MON-007 Can Virtual Patient Simulation Improve Management of Hypoparathyroidism?

Abstract

Background: Despite improvements in available options for the management of hypoparathyroidism and its significant impact on quality of life, this disorder remains suboptimally managed. We sought to determine if an online, virtual patient simulation (VPS)-based continuing medical education (CME) intervention could improve performance of diabetologists/endocrinologists (D/Es) and primary care physicians (PCPs) in the evidence-based management of hypoparathyroidism. Methods: The intervention comprised two patients presenting in a VPS platform that allows learners to order lab tests, make diagnoses, and prescribe treatments supported by an extensive database of diagnostic and treatment possibilities matching the scope and depth of actual practice. Tailored clinical guidance (CG), based on current evidence and expert recommendation, was provided following each decision, accompanied by the opportunity for the learner to modify to their decisions. Decisions were collected post-CG and compared with each user’s baseline (pre-CG) decisions using a 2-tailed paired t-test to determine P values. Absolute percent difference was calculated and is presented as percent improvement in the results. Results: Significant improvements were observed after CG: Case 1 (n=148 D/Es, n=566 PCPs): • Appropriate diagnosis of hypoparathyroidism: 26% improvement among D/Es (47% pre-CG vs 73% post-CG; P<.001), 27% improvement among PCPs (42% pre-CG vs 69% post-CG; P<.001) o Further, most appropriate diagnosis of hypoparathyroidism status post-subtotal thyroidectomy: 45% improvement among D/Es (17% pre-CG vs 62% post-CG), 49% improvement among PCPs (7% pre-CG vs 56% post-CG; P<.001) • Order patient education: 22% improvement among D/Es (44% pre-CG vs 66% post-CG; P<.001), 18% improvement among PCPs (51% pre-CG vs 69% post-CG; P<.001) Case 2 (n=92 D/Es, n= 381 PCPs): • Initiate parathyroid hormone: 37% improvement among D/Es (14% pre-CG vs 51% post-CG; P<.001), 41% improvement among PCPs (11% pre-CG vs 52% post-CG; P<.001) • Order patient education: 16% improvement among D/Es (38% pre-CG vs 54% post-CG; P<.001), 19% improvement among PCPs (42% pre-CG vs 61% post-CG; P=.012) Conclusion: VPS that immerses and engages specialists in an authentic and practical learning experience can improve evidence-based clinical decisions related to management of hypoparathyroidism.

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