276 - Use of “Bug-in-the-Ear” Technology in Improving Pediatric Residents’ Diagnosis and Treatment of ADHD

Poster Number: 276
Publication Number: 276.331

Alexa E. Coon, University of Texas Medical Branch School of Medicine, League city, TX, United States; Diane L. Langkamp, Akron Children's Hospital, Akron, OH, United States; Beth Wildman, Kent State University, Kent, OH, United States

Background: Use of Bug-in-the-ear (BIE) technology is innovative & novel in medical education (ME). BIE is a small, wireless one-way communication device that allows the supervisor to communicate immediately & privately with the trainee, giving the trainee an opportunity to immediately change their behavior. Traditional ME techniques have increased residents’ knowledge about ADHD, but have not shown improvement in practice skills in the care of children with ADHD.

Objective: To improve pediatric residents’ practice skills in the diagnosis & treatment of children with ADHD by using BIE to provide immediate feedback, & to assess the feasibility & acceptability (F&A) of using BIE in resident training.

Design/Methods: This study, conducted during the PGY-2 rotation in DBP, had 2 treatment groups & 3 standardized patient (SP) practice sessions (PS). PS1 served as baseline. Only in PS2, intervention group (IG) received feedback via BIE while control group (CG) received traditional feedback. PS3 (3 months later) assessed maintenance of skills & neither group had BIE. The sessions, held over video conference, involved a different ADHD case of children 6-11 years old & the SP represented the “parent.” Each session was recorded & scored by research assistants trained with a novel scoring system. The scoring system was an observational instrument based on current AAP ADHD guidelines & DSM-5 criteria for ADHD. Residents completed pre- & post-tests to assess ADHD knowledge & pre- & post-self-efficacy surveys about ADHD. IG completed the BIE F&A survey. Repeated Measures ANOVA was used to analyze PS scores.

Results: 25 pediatric residents participated; 13 in CG & 12 in IG. Total possible points for each PS was 44. IG means for PS1, 2, & 3 were 20.9, 40.7, & 29.2, respectively. CG’s means for PS1, 2, & 3 were 21.3, 28.9, & 24.2, respectively. Mean difference between PS1 & 3 for IG & CG were 8.27 (p < 0.001) & 2.85 (p=0.54), respectively. Mean difference between IG & CG for PS2 was 11.7 (p < 0.001) & PS3 was 5.03 (p=0.14). Mean percent change for pre- & post-tests for IG was 24.5 & 20.7 for CG (p=0.11). The mean score difference between IG & CG for self-efficacy survey was 0.21 (p=0.27). The BIE F&A survey was out of 5 points (5=Strongly Agree) & the mean was 4.1.Conclusion(s): Giving immediate feedback via BIE showed a significant difference in residents’ practice skills in PS2 between IG & CG, & IG’s mean difference between PS1 & PS3. One exposure of BIE was not enough for IG to maintain their practice skills, & further research is needed to determine how many exposures of BIE is needed for greater maintenance of practice skills.
Comparison of Practice Session Scores by Practice Session Number and Treatment GroupPS- Practice Session
Practice Session Scores by Practice Session Number and Treatment GroupPS- Practice Session