Author + information
- Amy Larkin,
- David Anderson,
- Martin Warters,
- Gwen Littman,
- Javed Butler and
- Mikhail Kosiborod
We sought to determine if an online, virtual patient simulation (VPS)-based continuing medical education (CME) intervention could improve performance of cardiologists related to identification of patients with heart failure and hyperkalemia, and subsequent management of hyperkalemia.
The intervention comprised two patients presenting in a VPS platform that allows learners to order lab tests, make diagnoses, and prescribe treatments in a manner matching the scope and depth of actual practice. Tailored clinical guidance (CG), based on current evidence and expert recommendation, was provided following each decision, followed by the opportunity for the learner to modify to their decisions. Decisions were collected post-CG and compared with each user’s baseline (pre-CG) decisions using a 2-tailed paired t-test to determine P values. The activity posted April 30, 2019; data were collected through July 25, 2019.
In total, 122 cardiologists were included. Significant improvements (reported as absolute) were observed after CG: Case 1 (N=122):
• Initiate a loop diuretic: 26% improvement (29% pre-CG vs 55% post-CG; P<.001)
• Order nutritional counseling: 16% improvement (45% pre-CG vs 61% post-CG; P<.001)
• Initiate a newer potassium binder: 43% improvement (2% pre-CG vs 45% post-CG; P<.001)
• Discontinue spironolactone: 22% improvement (48% pre-CG vs 70% post-CG; P<.001) Case 2 (N=101):
• Diagnose chronic hyperkalemia: 18% improvement (29% pre-CG vs 47% post-CG; P<.001)
• Order nutritional counseling: 14% improvement (50% pre-CG vs 64% post-CG; P<.001)
• Initiate newer potassium binder therapy: 42% improvement (18% pre-CG vs 60% post-CG; P<.01)
• Continue a loop diuretic: 20% improvement (75% pre-CG vs 95% post-CG; P<.001)
VPS that immerses and engages specialists in an authentic and practical learning experience can improve evidence-based clinical decisions related to patient identification and management of hyperkalemia in patients with heart failure.
Posters Hall_Hall A
Saturday, March 28, 2020, 12:30 p.m.-1:15 p.m.
Session Title: Spotlight on Special Topics: Education and Training 2
Abstract Category: 42. Spotlight on Special Topics: Education and Training
Presentation Number: 1174-275
- 2020 American College of Cardiology Foundation