alert 2014-progress-pusic-boutis

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Progress Report Presentation: Learning Retention and the Timing of Refresher Education After The Deliberate Practice of Radiograph Interpretation K. Boutis, M. Pecaric, J. Beckstead, P. Babyn, M. Pusic UToronto, USF, NYU IMSH 2014: San Francisco, CA / USA International Network for Simulation-based Pediatric Innovation, Research and Education

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Page 1: Alert 2014-progress-pusic-boutis

Progress Report Presentation: Learning Retention and the Timing of Refresher Education After The Deliberate Practice of Radiograph Interpretation

K. Boutis, M. Pecaric, J. Beckstead, P. Babyn, M. Pusic

UToronto, USF, NYU

IMSH 2014: San Francisco, CA / USA

International Network for Simulation-based Pediatric Innovation, Research and Education

Page 2: Alert 2014-progress-pusic-boutis

• Content Area: PEM Radiology

• Instructional Design:

Online Deliberate Practice (Screen Simulation)

• Question:

What is the rate of skill decay?

International Network for Simulation-based Pediatric Innovation, Research and Education

Background

Page 3: Alert 2014-progress-pusic-boutis

P: PEM Fellows

I: Online deliberate practice

C: Same + Refresher Training

O: Knowledge retention over 18 mo

International Network for Simulation-based Pediatric Innovation, Research and Education

PICO Question

Page 4: Alert 2014-progress-pusic-boutis

Marty, can you create a Couple of screenshot slidesFrom the tutorial (showing lines)And from one case showingFeedback with green.

Page 5: Alert 2014-progress-pusic-boutis

Marty, can you create a Couple of screenshot slidesFrom the tutorial (showing lines)And from one case showingFeedback with green.

Page 6: Alert 2014-progress-pusic-boutis

ABNORMAL

Page 7: Alert 2014-progress-pusic-boutis

NORMAL

Page 8: Alert 2014-progress-pusic-boutis

Two Phases:

1. Radiograph Calibration– Remove educationally poor cases

– Broad sample of expertise

– Use Rasch Modelling to ensure appropriate difficulty

2. Actual Trial– Target Population

International Network for Simulation-based Pediatric Innovation, Research and Education

Study Protocol

Page 9: Alert 2014-progress-pusic-boutis

Final Sample size: 100 + 100

International Network for Simulation-based Pediatric Innovation, Research and Education

PICO Question

CALIBRATION:(Read 100 Xrays Once)

TRIAL:(Read 220 Xrays/18mo)

Medical Students 20

EM Residents 20 40

Peds Residents 20

PEM Fellows 20 60

PEM Attendings 10

Peds Radiology 10

Page 10: Alert 2014-progress-pusic-boutis

International Network for Simulation-based Pediatric Innovation, Research and Education

Approach / Design

Adding fourth group: No Refresher

Page 11: Alert 2014-progress-pusic-boutis

TIME

PE

RF

OR

MA

NC

E COMPETENCE

Ove

rlear

ning

Slope of Decay Curve

Area Under Curve

Stops training

Training -- Learning (Units of Deliberate Practice)

Skill Degradation (Units of Elapsed Time)

Refresher T

raining

Approach / Design

Page 12: Alert 2014-progress-pusic-boutis

Final Sample size: 100 + 100

International Network for Simulation-based Pediatric Innovation, Research and Education

PICO Question

CALIBRATION:(Read 100 Xrays Once)

TRIAL:(Read 220 Xrays/18mo)

Medical Students 20

EM Residents 20 40

Peds Residents 20

PEM Fellows 20 60

PEM Attendings 10

Peds Radiology 10

Page 13: Alert 2014-progress-pusic-boutis

• Calibration phase almost completed

• IRB through at:

– University of Toronto

– NYU

– Dalhousie

– Universite de Montreal

International Network for Simulation-based Pediatric Innovation, Research and Education

Progress since Jan 2013

Page 14: Alert 2014-progress-pusic-boutis

1. Going well

2. IRB issues for coinvestigators

3. Keeping people in the study over the

18 months.

International Network for Simulation-based Pediatric Innovation, Research and Education

Needs / Challenges

Page 15: Alert 2014-progress-pusic-boutis

1. @ IMSH 2014: Recruit 2 centers

2. In 3 months: Commence study phase 2

3. Over 1 year: Continue data collection

International Network for Simulation-based Pediatric Innovation, Research and Education

How can INSPIRE help?

Page 16: Alert 2014-progress-pusic-boutis

Name: Martin Pusic

Institution: NYU

E-mail: [email protected]

Website: www.medals-silver.org/INSPIRE

International Network for Simulation-based Pediatric Innovation, Research and Education

Contact Information