to provide online education that could be classified as a “live” event so it would be ACPE accredited as one (1) live Continuing Education Unit (CEU). The distribution of the “webinar” met this need.
Webinar is short for web-based seminar, a presentation, lecture, or workshop that is transmitted over the Internet. A key feature of a webinar is its interactive elements, the ability to send, receive and discuss information among students and instructor. This is the strength of the webinar; the ability of students to interact with the content and ask questions in a group setting while everyone is located at different locations.
Figure 2. Screenshot of a webinar in progress
Figure 2 shows a PowerPoint slide area for the visual content on screen left and a chat box for students to ask questions on screen right. The lower left is a biography of the speaker and on the lower right is where the audio streams. In addition, on the bottom of the screen is where the student can seek technical help, download a copy of the presentation, refresh the page, and access the calendar of upcoming events.
There were four webinars in the study. Dates, title, and objectives for each are listed below.
The first webinar conducted on 3/21/07 was Insulin Therapy for Diabetes. The objectives were
(1) Identify the mechanisms of action, pharmacology, and other important information for insulin therapy used to treat both types of diabetes and (2) Categorize the practical and essential information that has application in the daily pharmaceutical practice.
The next webinar conducted on 4/4/07 (and repeated on 5/2/07) was Asthma: The Challenge of Children, Minorities, and Low-Income Populations. The objectives were (1) Describe the highest risk asthma populations, (2) Outline the significant features of the asthma management guidelines, (3) Describe adherence issues and methods to overcome difficulties, and (4) Describe new advances in the diagnosis and pharmacological treatments of asthma.
The third webinar was conducted on 4/11/07 (and repeated on 5/9/07) was The Pharmacist’s Role in Treating Hypertension. The objectives were (1) Enhance your understanding of hypertension to include cardiovascular risks, management, and goals for individual patients, (2) Review and discuss the current pharmacotherapy standards of care for hypertension, and (3) Describe the pharmacist’s role in counseling patients on hypertensive medications.
The final webinar was conducted on 7/6/07 (and repeated on 7/11/07) was Pharmacological Help for A Good Night’s Sleep. The objectives were (1) Define insomnia and characterize the symptoms and array of causes, (2) Describe traditional and newer pharmacologic approaches to the management of insomnia, (3) Evaluate the comparative efficacy, pharmacokinetics, and contraindications of agents used to treat insomnia, and (4) List strategies for pharmacists to educate and counsel patients with insomnia.
The research methods implemented in the study are an analysis among the research questions posed. This investigation consists of a review of pedagogical theories and literature, student affective assessments, and a review of the procedures to offer live online education.
Results and Analysis
The study sought to identify qualities in students that identify them a good candidates for distance learning courses. As identified in the research of Ornstein and Hunkins (1998) they identified these qualities. They include students that are self-motivated and self-disciplined, never (or at least rarely) procrastinate, resist constant distractions, feel alright about missing the social elements of traditional schools, communicate effectively through reading and writing, accept critical thinking and decision making as part of the learning process, meet the minimum technology requirements for the course, and feel that high quality learning can take place without going to a traditional classroom.
The convenience of distance education can attract many adult students since it is flexible and can accommodate various schedules (Thomas, 2008). However, it may not be the best fit for every student. An instructor or provider of education should include suggestions in the syllabus of ideal qualities for a student to have before enrolling into a course at-a-distance. This study provided potential students with the mentioned list of qualities and expectations for students to keep in mind while participating in distance education. This process helps student, instructor, and educational programs to succeed.
The analysis of student interest and successfulness of completing an educational course is important to understand the effectiveness of the program. The first research question in the study asked to determine the effectiveness of asynchronous learning on student performance. A survey of student interest was collected in the webinar programs. The webinars were delivered online between March and July 2007. The following statistics were obtained from the pharmacy webinar website, where users must login to access the information and this access is logged. The first three webinars focused on being accessible and easy-to-use since this was the first time that this technology was being implemented on a large international level with pharmacists and pharmacy technicians online.
The first topic to be addressed was Insulin Therapy for Diabetes. 460 people clicked on the link for more information, 390 (85%) registered for the program; 292 (75%) attended the session; 164 (56%) completed the course survey. The 25% that registered but did not attend the program were followed up with to find out why they did not attend. The reasons cited included: first time they used webinar software; internet connection problems; phone problems (calling in to conference call); and other technology problems (computer/access problems). Other reason cited were: the webinar was competing with popular television shows in the same time slot; family and work commitments;, and simply forgot about the webinar.
The next topic of the webinars was Asthma: The Challenge of Children, Minorities, and Low-income Population. There were 636 people that clicked on the link for more information; of those, 516 (81%) registered for the program. 314 (61%) attended the session and 174 (55%) completed the course survey. The 39% that registered but did not attend the program were followed up with to find out why they did not attend. They reported the same reasons as for the insulin webinar.
The final topic of the webinars was The Pharmacists' Role in Treating Hypertension. There were 460 people that clicked on the link for more information, of those, 390 (85%) registered for the program. Then 292 (75%) attended the session, of them, 137 (47%) completed the course survey. The 25% that registered but did not attend the program were followed up with to find out why they did not attend. The students that did not attend reported the same reasons as for the insulin and asthma webinars.
The study addressed the concerns cited by the students to increase recruitment and retention rates of the students. For students that were accessing incorrect websites, the webpage for the program was revised with clearer instructions and links. The webinars also included technical support by technicians being available online and on the phone for the students. This greatly reduced problems such as internet connection problems and other technology/computer-related problems. Also, the webinars were originally sending audio over the telephone but to address students’ concerns the audio was streamed online. That way the students were not tying up the phone line for an hour or making a long distance call. As for competing with popular television shows, family, and work commitments the webinars were then offered on different times and days of the week so the students could choose which ones met their scheduling requirements the best.
All of the educational programs were very successful and scored very high for covering the objectives, applying to their practice/patient care, and overall evaluation of the activity. The students reported that the instructor did a good job of writing the programs and delivering the online lectures. It was interesting that the webinars attracted a younger population of pharmacists while the majority of the traditional mailer monographs were students 41 and older.
The students’ satisfaction with each additional program increased. The instructional design model with a focus on a constant evaluation resulted in better and better continuing education programs as attention was made to keep increasing the quality of technology to deliver the programs and the quality of the content of the programs. This focus on quality education resulted in students referring others to the courses and repeat students in the programs.
In summary, the webinar method was a preferred distance learning technique according to the students in the study. The webinars were a popular choice by the students. The data rated the webinars very favorably and when asked if they would return again, 99% responded that yes, they would return again for another webinar. Also, according to the surveys the majority of the students would recommend attending a webinar class to a colleague.
This study has conducted research of webinars, an emerging methodology and application that is growing in the field of distance education. The outcomes of the study provide data and information for educational policy and application changes within the academic community and also provide literature content for future publications and presentations. Finally, the study provides proof-of-concept of delivery and support to large numbers of students at a distance in pharmacology.
The online programs have especially been beneficial for members of the military. Several military pharmacists participated in the programs stateside and around-the-world. For example, several pharmacists located at the Ali Al Salem and Ahmed Al Jaber United States Air Force bases in Kuwait attended the webinars.
The students in the study benefited from access to accredited continuing education for those in rural and remote locations. They could benefit from learning the latest pharmaceuticals to be released in the marketplace and be educated on innovative patient consultation techniques. The public also benefits by having an informed pharmaceutical workforce who is aware of new medicines and treatment guidelines.
Accreditation Council for Pharmacy Education. (2008). Accreditation standards and criteria. Retrieved August 7, 2008 at: http://www.acpe-accredit.org/ceproviders/standards.asp.
Barron, A. (1999). A teacher’s guide to distance learning. Florida: Florida Department of Education.
Centers for Disease Control and Prevention (CDC). (2005). Behavioral Risk Factor Surveillance System Survey Questionnaire and Data. Atlanta, Georgia: United States Department of Health and Human Services, Centers for Disease Control and Prevention.
Driesen, A., Verbeke, K., Simoens, S., & Laekeman, G. (2007). International trends in lifelong learning for pharmacists. American Association of Colleges of Pharmacy, 71(3), 52.
Environmental Protection Agency. (2008). Reports and data. Retrieved August 17, 2008 at: http://epa.gov/airtrends.
Ornstein, A. & Hunkins, P. (1998). Curriculum evaluation. Boston: Allyn & Bacon.
Thomas, C. (2008). Are you a candidate for distance learning? Retrieved August 17, 2008 at: http://www.petersons.com/distancelearning.
About the Author
Dr. Kristine M. Zaragoza-Anderson graduated with a Doctor of Education in Curriculum and Instruction Studies from Indiana University of Pennsylvania on May 10, 2008. Dr. Anderson has a Bachelor of Science in Communications Media with a minor in Journalism (2000) and a Master of Arts in Adult Education and Communications Technology (2001). Her experiences include a U.S. Army two-time recipient of the World Wars Award of Merit, an award winning radio show, and Pennsylvania Program Service Provider Honor for her years of service with adult basic education in math and literacy in prisons and after-school programs.
She is currently an adjunct faculty member of Argosy University and the Distributed Learning Course Management Specialist at Saint Francis University’s Center of Excellence for Remote and Medically Under-Served Areas.
Contact her at: firstname.lastname@example.org