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Enhancing specialist competence in clinical pathways for left ventricular hypertrophy: design and evaluation of a
Yanjia Chen1, Jie Jiang2, Wei Jin3
1Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, P.R. China.
Insights
A new competency-based curriculum improved cardiologists' knowledge and diagnostic skills for left ventricular hypertrophy (LVH) and its rare causes. This program standardizes clinical pathways, enhancing care coordination for LVH patients.
Area of Science:
- Cardiology
- Medical Education
- Health Services Research
Background:
- Left ventricular hypertrophy (LVH) presents diverse etiologies, leading to diagnostic challenges and delays.
- Variability in specialist reasoning and inconsistent clinical pathways contribute to diagnostic gaps in LVH.
- Standardizing diagnostic approaches is crucial for improving patient outcomes in LVH.
Purpose of the Study:
- To design and evaluate a competency-based curriculum for standardizing LVH diagnostic pathways.
- To assess the curriculum's impact on physician knowledge, diagnostic reasoning, and clinical confidence.
- To explore the feasibility of a health services intervention for LVH care.
Main Methods:
- A blended learning curriculum was developed for 45 cardiologists, focusing on patient-centered care and multidisciplinary collaboration.
- The program included guideline reinforcement, genetics-focused learning, case discussions, and pathway design exercises.
- Outcomes were measured via pre/post-training knowledge tests, case evaluations, and confidence surveys.
Main Results:
- Mean knowledge scores significantly increased from 62% to 86% (p < 0.001).
- Accurate identification of rare LVH etiologies improved from 35% to 78%.
- Participants reported significantly higher diagnostic confidence and high course satisfaction (92%).
Conclusions:
- The competency-based curriculum demonstrated short-term improvements in specialist knowledge and diagnostic reasoning for LVH.
- The program has the potential to reduce practice variability and standardize clinical pathways for LVH.
- This intervention may enhance referral consistency and inter-provider care coordination for LVH patients.
Background:
Left ventricular hypertrophy (LVH) is a frequent clinical phenotype with diverse etiologies, including hypertensive heart disease, hypertrophic cardiomyopathy, and infiltrative or metabolic disorders. Despite the availability of disease-specific therapies, diagnostic delays and misclassifications remain prevalent. From a health services perspective, these diagnostic gaps are often driven by significant variability in specialist-level diagnostic reasoning and the inconsistent implementation of clinical pathways. To design and evaluate the feasibility of a competency-based curriculum aimed at standardizing specialist-level clinical pathways for LVH-related diseases, and to assess its immediate impact on physician knowledge acquisition, diagnostic reasoning, and clinical confidence.
Methods:
A structured curriculum was developed following principles of patient-centered care and multidisciplinary collaboration. The program, delivered as a continuing medical education (CME) initiative for 45 cardiologists, incorporated guideline reinforcement, genetics-oriented learning, case-based discussions, and pathway design exercises via a blended learning format. Outcomes were assessed through pre- and post-training knowledge tests, structured case-based evaluations, and self-reported confidence and satisfaction surveys.
Results:
Forty-five cardiologists from secondary and tertiary centers completed the program. Mean knowledge test scores significantly improved from 62% ± 12% pre-training to 86% ± 8% post-training (p < 0.001). The correct identification of rare LVH etiologies (e.g., Fabry disease, cardiac amyloidosis) in structured cases rose from 35% to 78%. Participants reported significantly higher diagnostic confidence for both common and rare etiologies, and overall course satisfaction was high (92% rating ≥ 4/5).
Conclusion:
This competency-based curriculum was associated with short-term improvements in specialist-level knowledge and diagnostic reasoning for LVH-related diseases. This program shows potential to assist in reducing variability in specialist practice and establishing standardized clinical pathways, serving as a preliminary health services intervention that may enhance downstream referral consistency and inter-provider care coordination.
Clinical Trial Number:
Not applicable.
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