Daily smartphone training helps urology department order more appropriate CT exams

Quizzing healthcare providers on their smartphones can lead to better patient care, according to a new case study published in the Journal of the American College of Radiology.

The authors noted that “appropriate utilization and accurate ordering of radiology examinations” is a consistent challenge in today’s healthcare system, one that persists despite widely available guidelines. Workplace-based learning can help improve this issue, they added, but providers don’t exactly have a lot of free time. One potential solution comes in the form of “spaced education.”  

“The core principles of spacing and testing imply that a learner is presented with educational content at spaced intervals (e.g., daily or weekly), and testing provides the means to ‘activate’ the learning via the delivery of a question followed by education on the topic after a learner answers the question,” wrote Meaghan Magarik, MD, PhD, department of radiology and radiological sciences at Vanderbilt University Medical Center in Nashville, Tennessee, and colleagues. “Several studies with practitioners, patients, and trainees have shown benefit to this approach, with this method of learning being well accepted and associated with enhanced participation and demonstrating an impact on physician behavior.”

For the case study, a total of 28 urologists and non-physician providers from the department of urology at a single institution were sent daily multiple-choice questions via email or text message. Questions were delivered Monday through Thursday, except for holidays or the days before or after holidays, over a three-month period. Participants would answer the multiple-choice question—all answers were anonymous—and then receive feedback explaining the question in great detail.

Ordering habits during the three months before the intervention were then compared with habits during the intervention, in the first three months after the intervention was complete and in the next three months after it was complete. Overall, before the intervention, 34.3 percent of CT examinations ordered by the urology department had to be re-protocoled. That number dropped to 29.5 percent during the intervention, 24.2 percent in the first three months following the intervention and 19.9 percent in the next three months following the intervention.

“We examined whether asynchronous spaced education with case-based questions could increase the number of appropriately ordered CT examinations in a single department at an academic medical center,” the authors wrote. “This pilot study demonstrated that a 3-month intervention led to a significant reduction in incorrect CT orders requiring re-protocoling by the radiology department and thus represented a change in ordering behaviors.”

Such education techniques can be used in “clinical training, continuing medical education and quality improvement projects,” the team added.