Danielle M McCarthy1, Kyle T Formella2, Eric Z Ou3, John A Vozenilek4, Kenzie A Cameron5, David H Salzman6, Amanda Mb Doty7, Katherine Piserchia8, Dimitrios Papanagnou9, Kristin L Rising10. 1. Department of Emergency Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA. Electronic address: d-mccarthy2@northwestern.edu. 2. Jump Trading Simulation and Education Center, OSF Healthcare, Peoria, IL, USA. Electronic address: kyle.t.formella@jumpsimulation.org. 3. Jump Trading Simulation and Education Center, OSF Healthcare, Peoria, IL, USA. Electronic address: Eric.Z.Ou@jumpsimulation.org. 4. Jump Trading Simulation and Education Center, OSF Healthcare, Peoria, IL, USA; Department of Emergency Medicine, University of Illinois College of Medicine at Peoria, Peoria, IL, USA; Department of BioEngineering, University of Illinois Grainger College of Engineering Urbana, IL, USA. Electronic address: John.A.Vozenilek@jumpsimulation.org. 5. Division of General Internal Medicine and Geriatrics, Department of Medicine, Northwestern University, Chicago, IL, USA; Department of Medical Education, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA. Electronic address: k-cameron@northwestern.edu. 6. Department of Emergency Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA; Division of General Internal Medicine and Geriatrics, Department of Medicine, Northwestern University, Chicago, IL, USA. Electronic address: dsalzman005@northwestern.edu. 7. Department of Emergency Medicine, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA; Center for Connected Care, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA. Electronic address: Amanda.doty@jefferson.edu. 8. Department of Emergency Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA. Electronic address: k-piserchia@northwestern.edu. 9. Department of Emergency Medicine, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA. Electronic address: Dimitrios.Papanagnou@jefferson.edu. 10. Department of Emergency Medicine, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA; Center for Connected Care, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA. Electronic address: Kristin.Rising@jefferson.edu.
Abstract
BACKGROUND: Clear communication is integral to good clinical care; however, communication training is cost and time intensive. Mobile applications (apps) may provide a useful adjunct to traditional simulation skills training. OBJECTIVE: To evaluate (1) use of an app for teaching communication skills about diagnostic uncertainty, (2) feedback on app use, and (3) the association between use and skill mastery. PATIENT INVOLVEMENT: The app under study is designed to improve doctor-patient communication. METHODS: The study was a planned sub-analysis of a randomized controlled waitlist trial with emergency medicine resident physicians randomized to receive immediate or delayed access to an educational curriculum focused on diagnostic uncertainty. The curriculum included a web-based interactive module and the app. Metrics describing participants' use of the app, feedback on use, and association of use and achieving mastery in communicating diagnostic uncertainty are reported. Differences between groups utilizing the app were analyzed using Chi-squared test; logistic regression assessed the association between app use and achieving mastery of the communication skill. RESULTS: Among 109 participants completing the trial, only 34 (31.2%) used the app. Most participants engaged with the app on one occasion for a median of 50 min (IQR 31, 87). Senior residents were more likely to use the app than junior residents (41.3% vs 23.8%, p=0.05). Overall reviews were positive; 76% reported the app helped them learn. There was no significant association between app use and achieving mastery of the communication skill in the trial [OR 2.1, 95% CI (0.91-4.84)]. DISCUSSION: Despite positive reviews of app use, overall use was low and there was no association with achieving mastery. PRACTICAL VALUE: Offering an app as an auxiliary training opportunity may be beneficial to some residents, but shouldn't be planned for use as a primary didactic modality unless there is evidence for effectiveness and use is mandated. AVAILABILITY OF DATA AND MATERIALS: The datasets generated and/or analyzed during the current study are not publicly available since some data may be identifiable but are available from the corresponding author on reasonable request.
BACKGROUND: Clear communication is integral to good clinical care; however, communication training is cost and time intensive. Mobile applications (apps) may provide a useful adjunct to traditional simulation skills training. OBJECTIVE: To evaluate (1) use of an app for teaching communication skills about diagnostic uncertainty, (2) feedback on app use, and (3) the association between use and skill mastery. PATIENT INVOLVEMENT: The app under study is designed to improve doctor-patient communication. METHODS: The study was a planned sub-analysis of a randomized controlled waitlist trial with emergency medicine resident physicians randomized to receive immediate or delayed access to an educational curriculum focused on diagnostic uncertainty. The curriculum included a web-based interactive module and the app. Metrics describing participants' use of the app, feedback on use, and association of use and achieving mastery in communicating diagnostic uncertainty are reported. Differences between groups utilizing the app were analyzed using Chi-squared test; logistic regression assessed the association between app use and achieving mastery of the communication skill. RESULTS: Among 109 participants completing the trial, only 34 (31.2%) used the app. Most participants engaged with the app on one occasion for a median of 50 min (IQR 31, 87). Senior residents were more likely to use the app than junior residents (41.3% vs 23.8%, p=0.05). Overall reviews were positive; 76% reported the app helped them learn. There was no significant association between app use and achieving mastery of the communication skill in the trial [OR 2.1, 95% CI (0.91-4.84)]. DISCUSSION: Despite positive reviews of app use, overall use was low and there was no association with achieving mastery. PRACTICAL VALUE: Offering an app as an auxiliary training opportunity may be beneficial to some residents, but shouldn't be planned for use as a primary didactic modality unless there is evidence for effectiveness and use is mandated. AVAILABILITY OF DATA AND MATERIALS: The datasets generated and/or analyzed during the current study are not publicly available since some data may be identifiable but are available from the corresponding author on reasonable request.
Authors: Kristin L Rising; Rhea E Powell; Kenzie A Cameron; David H Salzman; Dimitrios Papanagnou; Amanda M B Doty; Lori Latimer; Katherine Piserchia; William C McGaghie; Danielle M McCarthy Journal: Acad Med Date: 2020-07 Impact factor: 6.893
Authors: Danielle M McCarthy; Rhea E Powell; Kenzie A Cameron; David H Salzman; Dimitrios Papanagnou; Amanda Mb Doty; Benjamin E Leiby; Katherine Piserchia; Matthew R Klein; Xiao C Zhang; William C McGaghie; Kristin L Rising Journal: BMC Med Educ Date: 2020-02-19 Impact factor: 2.463