Abstract: SA-PO916

Virtual Patient Simulation Improves Clinical Decisions for Hyperkalemia Treatment in Patients with Heart Failure

Session Information

  • Educational Research
    November 04, 2017 | Location: Hall H, Morial Convention Center
    Abstract Time: 10:00 AM - 10:00 AM

Category: Nephrology Education

  • 1301 Educational Research

Authors

  • Gitzinger, Susan, Medscape, Lexington, Kentucky, United States
  • Blatherwick, Donald, Medscape, Lexington, Kentucky, United States
  • Blevins, Douglas, Medscape, Lexington, Kentucky, United States
Background

This study was conducted to determine if an online, virtual patient simulation-based continuing medical education (CME) intervention could improve performance of nephrologists and cardiologists in the management of patients with heart failure and hyperkalemia.

Methods

The CME intervention comprised 2 cases presented in a virtual patient simulation (VPS) platform, allowing learners to choose from lab tests, diagnoses, and treatments matching the scope and depth of actual practice. Learner clinical decisions, entered using open field entries, were analyzed using a sophisticated decision engine; tailored clinical guidance (CG) was provided based on current evidence and expert recommendation. Decisions were collected post-CG and compared with each user’s pre-CG data using a 2-tailed paired t-test to determine P values. Data is reflective of learners who participated in the assessment from 2/23/17 to 4/21/17.

Results

Significant improvements include:

Case 1 (n=86 nephrologists, n=126 cardiologists):
Nephrologists and cardiologists demonstrated statistically significant changes from pre-CG to post CG in (all P<0.001):
Diagnosis of hyperkalemia (3% vs 37% of nephrologists; 0% vs 45% of cardiologists)
Orders for patiromer (1% vs 29% of nephrologists; 1% vs 36% of cardiologists)
Orders for a preferred beta-blocker (12% vs 51% of nephrologists; 26% vs 56% of cardiologists)
Orders for an ACEi (12% vs 40% of nephrologists; 30% vs 56% of cardiologists)
Orders for influenza vaccination (0% vs 35% of nephrologists; 0% vs 36% of cardiologists)

Case 2 (n=68 nephrologists, n=102 cardiologists):
Nephrologists and cardiologists demonstrated statistically significant changes from pre-CG to post CG in (all P<0.001):
Orders for patiromer (35% vs 68% of nephrologists; 21% vs 63% of cardiologists)
Orders for sacubitril/valsartan (10% vs 46% of nephrologists; 19% vs 59% of cardiologists)
Orders for influenza vaccination (0% vs 46% of nephrologists; 0% vs 40% of cardiologists)
Orders for pneumococcal vaccination (0% vs 49% of nephrologists; 0% vs 43% of cardiologists)

Conclusion

This study demonstrated the success of online, VPS-based education that engages nephrologists and cardiologists for an authentic and practical learning experience that can improve evidence-based clinical decisions in the management of hyperkalemia in patients with heart failure.

Funding

  • Commercial Support