269 - Assessing use of bug-in-ear technology as a novel feedback tool

Poster Number: 269
Publication Number: 269.331

Kristen Stefanski, Akron Children's Hospital, Akron, OH, United States; Miraides Brown, Akron Children's Hospital, Akron, OH, United States; Diane L. Langkamp, Akron Children's Hospital, Akron, OH, United States

Background: Bug-in-ear (BIE) technology allows remote observation and instantaneous feedback to learners via an earpiece. It has been used successfully in education, athletic training and psychology, but its use in medical education has been limited.

Objective: In this pilot study, we evaluated the feasibility and acceptability of using BIE technology to provide real-time feedback to pediatric residents. We also assessed the impact of BIE compared to traditional post-encounter feedback on residents’ shared decision making (SDM) self-efficacy, attitudes and skills.

Design/Methods: PGY-1 pediatric residents were randomly assigned to BIE feedback using a $26 earpiece or traditional post-encounter feedback groups for two consecutive simulated SDM cases at intern orientation. They completed a survey assessing feasibility and acceptability of BIE technology for feedback. Validated scales were used to measure residents’ SDM skills (OPTION 5) after cases; attitudes (Patient-Practitioner Orientation Scale (PPOS)) and self-efficacy (SE-12 self-efficacy questionnaire) were measured before, immediately after and four months later. We evaluated feasibility and acceptability using descriptive statistics and compared outcomes between resident feedback groups using mixed-models.

Results: 18 residents participated with 8 in BIE group. 100% of residents who used BIE found it effective or highly effective for feedback and 75% felt BIE feedback enhanced their learning. 62.5% of the 8 residents would use BIE feedback again. Reported disadvantages of BIE feedback included moderate or considerable distraction (37.5%) and earpiece discomfort (12.5%) (see Table). The PPOS and SE-12 scores showed no significant change over time for either BIE or traditional feedback groups. We found a treatment effect on the total scores for the PPOS (p=0.02, 95%CI 1.15-11.94) and SE-12 (p=0.04, 95%CI 0.16-6.42) with residents in the traditional feedback group scoring higher at study start and completion. Mean scores on the OPTION 5 were higher in the BIE group (52.5 (SD 14) vs 48.7 (SD 10.3)), but this difference was not statistically significant (p=0.34).Conclusion(s): BIE technology is a feasible and acceptable means of providing real-time feedback to residents. Optimal equipment and adequate practice are necessary to maximize the impact of feedback and minimize distractions. Residents’ SDM self-efficacy, attitudes and skills did not improve with BIE compared to traditional post-encounter feedback. Further evaluation with a larger sample is necessary to explore the ideal BIE feedback dose to change outcomes and the impact of BIE feedback on patient care.
Feasibility and Acceptability of Bug-in-Ear Technology for Feedback