Online ‘spaced education’ improves safety practices of interns

By Sarah Guy, medwireNews Reporter

An online "spaced education" (SE) program designed to improve patient safety knowledge changes behaviors more effectively and is more engaging to medical and surgical interns than a slideshow plus quiz (SQ), report researchers.

While both methodologies improved knowledge surrounding National Patient Safety Goals (NPSG), SE impacted interns' confidence more significantly and changed the safety behaviors of surgical residents acting in a central line simulation scenario, compared with SQ, the study results show.

The greater impact of SE versus SQ is likely to result from multiple factors, note Tim Shaw (The University of Sydney, New South Wales, Australia) and colleagues who assessed the effects of both programs in two US hospitals.

"The literature indicates that continuing medical education (CME), that is case-based and interactive, has a greater impact on knowledge and behaviour," writes the team in BMJ Quality and Safety.

A total 120 interns randomly assigned to complete the SE also completed a pre- and postintervention test examining NSPG knowledge, while 85 interns assigned to the SQ program completed those same tests. A respective 53 and 48 SE and SQ interns from one of the institutions involved also undertook the central line simulation scenario.

The SE program involved 16 multiple-choice questions based on real-life patient scenarios, two of which were emailed to participants to complete every 2 days. Those who responded incorrectly were emailed the same question again 8 days later, and those who responded correctly were emailed 16 days later. Two successive correct responses rendered the question complete.

The SQ program contained 15 slides discussing important aspects of the NPSGs followed by a 14-question multiple choice quiz, explain Shaw and co-authors.

Overall, postintervention test scores were significantly higher than preintervention scores for both the SQ (average 1.0-point difference) and the SE group (average 1.3-point difference).

However, in the simulation scenario, SE interns demonstrated more NSPG-compliant behaviors than their SQ colleagues, but the difference was nonsignificant, with mean scores of 4.79 and 4.17 of a possible 13.00.

Postintervention questionnaires revealed significantly higher fractions of SE-assigned than SQ-assigned interns who "strongly agreed" or "agreed" with items corresponding to: improved confidence in patient handoff, infection control, and that their program was effective, engaging, and enjoyable.

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