Dr. Martin V Pusic (NYU)

1. ALERT Presentation:
Learning Retention and the Timing of Refresher Education
After The Deliberate Practice of Radiograph Interpretation
K. Boutis, M. Pecaric, J. Beckstead, P. Babyn, M. Pusic
Utoronto, USF, NYU
IMSH 2013: Orlando, Florida / USA
International Network for Simulation-based Pediatric Innovation, Research and Education

2. Background
• Content Area: PEM Radiology
• Instructional Design:
Online Deliberate Practice (Screen Simulation)
• Question:
What is the rate of skill decay?
International Network for Simulation-based Pediatric Innovation, Research and Education

3. PICO Question
• P: PEM Fellows
• I: Online deliberate practice
• C: Same + Refresher Training
• O: Knowledge retention over 18 mo
International Network for Simulation-based Pediatric Innovation, Research and Education

4. Approach / Design
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5. Study Protocol
Two Phases:
1. Radiograph Calibration
– Remove educationally poor cases
– Broad sample of expertise
– Use Rasch Modelling to ensure appropriate difficulty
2. Actual Trial
– Target Population
International Network for Simulation-based Pediatric Innovation, Research and Education

6. PICO Question
Final Sample size: 100 + 100
CALIBRATION: TRIAL:
(Read 100 Xrays (Read 220
Once) Xrays/18mo)
Medical Students 20
EM Residents 20 40
Peds Residents 20
PEM Fellows 20 60
PEM Attendings 10
Peds Radiology 10
International Network for Simulation-based Pediatric Innovation, Research and Education

7. Approach / Design
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8. Approach / Design
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9. Approach / Design
Slope of Decay Curve
Overlearning
PERFORMANCE
Area Under Curve
COMPETENCE
Refresher Training
Training -- Learning (Units of Skill Degradation (Units of Elapsed Time)
Deliberate Practice)
Stops
TIME
training

10. PICO Question
Final Sample size: 100 + 100
CALIBRATION: TRIAL:
(Read 100 Xrays (Read 220
Once) Xrays/18mo)
Medical Students 20
EM Residents 20 40
Peds Residents 20
PEM Fellows 20 60
PEM Attendings 10
Peds Radiology 10
International Network for Simulation-based Pediatric Innovation, Research and Education

11. 3 Questions to improve study
1. How to balance number of centers with
number of participants per center.
2. How to ensure completion where
participation requires activity over 18
months.
3. Role of site investigators
International Network for Simulation-based Pediatric Innovation, Research and Education

12. Contact Information
Name: Martin Pusic
Institution: NYU
E-mail: mpusic@gmail.com
Website: www.medals-silver.org/INSPIRE
International Network for Simulation-based Pediatric Innovation, Research and Education