ABSTRACT
Background: BCMA-directed modalities including CAR T-cell therapy, bispecific antibodies and antibody-directed cytotoxic agents are potentially transformative next steps in managing patients with multiple myeloma. However, beyond expert centres physicians have little experience of such agents to date. Aims: This study aimed to determine whether online continuing medical education could improve the knowledge and confidence of clinicians in their understanding of the rationale for and clinical aspects of different BCMA-directed therapies Methods: Three educational activities were launched for physicians outside the USA during 2020 to a target audience of hematologist/oncologists and ophthalmologists. Activities comprised a 30-minute video lecture, a 15-minute video collegial discussion, and a 30-minute online video panel discussion. Data were collected March to June 2020. For each activity educational effect was assessed with repeated-pairs pre-/ post-activity, where individual participants served as their own control. 3 multiple-choice, knowledge questions and 1 self-efficacy, 5-point Likert scale confidence question were analyzed. Data were subsequently combined and analyzed to provide a summative overview of the effect of the education across the combined knowledge-based learning objectives and confidence questions from the three programs. A McNemar's test was conducted to assess statistical significance of changes from pre- to post-assessment. Results: Between 66 and 103 hematologist/oncologists (combined total n=259) and 39-41 ophthalmologists (combined total n=121) completed pre- and post-activity questions. A statistically significant effect was observed for hematologist/oncologists across all 3 learning objectives (P<0.05-P<0.001) with a relative improvement in % of correct responses ranging from 10-44%. Furthermore, there was an overall improvement in confidence, with a 72% gain in confidence in those reporting increased confidence. The education had less impact on ophthalmologists;while some improvements were noted in individual activities, in the summative overview the greatest improvement was noted in knowledge of AEs associated with BCMA-directed therapies. The summative overview revealed that hematologists/oncologists demonstrated improvements in knowledge across the 3 learning objectives: 10% (P<0.05) regarding rationale and types of BCMA-directed therapies, 44% (P<0.001) regarding AEs associated with BCMAdirected therapies, and 29% (P<0.001) regarding BCMA clinical trials data. Ophthalmologists showed knowledge changes of -2% (NS) regarding knowledge of clinical data and the rationale and type of BCMA-directed therapy, and a 41% (P<0.05) improvement in knowledge of BMCA-therapy associated AEs. In combined self-assessed confidence questions, 51% of hematologist/oncologists had a measurable increase in and 46% maintained confidence. Thirty-three percent of ophthalmologists had a measurable increase in and 59% maintained confidence. All changes in confidence were significant (P<0.01 or P<0.001). At the individual activity level, ~50% of all participants stated that they would modify treatment plans and ~90% were committed to those changes. Summary/Conclusion: These three educational activities resulted in a considerable educational impact, particularly for hematologist/oncologists. Online medical education is valuable in improving knowledge and confidence, as well as identifying areas of continued educational need and potentially improving patient outcomes, of particular importance during the COVID-19 pandemic where in-person conference learning is inaccessible.
ABSTRACT
Introduction/Background The treatment of newly diagnosed advanced ovarian cancer is changing rapidly with the expanded use of PARP inhibitors. This study determined whether online continuing medical education could improve the knowledge, competence and confidence of oncologists and obstetricians/gynaecologists (obs/gyns) with regard to the application of PARP inhibitors in this setting. Methodology A 30-minute online video panel discussion with synchronized slides was launched for physicians outside the USA in November 2019. Data was collected to January 2020. Educational effect was assessed with repeated-pairs pre-/post-activity, where individual participants served as their own control. 3 multiple-choice, knowledge questions and 1 self-efficacy, 5-point Likert scale confidence question were analyzed. Chi-squared test assessed pre- to post-activity change (5% significance level, P <.05). Magnitude of change in total number of correct responses overall, and for each question, were determined with Cramer's V (<.06=Modest, 0.06-0.15=Noticeable, .16-.26=Considerable, >.26=Extensive). Results 157 oncologists and 152 obs/gyns completed pre- and post-activity questions. A positive educational effect was observed for both oncologists (considerable effect, V=.159, P<.0001;with average% of correct responses increasing from 59 to 74%) and obs/gyns (noticeable effect, V=.101, P<.01;average% of correct responses increasing from 48 to 58%). Participants with 3/3 correct answers increased from pre- to post-activity (16 to 44% for oncologists and 11 to 32% for obs/gyns). Improvements in% of correct responses post-activity were seen for questions on identifying data from PRIMA trial of niraparib (oncologists: 18 to 48%;obs/gyns 16 to 41%) and the PAOLA trial data for olaparib (oncologists: 68 to 80%;obs/gyns 53 to 59%). Participants had a good baseline understanding of the correct treatment approach for a patient presenting with HRD +ve advanced ovarian cancer (90% oncologists, 74% obs/gyns with the correct answer), although no increases were observed post-activity. Confidence in the ability to integrate PARP inhibitors into practice improved post-activity (total average confidence shift: 14% for oncologists and 29% for obs/gyns). 47% of all participants stated they would modify treatment plans as a result of participation in the activity. Conclusion This on-demand, online video panel discussion resulted in a positive educational impact. However, education gaps remain evident, especially amongst obs/gyns. Online medical education, increasingly important during the COVID-19 pandemic, is valuable in supporting implementation of new treatment strategies and identifying areas of continued educational need.