Brazil - Evidence-based Education: What Works?

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Flipping the classroom. Victoria Brazil examines how different approaches to teaching can improve patient outcomes.

Flipping the classroom. Victoria Brazil examines how different approaches to teaching can improve patient outcomes.

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  • Personal excellence in technical and humanistic skills
    Mastering the scientific foundations of system performance
    Participating and leading team based improvement
    Patient focus at all times

Transcript

  • 1. EVIDENCE BASED EDUCATION - WHAT WORKS? Victoria Brazil @SocraticEM
  • 2. EVERYTHING WORKS ! Answer:
  • 3. www.bemecollaboration.org/
  • 4. HANDWASHING – WHAT WORKS? • Taking part in any structured intervention • Combining with reminders, incentives, checklists, surveillance, audit and feedback • Repeated sessions • Assessment • Delivery using internal teams
  • 5. AIRWAY MANAGEMENT – WHAT WORKS? • Taking part in any structured intervention • Combining with reminders, incentives, checklists, surveillance, audit and feedback • Repeated sessions • Assessment • Delivery using internal teams
  • 6. PROCEDURAL SKILLS – WHAT WORKS? • Taking part in any structured intervention • Combining with reminders, incentives, checklists, surveillance, audit and feedback • Repeated sessions • Assessment • Delivery using internal teams
  • 7. COMMUNICATION SKILLS – WHAT WORKS? • Taking part in any structured intervention • Combining with reminders, incentives, checklists, surveillance, audit and feedback • Repeated sessions • Assessment • Delivery using internal teams
  • 8. ED LEADERSHIP – WHAT WORKS? • Taking part in any structured intervention • Combining with reminders, incentives, checklists, surveillance, audit and feedback • Repeated sessions • Assessment • Delivery using internal teams
  • 9. SIMULATION?
  • 10. YES !
  • 11. SIMULATION – WHAT WORKS? Providing feedback Repetitive practice Curriculum integration Multiple learning strategies Defined outcomes
  • 12. Its not ‘whether’ medical education works , but ‘how’ it works
  • 13. “RAPID CYCLE DELIBERATE PRACTICE”
  • 14. Efficient Delivery Of Mandatory Training
  • 15. WHAT LAST YEAR’S STUDENTS THOUGHT.. • “it was interactive and very realistic. A lot of things (labs, Hxs, patient information, PES) were integrated, introducing us to a more integrated approach” • “Enhanced exposure to clinical reasoning skills” • “… I felt responsible for my patients.”
  • 16. EVIDENCE BASED EDUCATION – WHAT WORKS?
  • 17. NOTHING WORKS ! Answer:
  • 18. PROGRESS TESTING AT MAASTRICHT Test score Year at medical school
  • 19. PROGRESS TESTING AT MAASTRICHT Test score Year at medical school
  • 20. PROGRESS TESTING AT MAASTRICHT Test score Year at medical school
  • 21. More than 90% of your individual performance is predicted by your performance at baseline Curricular change/ different medical schools appears to make no impact
  • 22. ‘NOTHING’ WORKS….
  • 23. EVALUATION • 100% of respondents strongly agreed “Dr Fox stimulated my thinking” • 90 % agreed that he “presented his material in organized and interesting way”
  • 24. ………allowed the researchers to draw the conclusion that “style was more influential than content in providing learner satisfaction.”
  • 25. EVIDENCE BASED EDUCATION – WHAT WORKS?
  • 26. WHAT DO YOU MEAN ‘WORKS’? Answer:
  • 27. Lucey, Acad Med 2013 “Medical education today is pedagogically superb…. ……….but our collective target is wrong”
  • 28. AN ASSUMPTION……. Training health care professionals = better at their job = better patient care
  • 29. “WORKS” = PATIENT FOCUSED ENDPOINTS
  • 30. Saving Money And Reducing Infections Central lines
  • 31. Saving Money And Reducing Infections Training intervention  $781k saved in one year Barsuk et al
  • 32. 70% REDUCTION IN FOETAL HYPOXIC INJURY 30 % REDUCTION IN TRANSFUSION REQUIREMENTS IN PPH “This is the first time an educational intervention has been shown to be associated with a clinically important, and sustained, improvement in perinatal outcome”
  • 33. THE HEALTH PRACTITIONER OF THE 21ST CENTURY Lead in complexity, and be expert in systems and team based care Improve care through practice audit and skilled analysis of patient outcome data
  • 34. SUMMARY All educational modalities are potentially effective or completely useless The biggest impact on learning is the learner Aim for ‘patient outcome’ endpoints for training