Literature review matrix walden university

Literature Review Matrix

Part I: PICO Analysis of Research Topic

P: Patient or Population

I: Anticipated Intervention

C: Comparison group or Current standard

O: Outcome desired

Source: Adapted from Elkins (2010)

Step 1: Frame your clinical question using the PICO method.

P: Patients supported by a Mechanical Circulatory Support Device

I: who participate in an online educational and skills review training program

C: compared to patients who do not participate in the online training

O: are more likely able to recall critical skills necessary in care of the MCS device.

Part II: Search Strategy

Using the Walden Library and other appropriate databases, locate ten scholarly articles that pertain to a practice issue of interest to you and that is appropriate for an evidence-based practice project.

Step 1: Identify the resources you will utilize, or utilized, to find articles that pertain to your topic

Electronic Databases

Research or Professional Organizations

Experts in the field to consult

Books, encyclopedias, handbooks

Walden Library Databases

ISHLT

MyLVAD.com

Google Scholar

ICCAC

Device Manufacturers

HFSA

Step 2: Identify search terms and criteria

Key words & phrases

Major authors

Inclusion criteria

Exclusion criteria

Online training

Kolb

Primary research

Medical Education

Online education

Systematic Reviews

Nursing education

Virtual education

Virtual training

MCS or Mechanical Circulatory Support

LVAD or Left ventricular assist device

Skills verification knowledge verificaiton

Patient education

MCS patient or LVAD patient

Step 3: Identify Boolean search strings

To obtain research articles involving online patient education Boolean search strings included “Online or virtual Patient education or patient training Skills.” Terms excluded from the search strings included:

· Not virtual patient;

· Not medical;

· Not nursing;

· Not surgery or surgical training;

· Not pharmacy.

Dates were limited to 2009 to present to obtain recent literature and the search was limited to peer reviewed scholarly journals.

Part III: Analysis of Literature

Step 1: Summarize the ten (10) articles you select from your search efforts completing the table below.

Summary Table of Analyzed Articles (you may determine your own headings)

Citation

Conceptual Framework/ Theory

Main finding

Research method

Strengths of study

Weaknesses

Level of Evidence

Attai (2015)

Patient centered care

Proof of concept – participant’s knowledge of disease specific information and self care was increased

· Convenience Sample

· Online twitter survey – Likert scale

· Increased reach to various patients geographically

· Survey not validated

· Recall bias

· No control group

· Similar demographic characteristics of respondents

· Unclear if results can be generalized

· Lurking un-trackable

VI

Calvillo (2015)

Patient Empowerment

· Four levels of patient empowerment exist.

· Any current online interface supports patient empowerment

· Technology already exists

· Attitude change needed to fully engage technology

Systematic review of literature

· Comprehensive search across multiple specialties

· Distinct definition and plan for inclusion and exclusion of articles

· Strong theoretical basis

· English articles only reviewed

I

Song (2009)

Patient self care – (empowerment)

· Web based programs have potential as an alternative to live diabetes patient education

· Quasi-experimental

· Non equivalent control group

· Pre/post test design

· No statistical difference in group characteristics

· High drop out

· Non randomization

· Short duration of data collection

III

Finkelstein (2013)

Adult learning theories

· Intervention group had significantly higher knowledge score

· Better experience with guided learning

· Mixed methods

· Randomized control trial

· Intervention group – CO-ED system

· Control group – internet search

· Pre and post test knowledge assessments

· Semi structured interviews for experience

· Randomized controlled intervention

· Similar knowledge level at baseline

· Mixed method to evaluate experience as well as intervention effect.

· Only used white English speaking population

II

Bol (2015)

Cognitive theory of multimedia learning

· Adding illustrations is beneficial to all

· Older patients benefited with cognitive or affective illustrations

· Older patients recall better with cognitive illustrations.

· Randomized assignment to 3 separate experimental groups

· Text only, text plus illustrations younger, text plus illustrations older

· Randomized sampling.

· Adequate sample size.

· Exposed patients to online cancer information without context of needs

· Underrepresentation of older and female patients

III

Wiecha (2015)

Social cognitive theory and eHealth theoretical models

· Digital applications have potential to support multiple aspects of health care and health behavior

· Prospective randomized pilot trial

· Subjects assigned to one of three groups control with two separate levels of online intervention

· Strong design

· Randomization

· Small sample size limited statistical power

· Consolidation of intervention groups resulting in asymmetrical groups

III

Fraval (2015)

Patient education/ information

(empowerment)

· Patient knowledge improved with website use

· Randomized controlled trial

· Large sample

· Multiple clinical sites

· Lack of longitudinal follow up.

II

Ganier (2014)

Learning transfer theory

· Performance was the same with virtual and live group training

· Randomized controlled trial

· Randomized distribution of participants

· Training of control group done as group, virtual training done individually

· Limited sample size

IV

Bernardino (2015)

(Spanish)

Patient self care – (empowerment)

· Patients who participated in the video group had better knowledge of self care

· Prospective randomized multicenter trial

· Study design

· Sample size

· Author bias – same author created video and questionnaire –

· Timing of questionnaire completion

· Only knowledge measured – no functional outcomes

· Questionnaire not validated

II

Tuong (2015)

Patient self care – (empowerment)

· Internet based patient education appears to be effective

· Increasing interactivity enhances effectiveness of patient education.

· Randomized trial – 1:1 randomization to standard website group or automated counseling group

· Strong design

· Only involved adolescents

· Repeat access to site was self reported

· Questionnaire not validated

II

Step 2: Briefly summarize the history and purpose of your research question.

The mechanical circulatory support (MCS) field began in the mid-1990's with the first FDA approval of a ventricular assist device (VAD). Those devices were large and required the patient to stay in the hospital while waiting for a cardiac transplant. By 2001 the first devices were portable enough to allow patient discharge from the hospital. Patient education surrounding MCS device therapy has been largely dictated by the manufacturers with adjustments for institutional practices, but very little research has been conducted related to patient education, training, and retraining. Patients are required to maintain a minimal level of competency to perform emergency procedures should their device malfunction. These skills are taught at implant but rarely reviewed in follow-up clinic visits. Other fields have used virtual or online training as a successful means of patient teaching reporting a higher recall of subject matter with participation in online training (Tuong, 2015, Bernardino, 2015, Fraval 2015, Song 2009). Creation of an online training module to reinforce emergency procedures related to MCS self-care should help to fill this practice gap, giving patients a monitored review of lifesaving MCS skills.

Step 3: Analysis of strengths and weaknesses of existing literature.

Strengths

Weaknesses

Multiple disciplines with similar outcomes.

No research involving MCS technology.

Patient empowerment is an underlying trend in theory base.

Un-validated questionnaires

Randomized interventions.

Lack of longitudinal follow up

Limited sample sizes

Step 4: What gap exists in the current literature? Explain.

The current literature regarding MCS education and re-education is non-existent. The entire realm of what and how MCS patients are taught and learn has not been systematically described or explored through research. Training of patients and caregivers between institutions is inconsistent with some centers providing written material developed by the manufacturers, some providing written material adapted from the manufacturers, and some using video to help aid in training. The most consistent method of teaching is using a hands-on approach to practice connections and expose patients and caregivers to alarms. There are a few anecdotal descriptions of single institutional training methods in the literature, but no investigation as to most effective means for providing training. Research needs to be done to determine content, timing, and methods of instruction as well as optimal ways of providing retraining for maintaining skills related to emergency procedures for MCS devices.

Part IV: Identify the influence of empiricism on quantitative research methodology. Discuss its applicability to evidenced-based practice projects.

Empiricism has had a major influence on quantitative research methodology. Empirical methods allow researchers to break down questions into small bytes of knowledge that can be studied individually (McEwen & Wills, 2014). Extraneous variables are controlled by isolating the research subject and manipulating one variable to determine the effect of the intervention (McEwen & Wills, 2014). Empirical research does not consider phenomena within the context of its environment. Not all research questions can be looked at from an empirical perspective, especially those that involve human subjects. There is variation in human nature and humans, and their environments are actively integrated. Therefore, research surrounding human phenomena has to take into account the environment in which they are a part. Study design must allow for those variations. Evidence-based research revolves around human interventions and human phenomena. Some things can be controlled, but removing all extraneous influences is impossible. Removal of the subject from its environment can bias study results as well (McEwen & Wills, 2014). It is for that reason an empirical methodology is not adequate when doing evidenced based research. Research involving mixed methods incorporating quantitative and qualitative aspects can help to characterize evidence-based research in a more accurate dimension (McEwin & Wills, 2014).

References

Attai, D. J., Cowher, M. S., Al-Hamadani, M., Schoger, J. M., Staley, A. C., & Landercasper, J. (2015). Twitter Social Media is an Effective Tool for Breast Cancer Patient Education and Support: Patient-Reported Outcomes by Survey. Journal of Medical Internet Research, 17(7), e188.

Bol, N., Smets, E., Eddes, E., DeHaes, J., Loos, E., Van Weert, J. (2015). Illustrations enhance older colorectal cancer patients’ website satisfaction and recall of online cancer information. European journal of cancer care, 24, 213-223.

Calvillo, J., Román, I., & Roa, L. M. (2015). lHealth Expectations: An International Journal of Public Participation in Health Care and Health Policy, 18(5), 643–652.

Cooper, H., Cooper, J., & Milton, B. (2009). Technology-based approaches to patient education for young people living with diabetes: a systematic literature review. Pediatric Diabetes, 10(7), 474–483.

Elkins, M. Y. (2010). Using PICO and the brief report to answer clinical questions. Nursing, 40(4), 59-60.

Fraval, A., Chandrananth, J., Chong, Y., Tran, P., Coventry, L. (2015). Internet based patient education improves informed consent for elective orthopaedic surgery: a randomized controlled trial. BMC Musculoskeletal disorders, 16:14. DOI 10.1186/s12891-015-0466-9.

Ganier, F., Hoareau, C., & Tisseau, J. (2014). Evaluation of procedural learning transfer from a virtual environment to a real situation: a case study on tank maintenance training. Ergonomics, 57(6), 828–843.

McEwin, M., & Wills, E.M. (2014). Theoretical basis for nursing. (4th. ed.). Philadelphia, PA: Wolters Kluwer Health.

Molano Bernardino, C., Maestro Fernández, A., Seijas Vázquez, R., Cintado Avilés, M., Edelaar, P., & Pérez Carro, L. (2015/8). Eficacia de Internet audiovisual para educación de pacientes con artroscopia de rodilla. Revista Española de Artroscopia Y Cirugía Articular, 22(2), 85–92.

Rose, F. D., Attree, E. A., Brooks, B. M., Parslow, D. M., Penn, P. R., & Ambihaipahan, N. (2000). Training in virtual environments: transfer to real world tasks and equivalence to real task training. Ergonomics, 43(4), 494–511.

Song, M., Choe, M.-A., Kim, K. S., Yi, M. S., Lee, I., Kim, J., … Shim, Y. S. (2009). An evaluation of Web-based education as an alternative to group lectures for diabetes self-management. Nursing & Health Sciences, 11(3), 277–284.

Schnetter, V. A., Lacy, D., Jones, M. M., Bakrim, K., Allen, P. E., & O’Neal, C. (2014). Course development for web-based nursing education programs. Nurse Education in Practice, 14(6), 635–640.

Tuong, W., Wang, A. S., & Armstrong, A. W. (2015). Comparing the effectiveness of automated online counseling to standard web-based education on improving acne knowledge: a randomized controlled trial. American Journal of Clinical Dermatology, 16(1), 55–60.

Wiecha, J., Adams, W., Rybin, D., Rizzodepaoli, M., Keller, J., Clay, J. (2015). Evaluation of a web-based asthma self management system: a randomized controlled pilot trial. BMC Pulmonary medicine, 15:17. DOI: 10.1186/s12890-015-0007-1