Abstract: SA-PO244
Iron Deficiency Anemia in Clinical Practice: Can Virtual Patient Simulation Improve Management?
Session Information
- Anemia and Iron Metabolism: Clinical
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Anemia and Iron Metabolism
- 202 Anemia and Iron Metabolism: Clinical
Authors
- Larkin, Amy, Medscape Education, Nicholasville, Kentucky, United States
- Blatherwick, Donald, Medscape , Medford, New Jersey, United States
- Warters, Martin, Medscape Education, Nicholasville, Kentucky, United States
- Blevins, Douglas, Medscape, Durham, North Carolina, United States
Background
We sought to determine if an online, virtual patient simulation (VPS)-based continuing medical education (CME) intervention could improve performance of nephrologists and primary care physicians (PCPs) in diagnosising and managing iron deficiency anemia (IDA).
Methods
The intervention comprised two patient cases where learners ordered lab tests, made diagnoses, and prescribed treatments similar to 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 launched May 10, 2019; data were collected for initial abstract submission through May 22, 2019.
Results
To date, 11 nephrologists and 47 PCPs have participated (larger sample size expected by ASN conference).
Case 1:
IDA diagnosis: 22% absolute improvement among nephrologists (22% pre-CG vs 44% post-CG; P=.18), 5% improvement among PCPs (53% pre-CG vs 58% post-CG; P=.16)
Diagnosis of chronic kidney disease stage 5: 33% absolute improvement among nephrologists (0% pre-CG vs 33% post-CG; P<.001), 34% improvement among PCPs (16% pre-CG vs 50% post-CG; P<.01)
Dialysis referral: 22% absolute improvement among nephrologists (22% pre-CG vs 44% post-CG; P=.18), 21% improvement among PCPs (21% pre-CG vs 42% post-CG; P<.05)
Initiate oral iron supplement: 22% absolute improvement among nephrologists (22% pre-CG vs 44% post-CG; P=.18), 32% improvement among PCPs (39% pre-CG vs 71% post-CG; P<.01)
Case 2:
IDA diagnosis: 27% absolute improvement among nephrologists (27% pre-CG vs 54% post-CG; P=.08), 21% improvement among PCPs (30% pre-CG vs 52% post-CG; P<.01)
Diagnosis of chronic kidney disease stage 4: 36% absolute improvement among nephrologists (27% pre-CG vs 63% post-CG; P<.05), 32% improvement among PCPs (17% pre-CG vs 49% post-CG; P<.01)
Initiate oral iron supplement: 36% absolute improvement among nephrologists (36% pre-CG vs 82% post-CG; P=.01), 21% improvement among PCPs (9% pre-CG vs 57% post-CG; P<.01)
Conclusion
VPS that immerses and engages specialists in an authentic and practical learning experience can improve evidence-based clinical decisions related to diagnosis and management of IDA.