Improving Clinical Practice Through Education: A Case Study of Online CME on Metastatic Renal Cell Carcinoma
Between February 6, 2014 and March 15, 2014 a total of 529 physicians, nurse practitioners, physician assistants, nurses, pharmacists and medical students participated in the online CME activity “Optimizing Dose Intensity for Patients with Metastatic Renal Cell Carcinoma.” An assessment of the learning activity revealed an improvement in the knowledge and competence of the participants, who hailed from 45 different countries and 40 different U.S. states.
The goal of the activity, which features a video recap of a Grand Rounds presentation given by Dr. Roberto Pili, Chief, Genitourinary Section and Leader, Genitourinary Program, Department of Medicine, Roswell Park Cancer Institute and Dr. Michael Krabak, CCS Oncology, on November 1, 2013, is to improve clinician knowledge and self-reported performance with the aspects of clinical care for patients with metastatic renal cell carcinoma (mRCC); namely, choosing therapy, optimizing dose, and managing side effects with particular focus on vascular endothelial growth factor tyrosine kinase inhibitors.
Participants are provided resources pertaining to schedule changes, how best to manage adverse effects from oral therapies and scheduling follow-up care, along with materials for patients and their families to promote compliance with the treatment medication, how to minimize side effects, and when to call the doctor’s office if the side effects become unmanageable.
Improved knowledge and competence by the oncologists who completed the CME activity demonstrated a statistically significant impact of the intervention. Improvement was demonstrated in using strategies to manage treatment-related toxicities and being able to retain efficacy without changing therapies or dose, but by changing the treatment schedule for patients with mRCC. Prior to engaging in the activity, only 26% of oncologists recognized this appropriate treatment modification. However, this number increased to 85% in the post-assessment, demonstrating a significant improvement in learning. Comparing pre-assessment and post-assessment responses shows that 61% of responders demonstrated an improvement in understanding the learning concept. The concept was reinforced for 24% of responders.
Dr. Pili shares that he “found the results very thought provoking. It confirms that effective educational programs can change practice. These data are encouraging because, hopefully, with the first signs of toxicities more physicians will consider a change in the schedule, rather than the dose of sunitinib, one of the most commonly used drugs for renal cell carcinoma.”
Funding for this project was provided through an educational grant from Pfizer.
The activity will be available online until February 6, 2015. Click here and select Optimizing Dose Intensity for Patients with Metastatic Renal Cell Carcinoma (Medscape) to access the activity.