Skills Degradation Modeling ForPreemptive Knowledge Refresh Scheduling: A Randomized Trial

Conducted by the Kentucky Ambulatory Network and ABFM

Michael D. Hagen, MD, FAAFPSenior Vice President, ABFM

Professor, Department of Family and Community MedicineUniversity of Kentucky College of Medicine

Objectives

• To introduce the concept of knowledge degradation• To describe a randomized trial to examine approaches to knowledge refreshment• To describe recruitment for participants in the randomized trial

The Problem

• ABFM and literature data demonstrating knowledge degradation over time if no explicit process to refresh

• Also a problem recognized in the military: intermittent training, intervals between deployments leading to skills decay

• Corollary new issue: Next Accreditation System from the ACGME requires finer “granularity” in assessment and monitoring of trainees

The Approach

• Contract proposal from DOD for potential approaches to addressing the knowledge extinction issue and how to monitor level of skill over time

• Led to contract with Accella (Louisville) to develop a record system for such monitoring and conduct a trial to poplulate and evaluate the function of the record

• Accella subcontracted to ABFM and the Kentucky Ambulatory Network to conduct the work

The Design• Trial domain: retinopathy of diabetes and hypertension

• Trial design:Pre-testTraditional lectureRandomized to:

Computer-based instructionAdaptive/Non-adaptive

Manequin-based instructionAdaptive/non-adaptive

Post-test (6 weeks later)

The Design

Logistics• Will deliver content in multiple different venues

• $500 incentive for completing all components

• Protocol reviewed/approved by the UK Medical IRB

• NO impact on ABFM board certification status

• KAN providing logistical/administrative support:Roberto Carderelli, DO, MPHJennifer SchillingAnn Williamson