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TRANSCRIPT
CONCLUSIONS This web-based education included a 1-hour lecture with slides. The activity was available for 1 year from December 27, 2016, - December 27, 2017. During this period 1923 individ-uals accessed the online program and viewed a portion of the content. Some 757 completed the pre-test, 610 completed the post-test, 622 completed the course evaluation. The completion rate for those accessing a portion of the content was 31%. The completion rate among those completing the pretest was 81%. Among the practitioners completing the entire program: 80% had prescriptive privileges (MD/DO: 30%, NP/PA: 50%). The program is archived online and since December 27, 2017, 150 practitioners have viewed the content. The median number of patients with heart failure seen monthly by participants is 18.
PRACTICE CHANGES MADE AS A RESULT OF THIS EDUCATION WILL AFFECT
SOME 10,872 PATIENTS MONTHLY. These data suggest that this online educational program in-creased practitioner knowledge as evidenced by the percent changes from pre to post activity knowledge scores. When asked if they would change their practice based on their par-ticipation in this activity, only 24% stated they would. However, in a follow-up question asking them to identify the specific areas in which they would make practice changes, 100% se-lected a practice parameter that they would change. Specifi-cally, 35% intended to change their diagnostic procedures and 44% would change their treatment approach. Self-reported survey 3 months after the program showed that 88% made changes to their practice.
COMMERCIAL SUPPORT DISCLOSURE This activity was supported by an educational grant from Novartis, Relypsa Inc., and ZS Pharma, Inc. (AstraZeneca).
TARGET AUDIENCE This activity was intended for cardiologists, cardiothoracic surgeons, and general internists.
REFERENCES ACCME: How is an enduring material activity defined? Available: https://www.accme.org/faq/how-enduring-material-activity-defined. Accessed: April 6, 2019. Ferreri SP, O’Connor SK. Redesign of a large lecture course into a small-group learning course. Am J Pharm Educ. 2013;77(1):13 Ilic D, Maloney S. Methods of teaching medical trainees’ evidence-based medicine: a systematic review. Med Educ. 2014;48(2):124-135. Schönwetter DJ, Gareau-Wilson N, Cunha RS, et al. Assessing the Impact of Voice-Over Screen-Captured Presentations Delivered Online on Dental Students' Learning. J Dent Educ. 2016 Feb;80(2):141-148.
INVESTIGATOR DISCLOSURES Margaret V. Clark has disclosed no relevant financial relationships. James L. Januzzi, Jr.: Consultant: Novartis Pharmaceuticals Corporation; Philips; Roche Diagnostics. Contracted Research: Amgen Inc.; Novartis Pharmaceuticals Corporation; Prevencio, Inc.; Roche Diagnostics; and Singulex, Inc. Barry Greenberg: Speakers Bureau: Relypsa, Inc.; Otsuka America Pharmaceutical, Inc., Novartis Pharmaceuticals Corporation. Consultant: Novartis Pharmaceuticals Corporation; Relypsa, Inc.; Teva Pharmaceutical Industries Ltd.; Zensun USA, Inc., ZS Pharma, Inc. Celladon Corporation; and Johnson & Johnson. Steve Eckert disclosed no relevant financial relationships.
ABSTRACT BACKGROUND: Utilization of web-based technology to deliver continuing medical education (CME) has risen rapidly in the last 10 years. However, there are few published data on the effect of web-based learning on participant’s knowledge, practice patterns, commitment to change (COC), and clinical practice. As CME providers adopt online technology, it is critical that the effective-ness of this education be evaluated. The aim of this prospective study was to assess the effectiveness of an online educational activity on participant’s knowledge, practice patterns, COC, and clinical practice among cardiologists, cardiothoracic surgeons, and internists.
METHODS: An online activity consisting of a recorded lecture with slides titled The New Age of Heart Failure: Innovative Diagnosis and Treatment Strategies which was available from December 27, 2016, - December 27, 2017. Analysis of participant demo-graphics, pre and post knowledge levels and COC were conducted utilizing knowledge-based questions, self-reported practice related evaluations, COC statements, and a 2018 follow-up survey.
RESULTS: The program had 1958 participants who viewed the education, 757 who completed the pre-test and 610 attendees who completed the post-test, earning 1.0 AMA PRA Category 1 Credits™. Twenty-four percent listed Cardiology and 12% Primary Care as their specialty; 80% of attendees had prescriptive privileges. Notably, Advanced Practitioners comprised 50% of participants. Improvements in knowledge were noted in all 6 pre to post-test questions assessed with significant improvements in the areas of diagnosis and medication usage (pre to post-test % change: 66% and 52%, respectively). Post activity COC state-ments showed that 35% intended to change their diagnostic procedures and 44% would change their treatment approach. Self-reported survey results 3 months after the program showed that 88% of participants made changes to their practice, 10,872 patients are affected monthly by these changes. In addition, 99% of participants stated the program met their educational needs. The most important information learned in the program as identified by participants was: medications.
CONCLUSIONS: These findings show that this online education significantly impacted participant knowledge and self-reported practice changes.
ATTENDANCE
n 1952 participants overall accessed the online program.
n 757 completed the pre-test, 610 completed the post-test, 622 completed the course evaluation.
n 24% listed Cardiology as their primary specialty.
n 80% of attendees had prescriptive privileges (MD/DO: 30%, NP/PA: 50%)
n 86% of those completing the program were from the US.
98%
99%
Assessing the Impact of an Online Educational Program on Participant’s Knowledge, Satisfaction, Practice Patterns and Commitment to Change
1. Clark Medical Writing, North Chesterfield, VA 2. Hutter Family Professor of Medicine, Harvard Medical School, Massachusetts
General Hospital, Faculty, Harvard Clinical Research Institute, Boston, MA 3. Director, Advanced Heart Failure Treatment Program, Professor of Medicine, UCSD,
San Diego, CA 4. AKH Inc., Advancing Knowledge in Healthcare, Scottsdale, AZ
Margaret V. Clark,1 James L. Januzzi, Jr.2 Barry Greenberg,3 Steve Eckert 4
30%Physician
37%PhysicianAssistant
ATTENDANCE BY PROFESSION 12.80% Nurse Practitioner 7.60% Nurse 10.40% Other Healthcare Professional 1.06% Resident/Student 0.93% Pharmacist 0.13% Consumer/Patient
N=750
24%Cardiology
15%Surgery
ATTENDANCE BY SPECIALTY12.38% Family Medicine/
General Practice 8.70% Internal Medicine
6.39% Emergency Medicine
5.30% Orthopedics
4.62% Other
2.58% Anesthesiology 2.58% Critical Care Medicine 2.17% Geriatric Medicine 1.49% Hospitalist 1.08% Pediatrics
N=735
PRE TEST N=757 POST TEST N=610 FOLLOW-UP SURVEY N=25
QUESTION 1:Symptoms/
Presentation
QUESTION 2:Diagnosis
QUESTION 3:Guidelines/Diagnosis
QUESTION 4:Guidelines/Medications
QUESTION 5:Medications
QUESTION 6:Medications
87
.74 9
9.0
2
92
.00
30
.30
96
.00
32
.00
63
.11
97
.92
80
.00
28
.85
79
.60
36
.00 50
.33
94
.40
52
.00
35
.84
87
.68
56
.00
100%
80%
60%
40%
20%
0%
Do nothingbecause content
was notconvincing
*Barriers listed: not a physician; different specialty; economic barriers
Seek additionalinformationon this topic
Changemy practice
Do nothingas current
practice reflects activity
recommendations
Do nothing as thefollowing barriers exist preventing my adoption
of presented guidelines and
recommendations*
8%
52%
24% 21%
4%
80%
60%
40%
20%
0%
Diagnosis Patient Safety Documentation(appropriate)
TreatmentApproach
PatientEducation
Medication
26%32%
22%
44%37%
26%
50%
40%
30%
20%
10%
0%
Strongly Agree Agree Disagree Strongly Disagree
34%
64%
1% 1%
70%
60%
50%
40%
30%
20%
10%
0%
KNOWLEDGE ASSESSMENT
PARTICIPANT SATISFACTION (N=615)
COMMITMENT TO CHANGE STATEMENTS (N=615)
Allergy/Immunology Bariatric Medicine Complementary/Alt. Medicine Dental Dermatology Diabetes Endocrinology Gastroenterology/Proctology
Hematology/Oncology Infectious Disease Long-Term Care Nephrology Neurology Obstetrics/Gynecology Oncology Ophthalmology
Pain Medicine Pathology Physical Medicine/Rehabilitation Psychiatry Pulmonology Radiology/Nuclear Medicine Sports Medicine Urology
LESS THAN 1%
of attendees agreed or strongly agreed that their educational needs were met.
Post activity Commitment to Change statements from participants showed that 24% would change their practice and 52% intended to seek additional information on the topic.
AREAS OF PRACTICE CHANGE (N=615)
PARTICIPANT CONFIDENCE (N=615)
Participants were then asked in which areas of practice they would make changes based on their participation in this activity. Though only 24% had previously stated they would make changes, 100% of respondents selected at least 1 area in which they would make changes. (Respondents could choose more than 1 area of change.)
Self-reported follow – up survey results at 3 months showed that 88% of
participants made changes to their practice following their participation
in this activity.
n 99% of attendees agreed or strongly agreed that the educational materials were effective.
n 99% stated that the content was objective, current,
scientifically sound and free of commercial bias. n 99% of attendees agreed or strongly agreed that the
learning activities were effective and incorporated active learning methods.
88%
98%Following the program, participants were asked to assess their confidence levels relating to the learning objectives/goals of the activity.
n After participating in this program, I am better prepared to review current biomarkers and their role in establishing the diagnosis and prognosis of heart failure.
n After participating in this program, I am better prepared to differentiate between the type and severity of heart failure based on patient history, evaluation, and diagnostic workup.
n After participating in this program, I am better prepared to review the benefits and limitations of current heart failure therapies.
n After participating in this program, I am better prepared to discuss new and emerging therapies for heart failure and their role in therapeutic management.
n After participating in this program, I am better prepared to review the effects and implications of risk factors and comorbidities on potassium levels and hyperkalemia in heart failure patients.
Strongly Agree or Agree
These findings show online education significantly impacted participant knowledge and self-reported practice changes.