Abstract
The International Interdisciplinary Wound Care Course at the University of Toronto was designed to emphasise interdisciplinary collaboration, examine the evidence base and develop wound care opinion leaders across Canada and internationally. There is a need to translate the new wound care evidence base for diagnosis and treatment into patient care and ultimately improve patient outcomes.
Keywords: Wound care education, International, Interdisciplinary, Canada
Course description
This 8‐month longitudinal certificate course is designed to train opinion leaders and improve patient care. It consists of two 4‐day residential weekends, nine self‐study modules and a selective related to each registrant's day‐to‐day activities. The International Interdisciplinary Wound Care Course (IIWCC) is founded on principles of adult education, interdisciplinary collaboration and evidence‐based medicine and focuses on the re‐education of wound care specialists as opinion leaders in an attempt to improve health care outcomes and patient wellness.
Major purpose
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To provide comprehensive educational experience for wound care specialists
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To translate new knowledge into practice
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To create partnerships and provide resources for improved wound care
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To optimise interdisciplinary wound care for enhanced patient outcomes
Target audience
This programme is designed for wound care specialists with some prior training and experience. Our objective is to recruit a mix of physicians, nurses, enterostomal therapists, occupational therapists, foot care specialists and other health care professionals working in therapeutic area or in related industry.
Objectives
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To assess and critically review wound care literature in key subject areas.
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To integrate wound care principles by a self‐directed learning programme formulated with a learning contract.
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To demonstrate the application of best practices by developing a selective related to the student's everyday activities.
Demographics
The course demographics have changed from year to year. Over the 4 years, we have seen varied professions (Table 1) from a variety of geographical regions across both Canada and the world (Table 2).
Table 1.
Composition of International Interdisciplinary Wound Care Course by profession
| Profession | 1999–2000 | 2000–2001 | 2001–2002 | 2002–2003 |
|---|---|---|---|---|
| Physicians | 6 | 5 | 12 | 6 |
| Podiatrist/chiropodist | 7 | 6 | 1 | 5 |
| Nurses – acute care facilities | 16 | 11 | 13 | 19 |
| Nurses – community care | 25 | 13 | 18 | 13 |
| Nurses – long‐term care facilities | 3 | 4 | 6 | 6 |
| Nurse practitioner | 1 | 1 | 7 | 8 |
| Nurse educator | — | — | 2 | 3 |
| Enterostomal therapist | 1 | 1 | 2 | 2 |
| Occupational therapist | 1 | 1 | 1 | 4 |
| Physical therapist | — | — | 2 | 3 |
| Medical technician | — | — | 2 | — |
| Industry (nurses) | 12 | 4 | 8 | 7 |
| Industry (other) | 8 | 4 | 2 | 1 |
| Self‐employed nurse | — | — | — | 1 |
| Government | — | — | — | 1 |
| Pharmacist | — | — | — | 1 |
Enrolment in year 1999–2000 was 80; enrolment in year 2000–2001 was 50; enrolment in year 2001–2002 was 76; enrolment in year 2002–2003 was 81.
Table 2.
Composition of International Interdisciplinary Wound Care Course by geographic area
| 1999–2000 | 2000–2001 | 2001–2002 | 2002–2003 | |
|---|---|---|---|---|
| In Canada | ||||
| Maritimes | 3 | 2 | 2 | 2 |
| Quebec | 6 | 2 | 5 | 1 |
| Central and southern Ontario | 19 | 16 | 14 | 29 |
| Toronto and suburbs | 30 | 19 | 19 | 19 |
| Eastern Ontario | 4 | 2 | 4 | 2 |
| Northern Ontario | 2 | 1 | 1 | 1 |
| Northwestern Ontario | 2 | 1 | — | 7 |
| Prairies | 4 | 2 | 4 | 3 |
| Alberta | 5 | 1 | 8 | 6 |
| British Columbia | 3 | 1 | 11 | 3 |
| Yukon and Northwest Territories | — | 2 | — | — |
| Outside Canada | ||||
| USA | 1 | 1 | 5 | 3 |
| South Korea | 1 | — | — | — |
| Belgium | — | — | 1 | — |
| United Kingdom | — | — | 1 | — |
| Italy | — | — | 1 | — |
| Australia | — | — | — | 1 |
| Singapore | — | — | — | 1 |
| Switzerland | — | — | — | 1 |
| Venezuela | — | — | — | 1 |
| Taiwan | — | — | — | 1 |
Self‐study modules
The module readings were initially selected by a team of international and national wound care experts. This formed the framework for a revision of a major textbook on wound care to meet the students' needs.
Chronic Wound Care: A Clinical Source Book for Healthcare Professionals, Third Edition, 2001, was coedited by Diane L Krasner, PhD, RN, CWOCN, CWS, FAAN, George T Rodeheaver, PhD, and R Gary Sibbald, BSc MD, FRCPC (Medical/Derm), MACP, DABD. There are contributions from 110 expert authors around the world. The textbook is organised into the nine self‐study modules and is supplemented by major studies or reviews from the literature in each topic area.
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1
State of Science, Art and Education
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2
Holistic Patient Care: Prevention, Pain and Quality of Life
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Healthcare Delivery
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Local Wound Care
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Infection, Preparing the Wound Bed and Adjunctive Therapies
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Leg Ulcers – Venous, Arterial and Others
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Diabetic Foot Ulcers
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Pressure Ulcers
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Non Healing Chronic Wounds
Course outcomes analysis
Quantitative
Attendees participated in pre and post tests (first/second residential weekends) via Touchpad Technology provided through an unrestricted educational grant from 3M Canada. Questions were designed to identify knowledge gained from the self‐study modules.
1, 2 demonstrate how our student's ability to identify and diagnose wound types and also to choose appropriate treatments improves during the course.
Figure 1.
Students' ability to determine correct dressing for various wounds.
Figure 2.
Students' ability to diagnose various types of wound.
Qualitative
Attendees participated in a 15‐minute exit interview.
The major themes explored were:
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benefits of residential weekends and modules;
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factors influencing choice of selective and selective accomplishments;
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most positive and negative aspects of the course;
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barriers to course implementation.
Table 3 provides insight into the important benefits and accomplishments our students obtain from the course.
Table 3.
Exit interview outcomes
| Benefits of the residential weekend | |
| Rating | Benefit |
| 1 | Networking |
| 2 | Sharing and exchanging information with other students |
| 3 | Obtaining expert opinions from faculty |
| Benefits of the self‐study modules | |
| Rating | Benefit |
| 1 | Wealth of current information |
| 2 | Pre‐selection of articles |
| 3 | Critical thinking |
| 4 | Self‐directed and flexible adult learning |
| 5 | Facilitated application to practice |
| Selective accomplishments | |
| Rating | Accomplishment |
| 1 | Educate |
| 2 | Promote change in the workplace |
| 3 | Establish specialised clinic, wound care programme or interdisciplinary team |
| 4 | Increase personal knowledge |
| Most positive aspect of course | |
| Rating | Positive aspect |
| 1 | Learning new information about current wound care practices |
| 2 | Networking |
| 3 | Knowledgeable and enthusiastic faculty |
| 4 | Interacting with colleagues |
Evolution to master's programme
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Master's of Healthcare (Wound Healing)
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Total of ten courses or a major research project as 1–2 credit equivalent
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Two courses from residential weekends and module completion
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Selective may substitute for self‐study course or part of major research project
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Other courses from public health, education, epidemiology, etc.
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Two courses selected as electives and may include programmes at universities around the world.
Conclusions
The IIWCC is an example of a continuing education programme designed to:
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provide longitudinal educational framework;
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utilise residential weekend structure and self‐study to train health care professionals living long distances from the training centre and allowing them to continue full‐time employment;
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provide a certificate of completion from the University of Toronto instead of a certificate of attendance;
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allow for interdisciplinary focus and international networking;
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empower individuals to become opinion leaders and interpret their new knowledge for their current work community (selective).
The re‐education of health care professionals to improve health care outcomes must be accomplished with knowledge, coexisting skill development and attitudinal change. Key elements include knowledgeable and enthusiastic faculty, networking and empowerment.
Acknowledgement
We acknowledge the support of the Ballard Foundation in the establishment and development of this course.