Epilepsy Across the Spectrum Promoting Health and Understanding (2012) / Chapter Skim
Currently Skimming:
5 Health Professional Education
5 Health Professional Education
Pages 231-268
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From page 231... ...
Negative perceptions of people with epilepsy among health professionals contribute to stigma and can affect quality of care. Epilepsy centers and epilepsy advocacy organizations can -- and often do -- play a major role in supporting professional education programs.
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From page 232... ...
Therefore, this chapter focuses on how education and training could be improved broadly, across all professions involved in caring for people with epilepsy, rather than focusing on specific professions or educational opportunities, except to describe a few illustrative programs and knowledge gaps. The committee's vision for the education of health professionals about epilepsy would culminate in a workforce that has been taught and trained in multidisciplinary settings to provide high-quality, coordinated, and patient
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–Susan Farber Through its work the committee identified three areas with documented knowledge gaps in epilepsy care: providing primary care, treating comorbidities, and responding to the specific needs of women. The testimony provided to the committee during its deliberations by people with epilepsy and their families suggests additional gaps in knowledge, including areas related to accurate diagnoses, new treatment options, the risks of sudden unexpected death in epilepsy (SUDEP)
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. In the United States, high-quality primary care is essential for people with epilepsy, inasmuch as only 17 percent of those with new-onset epilepsy see a neurologist, and primary care physicians provide most of the day-to-day care and treatment for about 40 percent of epilepsy patients (Fountain et al., 2011; Montouris, 2000)
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Family Practice Curriculum in Neurology is the result of collaborations between neurology and family practice faculty that aims to provide family care physicians with knowledge about common neurological conditions. The curriculum was designed for medical students, residents, and practicing physicians and includes information and case studies on seizures and epilepsy (AAN, 2011)
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used a modular education program that included videos and was delivered via CD-ROM. The program significantly improved seizure recognition and classification skills among pediatric residents, nurses, and electroencephalography (EEG)
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Few studies have examined health professionals' knowledge about comorbidities of epilepsy and their specific educational needs. However, common concerns voiced among neurologists and epileptologists caring for both children and adults with epilepsy are that they are not confident in assessing and diagnosing common comorbid mental health conditions and that few mental health specialists are available and both willing and well
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From page 238... ...
Apparently, despite the demonstrated educational needs and concerns of health professionals, few efforts have been made to develop corresponding educational programs or resources. Developing creative ways to encourage and incentivize health 1 Of those psychiatrists surveyed, 95 percent had worked with people with epilepsy and men tal disorders previously and 48 percent frequently work with epilepsy patients with comorbid mental health conditions (Marchetti et al., 2004)
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From page 239... ...
However, little information is available on how often existing guidelines are followed or what role they play in educating health professionals. A survey was conducted in 1998 by the Epilepsy Foundation to assess the knowledge and awareness of health professionals involved in the care of women with epilepsy following the release of practice guidelines for providing care for women with epilepsy by the AAN and the American College of Obstetricians and Gynecologists.
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–Paula Apodaca Effective epilepsy care requires a productive and positive relationship and effective communication among health care providers and patients and their families. Negative attitudes and beliefs about people with epilepsy that may exist among some health professionals can perpetuate stigma and negatively affect quality of care.
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. As mentioned above, some health professionals in the epilepsy field may also be concerned about the nature of the care provided to people with epilepsy by other health professionals, which can negatively affect the interface among primary care, mental health, and neurology professionals (Hayes et al., 2007; Sweetnam, 2011)
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It offers opportunities to improve and expand the reach of epilepsy educational information and programs, not only for health professionals, but also for individuals with epilepsy and their families (Chapter 7) as well as the public (Chapter 8)
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To date, the effectiveness of these types of resources in educating health professionals and how frequently they are used by those within and outside of the epilepsy field have not been systematically assessed. Existing online educational resources should be evaluated, kept up to date, and tested for reproducibility across different 3 See www.aesnet.org.
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From page 244... ...
Simulation One teaching strategy being deployed in many health professional education and training programs is the use of simulation, often involving high-fidelity mannequins.8 Simulation allows students to practice skills in a safe environment where they can make and learn from mistakes without endangering patients. Simulation can provide students with opportunities to practice decision making and prioritization; communication, collaboration, and conflict resolution; and delegation and role clarification (Deering et al., 2011; IOM, 2010b)
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that necessitate immediate and appropriate response from the health care team. High-fidelity simulation offers a unique opportunity to improve epilepsy education for health professionals, promote interdisciplinary education and collaboration, and ultimately improve quality of care.
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. However, some efforts are being made across the health professional education continuum in the United States to ensure the adequacy and availability of epilepsy-specific education; this section highlights a few of these models and approaches, most of which have focused on the physician workforce.
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These studies highlighted the importance of ongoing and continuous education about the epilepsies, the use of video and expert commentary in educational efforts, and the need for monitoring and evaluation of educational opportunities to determine efficacy and best teaching practices. Residency and fellowship programs for the range of physician specialties, and clinical rotations and preceptor programs for advanced practice registered nurses and physician assistants, offer additional opportunities for improving epilepsy education.
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In literature about the experiences of individual neurology residents, observations have indicated that these programs tend to focus on less prevalent neurological conditions in acute care settings rather than on more common neurological diseases and disorders, including epilepsy, that are predominant in outpatient care (Ances, 2011; D'Esposito, 1995; Moore and Chalk, 2005)
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Epileptologists, neurologists, and other health professionals involved in the care of people with epilepsy have benefited from the J Kiffin Penry Epilepsy Education Programs, developed almost three decades ago.
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CONTINUING EDUCATION CE is critical to a well-educated health care workforce and essential for keeping health professionals' knowledge and competencies up to date and abreast of advances in research, diagnosis, treatments, technology, and approaches to caring for patients with epilepsy. CE also offers an op
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2) and that "the science underpinning CE for health professionals is fragmented and underdeveloped" (p.
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for health professionals around the world. The sessions at these meetings range from lectures and poster presentations to interactive workshops and debates.
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Online epilepsy education programs should be evaluated for their suitability as models for a range of health professionals, such as other types of nurses, counselors, and direct care workers, and more broadly for others who interact with people with epilepsy, including teachers, day care workers, coaches, and social workers (Chapter 6)
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. In order to extend educational opportunities for health professionals globally, the ILAE in 2004 developed a distance-learning program called VIREPA (the Virtual Epilepsy Academy)
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Programs such as the one offered through the Epilepsy Foundation are necessary to ensure high-quality, safe emergency services for people with epilepsy. ROLE OF EPILEPSY ORGANIZATIONS AND CENTERS Epilepsy Organizations The AES, ILAE, Epilepsy Foundation, and ETP each play a vital role in educating health professionals, as described previously.
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and could be useful to medical students, residents, and practicing health professionals alike. However, the program consists of static slide sets that can be downloaded and reviewed by the user and is not interactive.
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Although the last webinar was hosted in 2009, the manuscripts and audio files are archived and available on the AES website.13 It appears that this program was among the few designed specifically for nurses and other nonphysicians, and the AES may be able to fill some of the remaining gap through the nurse-focused content being developed for the Epilepsy Education Program, above. In recent years, the AES has attempted to develop more interactive educational opportunities.
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. Despite promulgating professional education as a goal for epilepsy centers, the NAEC has not collected data from epilepsy centers about the actual educational opportunities they offer (Personal communication, E
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Significant opportunities exist for epilepsy centers not only to play a role in educating health professionals within the centers, but also to develop partnerships and educational opportunities for other health professionals in the communities and regions where they are located. The NAEC guidelines say that "comprehensive epilepsy center personnel [should]
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. Therefore, it is critically important that health professionals provide patients and their families with written information about their specific seizure type, epilepsy syndrome, and treatment plan to augment discussions that happen in the clinical setting.
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. • Ideally, epilepsy education programs would be evidence-based, with content designed to meet providers' needs and fill identified knowledge gaps; programs would be delivered in ways most likely to improve practice; and effective incentive systems would encour age participation by a wide range of health professionals.
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Throughout this chapter, the committee has provided the basis for its research priorities and recommendations regarding improvements needed in epilepsy education for health professionals that are detailed in Chapter 9. In order to improve epilepsy education for health professionals, additional research and time needs to be devoted to
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2011b. Epilepsy Education Program.
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1993. Epilepsy education in medical schools: Report of the American Epilepsy Society Committee on Medical Student Education.
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2007. Training the trainers and disseminating information: A strategy to educate health professionals on epilepsy.
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The J Kiffin Penry Epilepsy Education Programs and MiniFellow Network.
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2007. Training medical students to improve the management of people with epilepsy.
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2007. Basic knowledge of epilepsy among medical students.
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