The opioid crisis continues to plague the U.S., impacting communities across the country. Numerous educational initiatives have been developed and distributed to help clinicians tackle this challenge, with several programs emphasizing the Risk Evaluation and Mitigation Strategy programs. The FDA’s Blueprint for Prescriber Education is a requirement for those developing education for clinicians that is supported by the REMS Program Companies (RPC). The challenge for educators is: How do you follow all the aspects of the FDA Blueprint while, at the same time, implementing an engaging, impactful educational initiative that changes practice behavior?
In 2021, three education organizations set out to create an educational initiative that effectively engages learners, improves overall learner retention, and affects practice change for the participating clinicians. Purdue University took on the role of the accredited provider. Simumetrix — a leading medical education company and technology provider of innovative, award-winning CME content — brought years of experience implementing cutting-edge technology, including augmented reality, animations, artificial intelligence realistic patients and interactive video. ArcheMedX, an award-winning learning platform designed to drive behavior change, contributed design and user experience expertise with the ability to generate comprehensive assessment and outcomes data. This initiative was supported by an educational grant from the RPC.
Educational Design
The education was designed as an online, on-demand curriculum built across six short-form microlearning video modules that covered all aspects of the FDA Blueprint. All modules were designed to be consumed in 15–20 minutes and could be accessed across a variety of devices, including mobile, laptop and desktop. The short-form design allowed for learners to easily view an entire module in one brief setting, making it easier to fit the education into already packed schedules. The short-form educational design also allowed the educators to focus the content on a narrow set of learning objectives for each module, driving key points of learning and reinforcing evidence-based best practices for improved learner retention.
The videos utilized in the various modules were developed using a combination of case-based expert panel discussions, animations and innovative augmented reality (AR). The use of AR in this setting created an interactive and immersive virtual environment allowing learners to dive deeper into the more complex aspects of the education, helping them grasp complex information on mechanisms opioids’ action in the body, the impact of proper use of pharmacologic and non-pharmacologic treatments, and the underlying potential risks associated with opioid use.
Another key technology element within the education was the use of an artificial intelligence (AI) symbiont engine that replicates human behavior, providing an AI patient with which the faculty can interact and discuss. The use of this AI patient, named CYPHER, provided another opportunity to engage learners with focused education elements designed to bring content to life and achieve objectives with enhanced learner engagement and overall retention, with improved outcomes over traditional stagnant data slides.
The partnership also employed the ArcheMedX platform to host the content. The platform enhances the learner’s ability to engage with the video content, creating a personalized and adaptive learning experience. Learners are encouraged and nudged to engage, to dive deeper into key educational resources, and to reflect on their own practice which, ultimately, leads to successful integration of critical information into their long-term memory.
These education design elements were supported by a comprehensive retention strategy, engaging with learners for several weeks after they completed the curriculum. Learners were reminded of key best practices, provided with additional resources, and surveyed about their practice behavior, identifying any impact participation had on their performance.
Assessment and Outcomes
Did these approaches to educational design engage the learners and improve knowledge, increase competency, and change learner practice? To answer these questions, the partners of this educational initiative employed a comprehensive strategy utilizing the ArcheMedX platform to generate a variety of quantitative and qualitative data to assess the outcomes of the initiative.
The combination of AR, AI and the ArcheMedX platform engaged clinicians and drove them to complete each session. Clinician learners started 22,560 video sessions in the curriculum, completing 20,724 for a 96% completion rate. Learners also engaged with the various elements of the education, with over 25,800 actions taken while consuming the content. These included viewing and downloading resources, taking notes, and answering reflective questions.
Confidence-based Assessment (CBA) was utilized to assess knowledge and competence with the goal to drive learners to achieve correctness in their responses and have high confidence in their knowledge and/or competency (identified as achieving Mastery). Twenty thousand, four hundred and one paired pre- and post-tests were analyzed. An assessment of baseline pre-tests indicated 53% of responses were correct, but less than a third of those indicated high confidence in their answer, and 11% indicated they were guessing at the answer. Post-activity testing resulted in 67% correctness (26% relative increase from pre-test), and 54% of responses indicated high confidence in their answers, resulting in a 126% relative increase in mastery.
Post-activity retention strategies also engaged learners and drove them to apply what they learned. Seventy percent of learners agreed or strongly agreed that they planned to make changes to their practice. Learners who completed modules in the curriculum were engaged with post-activity surveys and reinforcing emails, with an average 50% open rate. Responses to surveys at four and six weeks showed adoption of key best practices from the education, including 63% indicating increased use of patient agreement forms and 58% indicating increased use of DSM-V criteria for Opioid Use Disorder (OUD).
While the need for education to help clinicians face the difficulties of safely and effectively utilizing opioid analgesics is without question, the challenge of designing education that covers all aspects of the FDA Blueprint and engages learners to affect practice change can be difficult for education providers. The partners on this initiative implemented an innovative educational design that included AR, AI from the Simumetrix team and the behavior change tactics employed with the ArcheMedX platform. The result of this powerful collaboration engaged learners, drove them to complete the curriculum, and showed improvements across knowledge, competence, confidence and practice change.
An experienced industry leader with demonstrated success developing businesses in the healthcare/medical education industry over several decades, Kenny Cox utilizes skills in management/leadership, education, marketing, technology, finance, business development and strategic planning to create new opportunities in medical education that lead to improved patient care and, ultimately, enhanced patient outcomes. He has held positions in numerous companies and currently is the VP of CME at ArcheMedX. Kenny has also served on various boards/committees for the Alliance and currently serves on the Almanac Editorial Board.
Bretten Gordeau is an accomplished CME professional with a diverse background spanning over 25 years of experience in various fields, including clinical medicine, television, and continuing medical education (CME). Throughout his career, Bretten has demonstrated a remarkable ability to produce high-quality and award-winning content, showcasing his innovative approach to content oversight. His interest in memory impairments propelled him to focus his clinical career on this area, leading him to co-found the American Academy of Physician Education in 2004 and Simumetrix CME in 2009. As the leader of a multi-innovative CME award-winning team, Bretten has contributed significantly to improving educational outcomes and skill change across CME. Bretten’s creative thinking and dedication to finding new ways to engage audiences and deliver content that resonates with them are widely recognized in the industry. His deep understanding of the importance of effective CME in the healthcare industry has earned him multiple awards for his work in content oversight and innovation. Driven by his passion for excellence, Bretten explores new and emerging technologies in the CME industry and eagerly incorporates new approaches and strategies into his work. His clinical training in trauma orthopedics and neurology at the University of Miami medical campus, coupled with his studies at renowned institutions such as Harvard and Cambridge, further enhance his expertise. Bretten’s career began in feature film and television, after which he moved to healthcare, blending his career to advance CME. He has overseen the publication of 12 texts in the field of neurology, authored two books for caregivers, and has been featured on national news programs and publications as an expert in Alzheimer’s disease patient care and caregiver expertise.
Dr. John Kriak has almost 30 years of experience providing clinical services, medical education, and applied business consulting expertise by designing and participating in clinical trials, providing clinical solutions for real-world medical challenges, authoring numerous textbooks, educational programs, courses and grants (private, state, federal and DoD) as well as coordinate the acquisition of ACPE +/- ACCME continuing education accreditation for several organizations. In July 2021, Dr. Kriak accepted a faculty position at the Noorda College of Osteopathic Medicine (Noorda COM) as an associate professor of pharmacology, a faculty clinical and biomedical researcher at the medical college, as well as Noorda-COM’s director of sponsored projects. In June 2022, Dr. Kriak began working as the director of medical education for Simumetrix.
R. Michelle Tyner Skidmore, MS, FACEhp, serves as senior director — education strategy for ArcheMedX, Inc. Michelle brings her passion for building key partnerships and designing engaging and impactful educational curricula to the ArcheMedX team. Michelle is a Fellow of the Alliance and is currently a member of the Alliance Board of Directors.
Marlene Heeg, MEd, has spent the last 12 years as the senior managing director for Purdue University College of Pharmacy’s Office of Continuing Education, an ACCME- and ACPE-accredited provider. Marlene brings a renewed perspective to continuing education as a result of skill sets acquired from her over 32 years in the corporate arena. Her background enables her to manage her team, who coordinates accreditation tasks for over 200 educational activities annually. She collaborates with clinical faculty who provide the expertise required to enhance current offerings and delves into new opportunities with highly regarded, national medical education and nonprofit partners.