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Randomized Controlled Trial
. 2015 Jan 5;17(1):e3.
doi: 10.2196/jmir.3344.

Development and assessment of an e-learning course on breast imaging for radiographers: a stratified randomized controlled trial

Inês C Moreira  1 , Sandra Rua Ventura, Isabel Ramos, Pedro Pereira Rodrigues
Affiliations
Randomized Controlled Trial

Development and assessment of an e-learning course on breast imaging for radiographers: a stratified randomized controlled trial

Inês C Moreira et al. J Med Internet Res. .

Abstract

Background: Mammography is considered the best imaging technique for breast cancer screening, and the radiographer plays an important role in its performance. Therefore, continuing education is critical to improving the performance of these professionals and thus providing better health care services.

Objective: Our goal was to develop an e-learning course on breast imaging for radiographers, assessing its efficacy, effectiveness, and user satisfaction.

Methods: A stratified randomized controlled trial was performed with radiographers and radiology students who already had mammography training, using pre- and post-knowledge tests, and satisfaction questionnaires. The primary outcome was the improvement in test results (percentage of correct answers), using intention-to-treat and per-protocol analysis.

Results: A total of 54 participants were assigned to the intervention (20 students plus 34 radiographers) with 53 controls (19+34). The intervention was completed by 40 participants (11+29), with 4 (2+2) discontinued interventions, and 10 (7+3) lost to follow-up. Differences in the primary outcome were found between intervention and control: 21 versus 4 percentage points (pp), P<.001. Stratified analysis showed effect in radiographers (23 pp vs 4 pp; P=.004) but was unclear in students (18 pp vs 5 pp; P=.098). Nonetheless, differences in students' posttest results were found (88% vs 63%; P=.003), which were absent in pretest (63% vs 63%; P=.106). The per-protocol analysis showed a higher effect (26 pp vs 2 pp; P<.001), both in students (25 pp vs 3 pp; P=.004) and radiographers (27 pp vs 2 pp; P<.001). Overall, 85% were satisfied with the course, and 88% considered it successful.

Conclusions: This e-learning course is effective, especially for radiographers, which highlights the need for continuing education.

Keywords: breast neoplasms; continuing education; distance learning; evaluation studies; mammography.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Study design and post-implementation duration: numbers in boxes represent number of participants; numbers in arrows correspond to the elapsed time in days (maximum, average) at each phase.
Figure 2
Figure 2
Screenshot of a Prezi presentation in the e-learning course.
Figure 3
Figure 3
Screenshot of mammography views in the e-learning course.
Figure 4
Figure 4
Screenshot of mammography views and schemes in the e-learning course.
Figure 5
Figure 5
Screenshot of one of the four self-assessment tests included in the e-learning course.
Figure 6
Figure 6
Participant flow diagram showing enrolled sample and respective dropouts. Individuals who did not answer the participation request were considered "lost to follow-up"; participants who did not finish the course were considered “discontinued intervention”.
Figure 7
Figure 7
Improvement stratified by professional status. Left plot (intention-to-treat): Inconclusive result for students but clear effect for radiographers. Right plot (per-protocol): Clear effect for both students and radiographers.
See this image and copyright information in PMC

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