title: Interactive spaced education to assess and improve knowledge of clinical practice guidelines: a randomized controlled trial.
abstract: OBJECTIVE
  To determine whether Interactive Spaced Education (ISE) is an effective and acceptable form of graduate and continuing medical education (GME/CME), using clinical practice guideline (CPG) education as an experimental system.
  
  
  BACKGROUND
  ISE is a novel form of online education, which combines the pedagogical merits of the spacing and testing effects. Its efficacy for GME and CME is not known.
  
  
  METHODS
  One-hundred sixty urologists and 320 urology residents were randomized to 1 of 2 cohorts. We developed and validated 48 ISE items (questions and answers) on 5 urology CPGs (hematuria and priapism [HP]; staghorn calculi, infertility, and antibiotic use [SIA]). Physicians were sent 3 emails a week, each containing 2 questions. Content was repeated 3 times over 20 weeks. Cohort A physicians received the 3-cycle ISE course on HP, with 24 control items on SIA in cycle 3. Cohort B physicians received the 3-cycle ISE course on SIA, with 24 control items on HP in cycle 3.
  
  
  RESULTS
  The ISE program was completed by 71% urologists and 83% residents. Cohort A scores on HP increased from mean 44.9% in cycle 1% to 75.7% in cycle 3, a 57% relative increase compared with controls (P < 0.001; Cohen effect size, 2.2). Similarly, cohort B scores on SIA increased from 45.2% in cycle 1% to 69.5% in cycle 3, a 56% relative increase compared with controls (P < 0.001; effect size, 2.2). Eighty-four percent of all participants requested to enroll in further ISE programs.
  
  
  CONCLUSIONS
  ISE is an effective and well-accepted form of GME and CME and is a promising new methodology to improve CPG knowledge.
authors.affiliation: Surgical Service (Urology), Veterans Affairs Boston Healthcare System, Boston, Massachusetts, USA. price.kerfoot@gmail.com
authors.forename: B Price
authors.initials: BP
authors.lastname: Kerfoot
authors.forename: Michael C
authors.initials: MC
authors.lastname: Kearney
authors.forename: Donna
authors.initials: D
authors.lastname: Connelly
authors.forename: Michael L
authors.initials: ML
authors.lastname: Ritchey
mesh_terms: D004502:Education, Medical, Continuing / Q000379:methods; D004503:Education, Medical, Graduate / Q000379:methods*; D006801:Humans; D020407:Internet; D007396:Internship and Residency; D017410:Practice Guidelines as Topic / Q000592:standards*; D014572:Urology / Q000193:education*