SimCare: A Model for Studying Physician Decisionmaking Activity

Dutta, Pradyumna; Biltz, George R.; Johnson, Paul E.; Sperl-Hillen, JoAnn M.; Rush, William A.; Duncan, Jane E.; O’Connor, Patrick J.

doi:10.1037/e448182006-001

Cited by 6 publications

(5 citation statements)

References 18 publications

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“…This is consistent with adult learning approaches, which suggest that physicians learn best in response to perceived relevant problems 53 . As a specific type of interactive technique, personalized feedback has been increasingly incorporated into successful education programs in many fields and has been shown to enhance learning 54,55 . Internetbased educational interventions provide the opportunity for interactivity and have grown rapidly in number across all health professions 56 .…”

Section: Discussionmentioning

confidence: 99%

Skin Cancer Education for Primary Care Physicians: A Systematic Review of Published Evaluated Interventions

et al. 2011

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BACKGROUND: Early detection of melanoma may provide an opportunity to positively impact melanoma mortality. Numerous skin cancer educational interventions have been developed for primary care physicians (PCPs) to improve diagnostic accuracy. Standardized training is also a prerequisite for formal testing of melanoma screening in the primary care setting. OBJECTIVE: We conducted a systematic review to determine the extent of evaluated interventions designed to educate PCPs about skin cancer, including melanoma. DESIGN: Relevant studies in the English language were identified through systemic searches performed in MEDLINE, EMBASE, BIOSIS, and Cochrane through December 2010. Supplementary information was obtained from corresponding authors of the included studies when necessary. APPROACH: Studies eligible for inclusion formally evaluated skin cancer education interventions and were designed primarily for PCPs. Excluded studies lacked a specified training intervention, used decision-making software, focused solely on risk factor identification, or did not directly educate or assess participants. Twenty studies met the selection criteria. Data were extracted according to intervention content and delivery format, and study outcomes.KEY RESULTS: All interventions included instructions about skin cancer diagnosis, but otherwise varied in content. Curricula utilized six distinct educational techniques, usually incorporating more than one. Intervention duration varied from 12 min to over 6 h. Eight of the 20 studies were randomized trials. Most studies (18/20, 90%) found a significant improvement in at least one of the following five outcome categories: knowledge, competence, confidence, diagnostic performance, or systems outcomes. Competence was most commonly measured; no study evaluated all categories. Variability in study design, interventions, and outcome measures prevented correlation of outcomes with intervention characteristics. CONCLUSIONS: Despite the development of many isolated educational interventions, few have been tested rigorously or evaluated under sufficient standardized conditions to allow for quantitative comparison. Improved and rigorously tested skin cancer educational interventions for PCPs with outcome measures focusing on changes in performance are needed.

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Section: Discussionmentioning

confidence: 99%

Skin Cancer Education for Primary Care Physicians: A Systematic Review of Published Evaluated Interventions

et al. 2011

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“…Details of the feedback and other aspects of the educational intervention have been previously described. 25,31,33 We asked SimDE residents to complete three L-cases each month, and cases could be started, stopped, and returned to, or repeated as many times as desired anytime during the intervention period.…”

Section: Methodsmentioning

confidence: 99%

Educating Resident Physicians Using Virtual Case-Based Simulation Improves Diabetes Management

et al. 2014

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Purpose To test a virtual case-based Simulated Diabetes Education (SimDE) intervention developed to teach primary care residents how to manage diabetes. Method Nineteen primary care residency programs, with 341 volunteer residents in all post-graduate years (PGY), were randomly assigned to a SimDE intervention group or control group (CG). The web-based interactive educational intervention used computerized virtual patients who responded to provider actions through programmed simulation models. Eighteen distinct learning cases (L-cases) were assigned to SimDE residents over 6 months from 2010–2011. Impact was assessed using performance on 4 virtual assessment cases (A-cases), an objective knowledge test, and pre-post changes in self-assessed diabetes knowledge and confidence. Group comparisons were analyzed using generalized linear mixed models, controlling for clustering of residents within residency programs and differences in baseline knowledge. Results The percentage of residents appropriately achieving A-case composite clinical goals for glucose, blood pressure, and lipids was: A-Case 1, SimDE = 21.2%, CG = 1.8%, P = .002; A-Case 2, SimDE = 15.7%, CG = 4.7%, P = .02; A-Case 3, SimDE = 48.0%, CG = 10.4%, P < .001; A-Case 4, SimDE = 42.1%, CG = 18.7%, P = .004. The mean knowledge score and pre-post changes in self-assessed knowledge and confidence were significantly better for SimDE group than CG participants. Conclusions A virtual case-based simulated diabetes education intervention improved diabetes management skills, knowledge, and confidence for primary care residents.

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“…Only a minority of the included interventions featured interactive components such as workshops, which have been shown to be more effective at promoting behavior change than passive learning alone [83]. Similarly, only a minority of interventions provided feedback, which has also been demonstrated to enhance learning [84]. An ideal intervention would encompass both interactive features and feedback in order to optimize the learning experience, while web-based dissemination would reduce geographic and scheduling barriers.…”

Section: Delivery Methodsmentioning

confidence: 99%

Educational Interventions to Support Primary Care Provider Performance of Diagnostic Skin Cancer Examinations: A Systematic Literature Review

et al. 2022

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To our knowledge, there is no available standardized educational curriculum designed to promote the incorporation of skin cancer examinations and procedures into general practice. To explore the contemporary training landscape, we conducted a systematic review of educational interventions designed to support skin cancer diagnostic examinations by primary care providers (PCPs). Our review uniquely encompasses all PCPs, including practicing physicians, residents, and advanced practice practitioners (APPs). The objective of this study is to review and synthesize worldwide data on educational interventions addressing PCP performance of skin cancer diagnostic examinations. A systematic review was performed in MEDLINE , Cochrane , EMBASE, and Scopus for English language articles worldwide published from 2000 onwards. Articles were screened for eligibility, and possibly overlapping datasets were resolved. Data extracted included curriculum content, delivery format, and educational outcomes. This review followed the PRISMA guidelines. A total of 63 studies were selected for data inclusion with one addressing training for resident physicians, 4 for APPs, and the remainder for practicing physicians. Educational interventions included in this review reflect the pre-SARS-CoV-2 pandemic educational environment: half provided live/synchronous instruction of about 5-h duration on average, and a quarter featured interactive components. Less than a quarter of interventions included practice change as a specific reported outcome. Without sustainable practice change, the anticipated long-term benefits of early cancer detection in patients remain limited. Previous and existing educational interventions designed to support skin cancer detection by PCPs demonstrate heterogeneous curriculum content, delivery methods, and educational outcomes. An ideal intervention would teach consensus-derived clinical competencies, provide meaningful learner feedback, and measure outcomes, such as knowledge/competency, confidence/attitudes, and practice change, using validated instruments. Supplementary Information The online version contains supplementary material available at 10.1007/s13187-021-02118-8.

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SimCare: A Model for Studying Physician Decisionmaking Activity

Cited by 6 publications

References 18 publications

Skin Cancer Education for Primary Care Physicians: A Systematic Review of Published Evaluated Interventions

Skin Cancer Education for Primary Care Physicians: A Systematic Review of Published Evaluated Interventions

Educating Resident Physicians Using Virtual Case-Based Simulation Improves Diabetes Management

Educational Interventions to Support Primary Care Provider Performance of Diagnostic Skin Cancer Examinations: A Systematic Literature Review

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