Education, Teaching, and Quality Improvement |

Simulation and Case-Based Education: Improving Evidence-Based Decisions for Pulmonary Arterial Hypertension Management FREE TO VIEW

Nimish Mehta, MBA; Catherine Capparelli
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Medscape, LLC, New York, NY

Chest. 2014;146(4_MeetingAbstracts):511A. doi:10.1378/chest.1988358
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SESSION TITLE: Education and Teaching in Pulmonary Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM

PURPOSE: A study was conducted to determine if simulation and other online case-based educational interventions could improve competence and performance of pulmonologists and cardiologists with respect to the management of pulmonary arterial hypertension (PAH).

METHODS: A cohort of US-practicing pulmonologists and cardiologists who participated in one of four case-based educational interventions was evaluated. The interventions consisted of three formats: patient simulation; text-based interactive case; and video scenario vignettes highlighting clinician/patient interaction. The outcomes survey methods included knowledge- and case-based, multiple-choice questions based on current evidence-based recommendations for the assessment and management of patients with PAH. Responses from the clinical cases and questions aligned to individual interventions were collected and compared with baseline data (internal control) or a matched group of nonparticipants (external control) in order to assess the impact of case-based education on the practice patterns of participants.

RESULTS: In total, a sample of more than 1000 pulmonologists and cardiologists were evaluated using different case-based educational interventions. Pulmonologist and cardiologists who participated in simulation, text-based interactive case, and video scenario vignettes were more likely to make evidence-based decisions, 35% (effect size of 0.54), 34% (effect size of 0.52) and 26.8% (effect size of 0.39), respectively. Significant improvements were observed in several specific areas as a result of participation in these activities, eg. characterizing a patient’s REVEAL risk index (P = 0.03), initiating ERA or PDE5 inhibitor therapy (P < 0.001), recognizing a patient’s clinical decline and appropriately augmenting PAH therapy (P = 0.02).

CONCLUSIONS: This study demonstrated the success of simulation and other case-based educational interventions on improving the evidence-based practice patterns of pulmonologists and cardiologists in the treatment of patients with PAH.

CLINICAL IMPLICATIONS: Case-based instruction that leads to improvement in physician performance in a consequence free environment can result in more evidence-based clinical decisions for PAH and improvement in patient outcomes.

DISCLOSURE: The following authors have nothing to disclose: Nimish Mehta, Catherine Capparelli

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