Patient and Provider Outcomes of E-Learning Training in Collaborative Assessment and Management of Suicidality (CAMS)
The overall aims of this project are to develop such an e-learning alternative for the CAMS program, determine its effectiveness relative to in-person CAMS training, and assess factors that may relate to adoption and implementation of CAMS in general and specifically through e-learning and in-person modalities. At a more theoretical level, the study also aims to provide information about the effectiveness and feasibility of e-learning as a pedagogical tool that can contribute to effective strategies for continuing medical education on this and other topics of importance to the VA. If the e-learning approach proves effective, the study investigators have a plan for ready dissemination to other VISNs.
|Study Design:||Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Single Blind (Outcomes Assessor)
Primary Purpose: Health Services Research
|Official Title:||Patient and Provider Outcomes of E-Learning Training in Collaborative Assessment and Management of Suicidality|
- Suicide morbidity and mortality [ Time Frame: 1 year ] [ Designated as safety issue: Yes ]
- health service utilization [ Time Frame: 1 year ] [ Designated as safety issue: No ]
- provider adherence [ Time Frame: 1 year ] [ Designated as safety issue: Yes ]
|Study Start Date:||July 2010|
|Estimated Study Completion Date:||December 2013|
|Primary Completion Date:||July 2013 (Final data collection date for primary outcome measure)|
Experimental: Arm 1
provider in person training (80 providers who serve 160 patients)
Collaborative assessment management in suicidality
Experimental: Arm 2
e-learning training (80 providers who serve 160 patients)
Collaborative assessment management in suicidality
No Intervention: Arm 3
Control Group-no training
Hide Detailed Description
Refine a CAMS e-learning course that covers the same material and meets the same learning objectives of CAMS in-person training.
We will refine an interactive, e-learning version of the standard CAMS in-person training approach and conduct qualitative de-briefing sessions with 10 providers. Revisions will be made based on this feedback.
Test the effectiveness of the CAMS e-learning modality compared to the CAMS in-person modality and a concurrent non-intervention control in terms of provider evaluation and behavior.
We will assess provider evaluation of the two learning experiences and a third arm, a concurrent non-intervention control condition, in order to capture information that would improve the experiences, rating content mastery, interactivity or participation, confidence in acquired skills, and satisfaction with convenience of learning experience. More importantly, in order to capture provider behavior, we will abstract information from the charts of high risk patients to assess CAMS guideline concordance for both learning modalities and a concurrent non-intervention control condition.
HO: Providers in each of the two CAMS arms will demonstrate higher levels of content mastery and confidence in acquired skills than providers in the no CAMS arm.
H2: In the 12 months post-training, suicidal patients of providers in each of the two CAMS arms will receive higher rates of CAMS guideline concordant treatment, compared with providers in the no CAMS arm.
Test the effectiveness of the CAMS e-Learning delivery compared to the CAMS In-person delivery and a concurrent non-intervention control in terms of patient outcomes.
We will assess patient outcomes of the two modalities through medical record abstraction of high risk patients, including the following information: health services use (inpatient and outpatient; mental health and non-mental health; emergency room use), duration of high risk episodes, number of high risk episodes.
H3: In the 12 months post-training, suicidal patients of CAMS e-learning providers and CAMS in-person providers will be similar for health services use patterns.
H4: In the 12 months post-training, suicidal patients of CAMS e-learning providers and CAMS in-person providers will have similar duration of high risk episodes.
H5: In the 12 months post-training, suicidal patients of CAMS e-learning providers and CAMS in-person providers will be similar for number of high risk episodes per patient.
H6: In the 12 months post training, suicidal patients of providers in the no CAMS arm will have higher rates of emergency room use and inpatient mental health admissions, have a longer average duration of high risk episodes and have more high risk episodes per patient.
- Assess factors that facilitate or inhibit adoption of CAMS through e-Learning or In-person.
We will complete a formative evaluation using RE-AIM to document both the facilitating and inhibiting factors related to both e-learning and in-person CAMS uptake. We do not present a specific hypothesis for this aim, but rather seek to evaluate at all levels factors that relate to adoption and implementation of CAMS guidelines.
This project is consistent with both the Institute of Medicine recommendations related to the training of health professionals for the highest quality and safest care (15) and policy reports from other national sources on suicide prevention which recommend empirically-based training, systematic evaluation of training, and outcome research (16-18). The rationale for this study is that there is a critical need to provide the growing numbers of veterans at risk for suicide with the safest and highest quality of care. Most mental health providers have not been trained in an empirically-based system for assessment or management of suicide (such as CAMS). Efficient forms of learning must be developed to train the increasing numbers of mental health providers being employed by the VA. CAMS e-Learning has the potential to provide effective and efficient training for large numbers of adult learners. It is unknown whether an e-Learning delivery will be as effective as the In-person version has demonstrated itself to be.
|United States, Alabama|
|VA Medical Center, Birmingham, AL|
|Birmingham, Alabama, United States, 35233|
|VA Medical Center, Tuscaloosa|
|Tuscaloosa, Alabama, United States, 35404|
|United States, Georgia|
|Atlanta VA Medical and Rehab Center, Decatur, GA|
|Decatur, Georgia, United States, 30033|
|United States, South Carolina|
|Ralph H Johnson VA Medical Center, Charleston|
|Charleston, South Carolina, United States, 29401-5799|
|Wm. Jennings Bryan Dorn VA Medical Center, Columbia SC|
|Columbia, South Carolina, United States, 29209|
|Principal Investigator:||Kathryn M. Magruder, PhD MPH BA||Ralph H Johnson VA Medical Center, Charleston|