Effectiveness of an educational strategy using educational games 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 great teaching potential for health professionals in training, although their use is limited. The objective of this study was to evaluate the effectiveness and adherence to e-EDUCAGUIA teaching strategy using educational game with simulated clinical scenarios to implement a CPG on antimicrobial therapy compared to the usual dissemination strategies in improving the knowledge and skills of family medicine residents.Methods: This was a multicentre cluster-randomized clinical trial in 7 teaching units in Madrid (Spain). Intervention: educational games based on CPG recommendations, compared with the passive dissemination of the guideline. Main outcome variable: knowledge and skills questionnaire scores one month after the intervention. The difference in mean scores between the intervention and control groups at one month was determined, along with the 95% CI using generalized linear models.Results: A total of 202 residents participated (104 in the intervention group and 98 in the control group). One hundred residents performed the post-test at one month (45 in the intervention group vs. 55 in the control group). The differences favoured the intervention group in terms of both the final scores at month (11.4, 95% CI 6.9–15.9) and the change from baseline scores (11.9, 95% CI 5.9–17.9), with estimated effect sizes of 0.88 for the between-groups difference and 0.75 for the change in baseline difference. For each additional hour of training in evidence-based medicine there was a an increase of 0.28 points (95 % CI 0.15–0.42). Conclusions: The e-EDUCAGUIA strategy improves the knowledge and skills of medicine residents for clinical decision-making during short-term antimicrobial therapy. Adherence to educational games in the absence of specific incentives is moderate.Trial registration: ClinicalTrials.gov Identifier: NCT02210442. Registered 6 August 2014, https://www.clinicaltrials.gov/ct2/show/NCT02210442