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

• 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

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

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

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

ABNORMAL

NORMAL

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

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

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

Approach / Design

Adding fourth group: No Refresher

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

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

• 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

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

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?

Name: Martin Pusic

Institution: NYU

E-mail: mpusic@gmail.com

Website: www.medals-silver.org/INSPIRE

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

Contact Information