Abstracts

Rationale: In many patients with epilepsy, seizure activity is not adequately controlled due to clinical challenges in both diagnosis and management. Underlying clinical practice gaps and educational needs were identified and a study was conducted to determine if online, simulation-based continuing medical education could improve competence and performance of neurologists managing patients with epilepsy.Methods: A cohort of US-practicing neurologists who participated in simulation-based education was evaluated. The simulation consisted of two cases presented in a platform that allowed physician learners to choose from numerous lab tests and assessment scales as well as thousands of diagnoses, treatments, and procedures matching the scope and depth of actual practice. The clinical decisions made by the participants were analyzed using an artificial intelligence engine, and instantaneous clinical guidance was provided employing current evidence-based and expert faculty recommendations. Participant decisions were collected after clinical guidance and compared with each user’s baseline data using a 2-tailed paired T-test, where P<0.05 was considered statistically significant, to assess the impact of simulation-based education on clinical decisions made by participants. Data is reflective of learners who participated in the activity from 11/24/15 through 02/25/15.Results: The assessment sample consisted of 335 neurologists who made clinical decisions within the simulation and proceeded to the concluding debrief section. As a result of clinical guidance provided through simulation, significant improvements were observed in several areas of management of patients with epilepsy, specifically: ●Improvement in the number of participants who correctly diagnosed the patient with complex partial seizures with secondary generalization (56% post education vs 15% baseline, P<0.001) ●Improvement in the number of participants who correctly diagnosed the patient with a cavernoma of the temporal lobe (53% post education vs 9% baseline, , P<0.001) ●Improvement in the number of participants who ordered a sleep deprived EEG (63% post education vs 39% baseline, P<0.001) ●Improvement in the number of participants who decided to discontinue current treatment in a patient who experienced adverse events and poor medication adherence (35% post education vs 19% baseline, P<0.001) ●Improvement in the number of participants who correctly selected AED combination therapy involving at least 1 medication that is dosed daily in a patient experience side effects and poor adherence to current therapy (40% post education vs 9% baseline, P<0.001)Conclusions: This study demonstrated the success of simulation-based educational interventions on improving the evidence-based clinical decisions of neurologists in the management of patients with epilepsy. Simulation-based instructions that lead to improvement in physician performance in a consequence-free environment can result in more evidence-based clinical decisions for epilepsy and may lead to improvement in patient outcomes.