Download Using the Internet to Provide Targeted EHDI Education for Physicians

Using the Internet to Provide Targeted
EHDI Education for Physicians
Robert C. Cicco, M.D.-
Pediatric Advisor, PA EPIC-EHDI Program
Neonatologist, West Penn Hospital, Pittsburgh, PA
Diane L. Sabo, Ph.D.
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Director of Audiology and Communication Disorders,
Children’s Hospital of Pittsburgh, Pittsburgh, PA
Associate Professor, University of Pittsburgh
Agenda
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Importance of educating physicians
Unique problems of reaching physicians in PA
Advantages of online learning
Using adult learning principles
Creating the educational program
Group Exercise
Developing resource material
Marketing
Funding an online learning experience
Why physician education?
• Essential for success of the program
• Families refer to their Primary Care
Physician (PCP) for advice
• Key component to follow up is PCP
EDHI Education for Physicians
• Knowledge of the state program and
program goals
• Knowledge of the guidelines
• Physician role in the EHDI process
• Continual reminder of the importance
of early diagnosis and treatment
Goal: Find best way to get physicians to
recognize the importance of EHDI
Barriers:
• Geographical uniqueness of PA – state has
large urban centers in east and west with
large rural mid-section and north central
area.
• Large number of small hospitals with
birthing centers.
• “Old School” disbelievers still exist
Pennsylvania’s 3-year EPIC-EHDI
project was . . .
• Conceived as a multi-faceted outreach strategy to inform
pediatricians and PCPs about the importance of EHDI
consistent with the Medical Home model.
• An outgrowth of an existing PA AAP Medical Home grant.
• Proposed as a key feature in PA DOH’s grant application to
HRSA/MCHB for UNHSI funding as the primary means of
program outreach to physicians.
• Formulated in cooperation with PA AAP using multidisciplinary input from PA DOH’s Infant Hearing Screening
Advisory Committee.
PA’s EPIC-EHDI Initiative is a multifaceted educational approach, utilizing . .
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Hospital-Based Grand Rounds Presentations
Mentoring and Technical Assistance
Audio Teleconference
Training Video
Web Based Learning Cases and Resource Information
Parent Packets available in offices
This concept allows educational goals to be achieved in a number
of learning formats.
Web Based Learning
• Easy access to learning experience
• Immediate access to resource material to
assist with learning
• Learners can work through cases at their own
pace
• Potential for on line discussion with other
users
• Allows use of multimedia audio and visual
files, if desired
Adult Learning Principles
• What motivates the adult learner?
– Achievement and competency
– Active engagement in the learning process
– Management of their own learning experience
– Ability to utilize what is learning in practical
setting
– Active participation in the learning experience
– Ability to interact with peers
– Immediate feedback regarding their performance
Creating The Educational
Program
• Online-EHDI created in collaboration with
University of Pittsburgh Health Sciences Internet
Learning program and Child Development Unit
• Four cases with learning objectives for each case
• SHORT cases designed to take learner no more
than 30 minutes to complete
• PRACTICAL cases designed to emphasize
specific common barriers to effective diagnosis
and treatment
• Presented in stages so that learner can think
through issues that present at different times in the
child’s course
Creating The Educational
Program
• Challenge learners to answer open ended
questions about their thought process and
management plans
• Faculty comments and answers accessible
only after case completed
• Pre and post testing with minimum required
on post test in order to receive CME
• Links to references and resources contained
in faculty comments
Creating The Educational
Program
• Group Exercise
The Cases: Jamiel
• Two week old did not pass initial hospital
screen
• Found to have moderate to severe SNHL
• Mother with possible perinatal depression
• Stresses physician’s role in assuring proper
follow up with diagnostic testing, medical
workup and initiation of treatment
The Cases: Ismael
• Two month old diagnosed with profound bilateral
SNHL
• Family inquires about the value of CI for their
child
• Stresses physician role in completing medical
evaluation and referral to EI
• Educates physician about criteria for CI
• Discusses cultural variation in caring for a child
with hearing loss
The Cases: Maria
• Seven month old raised in a two language family
• Child is new to practice with a history of a
persistent middle ear effusion treated with
recurrent courses of antibiotics
• Ultimately diagnosed with mixed conductive and
SNHL
• Stresses physician role in following and treating
middle ear effusion
• Discusses language development in bilingual
households
The Cases: Susan
• 2.5 month old fourth child
• NICU graduate -- PCP not identified before D/C
• Family contacted by state EHDI personnel after
failing to follow up on unilateral “did not pass”
• Mother concerned state may involve CYF
• Child found to have severe loss in one ear
• Stresses to physician the importance of unilateral
loss
• Stresses to physician the role of DOH in EHDI
• Discusses ways to address financial and social
parental concerns surrounding a child with hearing
loss
Enhancements
• Discussion Board:
– Will allow all participants to see the answers of others and
create opportunity for discussions regarding specific
management strategies, treatment plans, ways of addressing
problems, etc.
• New Cases:
– The child who passes the newborn screen but presents with
parental concerns about language and hearing
– The child who passes the newborn screen but has high risk
factors
– Child with mild hearing loss
– Deaf child with deaf parents
– ??? Others
Resource Material
• Resource sections for both parents and health care
providers
• Contains multiple links to other websites
• Includes reference materials such as flow sheets,
roadmaps, sample audiograms and parent handouts
• Pennsylvania specific information
• Links to other more detailed educational
opportunities
• Must have plan to provide ongoing update
Marketing
• Critical element of program implementation
• Although designed for physicians, audiologists also
benefit from the information
• General Marketing
– Flyers, email, PAAAP NewsFax, general mailing to
physicians and audiologists
• Opportunities for targeting marketing
– To physicians with new patients not passing the newborn
screen from state EHDI personnel
– To physicians from audiologists in reports
• Need to allot appropriate funding for ongoing
marketing activities
Costs
• Time for development of cases
• Time for development and maintenance of
resources
• Website development (in our case minimized
by utilization of existing UPMC educational
site)
• CME
• Marketing Activities
Take Home Points
• Internet provides opportunity to reach learners
efficiently and overcomes geographic barriers
• Case based learning allows for different aspects of
hearing loss and management to be presented
• Learning experience should be practical
information that is relevant to day-to-day practice
• As areas of deficits in knowledge are identified,
allows for customizations of the cases to highlight
new learning goals
• Marketing strategies, both general and targeted, are
critical to long term success
To Log On:
• https://cme.hs.pitt.edu
• Create an account and log on
• Click on “All Modules”
• Click on “Early Hearing Detection and Intervention”