title: The Impact of E-Learning on Adherence to Guidelines for Acute Gastroenteritis: A Single-Arm Intervention Study.
abstract: OBJECTIVE
  E-learning is a candidate tool for clinical practice guidelines (CPG) implementation due to its versatility, universal access and low costs. We aimed to assess the impact of a five-module e-learning course about CPG for acute gastroenteritis (AGE) on physicians' knowledge and clinical practice.
  
  
  METHODS
  This work was conceived as a pre/post single-arm intervention study. Physicians from 11 European countries registered for the online course. Personal data, pre- and post-course questionnaires and clinical data about 3 to 5 children with AGE managed by each physician before and after the course were collected. Primary outcome measures included the proportion of participants fully adherent to CPG and number of patients managed with full adherence.
  
  
  RESULTS
  Among the 149 physicians who signed up for the e-learning course, 59 took the course and reported on their case management of 519 children <5 years of age who were referred to their practice because of AGE (281 and 264 children seen before and after the course, respectively). The course improved knowledge scores (pre-course 8.6 ± 2.7 versus post-course 12.8 ± 2.1, P < 0.001), average adherence (from 87.0 ± 7.7% to 90.6 ± 7.1%, P = 0.001) and the number of patients managed in full adherence with the guidelines (from 33.6 ± 31.7% to 43.9 ± 36.1%, P = 0.037).
  
  
  CONCLUSIONS
  E-learning is effective in increasing knowledge and improving clinical practice in paediatric AGE and is an effective tool for implementing clinical practice guidelines.
authors.affiliation: Department of Translational Medical Science, Sector of Pediatrics. University Federico II, Naples, Italy; Paediatric Hepatology Gastroenterology and Transplantation Unit, Hospital Papa Giovanni XXIII, Bergamo, Italy.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Nicastro
authors.affiliation: Department of Translational Medical Science, Sector of Pediatrics. University Federico II, Naples, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Lo Vecchio
authors.affiliation: Department of Translational Medical Science, Sector of Pediatrics. University Federico II, Naples, Italy.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Liguoro
authors.affiliation: Department of Pediatrics, The Medical University of Warsaw, Warsaw, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Chmielewska
authors.affiliation: Universitair Ziekenhuis Brussel Kinderen, Vrije Universiteit Brussel, Brussels, Belgium.
authors.forename: Caroline
authors.initials: C
authors.lastname: De Bruyn
authors.affiliation: University Medical Centre, Maribor, Slovenia.
authors.forename: Jernej
authors.initials: J
authors.lastname: Dolinsek
authors.affiliation: Russian Medical Postgraduate Academy, Moscow, Russian Federation.
authors.forename: Elena
authors.initials: E
authors.lastname: Doroshina
authors.affiliation: Third Department of Pediatrics of University of Athens, Greece.
authors.forename: Smaragdi
authors.initials: S
authors.lastname: Fessatou
authors.affiliation: 2nd Pediatric Clinic, Iuliu Haţieganu, University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Tudor Lucian
authors.initials: TL
authors.lastname: Pop
authors.affiliation: Dr. von Hauner Children's Hospital, University of Munich Medical Center, Munich, Germany.
authors.forename: Christine
authors.initials: C
authors.lastname: Prell
authors.affiliation: Emma's Children's Hospital Academic Medical Centre, Amsterdam, Netherlands.
authors.forename: Merit Monique
authors.initials: MM
authors.lastname: Tabbers
authors.affiliation: Department of Pediatrics, Hospital Sao Joao, Porto, Portugal.
authors.forename: Marta
authors.initials: M
authors.lastname: Tavares
authors.affiliation: Department of Pediatrics, Marmara University, Istanbul, Turkey.
authors.forename: Pinar
authors.initials: P
authors.lastname: Urenden-Elicin
authors.affiliation: Department of Public Health, University of Naples "Federico II," Italy.
authors.forename: Dario
authors.initials: D
authors.lastname: Bruzzese
authors.affiliation: Russian Medical Postgraduate Academy, Moscow, Russian Federation.
authors.forename: Irina
authors.initials: I
authors.lastname: Zakharova
authors.affiliation: Department of Paediatric Gastroenterology, Bristol Royal Hospital for Children, Bristol, United Kingdom.
authors.forename: Bhupinder
authors.initials: B
authors.lastname: Sandhu
authors.affiliation: Department of Translational Medical Science, Sector of Pediatrics. University Federico II, Naples, Italy.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Guarino
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D002675:Child, Preschool; D004502:Education, Medical, Continuing / Q000379:methods*; D005260:Female; D005759:Gastroenteritis / Q000628:therapy*; D019983:Guideline Adherence; D006801:Humans; D007223:Infant; D007858:Learning; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic