Results of a CME-certified activity completed by a total of 986 cardiologists and 783 haematologists-oncologists (haem-oncs) from around the world were examined to determine whether virtual patient simulation could improve decision-making and performance within the simulation related to patient evaluation, tailoring anticoagulant therapy, and patient management to improve adherence using patient-centred care strategies. Results showed a significant overall impact of education from pre-to post-clinical guidance (CG) on correct decisions made in both cases for cardiologists, with a relative improvement of 22% for Case 1 (45% pre-to 55% post-CG, n = 475, t(474) = 14.12, P<.001, Cohen's d =.46) and 19% for Case 2 (62% pre-to 74% post-CG, n = 245, t(244) = 11.95, P<.001, Cohen's d =.59). Impact also was seen for haem-oncs, with a relative improvement of 27% for Case 1 (45% pre-to 57% post-CG, n = 280, t(279) = 11.91, P <.001, Cohen's d =.60) and 19% for Case 2 (63% pre-to 75% post-CG, n = 147, t(146) = 9.52, P <.001, Cohen's d =.58). Virtual patient simulation improved cardiologists' and haem-oncs management of patients with pulmonary embolism in a simulated environment.

322 Background: A considerable proportion of prostate cancer cases among men progress to mCRPC. As a result, appropriate treatment selection and sequencing is crucial to maximizing patient outcomes. A study was conducted to determine if simulation-based educational interventions to address underlying clinical practice gaps could improve clinical decisions of oncologists in the management of mCRPC. Methods: A cohort of US-practicing oncologists who participated in online simulation-based education was evaluated. The intervention consisted of two cases presented in a platform that allowed learners to assess the patient and choose from an extensive database of diagnostic and treatment possibilities matching the scope and depth of actual practice. Clinical decisions made by participants were analyzed using a decision engine, and instantaneous clinical guidance employing current evidence-based and expert faculty recommendations was provided at each decision point. Participant decisions before and after clinical guidance were compared using a 2-tailed paired T-test to provide p-values for assessing the impact of simulation-based education on the clinical decisions made by participants between 2/25/2014 and 9/12/2014. Results: The assessment sample consisted of 107 oncologists who made clinical decisions within the simulation. As a result of clinical guidance, significant improvements were observed in: a) Selection of an evidence-based regimen that included mCRPC targeted therapy (17%, p = 0.027) and treatment for bone metastases (26%, p < 0.0001), in an individual with a 6-year history of prostate cancer whose disease presented with bone metastasis; and b) Starting a bone resorption inhibitor (25%, p < 0.001) and switching mCRPC therapies (28%, p < 0.001) in a patient whose PSA levels were rising despite treatment. Conclusions: This study showed improvements in clinical decisions of oncologists in selecting evidence-based therapeutic regimens for patients with mCRPC. This study demonstrates that online, simulation-based instruction can result in an increase in appropriate clinical decisions, and may play a role in improving the quality of care and patient outcomes.

e20663 Background: In patients diagnosed with metastatic NSCLC it is now essential to identify targetable mutations and markers of treatment resistance in order to determine the appropriate therapy. A study was conducted to determine if simulation-based educational interventions to address clinical practice gaps could improve decisions of oncologists in the management of EGFR-mutated metastatic NSCLC. Methods: A cohort of US-oncologists who participated in a virtual patient simulation (VPS)-based education was evaluated. The VPS consisted of 2 cases that allowed oncologists to assess the patient and choose from a database of diagnostic possibilities matching the scope and depth of practice. Clinical decisions were analyzed using a decision engine, and instantaneous clinical guidance (CG) employing current evidence-based and expert faculty recommendations was provided after each decision. Oncologists were allowed a second chance at each decision point and decisions before and after CG were compared using a 2-tailed paired T-test to determine differences from pre- to post CG. P values are shown as a measure of significance; with P < .05 statistically significant. Results: 197 oncologists made clinical decisions within the simulation. As a result of CG, significant improvements were observed in: Ordering EGFR mutational testing (16%, P= 0.008) and making an accurate diagnosis (36%) Selecting an EGFR TKI in the first-line setting (24%, P< 0.001) Ordering a PET scan to assess disease progression (10%) and in diagnosing patients with EGFR T790M disease that is resistant (29% , P< 0.001) Evidence-based treatment selection for individuals whose disease progressed on first-line therapy (19%, P= .003) Number of oncologists who ordered adverse event education and counseling (23%, P< .001) Conclusions: This study showed improvements in evidence-based practices of oncologists in the diagnosis and management of EGFR-mutated NSCLC; demonstrating that VPS-based instruction that immerses and engages oncologists for an authentic, practical and16. consequence-free learning experience can result in an increase in appropriate clinical decisions. Therefore, VPS may have a role in improving the quality of patient care.

No abstract

Background: Breast cancer is the second leading cause of cancer death among women. The growth factor receptor HER2 is overexpressed in 20% to 30% of invasive breast cancers, and use of HER2-targeted therapies have improved responses and survival in patients with metastatic breast cancer (MBC). However, the choice of the most appropriate agents and their sequencing is crucial to maximizing beneficial patient outcomes. A study was conducted to determine if simulation-based educational interventions to address underlying clinical practice gaps could improve competence and performance of oncologists in the management of HER2-positive breast cancer. Methods: A cohort of US-practicing oncologists who participated in online simulation-based education was evaluated. The interventions consisted of two cases presented in a platform that allowed physician learners to assess the patient and choose from an extensive database of diagnostic possibilities matching the scope and depth of actual practice. Clinical decisions made by participants were analyzed using a sophisticated decision engine, and instantaneous clinical guidance was provided at each decision point employing current evidence-based and expert faculty recommendations. Participant decisions were collected after clinical guidance and compared with each user's baseline data using a 2-tailed paired T-test to provide P values for assessing the impact of simulation-based education on the clinical decisions made by participants as of 12/4/2014. Results: The assessment sample consisted of 123 oncologists who made clinical decisions within the simulation and proceeded to the concluding debrief section. As a result of clinical guidance provided through simulation, significant improvements were observed in several areas of management of patients with HER2-positive MBC, specifically: •35% improvement (P&lt;.001) in the selection of the preferred treatment regimen (trastuzumab, pertuzumab, with a taxel) in the first-line setting •21% improvement (P=.003) in evidence-based treatment selection for individuals whose disease progressed on first-line therapy •A 35% decrease was seen in the number of participants who selected trastuzumab for individuals whose disease progressed on first-line therapy, which demonstrated an improvement in oncologists ability to select the most appropriate selection based on the current evidence-base •39% (P&lt;.001) improvement in the number of oncologists who ordered adverse event counseling for the patient •Similarly, 33% more participants (P&lt;.001) referred a patient for psychosocial counseling after clinical guidance The data gathered during simulation also provided insights into the remaining gaps, including the choice of the most appropriate, evidence-based first line HER2-targeted regimen in patients with MBC. Conclusion: This study showed improvements in evidence-based practice patterns of oncologists who were selecting therapeutic protocols for patients with HER2-positive MBC, thus demonstrating that simulation-based instruction can result in an increase in evidence-based clinical decisions and, therefore, may play a role in improving the quality of care and patient outcomes. Citation Format: Herrmann TL, Blevins D, Warters M, Peters P. Simulation in continuing professional development in oncologic care: Advancing evidence-based decisions in the management of HER2-positive metastatic breast cancer. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P5-09-01.