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Progress Report Presentation:
Learning Retention and the Timing of Refresher Education
After The Deliberate Practice of Radiograph Interpretation

K. Boutis, M. Pecaric, J. Beckstead, P. Babyn, M. Pusic
UToronto, USF, NYU
IMSH 2014: San Francisco, CA / USA

International Network for Simulation-based Pediatric Innovation, Research and Education
Background
• Content Area: PEM Radiology
• Instructional Design:
Online Deliberate Practice (Screen Simulation)

• Question:
What is the rate of skill decay?
International Network for Simulation-based Pediatric Innovation, Research and Education
PICO Question
P: PEM Fellows
I:

Online deliberate practice

C: Same + Refresher Training
O: Knowledge retention over 18 mo

International Network for Simulation-based Pediatric Innovation, Research and Education
Marty, can you create a
Couple of screenshot slides
From the tutorial (showing lines)
And from one case showing
Feedback with green.
Marty, can you create a
Couple of screenshot slides
From the tutorial (showing lines)
And from one case showing
Feedback with green.
ABNORMAL
NORMAL
Study Protocol
Two Phases:
1. Radiograph Calibration
– Remove educationally poor cases

– Broad sample of expertise
– Use Rasch Modelling to ensure appropriate difficulty

2. Actual Trial
– Target Population

International Network for Simulation-based Pediatric Innovation, Research and Education
PICO Question
Final Sample size: 100 + 100
CALIBRATION:
TRIAL:
(Read 100 Xrays (Read 220
Once)
Xrays/18mo)
Medical Students

20

EM Residents

20

Peds Residents

20

PEM Fellows

20

PEM Attendings

10

Peds Radiology

10

40
60

International Network for Simulation-based Pediatric Innovation, Research and Education
Approach / Design

Adding fourth group: No Refresher

International Network for Simulation-based Pediatric Innovation, Research and Education
Overlearning

Slope of Decay Curve

Area Under Curve

COMPETENCE
Refresher Training

PERFORMANCE

Approach / Design

Training -- Learning (Units of
Deliberate Practice)

Skill Degradation
Stops
training

(Units of Elapsed Time)

TIME
PICO Question
Final Sample size: 100 + 100
CALIBRATION:
TRIAL:
(Read 100 Xrays (Read 220
Once)
Xrays/18mo)
Medical Students

20

EM Residents

20

Peds Residents

20

PEM Fellows

20

PEM Attendings

10

Peds Radiology

10

40
60

International Network for Simulation-based Pediatric Innovation, Research and Education
Progress since Jan 2013
• Calibration phase almost completed
• IRB through at:
– University of Toronto

– NYU
– Dalhousie
– Universite de Montreal

International Network for Simulation-based Pediatric Innovation, Research and Education
Needs / Challenges
1. Going well
2. IRB issues for coinvestigators

3. Keeping people in the study over the
18 months.

International Network for Simulation-based Pediatric Innovation, Research and Education
How can INSPIRE help?
1. @ IMSH 2014: Recruit 2 centers
2. In 3 months: Commence study phase 2

3. Over 1 year: Continue data collection

International Network for Simulation-based Pediatric Innovation, Research and Education
Contact Information
Name:

Martin Pusic

Institution:

NYU

E-mail:

mpusic@gmail.com

Website: www.medals-silver.org/INSPIRE

International Network for Simulation-based Pediatric Innovation, Research and Education

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Alert 2014-progress-pusic-boutis

  • 1. Progress Report Presentation: Learning Retention and the Timing of Refresher Education After The Deliberate Practice of Radiograph Interpretation K. Boutis, M. Pecaric, J. Beckstead, P. Babyn, M. Pusic UToronto, USF, NYU IMSH 2014: San Francisco, CA / USA International Network for Simulation-based Pediatric Innovation, Research and Education
  • 2. Background • Content Area: PEM Radiology • Instructional Design: Online Deliberate Practice (Screen Simulation) • Question: What is the rate of skill decay? International Network for Simulation-based Pediatric Innovation, Research and Education
  • 3. PICO Question P: PEM Fellows I: Online deliberate practice C: Same + Refresher Training O: Knowledge retention over 18 mo International Network for Simulation-based Pediatric Innovation, Research and Education
  • 4. Marty, can you create a Couple of screenshot slides From the tutorial (showing lines) And from one case showing Feedback with green.
  • 5. Marty, can you create a Couple of screenshot slides From the tutorial (showing lines) And from one case showing Feedback with green.
  • 8. Study Protocol Two Phases: 1. Radiograph Calibration – Remove educationally poor cases – Broad sample of expertise – Use Rasch Modelling to ensure appropriate difficulty 2. Actual Trial – Target Population International Network for Simulation-based Pediatric Innovation, Research and Education
  • 9. PICO Question Final Sample size: 100 + 100 CALIBRATION: TRIAL: (Read 100 Xrays (Read 220 Once) Xrays/18mo) Medical Students 20 EM Residents 20 Peds Residents 20 PEM Fellows 20 PEM Attendings 10 Peds Radiology 10 40 60 International Network for Simulation-based Pediatric Innovation, Research and Education
  • 10. Approach / Design Adding fourth group: No Refresher International Network for Simulation-based Pediatric Innovation, Research and Education
  • 11. Overlearning Slope of Decay Curve Area Under Curve COMPETENCE Refresher Training PERFORMANCE Approach / Design Training -- Learning (Units of Deliberate Practice) Skill Degradation Stops training (Units of Elapsed Time) TIME
  • 12. PICO Question Final Sample size: 100 + 100 CALIBRATION: TRIAL: (Read 100 Xrays (Read 220 Once) Xrays/18mo) Medical Students 20 EM Residents 20 Peds Residents 20 PEM Fellows 20 PEM Attendings 10 Peds Radiology 10 40 60 International Network for Simulation-based Pediatric Innovation, Research and Education
  • 13. Progress since Jan 2013 • Calibration phase almost completed • IRB through at: – University of Toronto – NYU – Dalhousie – Universite de Montreal International Network for Simulation-based Pediatric Innovation, Research and Education
  • 14. Needs / Challenges 1. Going well 2. IRB issues for coinvestigators 3. Keeping people in the study over the 18 months. International Network for Simulation-based Pediatric Innovation, Research and Education
  • 15. How can INSPIRE help? 1. @ IMSH 2014: Recruit 2 centers 2. In 3 months: Commence study phase 2 3. Over 1 year: Continue data collection International Network for Simulation-based Pediatric Innovation, Research and Education
  • 16. Contact Information Name: Martin Pusic Institution: NYU E-mail: mpusic@gmail.com Website: www.medals-silver.org/INSPIRE International Network for Simulation-based Pediatric Innovation, Research and Education