Improving Internal Medicine Residentsʼ Colorectal Cancer (CRC) Screening Knowledge via Smart Phone Application: A Novel Approach

Abstract

Introduction: Colo-Rectal cancer is the third most common type of cancer and the second leading cause of cancer death in the United States. The incidence and mortality of CRC have declined in the last decade, but still there is a room for improvement. About one in three adults in US is not getting the CRC screening as recommended. Internal medicine residents are deficient in CRC screening knowledge as shown by previous studies. we conducted this IRB approved study [UT IRB# 201713] to improve the residents CRC screening knowledge via smart phone application. Methods: A questionnaire was designed based on CRC screening guidelines of ACS, ACG and USPSTF. The questionnaire was emailed via SurveyMonkey link to all the residents of internal medicine department. The responses were analyzed after 4 weeks. Then a smart phone application was designed and was published on Play Store and App Store for android users and I phone users respectively. All the residents were introduced to the application. The survey was repeated and the responses were compared with the previous one. Pearson Chi square test and the fisher exact test was applied to look for statistical significance.Table: Number of Responders Correctly Identifying Appropriate Exams for CRC Screening.Table: Number of Responders Correctly Identifying Appropriate Exams for CRC Screening.Table: Number of Responders Correctly Identifying Appropriate Exams for CRC Screening.Results: 50 residents completed the first survey and 41 completed the second survey after publication of the application. There was no significant difference in knowledge by the residency years at baseline and knowledge improved equally across all the residency years. Survey was divided into seven domains to test various aspects of CRC screening knowledge. Some of the areas which showed statistically significant improvement (P value <0.05) included age to start CRC screening in African Americans, ordering preventive tests first, identification of CRC screening tests, identification of preventive and detection methods, positive tests to be followed by colonoscopy, follow up after colonoscopy findings and CRC surveillance in diseases. Conclusion: In this modern era of smart phones and gadgets, developing a smartphone based application or educational tool is a novel idea and can help in improving the knowledge of residents about colorectal cancer screening as shown by our study. Such smart phone based educational tool can be a part of residents' orientation before the start of residency to emphasize further on CRC screening.