BACKGROUND Annually, meningitis and encephalitis are responsible for tens of thousands of hospitalizations and significant morbidity and mortality. Timely and accurate diagnosis is not only key for determining the appropriate management strategy, but can reduce inappropriate antibiotic use, support antimicrobial stewardship efforts, reduce the length of hospital stay, and decrease morbidity and mortality. However, evaluation of the published literature has revealed knowledge and competence gaps among pediatricians with respect to the timely diagnosis of meningitis and encephalitis as well as appropriate use of rapid diagnostic tests to inform patient care decisions. METHODS To address identified gaps among pediatricians, a CME/CE-certified activity featuring a video-based, panel discussion was developed and posted online on August 2, 2017. Featuring 3 expert faculty, the discussion addressed: □ Key distinguishing characteristics of various laboratory methods for the diagnosis of meningitis and encephalitis; □ Considerations regarding the interpretation of test results; and □ Applying rapid molecular test results to patient care decisions, including antibiotic use and/or selection. Educational effectiveness was assessed with a repeated-pairs pre-/post-assessment study design, where individual participants served as his/her own controls. Three multiple-choice, knowledge/competence questions and 1 self-efficacy confidence question were analyzed. A chi-squared test assessed changes pre- to post-assessment. P values <0.05 are statistically significant. Effect sizes were evaluated using Cramer's V (<0.05 modest; 0.06-0.15 noticeable effect; 0.16-0.26 considerable effect; >0.26 extensive effect). Data were collected through April 9, 2018. RESULTS A total of 263 pediatricians answered all pre- and post-assessment questions. Significant improvements were observed overall (P<.0001) and in several specific areas of assessment (Table). Approximately 35% of pediatricians also indicated increased confidence in diagnosing meningitis and encephalitis using rapid molecular tests following participation in the CME/CE activity. CONCLUSIONS Participation in this online CME/CE intervention led to significant improvements in pediatricians’ knowledge and competence regarding the use of rapid molecular tests for the diagnosis meningitis and encephalitis. These findings highlight the positive impact of well-designed online education on pediatricians and uncovered ongoing gaps and educational needs that are being addressed in ongoing interventions.
Improving Timely Diagnosis of Meningitis and Encephalitis: The Impact of CME in Closing Healthcare Providers Gaps in Using Diagnostic Methodologies
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Simi Hurst, Susan Smith; Improving Timely Diagnosis of Meningitis and Encephalitis: The Impact of CME in Closing Healthcare Providers Gaps in Using Diagnostic Methodologies. Pediatrics August 2019; 144 (2_MeetingAbstract): 243. 10.1542/peds.144.2MA3.243
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