Traci A Wolbrink1,2, Sandrijn M van Schaik3, David A Turner4, Steven J Staffa1, Eleanor Keller1, Donald L Boyer5,6, Grace Chong7, Jarrod Cross8, Sylvia Del Castillo9, Andrew Feng10, R Stanley Hum11, Ebor Jacob James12, Amanda Johnson13, Sarah Kandil14, Martin Kneyber15, Ramachandran Rameshkumar16, Amanda Levin17, Rakesh Lodha18, Muralidharan Jayashree19, Anthony Olivero20, Felix Oberender21, Rahul S Panesar22, Puneet A Pooni23, Kyle J Rehder4, Shuba Sankaranarayanan24, Margaret Scheffler25, Rana Sharara-Chami26, Ashley L Siems17, Rajakumar Padur Sivaraman25, Ken Tegtmeyer27,28, Stacey Valentine13, Florencia Villois29, Amelie von Saint Andre-von Arnim30, Margaret Winkler31, Chris Dede32, Jeffrey P Burns1,2. 1. Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, MA. 2. Department of Anaesthesia, Harvard Medical School, Boston, MA. 3. Division of Pediatric Critical Care Medicine, University of California San Francisco, San Francisco, CA. 4. Division of Pediatric Critical Care, Department of Pediatrics, Duke Children's Hospital, Durham, NC. 5. Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, PA. 6. The Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. 7. Division of Pediatric Critical Care, University of Chicago, Comer Children's Hospital, Chicago, IL. 8. Paediatric Critical Care, Perth Children's Hospital, WA, Australia. 9. Department of Anesthesiology and Critical Care Medicine, Children's Hospital Los Angeles, Los Angeles, CA. 10. Kapiolani Medical Center for Women and Children, Honolulu, HI. 11. Division of Pediatric Critical Care Medicine, Department of Pediatrics, Columbia University, New York, NY. 12. Christian Medical College, Vellore, India. 13. Division of Pediatric Critical Care Medicine, University of Massachusetts Children's Medical Center, Worcester, MA. 14. Department of Pediatrics, Critical Care Medicine, Yale University School of Medicine, New Haven, CT. 15. Beatrix Children's Hospital, University Medical Center Groninger, University of Groningen, Groningen, The Netherlands. 16. Division of Pediatric Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India. 17. Division of Critical Care Medicine, Children's National Health System, Washington, DC. 18. Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India. 19. Postgraduate Institute of Medical Education and Research, Chandigarh, India. 20. Helen DeVos Children's Hospital, Grand Rapids, MI. 21. Pediatric Critical Care Medicine, Monash Children's Hospital, Melbourne, VIC, Australia. 22. Stony Brook Children's Hospital, Stony Brook, NY. 23. Dayanand Medical College and Hospital, Ludhiana, India. 24. Department of Pediatrics, Sri Ramachandra Medical College and Research Institute, Porur, Chennai, India. 25. Hasbro Children's Hospital, Providence, RI. 26. Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon. 27. Cincinnati Children's Hospital Medical Center, Cincinnati, OH. 28. Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH. 29. Garrahan Hospital, Buenas Aires, Argentina. 30. Division of Pediatric Critical Care, Department of Pediatrics, Seattle Children's and University of Washington, Seattle, WA. 31. University of Alabama at Birmingham, Birmingham, AL. 32. Harvard Graduate School of Education, Cambridge, MA.
Abstract
OBJECTIVE: Rapid advancements in medicine and changing standards in medical education require new, efficient educational strategies. We investigated whether an online intervention could increase residents' knowledge and improve knowledge retention in mechanical ventilation when compared with a clinical rotation and whether the timing of intervention had an impact on overall knowledge gains. DESIGN: A prospective, interventional crossover study conducted from October 2015 to December 2017. SETTING:Multicenter study conducted in 33 PICUs across eight countries. SUBJECTS: Pediatric categorical residents rotating through the PICU for the first time. We allocated 483 residents into two arms based on rotation date to use an online intervention either before or after the clinical rotation. INTERVENTIONS: Residents completed an online virtual mechanical ventilation simulator either before or after a 1-month clinical rotation with a 2-month period between interventions. MEASUREMENTS AND MAIN RESULTS: Performance on case-based, multiple-choice question tests before and after each intervention was used to quantify knowledge gains and knowledge retention. Initial knowledge gains in residents who completed the online intervention (average knowledge gain, 6.9%; SD, 18.2) were noninferior compared with those who completed 1 month of a clinical rotation (average knowledge gain, 6.1%; SD, 18.9; difference, 0.8%; 95% CI, -5.05 to 6.47; p = 0.81). Knowledge retention was greater following completion of the online intervention when compared with the clinical rotation when controlling for time (difference, 7.6%; 95% CI, 0.7-14.5; p = 0.03). When the online intervention was sequenced before (average knowledge gain, 14.6%; SD, 15.4) rather than after (average knowledge gain, 7.0%; SD, 19.1) the clinical rotation, residents had superior overall knowledge acquisition (difference, 7.6%; 95% CI, 2.01-12.97;p = 0.008). CONCLUSIONS: Incorporating an interactive online educational intervention prior to a clinical rotation may offer a strategy to prime learners for the upcoming rotation, augmenting clinical learning in graduate medical education.
RCT Entities:
OBJECTIVE: Rapid advancements in medicine and changing standards in medical education require new, efficient educational strategies. We investigated whether an online intervention could increase residents' knowledge and improve knowledge retention in mechanical ventilation when compared with a clinical rotation and whether the timing of intervention had an impact on overall knowledge gains. DESIGN: A prospective, interventional crossover study conducted from October 2015 to December 2017. SETTING: Multicenter study conducted in 33 PICUs across eight countries. SUBJECTS: Pediatric categorical residents rotating through the PICU for the first time. We allocated 483 residents into two arms based on rotation date to use an online intervention either before or after the clinical rotation. INTERVENTIONS: Residents completed an online virtual mechanical ventilation simulator either before or after a 1-month clinical rotation with a 2-month period between interventions. MEASUREMENTS AND MAIN RESULTS: Performance on case-based, multiple-choice question tests before and after each intervention was used to quantify knowledge gains and knowledge retention. Initial knowledge gains in residents who completed the online intervention (average knowledge gain, 6.9%; SD, 18.2) were noninferior compared with those who completed 1 month of a clinical rotation (average knowledge gain, 6.1%; SD, 18.9; difference, 0.8%; 95% CI, -5.05 to 6.47; p = 0.81). Knowledge retention was greater following completion of the online intervention when compared with the clinical rotation when controlling for time (difference, 7.6%; 95% CI, 0.7-14.5; p = 0.03). When the online intervention was sequenced before (average knowledge gain, 14.6%; SD, 15.4) rather than after (average knowledge gain, 7.0%; SD, 19.1) the clinical rotation, residents had superior overall knowledge acquisition (difference, 7.6%; 95% CI, 2.01-12.97;p = 0.008). CONCLUSIONS: Incorporating an interactive online educational intervention prior to a clinical rotation may offer a strategy to prime learners for the upcoming rotation, augmenting clinical learning in graduate medical education.
Authors: Prashant J Purohit; Laurie Yamamoto; Len Y Tanaka; Konstantine Xoinis; John Harrington; Rupert Chang; Andrew Feng Journal: Hawaii J Health Soc Welf Date: 2020-05-01
Authors: Ashley Bjorklund; Tina Slusher; Louise Tina Day; Mariya Mukhtar Yola; Clark Sleeth; Andrew Kiragu; Arianna Shirk; Kristina Krohn; Robert Opoka Journal: Front Pediatr Date: 2022-01-31 Impact factor: 3.418