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spatial and temporal gait parameters of people with Alzheimer's disease. Gait & Posture 2008; 28: 392–396. Hauer K, Oster P. Measuring functional performance in persons with dementia. Journal of the American Geriatrics Society 2008; 56: 949– 950. Iersel M, Benraad C, Rikkert M. Validity and reliability of quantitative gait analysis in geriatric patients with and without Dementia. Journal of the American Geriatrics Society 2007; 55: 632–634.
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Blankevoort CG, van Heuvelen MJ, Scherder EJ. Reliability of six physical performance tests in older people with dementia. Physical Therapy 2012; 93: 69–78. Wilkins CH, Roe CM, Morris JC. A brief clinical tool to assess physical function: The mini-physical performance test. Archives of Gerontology and Geriatrics 2010; 50: 96–100.
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Evaluation of a blended learning model in geriatric medicine: The need to delve more deeply Dear Editor, Duque et al. deserve high praise for presenting the results of a fascinating evaluation of a blended learning innovation in geriatric medicine for medical students [1]. The inexorable rise in the number of older people in nearly all countries means that education of students and health-care professionals in the essentials of good geriatrics care will be ever more important. The investigators have demonstrated the broad effectiveness of their solution but what other conclusions if any can we draw from their results? Certainly, we know that the students liked the innovation and that the innovation seemed to have a statistically significant effect on their knowledge levels. But the increase in knowledge level was short term – we really don’t know whether the increase was sustained (nor do we know whether the knowledge increase was of applied knowledge that might be useful to students’ future practice or whether it was of academic knowledge). It may have been the learning intervention that caused the increase from pretest to post-test but may equally have been the cueing effect of the pretest itself – a phenomenon that is well described in the literature [2]. An even more important question is whether the intervention might have made a difference to the learners’ long-term practice – in this regard, a follow-up study might be worthwhile. Blended learning solutions are likely to be an important method of education for the future – but a downside of this
Australasian Journal on Ageing, Vol 32 No 4 December 2013, 247–249 © 2013 ACOTA
methodology is that it can be difficult to find out exactly what component within the ‘black box’ of the blended learning made the actual difference to the students. A follow-up study that looked at this as well may be worthwhile. The follow-up study might find that actually there was no single component within the educational intervention that made a difference and that it truly was the ‘blend’ that made the difference – but this finding in itself would be useful. Some might call for a randomised controlled trial of this educational intervention comparing it to an alternative intervention or indeed to no intervention, but randomised controlled trials in education are not as straightforward as those in clinical medicine and do not always yield useful or usable results. A secondary cost analysis of the intervention might be more helpful and might ultimately tell us whether the intervention was cost-effective as well as effective. Kieran Walsh BMJ Learning, BMJ Publishing Group, London, UK
References 1 2
Duque G, Demontiero O, Whereat S et al. Evaluation of a blended learning model in geriatric medicine: A successful learning experience for medical students. Australasian Journal on Ageing 2013; 32: 103–109. Norman G, Eva K. Quantitative research methods in medical education. In: Swanwick T, ed. Understanding Medical Education. Chichester: Wiley Blackwell, 2007: 301–322.
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spatial and temporal gait parameters of people with Alzheimer's disease. Gait & Posture 2008; 28: 392–396. Hauer K, Oster P. Measuring functional performance in persons with dementia. Journal of the American Geriatrics Society 2008; 56: 949– 950. Iersel M, Benraad C, Rikkert M. Validity and reliability of quantitative gait analysis in geriatric patients with and without Dementia. Journal of the American Geriatrics Society 2007; 55: 632–634.
10 11
t o
t h e
E d i t o r
Blankevoort CG, van Heuvelen MJ, Scherder EJ. Reliability of six physical performance tests in older people with dementia. Physical Therapy 2012; 93: 69–78. Wilkins CH, Roe CM, Morris JC. A brief clinical tool to assess physical function: The mini-physical performance test. Archives of Gerontology and Geriatrics 2010; 50: 96–100.
bs_bs_banner
Evaluation of a blended learning model in geriatric medicine: The need to delve more deeply Dear Editor, Duque et al. deserve high praise for presenting the results of a fascinating evaluation of a blended learning innovation in geriatric medicine for medical students [1]. The inexorable rise in the number of older people in nearly all countries means that education of students and health-care professionals in the essentials of good geriatrics care will be ever more important. The investigators have demonstrated the broad effectiveness of their solution but what other conclusions if any can we draw from their results? Certainly, we know that the students liked the innovation and that the innovation seemed to have a statistically significant effect on their knowledge levels. But the increase in knowledge level was short term – we really don’t know whether the increase was sustained (nor do we know whether the knowledge increase was of applied knowledge that might be useful to students’ future practice or whether it was of academic knowledge). It may have been the learning intervention that caused the increase from pretest to post-test but may equally have been the cueing effect of the pretest itself – a phenomenon that is well described in the literature [2]. An even more important question is whether the intervention might have made a difference to the learners’ long-term practice – in this regard, a follow-up study might be worthwhile. Blended learning solutions are likely to be an important method of education for the future – but a downside of this
Australasian Journal on Ageing, Vol 32 No 4 December 2013, 247–249 © 2013 ACOTA
methodology is that it can be difficult to find out exactly what component within the ‘black box’ of the blended learning made the actual difference to the students. A follow-up study that looked at this as well may be worthwhile. The follow-up study might find that actually there was no single component within the educational intervention that made a difference and that it truly was the ‘blend’ that made the difference – but this finding in itself would be useful. Some might call for a randomised controlled trial of this educational intervention comparing it to an alternative intervention or indeed to no intervention, but randomised controlled trials in education are not as straightforward as those in clinical medicine and do not always yield useful or usable results. A secondary cost analysis of the intervention might be more helpful and might ultimately tell us whether the intervention was cost-effective as well as effective. Kieran Walsh BMJ Learning, BMJ Publishing Group, London, UK
References 1 2
Duque G, Demontiero O, Whereat S et al. Evaluation of a blended learning model in geriatric medicine: A successful learning experience for medical students. Australasian Journal on Ageing 2013; 32: 103–109. Norman G, Eva K. Quantitative research methods in medical education. In: Swanwick T, ed. Understanding Medical Education. Chichester: Wiley Blackwell, 2007: 301–322.
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