We sought to determine if online continuing medical education (CME) could improve the competence and confidence of pulmonologists related to strategies to improve treatment adherence in PAH. METHODS:This CME intervention comprised of a 15-minute online video-based rapid-fire discussion between 2 expert faculty. A repeated pairs pre-/post-assessment study design was used and McNemar's test (P <.05 is considered significant) assessed education effect, with Cohen's d being used to assess educational impact (.20-.49 a small effect, .50-.79 a moderate effect, and >.80 a large effect). The activity launched October 1, 2020 and data were collected through January 11, 2021. RESULTS:In total, 34 pulmonologists were included in the analysis. Overall, there were competence and confidence improvements seen among participants from pre-to post-assessment: 21% of pulmonologists (P<.01) improved at selecting the most appropriate PAH therapy to improve adherence for a patient who requires treatment escalation due to intermediate-risk status yet struggles to follow a rigid medication schedule 21% of pulmonologists (P<.05) improved at selecting the most appropriate PAH therapy to improve adherence for a patient who requires parenteral therapy due to high-risk status and wants to maintain an active lifestyle 35% of pulmonologists had a measurable increase in confidence in ability to manage side effects during uptitration of PAH specific therapiesContinued educational gaps: 44% of pulmonologists failed to choose appropriate therapy to improve adherence for an intermediate-risk patient who struggles to follow a rigid medication schedule 38% of pulmonologists failed to select appropriate therapy to improve adherence for a high-risk patient requiring parenteral therapy who wants to maintain an active lifestyle CONCLUSIONS: This study demonstrates the success of online CME on improving competence and confidence of pulmonologists related to improvement of treatment adherence in PAH. Continued gaps were identified for future educational targets.
Introduction: The ability of virtual patient simulation (VPS) case-based interventions to improve clinical decision making for patients with peripheral artery disease (PAD) is unknown. Methods: Two patient cases were presented using a VPS platform where learners could order tests, make diagnoses, and order treatments in a manner matching the scope and depth of actual practice. Clinical decisions were analyzed, and learners received clinical guidance (CG) based on current evidence and expert recommendations. Learners could modify their decisions post-CG. Pre-(baseline) vs. post-CG decisions were compared using McNemar’s test. The intervention launched on July 30, 2021, and data were collected through October 13, 2021. Results: Overall, 143 physicians participated (76 case 1, 67 case 2). Physician specialties included cardiology (74%), and vascular surgery (26%). Most physicians were male (62%) with the following age distribution < 30 (8%), 30-39 (25%), 40-49 (19%), 50-59 (17%), and ≥ 60 (31%). Significant improvements were seen for appropriate diagnosis and treatment selection in the overall learner population; treatment improvements were greatest for tailoring antithrombotic therapy in patients with newly diagnosed PAD ( Table ). Improvements in selection of appropriate antithrombotic treatment were observed for all specialties, although specialty-specific differences were apparent ( Table ). Conclusions: Case-based PAD intervention employing VPS was associated with improvements in diagnostic and therapeutic decision-making among cardiologists and vascular surgeons. Despite the observed improvements, gaps remain in diagnosing and selecting appropriate antithrombotic strategies for patients with PAD.
Background: Even though cardiovascular (CV) tests, which are used to assess coronary arterial disease (CAD) are included in medical guidelines, cardiologists have limited ability to adequately perform appropriate testing modalities. In parallel, many patients have concerns or anxiety related to CV testing, and are not proactively educated on how to prepare for their procedure. Goals: To determine if an online parallel physician-patient education interventions could improve performance of cardiologists related to CV stress testing, and patient knowledge about the procedure. Methods: An online CME activity was developed as a 25-minute roundtable discussion with 3 leading experts on criteria for appropriate use of stress testing and preparing physicians to communicate the risks and benefits of testing modalities to their patients. The activity included a transcript of the discussion and a downloadable slide deck to reinforce key recommendations. Participant responses to questions were collected after the education (post-assessment) and compared with each user’s baseline data (pre-assessment) using a 2-tailed paired T-test to provide P values for assessing the impact of education. The CME activity also included a link to a patient/caregiver education module, developed in parallel to educate patients and their caregivers about cardiac stress testing. Patient/caregiver responses post-education compared to pre-education were also assessed to measure improvement in knowledge. Results: A total of 312 of cardiologists who participated in the CME activity and answered all pre- and post-assessment questions were included in the analysis. In addition, 3458 patients preparing for a stress test, 640 family members, 116 caregivers, and 3299 other participants interested in the topic of CV testing who completed the patient/caregiver education module and the pre- and post-education questions were included in the assessment. Post-education, significant improvements were observed (Table). Conclusion: This study demonstrated that both knowledge/competence of cardiologists on evidence-based practices as well as the understanding of patient/caregivers on CV testing can be improved using a dual approach to education.
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