ASTHMA CONTROL AND EDUCATION (ACE): USE OF AN ELECTRONIC TEACHING TOOL TO IMPROVE RESIDENT SKILLS, KNOWLEDGE, AND SELF EFFICACY FOR TEACHING OF INHALED THERAPIES

Abstract

SESSION TITLE: Interventions to Advance Patient Care SESSION TYPE: Original Investigations PRESENTED ON: 10/08/2018 04:30 pm - 05:30 pm PURPOSE: Poor control of airway diseases like asthma is often seen in patients who are not adequately trained in the correct technique of inhaler use. We investigated the familiarity of internal medicine residents with dry-powder and metered-dose inhalers (DPI, MDI). An attempt was also made to assess the impact of a phone app with educational videos on correct inhaler technique. METHODS: Baseline assessment of the knowledge of inhaler use among internal medicine residents was done. Residents’ inhaler use technique skills were evaluated with Vitalograph-AIM, an inhaler training device which provides real-time feedback on MDI / DPI use. Following the baseline assessment, the residents watched the educational videos from the phone app. The app was shared with the residents and frequency of their use of the app was remotely monitored. A month later, similar assessment of the residents was done and results were compared. RESULTS: 40 residents were enrolled. Only 24 residents filled the re-surveys at 1 month. At baseline, 42.5% were first-year residents, 7.5% planning for pulmonary sub-specialty. 23.08% had personal history of asthma, though only 15.38% and 5.13% felt comfortable using an MDI / DPI. 12.82% reported previous residency inhaler education. 82.05% prescribed inhalers but 76.92% never checked their patients’ inhaler technique. Although all residents watched the educational videos after baseline assessment on day 1 in class, only one resident revisited the videos again by using the app afterwards. On reassessment at one month, the percentage of correct survey responses changed from 53.25% to 58.5%. Ten out of twelve questions had no or some improvement, with only one being statistically significantly improved. 2 more residents passed the Vitalograph-AIM on MDI and 3 more on DPI when compared with baseline. CONCLUSIONS: The baseline assessment of the residents’ familiarity with inhaler affirms the gap in knowledge. Demonstration of the right inhaler-use technique with the aid of educational videos displayed during a didactic session resulted in some, but not statistically significant, improvement in knowledge at one month. The impact of the interactive phone app which allows residents to revisit the educational videos at their convenience and also teach their patients in clinic could not be assessed as majority of the residents did not open the app that was shared with them CLINICAL IMPLICATIONS: Training residents on the correct use of MDI, DPI and other inhalers is not formally incorporated into medical school or residency curriculum. Teaching aids such as the online phone app that we developed may be considered to address this. However, methods to improve residents’ phone app usage as a teaching tool should be further explored. DISCLOSURES: No relevant relationships by Cheryl Cheah, source=Web Response no disclosure on file for Paul Christensen; No relevant relationships by Alexandra Halalau, source=Web Response No relevant relationships by vivek jayaschandran, source=Web Response No relevant relationships by Girish Nair, source=Web Response