Transcript Skills Degradation Modeling For Preemptive Knowledge

Skills Degradation Modeling For
Preemptive Knowledge Refresh
Scheduling: A Randomized Trial
Conducted by the Kentucky
Ambulatory Network and ABFM
Michael D. Hagen, MD, FAAFP
Senior Vice President, ABFM
Professor, Department of Family and Community
Medicine
University 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-test
Traditional lecture
Randomized to:
Computer-based instruction
Adaptive/Non-adaptive
Manequin-based instruction
Adaptive/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, MPH
Jennifer Schilling
Ann Williamson