Use of "Bug-in-the-Ear" Technology in Improving Pediatric Residents' Skills in Diagnosis and Treatment of Attention
Alexa Coon1, Diane Langkamp1, Miraides Brown2
1Akron Children's Hospital (A Coon and D Langkamp), Neurodevelopmental Science Center, Akron, Ohio.
Insights
Pediatric residents improved Attention Deficit Hyperactivity Disorder (ADHD) diagnostic skills with real-time Bug-in-the-Ear (BIE) feedback. However, one BIE session was insufficient for sustained skill improvement, indicating a need for further research.
Area of Science:
- Medical Education
- Pediatrics
- Clinical Skills Training
Background:
- Pediatric residents require enhanced skills in diagnosing and treating Attention Deficit Hyperactivity Disorder (ADHD).
- Traditional feedback methods may not be sufficient for rapid skill acquisition in complex pediatric conditions.
Purpose of the Study:
- To evaluate the effectiveness of Bug-in-the-Ear (BIE) technology for real-time feedback in improving pediatric residents' ADHD management skills.
- To assess the immediate impact and maintenance of skills gained through BIE-assisted training.
Main Methods:
- A prospective, controlled study involving pediatric residents undergoing standardized patient (SP) sessions.
- An intervention group received real-time feedback via BIE, while a control group received traditional feedback.
- Skills were assessed using the Clinical Practice Index (CPI), based on AAP ADHD guidelines and DSM-5 criteria.
Main Results:
- The intervention group (IG) demonstrated a significant increase in CPI scores from baseline to follow-up (P<0.001).
- The control group (CG) showed no significant change in CPI scores.
- Significant differences in scores were observed between groups at Session-2 (P<0.001), but not at Session-3.
Conclusions:
- Real-time BIE feedback significantly improved pediatric residents' ADHD diagnostic and treatment skills.
- A single BIE exposure was insufficient for long-term skill maintenance.
- Further research is needed to determine optimal BIE exposure frequency for sustained skill development.
Objective:
To improve pediatric residents' skills in the diagnosis and treatment of children with Attention Deficit Hyperactivity Disorder (ADHD) by giving real-time feedback utilizing Bug-in-the-Ear technology (BIE).
Methods:
This prospective, controlled study had two treatment groups and three standardized patient (SP) sessions. Session-1 was baseline. In Session-2, the intervention group (IG) received feedback via BIE and the control group (CG) received traditional feedback. Session-3 (3 months later) assessed maintenance of skills, and neither group used BIE. Sessions were recorded and scored by research assistants trained with a novel scoring system called the Clinical Practice Index (CPI). The CPI is an observational instrument based on current American Academy of Pediatrics (AAP) ADHD guidelines and DSM-5 criteria for ADHD and was reviewed by content experts in ADHD. CPI scores were analyzed using Repeated Measures ANOVA.
Results:
Twenty-five pediatric residents participated; 13 in the CG and 12 in the IG. Maximum obtainable CPI score was 44 points. The IG showed a significant increase in their CPI score from Session-1 to Session-3 (8.27, P<0.001). The CG's CPI scores from Session-1 to Session-3 did not change significantly (2.85, P=0.536). The IG and CG CPI scores were significantly different at Session-2 (11.7, P<0.001), but not Session-3 (5.03, P=0.1407).
Conclusion:
Immediate feedback via BIE showed significant improvement in the IG's skills in Session-2 and the IG's mean difference between Session-1 and Session-3. One exposure of BIE was not sufficient for the IG to maintain their skills, and further research is warranted to determine the number of BIE exposures needed for greater maintenance of skills.
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