Effectiveness of a game-based educational strategy e-EDUCAGUIA for implementing antimicrobial clinical practice guidelines in family medicine residents in Spain: a randomized clinical trial by cluster

Abstract

Background Clinical practice guidelines (CPGs) have teaching potential for health professionals in training clinical reasoning and decision-making, although their use is limited. The objective was to evaluate the effectiveness of a game-based educational strategy e-EDUCAGUIA using simulated clinical scenarios to implement an antimicrobial therapy GPC compared to the usual dissemination strategies to improve the knowledge and skills on decision-making of family medicine residents. Additionally, adherence to e-EDUCAGUIA strategy was assessed. Methods A multicentre pragmatic cluster-randomized clinical trial was conducted involving seven Teaching Units (TUs) of family medicine in Spain. TUs were randomly allocated to implement an antimicrobial therapy guideline with e-EDUCAGUIA strategy ( intervention) or passive dissemination of the guideline (control). The primary outcome was the differences in means between groups in the score test evaluated knowledge and skills on decision-making at 1 month post intervention. Analysis was made by intention-to-treat and per-protocol analysis. Secondary outcomes were the differences in mean change intrasubject (from the baseline to the 1-month) in the test score, and educational game adherence and usability. Factors associated were analysed using general linear models. Standard errors were constructed using robust methods. Results Two hundred two family medicine residents participated (104 intervention group vs 98 control group). 100 medicine residents performed the post-test at 1 month (45 intervention group vs 55 control group), The between-group difference for the mean test score at 1 month was 11 ( 8.67 to 13.32) and between change intrasubject was 11,9 ( 95% CI 5,9 to 17,9). The effect sizes were 0.88 and 0.75 respectively. In multivariate analysis, for each additional evidence-based medicine training hour there was an increase of 0.28 points (95% CI 0.15–0.42) in primary outcome and in the change intrasubject each year of increase in age was associated with an improvement of 0.37 points and being a woman was associated with a 6.10-point reduction. 48 of the 104 subjects in the intervention group (46.2%, 95% CI: 36.5–55.8%) used the games during the month of the study. Only a greater number of evidence-based medicine training hours was associated with greater adherence to the educational game ( OR 1.11; CI 95% 1.02–1.21). Conclusions The game-based educational strategy e-EDUCAGUIA shows positive effects on the knowledge and skills on decision making about antimicrobial therapy for clinical decision-making in family medicin residents in the short term, but the dropout was high and results should be interpreted with caution. Adherence to educational games in the absence of specific incentives is moderate. Trial registration ClinicalTrials.gov Identifier: NCT02210442. Registered 6 August 2014.

Barreras y facilitadores para el uso de las guías de práctica clínica por residentes de Medicina Familiar y Comunitaria: estudio cualitativo con grupos focales

“…En nuestro entorno existen estudios sobre la actitud del personal médico sanitario que indican una variabilidad en las decisiones clínicas con un bajo nivel de adherencia a las recomendaciones de las GPC 6,7 . El proyecto EDUCAGUIA estudió la efectividad de una estrategia educativa basada en juegos e-EDUCAGUIA 8 para mejorar la adherencia a las recomendaciones de las guías en la prescripción de antibióticos por parte de residentes de Medicina Familiar y Comunitaria (MFyC) en nuestro entorno, encontrando efectos positivos a corto plazo sobre los conocimientos y habilidades en la toma de decisiones sobre terapia antimicrobiana, aunque la adherencia a los juegos educativos fue moderada y las pérdidas en el seguimiento fueron elevadas y con diferencias de género.…”

Pengembangan Digital Game sebagai Sarana Pembelajaran Matematika untuk Difabel

“…Game dapat menjadi media hiburan sekaligus media pengembangan kemampuan serius (Sabirli & Çoklar, 2020). Serious game atau game serius memiliki banyak sekali kegunaan, mulai dari melatih kemampuan membaca anak (Szili et al, 2022), latihan gerak dewasa (Brauner & Ziefle, 2020), latihan penanggulangan bencana (Gampell et al, 2020), desain interior fasilitas umum (Yang et al, 2021), hingga pendidikan praktek antimikroba (del Cura-González et al, 2022). Game serius dalam berbagai bentuk memberikan hasil positif pada pendidikan (Khan et al, 2021).…”