Background and aim
In the dynamic field of prostate cancer (PCa), keeping abreast of scientific developments and translating these into appropriate clinical decisions is challenging and time-consuming. We tested an innovative type of micro-CME consisting of weekly cases with direct feedback.
Since January 2016 weekly cases on various clinical situations in PCa are sent to ± 1,500 subscribers of an online PCa educational platform. Cases are selected from 2,630 scenarios developed by 5 international multidisciplinary expert panels using the RAND/UCLA Appropriateness Method. A link in the notifying email provides instant access to the weekly case containing a short patient description (mean 50 words) and 2 clinical decision options. After selecting an option, direct feedback shows the overall score of other participants, together with the recommendation of the expert panel (appropriate, inappropriate, uncertain), and related scientific evidence. To evaluate participants’ opinions, a survey was sent out 1 year after the start.
For the first series of 50 cases, 37% of weekly emails were opened, and 60% of these led to active participation (overall conversion rate 22%). Most participants were urologists (62%), followed by medical oncologists (10%) and radiation oncologists (7%). About one-third of the participating physicians completed a case at least once a month. For cases in which one option was more appropriate than the other (N=42), agreement with the panel recommendation was 68%. Agreement was highest for cases on high-risk prostate cancer, and lowest for those on biochemical recurrence after radical treatment (Figure). Agreement was higher if the difference in appropriateness between the 2 options was larger: 79% for appropriate vs. inappropriate; 64% for appropriate vs. uncertain). The 1-year evaluation survey (N=112, around a quarter of the weekly active users) revealed much enthusiasm for this educational service, particularly because of its conciseness, comparison with peers and experts, and summary of up-to-date evidence from clinical studies.
The high conversion rate, considerable number of returning visitors and positive feedback suggest this weekly case service to be an attractive new form of micro-CME. As participants’ choices were suboptimal in one-third of cases, there is obviously a learning need in this field. Further research should determine the educational effectiveness of this service and its impact on clinical decisions.