Spaced Education to Optimize Prostate Cancer Screening

Harvard University Faculty of Medicine95 enrolled

Overview

Two memory research findings (the spacing and testing effects) can dramatically improve retention of learning, but they have largely have been ignored by educators. The researchers have developed a novel form of online education (termed 'spaced education') based on these two effects which has been shown in randomized trials to improve knowledge acquisition and boost learning retention. Using prostate cancer screening as an experimental system, the researchers investigated whether spaced education could durably improve clinicians' behaviors, not just their knowledge.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

NONE

Enrollment

Conditions

Prostate Cancer

Interventions

Online spaced educationBEHAVIORAL

Spaced education is currently delivered via periodic emails that contain clinical case scenarios and multiple-choice questions. Upon submitting answers to each question online, clinicians receive immediate feedback and educational material. The questions are then repeated over spaced intervals of time to harness the pedagogical benefits of the spacing effect.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Primary care providers (physicians, nurse practitioners, and physician assistants) from the 8 Veterans Affairs (VA) hospitals in the New England region (Veterans Integrated Service Network 1 \[VISN-1\]) were eligible to enroll. Exclusion Criteria: * Primary care providers (PCPs) who ordered PSA as a screen for prostate cancer less than 10 times each year were excluded.

Locations (1)

Veterans Affairs Boston Healthcare System

Boston, Massachusetts, United States

Outcomes

Primary Outcomes

Percentage of inappropriate prostate-specific antigen (PSA) screening performed by clinicians

The primary outcome measure was the difference in the percentage of inappropriate PSA screening performed by clinicians in the spaced education and control cohorts. Based on published clinical guidelines and reports, inappropriate PSA utilization was defined as the use of PSA for prostate cancer screening in patients \>76 or \<40 years old, or with an estimated life expectancy of less than 10 years.

Time frame: Weeks 1-108

Secondary Outcomes

Change in test scores between cohorts measured in weeks 1-36

Time frame: Weeks 1-36

Change in spaced education performance measured in weeks 1-36

Time frame: Weeks 1-36

Clinicians' intention to participate in future spaced education programs

Assessed on end-of program survey at week 36

Time frame: Week 36

Time required by clinicians to complete the spaced education questions-explanations

Assessed on end-of program survey at week 36

Time frame: Week 36

Data from ClinicalTrials.gov

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