Interactive Case-Based Education on Pyruvate Kinase Deficiency Improves Hematologists' Competence in Implementing the Latest Diagnostic and Management Approaches

Abstract

INTRODUCTION The diagnosis of pyruvate kinase deficiency (PKD) is challenging, resulting in long diagnostic delays, sometimes into late adulthood. Management has previously only been supportive, but is evolving, therefore, physicians need to understand the latest evidence-based approaches. This study was conducted to determine whether online interactive case-based independent medical education could improve clinicians' competence in diagnosing and managing PKD according to the latest evidence. METHODS 174 hematologists participated in a text, case-based activity, and completed pre- and post-questions (Al Samkari H. Investigating Anemia and the Possibility of Pyruvate Kinase Deficiency: What Is Your Next Step? www.medscape.org/viewarticle/989782) Educational effect was assessed using a 3-question repeated-pair design with pre-/post-assessment. A paired samples t-test was conducted for significance testing on overall average number of correct responses and for confidence rating, and a McNemar's test was conducted at the learning objective level (5% significance level, P <.05). Cohen's d with correction for paired samples estimated the effect size of the education on number of correct responses. Data were collected from 3/21/2023-6/14/2023. RESULTS 48 hematologists completed all pre- and post-assessment questions. Overall significant improvements were seen after participation: 56% average correct response rate at pre-assessment vs 81% at post-assessment; P<.001, Cohen's d= 0.70. In addition, 65% of hematologists improved their competence, selecting correct responses in the post assessment after having selected incorrect responses in the pre-assessment. Significant improvements were achieved with regards to competence in diagnosing PKD and selecting an appropriate treatment approach (both P <.01). After participating, 42% had measurable improved confidence (P<.001) in their ability to implement new treatment approaches for patients with PKD. CONCLUSIONS This study demonstrates the success of online, interactive case-based education in improving clinicians' competence in diagnosing and managing PKD according to the latest evidence. Both improvement and reinforcement in the context of a linked learning assessment have been shown to positively correlate with increases in confidence as well as intention to make clinical practice changes (Lucero KS, Chen P. J Eur CME. 2020 Oct 12;9(1):1834759), suggesting that most clinicians who participated in this activity are likely to make improvements in their practice. This could lead to earlier appropriate treatment and improved overall outcomes for these patients.