Dynia: combining webinars, virtual patients & forums for KT in chronic pain

David Topps, Heather Armson, Paul Taenzer, Eloise Carr, Ashi Mehta, Rachel Ellaway

Medbiq Conference, 2014

No conflict of interest to declare

The Problem

• Poor uptake of CPGs despite great effort– Well-written– Well-publicized as part of TOP guidelines

• Knowledge translation– KT interventions incorporating interactive education in

chronic noncancer pain led to positive effects on patients' function and knowledge about pain (Ospina et al, 2013)

• Measurable change in physician behavior• Potential professional isolation for rural practices

Approach

• Webinars for small group learning– Distributed rural sites– Highly interactive sessions– No ‘sage-on-stage’ effect

• Virtual patients with SCT– More tuned to experienced docs– Detailed metrics

• Online forums– Pre & post webinar discussions

SCT pattern design examples

Two SCT Designs

• Traditional Script Concordance Testing– Stem, hypothesis given, then does data confirm…?– Avoids best-of-five; all answers reasonable– Better correlation with experience

• Modified SCT Design– Stem as usual– Prioritized choice of hypotheses, + data confirm…?– Rapid Reporting Real-time Responses (4R)

Example case - Kendal

Scenario Based Design

• ‘Scenario-Based eLearning Design’ – R Colvin Clark

– Based on SBL workshop from Medbiq 2013• Blended PBL & other activities• Subject matter experts– For case design & webinar presentation

• Cases authored by VP experts– based on SME content– mini-series to illustrate changed thinking

OLab3 as SBL Design tool

• Use Visual Editor map to link cases & activities• Similar to LAMS– www.lamscommunity.org – but simpler and more flexible

Scenario Manager in OLab3• Scenario Manager: control over who gets to play what when

Scenario Manager in OLab3• Scenario Manager: view progress during play

Secure Forum

• To guard against confidentiality lapses– Only 3 data points to make a case identifiable

• Single sign-on• Tight linking with cases and nodes• Very useful for collaborative authoring• IMS-LTI integration with Entrada– Considered at that point– Timeline constraints

Results

• Very high engagement– Despite being conceptually demanding

• Few technical glitches– Echo with many machines in same room

• Quotes and comments– Esp from SME about doing the cases so quickly

• Low traffic on Forums– Did not have critical mass

Results

• Example of 4R report graph• Failure on 2nd webinar was big disappointment

SCT Results

• Concordance lower than other SCT papers• But cases designed to be challenging & controversial

rather than an exam

Pathway analysis

PARTICIPANT PHA TE YUAN REFERENCE

Exploring ADL-xAPI

• Manual data analysis very time consuming• Experience API very applicable– Export to Learning Record Store– Detailed analysis of metrics through 3rd party tools

Conclusions

• Highly engaging combination• SCT approach preferred by docs in practice• Subtle shift in practice over series– Not as great as expected– But purposively sampled highly-updated sites