Background/Purpose: Gout is the most common type of inflammatory arthritis in the U.S., affecting 4% of the population. Despite modern advancements and the availability of reference tools, the current care from primary care providers is felt to be suboptimal in the U.S. One barrier to improving care in gout includes limited education during medical training.

To address limited education during training, we developed a digital adjunctive teaching tool, GoutPro, on the topic of gout. Utilizing a clinically integrative model proposed by Khan et al, it takes into consideration different learning styles, current guidelines on gout, interactive activities and clinical problem solving. In our pilot study, we obtained positive subject feedback through survey. To assess objective trainee improvement of gout knowledge, a single-blinded randomized controlled study assessing knowledge prior to and after GoutPro intervention was conducted.

Methods: We recruited a total of 19 medical trainees from Hennepin County Medical Center to participate in our study. Trainees included medical students of MS 3-4 training levels and residents of PGY 1-4 training levels. All trainees registered via an online registration form and consent forms were signed digitally. Registered participants were randomized proportionally according to level of training into the control and the study group via a novel automated cloud based system to keep the investigators blinded. Correspondence with participants was also managed by the automated system. All participants were sent an e-mail with a link to a pre-test of 14 questions on crystalline arthropathy based on recommendations from the 2012 ACR Gout Guidelines and MKSAP 17. The study group was instructed to attend a live session led by the investigators that utilized GoutPro. The control group was provided both the ACR Guidelines and UpToDate reference articles on crystalline arthropathy for review. All participants received an identical post-test 27 days later to avoid coinciding with trainee change of rotations. 15 out of 19 subjects completed the post-test. Our primary outcome was difference in pre- and post-quiz scores between the control and study group. The StudentÕs t-test was used for analysis.

Results:

Average Scores

Conclusion:

1) The study group had a slightly higher percent improved test scores (7%) compared to those in control group (3%). The results did not reach statistical significance due to the small study size (P=0.99).  

2) At baseline, medical trainees in the study demonstrated low knowledge on gout demonstrating the need for improved gout curriculum.

3) Future GoutPro studies with larger sample size from multiple centers will be needed.

4) Utilization of a novel cloud-based automated system to randomize and communicate with study subjects was an effective cost-efficient way to recruit, organize and manage study subjects while maintaining investigator blindness.