Background/Purpose: Understanding epidemiology and biostatistics is crucial for rheumatologists to accurately interpret the rheumatic disease literature and make appropriate clinical decisions. In 2014 rheumatology program directors (PD) endorsed the need for materials to support teaching and learning in this area, with a preference for web-based interactive modules. Acknowledging this need, we developed Critical Literature Assessment Skills Support – Rheumatology (CLASS-Rheum). We report on the development, implementation, feasibility and results of our 6-month pilot.

Methods:

CLASS-Rheum was organized as 10 modules on topics encountered in relevant journals (data/distributions, case series, cohorts, case control studies, randomized controlled trials, crossover studies, survival analysis, non-inferiority trials, systematic review/meta-analysis, instrument performance). Based on the science of test-enhanced learning, we developed 3-9 questions/module in rheumatologic contexts. The Learning Catalytics® platform allowed participants to access CLASS-Rheum on any web-enabled device, in synchronous, asynchronous, individual and team formats, with immediate feedback, answer rationales and supporting references.

With IRB exemption, six rheumatology programs of varied size across the US participated from January-June 2016. Each program had autonomy over implementation format and timing. Demographics were collected anonymously via RedCap. Data on use and feasibility were collected in person, via conference calls, email and RedCap. Learning Catalytics® captured responses to CLASS-Rheum questions.

Results:

Thirty fellows participated; 12 first year of fellowship, 14 second year, three third year, and one fourth year. 80% were women, 17% had pediatrics or internal medicine/pediatrics training, 10% had degrees in epidemiology/biostatistics. 62% were very interested and 34% somewhat interested in improving their understanding of epidemiology/biostatistics.

Variability in responses to CLASS-Rheum questions suggested an appropriate range of item difficulty. When team format was used with fellows responding individually and again after small group discussion, correctness of trainees’ responses increased.

Trainees reported CLASS-Rheum helped identify knowledge gaps, address learning needs and reinforce learning. Trainees’ comments indicated it was “engaging” “fun” and “helpful in challenging me to assess/clarify my own knowledge in an applied manner.” Trainees highlighted answer rationales as useful resources and described increased confidence and skill in assessing the quality of the literature after completing CLASS-Rheum.

Instructors/PD found CLASS-Rheum gave them insight into fellows’ learning needs and a feasible program to address them. They expressed desire for additional modules to support longitudinal assessment.

Conclusion:

CLASS-Rheum can be successfully implemented to support teaching in a range of rheumatology training programs. It was well received, the content was perceived as relevant, and the formats feasible and useful. CLASS-Rheum should be evaluated in a larger number of programs, with subsequent isomorphic modules to provide longitudinal assessment.

ACR Meeting Abstracts - https://acrabstracts.org/abstract/development-and-implementation-of-a-question-based-tool-promoting-learning-of-relevant-epidemiology-and-biostatistics-in-rheumatology-the-critical-literature-assessment-skills-support-rheumatology/