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Abstract Number: 2080

Teaching Fellows in Lupus: Rheumatology Fellows Are Successful Educators in Improving Lupus Recognition By Frontline Healthcare Providers

Amy Caron1, S. Sam Lim2, Lexi Rene3, Diane Gross4, Maria Dall'Era5, Rosalind Ramsey-Goldman6 and Amanda Sammut7, 1Lupus Research Institute, New York City, NY, 2Emory University School of Medicine, Atlanta, GA, 3Rollins School of Public Health, Emory University, Atlanta, GA, 4S.L.E. Lupus Foundation/Lupus Research Institute, New York, NY, 5University of California San Francisco School of Medicine, San Francisco, CA, 6Northwestern University Feinberg School of Medicine, Chicago, IL, 7Columbia University Medical Center and Harlem Hospital Center, New York, NY

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: Assessment, Education, educational innovation and fellowship programs, Lupus, medical

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Session Information

Date: Monday, November 9, 2015

Session Title: ARHP II: Lupus

Session Type: ARHP Concurrent Abstract Session

Session Time: 2:30PM-4:00PM

Background/Purpose: The heterogeneity and
non-specific features of lupus may delay diagnosis.  This delay can lead to
accrual of organ damage and an increased risk of death. Early detection by
frontline providers (primary care and emergency room physicians, physician
assistants, nurses, medical students) is critical to decrease the referral time
for diagnosis and treatment. Average time devoted to lupus education in the
first 2 years of medical school is 45 minutes and lupus education in years 3
and 4 is elective  so frontline providers may not have the knowledge to
recognize the disease. Given the shortage and high demand of rheumatologists,
this project enlisted rheumatology fellows to deliver a standardized presentation.
    

Methods: Four cities were selected as pilot
sites based on minority populations served, availability of rheumatology fellows,
and local lupus experts. Fellows were trained to deliver standardized content developed
material from the Lupus Initiative to provide a live presentation to frontline
providers. Local lupus agencies assisted with outreach to schedule seminars. A
voluntary, anonymous, paper-based pre/post assessment was used to evaluate
changes in knowledge and confidence and to collect other qualitative data. A
paired t-test was used to analyze the continuous variables and frequency tables
were used for categorical variables.

Results: Preliminary data from 339 matched
pre/post assessments were analyzed and scored on a 10 point scale. Total mean
score increased 1.59 (p<.0001). Mean score improvement was greatest among nurses
and physician assistants (3.09, 2.71 respectively; p<.0001) and providers in
community health centers (3.00; p<.0001). 94% of participants gained
confidence in knowing when to consider lupus based on patient history and exam and
93% in recognizing signs and symptoms. Over 90% were satisfied with the
content, pace, and delivery of the seminar and 89% would attend another seminar
led by a fellow.  100% of participating fellows noted the project as a positive
experience.

Conclusion: Rheumatology fellows can
effectively educate frontline providers about lupus recognition using a
standardized presentation.  Further dissemination and evaluation of this
program is warranted.

Table 1. Comparison of Pre and Post Assessment Scores

Characteristics

N

Total Score Mean Diff (SD)

P-Value

Total Matched Assessments

339

1.59 (1.65)

<0.0001

Location

 

Atlanta

96

1.18 (1.43)

<0.0001

Chicago

53

1.17 (1.49)

<0.0001

New York

149

1.87 (1.76)

<0.0001

San Francisco

41

2.10 (1.66)

<0.0001

Profession

Doctors/ Residents 

181

1.25 (1.48)

<0.0001

Physician Assistant/ Nurse Practitioner

17

2.71 (1.72)

<0.0001

Nurses

21

3.09 (1.61)

<0.0001

Medical Students

49

1.71 (1.54)

<0.0001

Place of Practice

Emergency Room

46

1.15 (1.61)

<0.0001

Primary Care Office

41

1.88 (1.86)

<0.0001

Hospital

47

1.35 (1.30)

<0.0001

Community Health Center

16

3.00 (1.59)

<0.0001

Multiple Locations

71

1.59 (1.50)

<0.0001

 

Table 2. Confidence and Satisfaction

Confidence Change (Among respondents who were “Not Very” and “Not At All” Confident on Pre-assessment)

N (%)

Confidence knowing when to consider lupus based on patient history exam (N=140)

131 (93.6)

Confidence to recognize signs and symptoms of lupus (N=120)

111 (92.5)

Confidence to appropriately refer patients (N=90)

81 (90.0)

Satisfaction

N (%)

Very/Somewhat Satisfied with Content (N=288)

277 (96.2)

Very/Somewhat Satisfied with Pace (N=288)

269 (93.4)

Very/Somewhat Satisfied with Delivery of Content (N=288)

268 (93.1)

Highly Likely/Somewhat Likely to attend another seminar led by a Fellow (N=288)

255 (88.5)

 


Disclosure: A. Caron, None; S. S. Lim, None; L. Rene, None; D. Gross, None; M. Dall'Era, None; R. Ramsey-Goldman, None; A. Sammut, None.

To cite this abstract in AMA style:

Caron A, Lim SS, Rene L, Gross D, Dall'Era M, Ramsey-Goldman R, Sammut A. Teaching Fellows in Lupus: Rheumatology Fellows Are Successful Educators in Improving Lupus Recognition By Frontline Healthcare Providers [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/teaching-fellows-in-lupus-rheumatology-fellows-are-successful-educators-in-improving-lupus-recognition-by-frontline-healthcare-providers/. Accessed January 20, 2021.
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