Prevention of VTE in hospitalized patients with acute infectious disease: Online CME improves physician competence and confidence

ABSTRACT

Background: Clinicians need updates on VTE prevention strategies for hospitalized medically ill patients. Aim(s) This study examined whether interactive, case-based, online CME could improve competence and confidence of cardiologists related to prevention of VTE in patients hospitalized with acute infectious disease. Method(s) Educational design included a "test, then teach" approach to elicit cognitive dissonance, with evidence-based feedback provided following each learner response. Educational effect was assessed using a repeated-pair design with pre-/ post-assessment. Three multiple choice questions assessed knowledge/competence, and 1, rated on a Likert-type scale, assessed confidence. A paired samples t-test was conducted on overall average number of correct responses and for confidence rating, and a McNemar's test was conducted at the question level (significance level, p < 0.05). Result(s) 186 cardiologists were included in the analysis. 83% of cardiologists improved their competence related to use of evidence-based antithrombotic strategies for VTE prevention in patients hospitalized with acute infectious disease (p < 0.001), showing a 75% relative change in responses correct from pre-to post. On a question level, further results indicate 54% improvement 41% reinforcement (p < 0.001) in competence in use of evidence-based antithrombotic strategies for VTE prevention in patients hospitalized with COVID-19;60% improvement and 25% reinforcement (p < 0.001) in competence of the use of evidence-based risk assessment tools to determine need for thromboprophylaxis in patient hospitalized with COVID-19;49% measurable increase in confidence in ability to prevent VTE in patients hospitalized with COVID-19, resulting in 41% who were mostly or very confident after education (p < 0.001). Conclusion(s) This study demonstrates the success of interactive, case-based, online CME at improving competence and confidence of cardiologists related to prevention of VTE in hospitalized patients with acute infectious disease. Case-based education with interactive questions and detailed explanations of best practices should be employed more often to help clinicians apply knowledge and evidence into practice to improve patient management.