EVIDENCE BASED EDUCATION

- WHAT WORKS?

Victoria Brazil

@SocraticEM

EVERYTHING WORKS !

Answer:

www.bemecollaboration.org/

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

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

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

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

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

SIMULATION?

YES !

SIMULATION – WHAT WORKS?

Providing feedback

Repetitive practice

Curriculum integration

Multiple learning strategies

Defined outcomes

Its not ‘whether’ medical education works , but ‘how’ it works

“RAPID CYCLE DELIBERATE PRACTICE”

Efficient Delivery Of Mandatory

Training

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.”

EVIDENCE BASED EDUCATION

– WHAT WORKS?

NOTHING WORKS !

Answer:

PROGRESS TESTING AT MAASTRICHT

Test score

Year at medical school

PROGRESS TESTING AT MAASTRICHT

Test score

Year at medical school

PROGRESS TESTING AT MAASTRICHT

Test score

Year at medical school

More than 90% of your individual performance is predicted by your performance at baseline

Curricular change/ different medical schools appears to make no impact

‘NOTHING’ WORKS….

EVALUATION

•100% of respondents strongly agreed “Dr Fox stimulated my thinking”

•90 % agreed that he “presented his material in organized and interesting way”

………allowed the researchers to draw the conclusion that

“style was more influential than content in providing learner satisfaction.”

EVIDENCE BASED EDUCATION

– WHAT WORKS?

WHAT DO YOU MEAN ‘WORKS’?

Answer:

Lucey, Acad Med 2013

“Medical education today is pedagogically superb….

……….but our collective target is wrong”

AN ASSUMPTION…….

Training health care professionals

= better at their job

= better patient care

“WORKS” = PATIENT FOCUSED ENDPOINTS

Saving Money And Reducing Infections

Central lines

Saving Money And Reducing Infections

Training intervention

$781k saved in one year

Barsuk et al

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”

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

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