OBJECTIVE: To assess the impact of LTBI-ASSIST, a free online decision support aid, as a novel educational tool and mechanism of delivering clinical practice guidelines for medical trainees.
METHODS: A single site, randomized controlled trial of trainees delivered by electronic survey.
METHODS: Medical students and Internal Medicine residents at the Johns Hopkins University School of Medicine.
METHODS: Participants were randomized in 1:1 ratio to receive the US clinical practice guidelines and recommendations for Latent TB management (control arm) or the guidelines plus an introduction to LTBI-ASSIST (LTBI-ASSIST arm) as they completed a case-based knowledge assessment and reported confidence with domains of LTBI care.
METHODS: (1) Proportion of questions answered correctly on a case-based knowledge assessment; (2) change in reported confidence with domains of LTBI care.
RESULTS: One hundred and thirty participants completed the knowledge assessment. Those randomized to receive the LTBI-ASSIST Tool performed better on the case-based knowledge assessment with a mean score of 75.9% (95% CI: 70.6-81.1), compared to 57.4% (52.8-62.0) in the group that received the guidelines only (p <0.001). Similarly, the LTBI-ASSIST group reported a higher change in confidence (measured as post-assessment confidence minus pre-assessment confidence), compared to the control group, in six of the seven domains of LTBI care.
CONCLUSIONS: LTBI-ASSIST can be an effective supplement to existing guidelines in educating medical trainees and helping providers find evidence-based, guideline-supported answers for questions encountered in clinical practice.
BACKGROUND: NIH Clinical Trial Registry No. NCT05772065.
目的:为了评估LTBI-ASSIST的影响,免费的在线决策支持援助,作为一种新颖的教育工具和机制,为医学学员提供临床实践指南。
方法:单个站点,通过电子调查对受训人员进行的随机对照试验。
方法:约翰霍普金斯大学医学院的医学生和内科住院医师。
方法:参与者以1:1的比例随机分配,以接受美国临床实践指南和潜伏性结核病管理建议(控制臂)或指南以及LTBI-ASSIST(LTBI-ASSIST臂)的介绍,因为他们完成了基于病例的知识评估并报告了对LTBI护理领域的信心。
方法:(1)在基于案例的知识评估中正确回答的问题比例;(2)LTBI护理领域报告的置信度变化。
结果:一百三十名参与者完成了知识评估。那些随机接受LTBI-ASSIST工具的人在基于案例的知识评估中表现更好,平均得分为75.9%(95%CI:70.6-81.1),与仅接受指南组的57.4%(52.8-62.0)相比(p<0.001)。同样,LTBI-ASSIST组报告了更高的置信度变化(以评估后的置信度减去评估前的置信度来衡量),与对照组相比,在LTBI护理的七个领域中的六个领域。
结论:LTBI-ASSIST可以有效地补充现有指南,以教育医学学员和帮助提供者找到基于证据的指南。指南支持的临床实践中遇到的问题的答案。
背景:NIH临床试验登记号。NCT05772065。