Understanding decision-making and educational need in the management of pediatric patients with moderate-to-severe asthma: analysis of a US-based clinician survey.

Background: Asthma creates a substantial burden on the pediatric healthcare system, particularly by those with moderate-to-severe disease. As few studies have been published specific to clinician evaluation and management of this population, this analysis serves to begin to identify educational needs and potential clinical impact.Methods: We conducted a case-based survey of US general pediatric (n = 227), allergy (n = 158), and pediatric pulmonology (n = 70) clinicians to understand the current approach to management of pediatric patients with moderate-to-severe asthma.Results: Results show inconsistencies in guideline adherence, identification of disease severity and control, referral practices, and knowledge of phenotypes, which may impact clinical decision making. While most clinicians refer to guidelines when managing pediatric patients with moderate-to-severe asthma, there is no preferred set, and they find the guidelines to be moderately useful. General pediatricians are more likely than specialists to have difficulty distinguishing control and severity and may not be familiar with the concept of asthma phenotype. Most surveyed pediatricians indicated they refer patients to a specialist, but did not always do so in the cases. Clinicians have little consensus on the best approach to manage patients with uncontrolled symptoms after optimized therapy. Many clinicians may have uncertainty about how elevated eosinophils or FeNO could affect patient management. Further, there may be gaps in incorporating parents and pediatric patients into shared decision-making in their care.Conclusions: Understanding the needs of those managing patients with moderate-to-severe asthma is critical to developing effective continuing education activities to improve patient outcomes.

Outcomes Standardisation Project (OSP) for Continuing Medical Education (CE/CME) Professionals: Background, Methods, and Initial Terms and Definitions.

Despite an increased focus and urgency for CE/CME professionals to effectively and systematically assess the impact of their educational interventions, the community has struggled to do so. This struggle is in large part due to the lack of a standardised outcomes language and a set of unified approaches to measure and communicate impact. In the spring of 2018, a group of volunteer educational research scientists and CE/CME professionals established a rigorous consensus-building process in an effort to address this need. This report describes the background, methods and first-year output (Glossary V1) of the Outcomes Standardisation Project (OSP); begins to introduce examples of how the OSP Glossary V1 may support the CE/CME professional community and concludes with plans for the future of establishing a common framework for the profession.

Personalized, assessment-based, and tiered medical education curriculum integrating treatment guidelines for atrial fibrillation.

BACKGROUND: This continuing medical education (CME) curriculum utilizes the Learner Assessment Platform (LAP), providing learners with personalized educational pathways related to atrial fibrillation treatment. HYPOTHESIS: There are improvements in knowledge among physician learners after CME, especially among LAP learners. METHODS: In this LAP-based curriculum, an evaluation of learner deficits on designated learning objectives was conducted in tier 1 and used to direct learners to individualized tier 2 activities. Performance was assessed across learner tracks from baseline to learners' final intervention. Retention data were measured by the postcurriculum assessment, completed 8 weeks after the learners last intervention. Additionally, each activity included a unique matched set of pretest and post-test questions assessing the 4 learner domains: knowledge, competence, confidence, and practice patterns. RESULTS: Significant learner improvement was measured across the curriculum over all 4 learner-domains: 48% (P < 0.0005), 78% (P < 0.0005), 21% (P < 0.0005), and 20% (P < 0.0005) improvements for knowledge, competence, confidence, and practice, respectively. Significant gains in participant performance scores (28% increase, P < 0.0005) by the final activity was observed. Learners who participated in the LAP (N = 989) demonstrated greater improvement in performance from baseline compared to non-LAP learners (41% increase for LAP vs 23% and 26% increase for non-LAP learners who completed 1 (N = 1899) or ≥2 (N = 533) activities, respectively, P = 0.003). CONCLUSIONS: The participant population (N = 3421) achieved statistically significant improvement across the curriculum, with LAP learners showing greater performance gains compared to non-LAP learners. These findings support the value of the LAP methodology in providing a cumulative and individualized CME experience.