2565. Initial and Recurrent Episodes of Clostridioides difficile: Online Education as a Tool to Improve Management Strategies

Abstract

BackgroundThe most common cause of infectious diarrhea in hospitalized patients, C. difficile is responsible for nearly half a million infections annually. Among persons over the age of 65 years, 1 in 11 die within a month of diagnosis.MethodsA CME-certified/ABIM MOC educational program was developed to evaluate and improve ID specialists’ application of the latest guideline recommendations for the diagnosis and management of individuals with C. difficile. Modeled on the interactive grand rounds approach, the activity blended case-based presentation with multiple-choice questions. Using a “test then teach” approach to elicit cognitive dissonance, the activity provided evidence-based feedback following each learner response. Educational effectiveness was assessed with a repeated-pairs pre-/post-assessment study design; each individual served as his/her own control. A chi-square test assessed changes pre- to post-assessment. P values < 0.05 are statistically significant. Effect sizes were evaluated using Cramer’s V (< 0.05 modest; 0.06–0.15 noticeable effect; 0.16–0.26 considerable effect; > 0.26 extensive effect). The activity launched on a website dedicated to continuous professional development on May 29, 2018. Data for this initial analysis were collected through March 27, 2019.ResultsTo date, 3274 HCPs, including 2946 physicians have participated in the activity. Data from the subset of ID specialists (n = 82) who answered all pre-/post-assessment questions during the initial study period were analyzed. Following activity participation, significant improvements were observed in the proportion of ID specialists who answered all assessment questions correctly (4% pre vs. 74% post; P < 0.0001; V = .555). Improvements were also observed in several specific areas of assessment (table). Additionally, 50% of ID specialists indicated they planned to modify their treatment approach and 18% planned to modify their diagnostic strategies for C. difficile.ConclusionParticipation in this online, interactive, case-based, educational intervention significantly improved ID specialists’ management strategies for initial and recurrent episodes of C. difficile. These findings highlight the positive impact of well-designed online education. Disclosures All authors: No reported disclosures.