title: 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.
abstract: 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.
  
  
  CONCLUSIONS
  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.
  
  
  CONCLUSIONS
  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.
authors.forename: Anab R
authors.initials: AR
authors.lastname: Lehr
authors.forename: Martha L
authors.initials: ML
authors.lastname: McKinney
authors.forename: Serge
authors.initials: S
authors.lastname: Gouin
authors.forename: Jean-Guy
authors.initials: JG
authors.lastname: Blais
authors.forename: Martin V
authors.initials: MV
authors.lastname: Pusic
authors.forename: Francine M
authors.initials: FM
authors.lastname: Ducharme
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D016390:Allied Health Occupations / Q000193:education*; D001249:Asthma / Q000175:diagnosis*; D001296:Audiovisual Aids; D002170:Canada; D002648:Child; D002675:Child, Preschool; D002983:Clinical Competence; D003194:Computer-Assisted Instruction / Q000379:methods*; D004501:Education, Medical / Q000379:methods*; D004509:Education, Nursing, Continuing / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D059032:Learning Curve; D008297:Male; D010865:Pilot Projects; D011594:Psychometrics; D012720:Severity of Illness Index
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