S0468 Virtual Patient Simulation Improves IBS Diagnosis and Treatment: A CME Study

Abstract

INTRODUCTION: Irritible bowel syndrome (IBS) is is a functional bowel disorder routiely encountered by gastroenterologists and primary care physicians (PCPs). This study examined whether online continuing medical education (CME) that incorporated a virtual patient simulation (VPS) can improve performance in the management of IBS. METHODS: An online CME case-based intervention in a VPS platform1 allowed learners to interact with patients via video, order lab tests, make diagnoses, and order treatments. Clinical decisions were analyzed, and learners received clinical guidance (CG) based on current evidence and expert recommendations. Learners were allowed to modify their decisions post-CG. Pre- (baseline) to post-CG decisions were compared using a McNemar's test. The intervention launched on August 27, 2019 and data were collected through December 2, 2019. RESULTS Significant improvements were observed as a result of participation in VPS: Case 1 (n = 168 gastroenterologists; n = 474 PCPs): • Communication with patients: 6% relative change among gastroenterologists (51% vs 54% pre/post CG; P < 0.05) and 6% relative change among PCPs (50% vs 53% pre/post CG; P < 0.001). • Order diagnostic tests: 8% relative change among gastroenterologists (84% vs 91% pre/post CG; P < 0.001) and 11% among PCPs (70% vs 81% pre/post CG; P < 0.001. • Tailoring treatment: 192% relative change among gastroenterologists (23% vs 68% pre/post CG; P < 0.001) and 300% relative change among PCPs (16% vs 63% pre/post CG; P < 0.001). Case 2 (n = 103 gastroentertologists; n = 294 PCPs): • Tailoring treatment: 85% relative change among gastroenterologists (32% vs 59% pre/post CG; P < 0.001) and 335% relative change among PCPs (13% vs 58% pre/post CG; P < 0.001). • Gastroenterologists and PCPs had significant increases in prescribing alosetron or eluxodoline following CG (Figure 1). • The top 2 rationales for selection of eluxadoline among both gastroenterologists and PCPs were efficacy in reducing symptoms and guideline recommended. CONCLISION: Participation in a VPS-based education initiative that immerses and engages learners in an authentic and practical learning experience significantly improves clinical decisions related to the diagnosis and selection of evidence-based pharmacologic treatments.Figure 1.: Prescribed treatments pre- and post- clinical guidance.