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Abstract: PO1376

Case-Based, Interactive Medical Education Significantly Improves Management of Chronic Hyperkalemia in Complex Patients

Session Information

Category: Educational Research

  • 800 Educational Research


  • Larkin, Amy, Medscape LLC, New York, New York, United States
  • Blatherwick, Donald, Medscape LLC, New York, New York, United States
  • Boutsalis, George, Medscape LLC, New York, New York, United States

We sought to determine if interactive, case-based online continuing medical education (CME) for nephrologists could improve clinical knowledge, competence, and performance in the area of chronic hyperkalemia management in complex patients.


The instructional method consisted of an online, case-based, interactive text activity. Clinicians were presented with 2 patient cases that included multiple-choice knowledge or competence questions allowing them to make clinical decisions about treatment. Educational effect was assessed using a 4-question repeated pairs pre-/post-assessment and McNemar’s chi-squared test. P values are shown as a measure of significance; P values <.05 are statistically significant. Cramer’s V determined the effect size (<0.05 no effect; 0.06-0.15 small effect; 0.16-0.30 medium effect; >0.30 large effect). The activity launched May 15, 2019; data were collected through June 24, 2019.


Significant overall improvements were seen (n = 59; P =.003; V= 0.156) as a result of participation in the CME activity. Specific areas of improvements include:
8% of nephrologists (P=.05; V=.179) improved at using a loop diuretic when a low-potassium diet was unsuccessful at lowering potassium levels
25% of nephrologists (P=.008; V=.241) demonstrated improvement at prescribing a newer potassium binder in a patient with consistently elevated potassium despite a low potassium diet and loop diuretic
10% of nephrologists (P=.4; V=.076) improved at using a newer potassium binder in a patient on dialysis with hyperkalemia
36% of nephrologists reported increased confidence using potassium binders in patients on RAAS inhibitors
Continued educational gaps:
29% of nephrologists did not initiate a newer potassium binder in an appropriate patient


This study demonstrates the success of an online, highly interactive, case-based educational intervention on improving knowledge, competence, and performance of nephrologists regarding complex management of chronic hyperkalemia.


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