Continuing Medical Education Activities Research Articles

Parkinson's Disease Psychosis and the Marketing of Pimavanserin.

In 2016, Nuplazid (pimavanserin) became the first FDA-approved treatment for Parkinson's Disease Psychosis (PDP). We explored the possibility that PDP was a term created to market Nuplazid. We examined trends in perceptions of psychosis in Parkinson's disease from the 1990s to 2020 through MEDLINE search term frequency, neurology textbooks, guidance from professional societies, Acadia annual reports, sponsored websites, and a sponsored meeting held by the National Institutes of Health (NIH). We analyzed continuing medical education (CME) activities on PDP and analyzed the connection between payments by the manufacturer of pimavanserin and prescriptions. Our analysis of nine sponsored CME activities reveals misleading themes, including: PDP is common, progressive, and not always drug-induced; there is no such thing as a benign hallucination, and psychotic symptoms always worsen; PDP increases mortality; and competing treatments are ineffective or dangerous while pimavanserin is safe and effective for treating PDP. Industry-sponsored CME was used to disseminate inaccurate and misleading marketing messages on psychosis related to Parkinson's disease. Some professional societies and some textbooks also resisted the PDP label. Reframing PDP as a unique condition is a typical example of condition branding. The establishment of PDP expanded the use of pimavanserin and is likely to have resulted in many avoidable deaths.

Assessing Knowledge, Competence, and Performance Following Web-Based Education on Early Breast Cancer Management: Health Care Professional Questionnaire Study and Anonymized Patient Records Analysis.

Web-based learning activities are key components of continuing medical education (CME) for health care professionals (HCPs). However, the published outcomes of web-based educational interventions for early breast cancer (EBC) are limited. This study aims to objectively assess knowledge, competence, and performance among HCPs following participation in 2 EBC-focused CME activities and to identify the remaining educational gaps. We developed 2 CME-accredited web-based educational activities addressing high-risk EBC, including integration of shared decision-making to optimize patient care (touchMDT) and stratification for early identification of high-risk patients and novel treatment strategies (touchPANEL DISCUSSION). Knowledge, competence, and performance were assessed before and after the activities against an expanded outcomes framework (levels 1-5) using self-reported questionnaires and an analysis of anonymized data extracted from patient records. Six months after the launch of the activity, 7047 and 8989 HCP participants engaged with touchMDT and touchPANEL DISCUSSION, respectively. The overall satisfaction was 82% (a total score of 20.6 out of 25) for the touchMDT and 88% (a total score of 21.9 out of 25) for the touchPANEL DISCUSSION. For the evaluation of knowledge and competence (50 respondents before the activity and 50 learners after the activity), there was a significant increase in the mean number of correctly answered questions from pre- to postactivity (touchMDT: median 4.0, IQR 3.0-5.0 to median 5.5, IQR 4.0-7.0; mean 4.00, SD 1.39 to mean 5.30, SD 1.56 and touchPANEL DISCUSSION: median 4.0, IQR 4.0-5.0 to median 6.0, IQR 5.0-7.0; mean 4.32, SD 1.30 to mean 5.88, SD 1.49; both P<.001). A significant improvement in self-reported performance (50 respondents before the activity and 50 learners after the activity) was observed in a combined analysis of both activities (median 3.0, IQR 2.0-3.0 to median 4.0, IQR 3.0-5.0; mean 2.82, SD 1.08 to mean 4.16, SD 1.45; P<.001). Patient record analysis (50 respondents before the activity and 50 learners after the activity) showed that the HCPs used a range of measures to determine EBC recurrence risk and revealed no significant differences in adjuvant therapies used before and after the activity (P=.97 and P>.99 for Ki-67 <20% and Ki-67 ≥20% tumors, respectively). The remaining educational gaps included strategies for implementing shared decision-making in clinical practice and the use of genetic and biomarker testing to guide treatment selection. Brief, web-based CME activities on EBC were associated with an improvement in HCP knowledge, competence, and self-reported performance and can help identify unmet needs to inform the design of future CME activities.

The Perceived Effectiveness of Online vs Physical Continuous Medical Education Sessions among Malaysian Doctors: A Cross-Sectional Study.

Ever since the pandemic, many educational platforms have gone online including Continuing Medical Education (CME). The objective of this study was to identify perceived focus and perceptions of both modes amongst Malaysian doctors. This was a cross-sectional study conducted from May to June 2020 via an online questionnaire. The researchers sent out the questionnaire to doctors via social media to study the perceived focus amongst attendees. We included all those who claimed to have participated in both types of CME previously. The final analysis included 357 respondents. The mean age of respondents was 46.54 (SD:17.52) years and the mean duration of practice was 21.46 (13.61) years. From the total, 46.5% of them were General Practitioners (GPs) and 49.9% were from the private sector. From the total, 60.4% of them participated in the online CME from their homes and 51.7% of them accessed it via their handphones. In a 60-minute CME activity, the perceived ability to focus (focus which participant perceive to have had/attained) in a physical CME was 32.94 (SD: 13.17) minutes and 32.65 (12.61) minutes for online CME (p=0.76). The perceived attention span and participation were better in a physical CME (both p&lt;0.001) and attention was mainly diverted to do other things during the meeting for online CME (p&lt;0.001). Although online CME was convenient during the pandemic, many participants felt they had a shorter attention span, less participation and had some attention diversion during online CME. Improving participation and attention span for online CME is very much needed.

Identifying and Addressing Knowledge and Confidence Gaps Regarding the Management of Patients with Sickle Cell Disease Via Engaging Continuing Medical Education

Introduction: While there have been recent advances in therapeutic options for the management of patients with sickle cells disease (SCD), hematology providers remain challenged by how to deliver an individualized approach to care, negatively impacting patient outcomes. To address this practice gap and identify drivers that underlie persisting challenges, an interactive continuing medical education (CME) activity was developed and implemented. Methods: Vindico Medical Education provided an interactive web-based CME activity on CME.Healio.com that was available for credit for one year starting August 31, 2022. The activity included opportunities for interaction with the content to encourage engagement, transfer knowledge, improve confidence, and encourage appropriate practice patterns. Impact of education was measured by comparing paired pre- and post-test responses. Results: As of July 2023, 221 hematology/oncology providers, including 116 MDs and advanced practice providers (APPs) and 105 nurses, who each see an average of 4 patients with SCD per month participated in the education. At baseline, scores on questions related to the latest evidence regarding new SCD therapies were low in both professional cohorts - an average 30% for MD/APPs and 16% for nurses. Moreover, 95% of HCPs in both cohorts lacked confidence in their knowledge of these agents and their appropriate use. This lack of knowledge and confidence translated into practice gaps. Specifically, 48% of those involved in treatment decisions indicated in the pre-test that they had never used a newer option for SCD management, and only 17% reported that they always consider the latest evidence when individualizing treatment for patients. On a post-test, however, the MD/APP and nurse cohorts scored an average of 81% and 84%, respectively, indicative of a robust impact of the education on clinician knowledge. Similarly, there was a 41% absolute increase in clinician confidence in understanding the latest evidence. These gains in knowledge and confidence translated into post-education planned practice improvements, with completers 22% more likely to apply this knowledge to clinical decision-making. Conclusion: Hematology/oncology providers lack knowledge and confidence regarding the latest evidence in SCD treatment. While the use of interactive CME led to robust gains in knowledge and confidence, follow-up case-based education is needed to facilitate the application of knowledge to practice while continuing to improve clinician confidence.

Impact on Knowledge, Competence, and Performance of a Faculty-Led Web-Based Educational Activity for Type 2 Diabetes and Obesity: Questionnaire Study Among Health Care Professionals and Analysis of Anonymized Patient Records.

Strategies for managing type 2 diabetes (T2D) and obesity are evolving with the introduction of targeted therapies, including incretin-based dual agonists and growing knowledge of the importance of multidisciplinary care. Accessible, effective continuing medical education (CME) activities are required to ensure that health care professionals (HCPs) understand and can implement the most recent data to optimize patient outcomes. We aimed to measure changes in knowledge, competence, and self-reported performance and quantitatively evaluate changes in performance using anonymized patient data following participation in a web-based educational activity. The faculty-led CME-accredited activity was based on incretin-based dual agonists and patient education on T2D and obesity. The remaining educational gaps in this field were also identified. A CME-accredited, web-based, multidisciplinary (touchMDT) educational activity titled "The future for glycemic control and weight loss in T2D and obesity: Incretin-based dual-agonists and optimizing patient education" was developed. HCP knowledge, competence, and performance were assessed before and after the activity against Moore's expanded outcomes framework (levels 1-5), using self-reported questionnaires and by analyzing anonymized patient record data. For evaluating knowledge and competence (50 respondents before and 50 learners after the activity), the mean number of correctly answered questions was significantly higher post activity (median 5.0, IQR 4.0-6.0 to 6.0, IQR 5.0-7.0; mean 4.98, SD 1.22 to 5.78, SD 1.13; P<.001). Modest, nonsignificant improvements in self-reported performance (N=50 respondents preactivity; N=50 learners postactivity) from before to after the activity were observed (median 4.0, IQR 3.25-4.0 to 4.0, IQR 4.0-4.0; mean 3.64, SD 0.69 to 3.76, SD 0.48; P=.32). PPatient data analysis indicated that patients were being treated more intensively postactivity: before the activity, the most commonly used treatment regimens were metformin monotherapy (13/50, 26%) and dual therapy with metformin plus injectable glucagon-like peptide-1 (GLP-1) receptor agonist (RA; 11/50, 22%); post activity, this changed to dual therapy with metformin plus injectable GLP-1 RA (12/50, 24%) and triple therapy with metformin plus injectable GLP-1 RA plus sodium-glucose cotransporter-2 inhibitor (SGLT2i; 10/50, 20%). In addition, there was an increased number of referrals to a combination of specialists (physicians referred 27%, 8/30 of patients to ≥2 specialists before the activity and 36%, 10/28 to ≥2 specialists post activity). The remaining educational gaps included understanding the biology and psychology of obesity, efficacy and safety data for incretin-based dual agonists, and the role of the diabetes educator or diabetes care and education specialist in managing T2D and obesity. This short, web-based CME activity on the management of T2D and obesity led to improvements in HCP knowledge, competence, and performance. Several remaining unmet needs were identified, which can be used to inform the content of future educational activities in this disease area.

SAGES SAFE CHOLE program changes surgeons practice in France-results of the FCVD implementation of SAFE CHOLE in France.

With the Society of Gastrointestinal and Endoscopic Surgeons supervision, the Safe Cholecystectomy Task Force (SAFE CHOLE) was translated into French by the the Federation of Visceral and Digestive Surgery (FCVD) and adopted to run on its national e-learning platform for surgical continuing medical education (CME). The objective of this study was to assess the impact of the SAFE CHOLE (SF) program on the knowledge and practice of French surgeons performing cholecystectomy and participating in the FCVD lead CME activity. To obtain CME certification, each participant must fill out three FCVD validated questionnaires regarding (1) the participants' routine practice for cholecystectomy, (2) the participants' knowledge and practice after successful completion of the program, and (3) the educational value of the SC program. From 2021 to 2022, 481 surgeons completed the program. The overall satisfaction rate for the program was 81%, and 53% of the surgeons were practicing routine cholangiography before the SC program. Eighty percent declared having acquired new knowledge. Fifty-six percent reported a change in their practice of cholecystectomy. Of those, 46% started routinely using the critical view of safety, 12% used a time-out prior transection of vital structures, and 11% adopted routine intraoperative cholangiography. Sixty-seven percent reported performing a sub-total cholecystectomy in case the CVS was unobtainable. If faced with BDI, 45% would transfer to a higher level of care, 33% would seek help from a colleague, and 10% would proceed with a repair. Ninety percent recommended adoption of SC by all general surgeons and 98% reported improvement of patient safety. Large-scale implementation of the SC program in France is feasible within a broad group of diverse specialty surgeons and appears to have a significant impact on their practice. These data should encourage other surgeons and health systems to engage in this program.

Preparing Clinicians to Provide Equitable Alzheimer’s Disease (AD) Care: What Continuing Medical Education (CME) Can Achieve (P12-2.003)

<h3>Objective:</h3> To assess the influence of live online CME on clinicians’ (HCPs) awareness of ethnic and racial differences in AD and ability to develop strategies to enhance care access for diverse patients. <h3>Background:</h3> Government agencies and advocacy groups have prioritized reduction of disparities in brain health. HCPs need to recognize the increased risks and burdens associated with AD in various ethno-racial groups and have outreach strategies for diverse underrepresented communities. <h3>Design/Methods:</h3> We partnered with advocacy groups and experts in community-based AD care to produce two 60-minute CME activities, launched 12/16/2021 and 3/2/2022. The activities were on-demand for one year. Experts recorded videos outlining their community-outreach strategy. In addition, HCPs could submit their outreach plans to be reviewed during the second CME activity. Responses to test questions before, immediately post, and 2 months after an activity, along with outreach plans, were analyzed for insights and identification of remaining gaps. Chi-square compared paired responses (pre/post and pre/2 mos, <i>P</i>&lt;0.05). <h3>Results:</h3> As of 10/4/22, 1,893 HCPs participated and 865 identified as treaters seeing 10 patients/week. Post activity, there were marked improvements in awareness of causes of AD care inequities (+37%, <i>P</i>&lt;0.05), genetic predisposition (+46%, <i>P</i>&lt;0.05), and ability to identify tools to evaluate cognitive status (+55%, <i>P</i>&lt;0.05). Reported practice changes included use of assessment tools and strategies to evaluate patients and account for genetic and cultural differences. Six outreach plans were reviewed (communities were rural, urban, and/or low-economic status). Outreach projects included providing culturally appropriate education to communities, hiring a socially sensitive workforce, connecting with churches, and enhancing research diversity. <h3>Conclusions:</h3> Data support the positive impact of live-online CME in preparing HCPs to provide equitable AD care through increased recognition of critical differences in risk among races and ethnic groups and development of outreach strategies to build trust and address barriers to access. <b>Disclosure:</b> Carole Drexel has nothing to disclose. Dr. Wilson has nothing to disclose. Ms. Bixler has nothing to disclose. Goldie S. Byrd has nothing to disclose. Dr. Zwerling has nothing to disclose. Dr. Allen has nothing to disclose. Ms. Lynn has nothing to disclose.

Evaluating the effectiveness of online Continuing medical education during the COVID-19 pandemic

Objectives The study determined the effects of online continuing medical education (CME) on the clinical competency, performance, and patient outcomes of physicians and other healthcare professionals during the COVID-19 pandemic regarding the topics of COVID-19 and back pain. Methods Survey studies on six online CME activities were conducted from April 2020 to February 2021 at a South Korean hospital. Surveys were conducted immediately after and three months after the CME activity to measure the effectiveness of the CME activity regarding professional competence and performance, as well as patient outcomes. Results A total of 624 individuals participated in the six CME activities. Of the 2007 post-activity responses, a total of 1135 out of 1332 (85.21%) participants indicated that they were satisfied with the online education activities, and a total of 1752 out of 2007 (87.29%) participants responded that the content would influence their clinical practice. Upon a three-month follow-up, 477 out of 611 (78.07%) respondents indicated that they had made actual changes to their clinical practice. Conclusions The online delivery method is effective for delivering CME. The results suggest that online CME ultimately influences physicians’ clinical competency and performance, which leads to enforcing change in clinical practice.

Impact of virtual continued medical education on carbon footprint and awareness of digital sobriety: A retrospective cross-sectional study among public health professionals in India.

Due to the COVID-19 pandemic, physical meetings and continuing medical education (CMEs) are being conducted in virtual mode. Digital sobriety has been advocated as a strategy for controlling the environmental emission from online events. The present study was undertaken to assess the impact of virtual CMEs on the environment and the participants' perception, knowledge, attitude, and practices of digital sobriety during the CMEs. A retrospective cross-sectional Google form-based online study was conducted among the 1,311 registrants of 23 virtual CMEs hosted in India. A pre-tested English questionnaire was used to collect the data. The potential carbon footprint of the significant physical CME activities and the carbon emission (CE) of the virtual CMEs were estimated. Among the registrants contacted, 251 consented and participated in the study. The CE of the virtual CMEs was 0.787 metric tons of carbon dioxide equivalent (MT CO2 Eq). If the CMEs were conducted physically, the potential CE was estimated to be 290.094 MT CO2 Eq. The awareness rate of digital sobriety was 35%. Most of the participants (58.7%) from the current study preferred the hybrid mode of CMEs. Virtual, digitally sober CMEs have reduced the potential CE by 99.7% compared to physical CMEs in India. The awareness and knowledge about digital sobriety is low in India. Knowledge, networking, social interactions, and overall satisfaction were relatively lower in the virtual mode of CMEs than in the physical mode.

Improving Palliative Care and Medical Assistance in Dying Practice in Canada: How Patients-Partners Could Contribute to Continuing Medical Education.

Medical Assistance in Dying (MAiD) is still considered an evolving practice in Canada. Practitioners are facing the challenge of staying up to date and hence need efficient continuing medical education (CME). A patient-partner has been recently invited as a keynote speaker to CME activities in Canada to share her perspectives and views about patient engagement in palliative care and MAiD practice, calling for compassion. To our knowledge, few data exist on patient-partners' contribution to CME on these topics. Based on that experience, we discuss different issues on patient engagement's contribution in such CME events and call for further research.

Tips and Tricks: Starting Your Own Continuing Medical Education Course

Tips and Tricks: Starting Your Own Continuing Medical Education Course

Physicians' continuing medical education activities and satisfaction with their ability to stay current in medical information and practice: A cross-sectional study.

Little is known about physicians' approaches to continuing medical education (CME) for continuing professional development despite the rapid evolution of CME offerings. We sought to identify the extent to which demographic, career, and experiential CME-activity variables were independently associated with physicians' satisfaction with their ability to stay current on medical information and practice. Using the 2019 Association of American Medical Colleges' National Sample Survey of Physicians data, we ran multivariable logistic regression models examining demographic, career, and experiential (participation in 11 CME activities in the past year) variables for their associations with physicians' satisfaction (satisfied vs. not satisfied/neutral) with their ability to stay current. Of 5926 respondents, 90% (5341/5926) were satisfied with their ability to stay current. Significant (each two-sided p < 0.05) predictors of respondents who were satisfied included (among others) a surgery specialty (vs. primary care; adjusted odds ratio [AOR] = 1.41, 95% confidence interval [CI] = 1.06-1.88), an academic affiliation (vs. none; AOR = 1.35, 95% CI = 1.10-1.66), and participation (vs. no participation) in each of professional meetings (AOR = 1.31, 95% CI = 1.07-1.60) and journal-based CME (AOR = 1.29, 95% CI = 1.07-1.56). Respondents who self-identified as a race/ethnicity underrepresented in medicine (vs. white; AOR = 0.68, 95% CI = 0.48-0.97) and were between ages 40 and 49 years (vs. 50-59; AOR = 0.74; 95% CI = 0.58-0.94) were less likely to be satisfied. Gender, board certification status, and medical degree type did not independently predict satisfaction (each p > 0.05). We observed independent associations between physicians' satisfaction with their ability to stay current in medical information and practice and each specialty, academic affiliation, race/ethnicity, age, and CME activity type (for 2 of 11 examined). Findings may be relevant to organizations and institutions designing and implementing CME activities in the current context of COVID-19 pandemic-related in-person activity limitations and can inform targeted interventions addressing differences in the satisfaction we observed to better support physicians' CME.

Virtual Patient Simulation Offers an Objective Assessment of CME Activity by Improving Clinical Knowledge and the Levels of Competency of Healthcare Providers

ABSTRACTThe main goal of continuing medical education (CME) is to help healthcare providers (HCP) improve their knowledge and levels of competency with an ultimate enhancement of their performance in practice. Despite the long and well-intentional history of CME, the proof of success (based on improved clinical outcomes) is difficult to obtain objectively. In the past several years, the traditional CME world has been disrupted by replacing multiple-choice questions with virtual simulation. We utilised an innovative, next-generation virtual patient simulation (VPS) platform to develop objective measures to assess the success of educational activities that can be applied to the CME. This VPS platform was used at five distinct educational events designed to assess learners’ knowledge and competency in the guideline-driven management of Type 2 diabetes, hyperlipidaemia, and hypertension. A total of 432 learners (medical doctors, nurse practitioners, and clinical pharmacists) participated in these educational events of whom 149 went through two consecutive cases with a similar clinical picture and educational goals. Their ability to achieve glycaemic, lipid, and blood pressure control improved significantly as they moved from the first to the second case. The participants improved their test performance in all categories – between 5 and 38%, achieving statistically significant increases in the many goals examined. In conclusion, this study employed the pioneering application of technology to produce, collect and analyse the VPS data to evaluate objectively educational activities. This VPS platform allows not only an objective assessment of the effectiveness of the CME activity but also provides timely and helpful feedback to both learners and providers of a given educational event.

@MondayNightIBD and the Expanding Gastroenterology Twitterverse: A Study on Continuing Medical Education on #GITwitter.

@MondayNightIBD provides weekly continuing medical education (CME) activities focused on inflammatory bowel diseases to clinicians on Twitter. Given its novelty, we assessed whether @MondayNightIBD improves learner knowledge and leads to practice change. We also examined whether inflammatory bowel disease topics addressed in @MondayNightIBD are aligned with entrustable professional activities (EPA) set forth by national gastroenterology societies. @MondayNightIBD CME sessions from February 2020 (date the handle was accredited to provide CME) to May 2021 were analyzed. Preactivity and postactivity knowledge was assessed for average score improvement using the Student t test and Cohen d effect size. Postactivity surveys examined for learners' perceptions of whether activities met educational goals and affected willingness to change clinical practice using descriptive percentages. In addition, activities from April 2019 (date of @MondayNightIBD inception) to May 2021 were assessed for whether they address EPA set forth by national gastroenterology societies. Learners' knowledge improved after @MondayNightIBD activities with average preactivity correct answers of 58% to a postactivity average of 79% ( P < 0.001). Greater than 95% of learners found that activities met learning objectives and enhanced knowledge. A total of 92% of learners were committed to practice change because of their @MondayNightIBD participation. Finally, 78% of EPA set forth by a national gastroenterology society have been covered by @MondayNightIBD since its inception. @MondayNightIBD is a Twitter-based CME activities platform for gastroenterologists and other clinicians that is embraced by learners, improves knowledge, and encourages practice change. Topics covered during @MondayNightIBD are aligned with EPA set forth by national gastroenterology societies. @MondayNightIBD is a successful model of social media medical education and a novel approach to effectively provide evidence-based CME.

Engaging Continuing Medical Education Reveals Persisting Knowledge and Practice Gaps in FLT3-Positve AML

Introduction: Given the rapid evolution of testing and treatment of FMS-like tyrosine kinase 3 (FLT3)-positive AML, oncology providers are challenged by how to administer the latest evidence-based care. Additionally, while the use of patient-reported outcomes (PROs) can improve patient care, they are underutilized in oncology practice An interactive continuing medical education (CME) activity was provided to assess baseline attitudes and practice patterns while also addressing identified gaps in knowledge and skills regarding the management of patients with FLT3-positive AML. Methods: Vindico Medical Education provided a web-based CME activity available on myCME.com and for credit from December 31, 2021 to December 30, 2022. The activity included opportunities for interaction with the content to encourage engagement, transfer knowledge, improve confidence, and assess current practice patterns. Impact of education was measured by comparing paired pre- and post-test responses. Results: As of July 2022, 216 hematology/oncology providers who each see an average of 8 patients with AML per month participated in the education. These providers scored an average 26% on a pretest for topics related to the evaluation of patients with AML the impact of FLT3 mutations on prognosis and management, and the use of PROs in practice. Post-learning, providers scored 49%, highlighting the impact of the education on knowledge gaps, but also demonstrating persisting gaps. Specifically, post-test scores remained lowest regarding the implications of FLT3 mutations on patient outcomes and treatment strategies for these patients. Notably, while 65% of these providers indicated that they were guessing on the pre-test, the percentage of those who were confident and correct on the post-test rose from 1% to 18%, demonstrating a sharp rise in confidence. However, these persisting knowledge and confidence gaps translated to practice gaps - only 40% currently report performing mutational analysis at relapse for patients with AML. Moreover, only 51% were familiar with FLT3 MRD testing and providers lacked consensus regarding first- and subsequent-line treatment for FLT3-positive patients. Forty-seven percent noted an uncertainty regarding optimal combinations and sequencing as the primary challenge they face when selecting treatment for these patients. While knowledge and confidence scores regarding the use of PROs were high, only 16% always use PROs in practice, with patient non-compliance as the biggest barrier to implementation. Conclusion: Hematology/oncology providers lack knowledge and confidence regarding testing and management of patients with FLT3-positive AML, which translates to practice gaps. While the use of interactive CME led to robust gains in knowledge and confidence, further education is needed to address persisting gaps regarding testing and management of patients with FLT3-positive AML. Moreover, skills-based training and patient resources are needed to facilitate the use of PROs in clinical practice.

Abstract 11538: The Impacts of the Patient Voice in Continuing Medical Education (CME) to Enhance Homozygous Hypercholesterolemia (HoFH) Diagnosis and Management

Introduction: Early diagnosis and management of HoFH are key to achieving CV risk reduction. However, barriers to identifying probable cases, low awareness of current guidelines, and a lack of knowledge of treatment options continue to present challenges to HCPs. Hypothesis: CME with the patient voice can enhance HCP's competence in diagnosing and managing HoFH and adopting newest treatment options. Methods: A 60-minute CME activity that incorporated the patient voice was launched live-online 7/20/21 and was available on-demand for 1 year. Test questions were administered before and immediately after the activity. A follow-up survey on HCP behavior was sent to post-test respondents 2 months after activity completion. Responses were analyzed for engagement, lessons learned, and continuing gaps. Chi-square tests compared paired responses (P less than 0.05; pre/post). Results: As of 6/6/22, 1,806 HCPs had engaged (14% cardiologists and 57% PCPs managing an average of 50.2 patients per year with very high lipid levels). At entry, 68% of HCPs were at least “somewhat confident” in managing HoFH, while 48% did not know about newly approved agents for HoFH. Outcomes showed significant increases (pre vs post) in ability to recognize manifestations of HoFH (47% vs 87%), apply guidelines to reduce high LDL-C levels despite statin therapy (38% vs 92%), and recognize mechanism of action of evinacumab (43% vs 88%). On follow up, HCPs reported positive impacts on practice related to diagnosing HoFH, applying guideline-driven care to lower LDL-C, identifying high-risk patients, and referring appropriately. Conclusions: Live and on-demand CME including the voice of the patient successfully highlighted HoFH patient’s expectations of care and enhanced HCPs’ ability to adapt to the changing HoFH landscape. Additional education on this evolving landscape and associated guidelines can further enhance quality of care for HoFH patients.

The Educational Impact of Web-Based, Faculty-Led Continuing Medical Education Programs in Type 2 Diabetes: A Survey Study to Analyze Changes in Knowledge, Competence, and Performance of Health Care Professionals.

BackgroundThe treatment landscape for type 2 diabetes (T2D) is continually evolving; therefore, ongoing education of health care professionals (HCPs) is essential. There is growing interest in measuring the impact of educational activities, such as through use of the Moore framework; however, data on the benefits of continuing medical education (CME) in the management of T2D remain limited.ObjectiveThis study aimed to evaluate HCP satisfaction; measure improvements in knowledge, competence, and performance following short, case-based, multidisciplinary web-based CME activities; and identify the remaining educational gaps.MethodsTwo faculty-led, CME-accredited, web-based educational activities on T2D and obesity, touchIN CONVERSATION and touch MultiDisciplinary Team, were developed and made available on a free-to-access medical education website. Each activity comprised 3 videos lasting 10 to 15 minutes, which addressed learning objectives developed based on a review of published literature and faculty feedback. Participant satisfaction (Moore level 2) was evaluated using a postactivity questionnaire. For both activities, changes in knowledge and competence (Moore levels 3 and 4) were assessed using questionnaires completed by representative HCPs before or after participation in the activities. A second set of HCPs completed a questionnaire before and after engaging in activities that assessed changes in self-reported performance (Moore level 5).ResultsEach activity was viewed by approximately 6000 participants within 6 months. The participants expressed high levels of satisfaction (>80%) with both activities. Statistically significant improvements from baseline in knowledge and competence were reported following participation in touchIN CONVERSATION (mean score, SD before vs after activity: 4.36, 1.40 vs 5.42, 1.37; P<.001), with the proportion of learners answering at least six of 7 questions correctly, increasing from 22% (11/50) to 60% (30/50). A nonsignificant improvement in knowledge and competence was observed following participation in touch MultiDisciplinary Team (mean score, SD 4.36, 1.24 vs 4.58, 1.07; P=.35); however, baseline knowledge and competence were relatively high, where 80% of the respondents (40/50) answered at least four of 6 questions correctly. A significant improvement in HCP self-reported performance was observed in a combined analysis of both activities (mean score, SD 2.65, 1.32 vs 3.15, 1.26; P=.03), with the proportion of learners selecting the answer representing the best clinical option for all 4 questions increasing from 32% (11/34) to 59% (20/34) after the activity. Several unmet educational needs were self-reported or identified from the analysis of incorrectly answered questions, including setting individualized glycemic targets and the potential benefits of sodium-glucose cotransporter 2 inhibitor therapies.ConclusionsShort, case-based, web-based CME activities designed for HCPs to fit their clinical schedules achieved improvements in knowledge, competence, and self-reported performance in T2D management. Ongoing educational needs identified included setting individualized glycemic targets and the potential benefits of sodium-glucose cotransporter 2 inhibitor therapies.

S1631 Education on the Treatment of Helicobacter pylori Infection Improves Clinician Knowledge

Introduction: The prevalence of Helicobacter pylori infection in US adults is around 35%. Eradication of H. pylori is essential to the successful management of peptic ulcer disease, and the potential prevention of gastric cancer. The goal of this project was to assess the role of continuing medical education (CME) on improving learners’ knowledge regarding evidence-based treatment of H. pylori infection. Methods: Gastroenterologists (N =1499) and primary care physicians (PCPs; N =1224) participated in an online text-based CME/CE activity on the diagnosis and treatment of H. pylori infection (1). Educational effect was assessed using a repeated-pair design with pre-/post-assessment and 2 multiple choice questions. This assessed knowledge and included evaluation questions that gauged patient numbers and overall satisfaction with the education. We calculated relative improvement ([post%-pre%]/pre%) to examine change in percentage of correct responses. We used the chi-squared test for significance testing on the number of correct responses pre- to post-activity with P < 0.05 considered statistically significant. The online CME activity launched on October 15, 2021; data were collected on May 31, 2022. Results: Sixty-six percent of gastroenterologists and 60% of PCPs strongly agreed that this education increased their knowledge regarding evidence-based treatments for H. pylori infection. First line therapy for H. pylori infection: Gastroenterologists had a 308% relative increase (13%/53% pre/post; P < .05), and PCPs had a 360% relative increase (10%/46%, pre/post; P < .05) in knowledge regarding recommended first-line treatment of H. pylori infection (Figure). Antibiotic resistance and H. pylori treatment: Gastroenterologists had a 33% relative increase (55%/73%, pre/post; P < .05), and PCPs had a 162% relative increase (26%/68%, pre/post; P < .05) in knowledge about antibiotic resistance to clarithromycin in patients with H. pylori infection (Figure). Conclusion: We found significant improvement in knowledge among gastroenterologists and PCPs regarding evidence-based management of H. pylori infection. However, additional educational effort is required to close some clinical knowledge gaps regarding selection of first-line treatment for H. pylori infection and resistance to antibiotics, with particular emphasis on clarithromycin.Figure 1.: Pre and Post results for gastroenterologists and primary care physicians knowledge for first-line treatment of Helicobacter pylori.

VP.39 A new era for gMG management: Impact of continuing education on improving diagnosis and classification of gMG patients

The management of gMG is changing with the advent of targeted therapeutics and an expanding pipeline. HCPs need to know how to use biomarkers and antibody testing to better individualize therapeutic decisions. We assessed the impact of online continuing medical education (CME) for clinicians (HCPs) on competence related to generalized myasthenia gravis (gMG) diagnosis and knowledge of current and new and emerging treatment options. One 60-min CME activity was launched live-online on 3/9/21 and remained on-demand for 1 year. Test questions were administered pre-, immediately post-, and 2 months post-activity. Responses from learner polling and follow-up surveys were analyzed for engagement, lessons learned, and continuing gaps. Chi-square compared paired responses (pre/post & pre/2 mos, p<.05). When the activity expired, 906 HCPs engaged with the activity, 223 of them reporting 9.4 patient visits for MG every month. Results showed statistically significant immediate increases in knowledge related to treatment-resistant gMG disease burden (76% post vs 30% pre), therapeutic predictive value of gMG associated antibodies (84% post vs 39% pre), and mechanisms of action of new immunoglobulin G (IgG) and emerging neonatal Fc receptor (FcRn) targeted agents (87% post vs 39% pre). During the follow-up survey, 88% of HCPs reported the education to benefit their clinical practice, with write-in examples of changes related to implementation of EMG and antibody testing for diagnosis, increased awareness of new treatments options, and enhanced ability to provide patient counseling regarding management options. These data support the positive impact of live and on-demand online CME education on awareness of gMG burden, diagnosis, prognosis based on biomarkers, and its evolving management. The education also revealed areas in need for continuous education regarding the impact on gMG burden on treament selection, and strategies to individualize therapy.

Avoiding Bias and Ensuring Content Validity in Accredited Continuing Education: What Do the Latest ACCME Standards Mean for Medical Writers?

Some continuing medical education (CME) activities are developed using financial support from entities such as pharmaceutical companies that may have a commercial interest in the therapeutic area being discussed. Accordingly, standards intended to shield CME from industry bias have been in place for decades. The latest iteration of these standards from the Accreditation Council for Continuing Medical Education (ACCME) has a special significance to medical writers due to their emphasis on clinical content validity. Once a separate entity, the content validity requirement is now incorporated into the ACCME standards. In fact, it is positioned as the number 1 standard, emphasizing its importance. It should be relatively straightforward for writers to support the goals of the guidance—that is, to provide relevant and scientifically accurate content that is free from industry manipulation or influence. However, the standards as published are not prescriptive in how to achieve these goals, leaving writers to ponder exactly what it means to be “fair and balanced.” This article provides background on the ACCME standards with a special emphasis on their relevance to CME writers, describes helpful downloadable resources for writers, discusses some scenarios that medical writers may encounter, and provides practical advice in interpreting and applying the current standards when developing content for CME activities.