Multisite Implementation of Radiology-TEACHES (Technology-Enhanced Appropriateness Criteria Home for Education Simulation)

Marc H Willis; Alana D Newell; Joseph Fotos; Pauline Germaine; John W Gilpin; Kristopher Lewis; Marjorie W Stein; Chris Straus; Karla A Sepulveda

doi:10.1016/j.jacr.2019.12.012

Multisite Implementation of Radiology-TEACHES (Technology-Enhanced Appropriateness Criteria Home for Education Simulation)

J Am Coll Radiol. 2020 May;17(5):652-661. doi: 10.1016/j.jacr.2019.12.012. Epub 2020 Jan 10.

Authors

Marc H Willis¹, Alana D Newell², Joseph Fotos³, Pauline Germaine⁴, John W Gilpin⁵, Kristopher Lewis⁶, Marjorie W Stein⁷, Chris Straus⁸, Karla A Sepulveda⁹

Affiliations

¹ Department of Radiology, Stanford School of Medicine, Stanford, California. Electronic address: marc.willis@stanford.edu.
² Center for Educational Outreach, Baylor College of Medicine, Houston, Texas.
³ Department of Radiology, Penn State Health, Hershey, Pennsylvania.
⁴ Department of Radiology, Cooper University Hospital/Cooper Medical School of Rowan University, Camden, New Jersey.
⁵ Department of Radiology, University of South Carolina School of Medicine Greenville, Greenville, South Carolina.
⁶ Department of Radiology, Augusta University, Augusta, Georgia.
⁷ Department of Radiology, Montefiore Medical Center, Bronx, New York.
⁸ Department of Radiology, University of Chicago, Chicago, Illinois.
⁹ Department of Radiology, Stanford School of Medicine, Stanford, California.

PMID: 31930982
DOI: 10.1016/j.jacr.2019.12.012

Abstract

Purpose: After encouraging results from a single-institution pilot, a novel case-based education portal using integrated clinical decision support at the simulated point of order entry was implemented at multiple institutions to evaluate whether the program is scalable and results transferable. The program was designed to fill key health systems' science gaps in traditional medical education curricula, ultimately aiding the transition from volume to value in health care. The module described uses commonly encountered medical vignettes to provide learners with a low-stakes educational environment to improve their awareness and apply curricular content regarding appropriate resource utilization, patient safety, and cost.

Methods: In 2016 and 2017, the team implemented the modules at eight US medical schools. A total of 199 learners participated in this institutional review board-approved study; 108 completed the module, and 91 were in the control group.

Results: The module group had higher posttest scores than their control group peers, after controlling for pretest scores (β = 4.05, P < .001). The greatest knowledge gains were on questions related to chest radiography (22% improvement) and adnexal cysts (20.33% improvement) and the least on items related to pulmonary embolism (0.33% improvement). The majority of learners expressed satisfaction with the educational content provided (70.4%) and an increased perception to appropriately select imaging studies (65.2%).

Conclusions: This program is promising as a standardized educational resource for widespread implementation in developing health systems science curricula. Learners at multiple institutions judged this educational resource as valuable and, through this initiative, synthesized practice behaviors by applying evidence-based guidelines in a cost-effective, safe, and prudent manner.

Keywords: CDS; Education; HSS; clinical decision support; health systems science; high-value health care; simulation.

MeSH terms

Curriculum
Education, Medical*
Humans
Radiography
Radiology* / education
Technology