Evaluation of an integrated system for classification, assessment and comparison of services for long-term care in Europe: the eDESDE-LTC study

Background: The harmonization of European health systems brings with it a need for tools to allow the standardized collection of information about medical care. A common coding system and standards for the description of services are needed to allow local data to be incorporated into evidence-informed policy, and to permit equity and mobility to be assessed. The aim of this project has been to design such a classification and a related tool for the coding of services for Long Term Care (DESDE-LTC), based on the European Service Mapping Schedule (ESMS). Methods: The development of DESDE-LTC followed an iterative process using nominal groups in 6 European countries. 54 researchers and stakeholders in health and social services contributed to this process. In order to classify services, we use the minimal organization unit or “Basic Stable Input of Care” (BSIC), coded by its principal function or “Main Type of Care” (MTC). The evaluation of the tool included an analysis of feasibility, consistency, ontology, inter-rater reliability, Boolean Factor Analysis, and a preliminary impact analysis (screening, scoping and appraisal). Results: DESDE-LTC includes an alpha-numerical coding system, a glossary and an assessment instrument for mapping and counting LTC. It shows high feasibility, consistency, inter-rater reliability and face, content and construct validity. DESDE-LTC is ontologically consistent. It is regarded by experts as useful and relevant for evidence-informed decision making. Conclusion: DESDE-LTC contributes to establishing a common terminology, taxonomy and coding of LTC services in a European context, and a standard procedure for data collection and international comparison.

Controversy between curriculum design and curriculum development of online "highly specialized" education in the field of construction

Nowadays, on a global level, the Higher Education System has a complex and broad horizon of curricular tools to use in the teaching and learning process. In addition to these new educational instruments, full of possibilities, we face specific socio-economic conditions that affect in a significantly way the Curriculum Development in certain knowledge areas (areas traditionally built on a methodology based on a physical presence of students in the classroom). Some areas such as Restoration, Rehabilitation or Construction Pathologies, and the construction sector in general, require very defined and particular knowledge that only a small number of experts claim as specialized training. All these aspects condition the teaching methodology performed in a physical classroom at a university campus (the only option used until recent years) and made us consider the integration of online teaching in these areas too. The present work shows the teaching methodology used for the development of two online courses, where we offer distance learning for "highly specialized" formation in the Edification area (an area where traditionally there was only classroom training). At the beginning, both courses were designed by classroom training, but got a really small number of applications due to the specialized topic proposed. Later, we proposed a "Curriculum Redesign" of the contents, offering an online modality, which implied a significant demand both within and outside the university area. A notable feature of this educational experience is the great spectrum opened for attendees of both courses in the online version. This situation improved significantly the "Curriculum Development" for the student and implied an interesting new proposal on the offered contents and materials (what would have been really difficult to get in a face to face classroom). In conclusion, the absence of certain types of specialized contents in the academic university curricula makes essential to raise new methodologies to save the gap in this area through additional training courses as those analyzed in this paper. Thus, our experience opens a debate on the appropriateness of implementing online training in relation to the face to face training in constructive content subjects and, especially, presents a new scheme, not without controversy, for the curriculum design.