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The Use of a Hemodynamic Monitor Perceptual and Adaptive Learning Module to Improve Clinical Interpretation Skills in
Jason S Lee1, Azad J Hirpara1, Sally Krasne1
1is an Assistant Clinical Professor in the Department of Anesthesiology and Perioperative Medicine, Ronald Reagan University of California, Los Angeles, Medical Center, Los Angeles, CA; is a Staff Physician at Kaiser Permanente, Los Angeles, CA; is a Professor Emeritus in the Department of Physiology, David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA; is a Distinguished Professor in the Department of Psychology, University of California, Los Angeles, Los Angeles, CA; is a Staff Physician at Cottage Health, Santa Barbara, CA; is a Resident Physician ss…sssin the Department of Anesthesiology, University of Southern California Keck School of Medicine, Los Angeles, CA; is an Associate Professor in the Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, Dallas, TX.
Background:
Perceptual and adaptive learning modules (PALMs) are educational tools designed to enhance pattern recognition and long-term memory. We evaluated the impact of a hemodynamic monitor PALM on first-year anesthesiology residents' performance in diagnosing clinical abnormalities via waveform and vital sign interpretation on simulated monitors.
Methods:
First-year residents were randomly assigned to a group (n = 20) that used the hemodynamic monitor PALM or a control group (n = 21) that did not. Both groups received a pretest that measured their accuracy and fluency (percentage of responses that were both accurate and made within a target response time) in hemodynamic monitoring interpretation. The PALM group then completed the PALM and an immediate posttest within 30 minutes. The Control group only completed an immediate posttest within 30 minutes. Both groups received a delayed test after 1 month. Accuracy and fluency in diagnosing clinical abnormalities at 1 month were the primary outcomes.
Results:
Pretest accuracy and fluency were similar between the 2 groups. The PALM group accuracy (mean = 87% ± 3%) and fluency (mean = 64% ± 4%) were statistically significantly better than the control group accuracy (mean = 67% ± 6%, P = .001, d = 1.39) and fluency (mean = 45% ± 6%, P = .01, d = 1.11) in diagnosing clinical abnormalities at 1 month.
Conclusions:
Exposure to a hemodynamic monitor PALM significantly improved the accuracy and fluency in diagnosing clinical abnormalities in a group of first-year anesthesiology residents at 1 month. The hemodynamic monitor PALM can be used to enhance the interpretation of waveform abnormalities in novices.
