2:40 - 3:00 pmSaturday, September 6
LK 102
Using massive open online courses (MOOCs) for advanced clinical training: A viable pathway for disseminating evidence-based treatments for rare disorders?
LK 102
Using massive open online courses (MOOCs) for advanced clinical training: A viable pathway for disseminating evidence-based treatments for rare disorders?
Research Instructor, Stanford School of Medicine
BackgroundFor rare and severe illnesses like anorexia nervosa, disseminating evidence-based treatments in a scalable way is a major priority.  Adapting MOOCs to small private online courses (SPOCs), for... Read more

Description

Background

For rare and severe illnesses like anorexia nervosa, disseminating evidence-based treatments in a scalable way is a major priority.  Adapting MOOCs to small private online courses (SPOCs), for the purposes of specialist psychotherapy training is worth exploring because some of the features that characterize MOOCs and by extension SPOC platforms either parallel best-practices in clinical training or can be leveraged to make them ideally positioned for this purpose.  Specifically, there are three core characteristics of MOOCs that make them ideal for clinical training.  1. First, the centrality of video allows for multiple presentations of role-played clinical scenarios.  This exposure may facilitate learning advanced and nuanced clinical concepts typically only made possible by extensive clinical experience.  2. Second, MOOCs facilitate a peer-learning environment that may enhance learning through engagement in debate.  Upon enrollment, clinicians are allocated to a cohort which can be leveraged by the instructional designers to be multi- or single-disciplinary teams, depending on learning priorities.  3. Finally, courses can be built around planned assessments that require immersion in uploaded clinical case material and a peer-review system for evaluation.  We present the development and pilot of an advanced training course for clinicians in psychotherapy for adolescent anorexia nervosa.  In addition, we describe the unique trial that will examine its ability to enhance training and patient outcomes.  

Methods

Participants were N=21 clinicians recruited from psychiatry outpatient clinics in Stanford School of Medicine who had expressed an interest in the course.  The 10-week course consisted of 6 lecture bundles released about every two weeks. Each lecture bundle comprised 5-8 very short (about 4-minutes in length) didactic videos that discuss the treatment model and segments from role-played therapy sessions with a typical case of anorexia nervosa, as well as supplementary readings and case material (e.g., weight charts, intake notes.).  Outcomes of interest were platform usage, quality of assignments, and responses to a usability questionnaire.  

Results

Ten clinicians (n=2 psychiatrists, n=4 psychologists; n=3 Masters’ level family therapists; n=1 other) completed the course and indicated moderate to high satisfaction with the course overall.  Where peer review was utilized, it led to extremely rich debate of the treatment model.  However there was only one post to a discussion forum suggesting that participants had little interest in this feature.  Usage dropped off towards the end of the course and the final weeks had a lower assignment completion rate.  The most commonly cited challenge to completion of assignments was lack of time.  

Conclusion

The use of SPOCs for advanced psychotherapy training is feasible and has potential for disseminating scaleable specialist training to a diverse group of clinicians.  However, some aspects of the platform - such as discussion forums and other peer-level features are underutilized and risk undermining some of the learning potential.  An upcoming NIH-funded randomized trial will answer whether the online training has the capacity to improve patient outcomes among a sample of community clinicians.  

Alison Darcy moved to the Bay Area from Ireland in 2008 for a Post-Doctoral Research Fellowship at Stanford School of Medicine. She has always been an advocate and pioneer for e-MentalHealth. To date she has developed and is currently piloting a smartphone application that allows patients to track their eating behaviors, and develop a contextual understanding of their symptoms. She has pioneered the use of Massive Open Online Course (MOOC) platforms for clinical training in eating disorders. Early in her research career, Alison built the first Internet-delivered support group for people with Eating Disorders in Europe. In addition, she has acted as advisor to many innovative and like-minded tech companies. Currently she is funded under the Global Federation for Eating Disorders to explore the feasibility of offering internet-delivered guided self-help to parents of adolescents with anorexia nervosa. If feasible, this project will mark a major innovation in healthcare addressing disparities of access.

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