Impact of online education on intern behaviour around joint commission national patient safety goals: a randomised trial.
OBJECTIVE
To compare the effectiveness of two types of online learning methodologies for improving the patient-safety behaviours mandated in the Joint Commission National Patient Safety Goals (NPSG).


METHODS
This randomised controlled trial was conducted in 2010 at Massachusetts General Hospital and Brigham and Women's Hospital (BWH) in Boston USA. Incoming interns were randomised to either receive an online Spaced Education (SE) programme consisting of cases and questions that reinforce over time, or a programme consisting of an online slide show followed by a quiz (SQ). The outcome measures included NPSG-knowledge improvement, NPSG-compliant behaviours in a simulation scenario, self-reported confidence in safety and quality, programme acceptability and programme relevance.


RESULTS
Both online learning programmes improved knowledge retention. On four out of seven survey items measuring satisfaction and self-reported confidence, the proportion of SE interns responding positively was significantly higher (p<0.05) than the fraction of SQ interns. SE interns demonstrated a mean 4.79 (36.6%) NPSG-compliant behaviours (out of 13 total), while SQ interns completed a mean 4.17 (32.0%) (p=0.09). Among those in surgical fields, SE interns demonstrated a mean 5.67 (43.6%) NPSG-compliant behaviours, while SQ interns completed a mean 2.33 (17.9%) (p=0.015). Focus group data indicates that SE was more contextually relevant than SQ, and significantly more engaging.


CONCLUSIONS
While both online methodologies improved knowledge surrounding the NPSG, SE was more contextually relevant to trainees and was engaging. SE impacted more significantly on both self-reported confidence and the behaviour of surgical residents in a simulated scenario.
Workforce Education and Development Group, K01, The University of Sydney, NSW 2006, Australia. tim.shaw@sydney.edu.au
Tim J
TJ
Shaw
Luise I
LI
Pernar
Sarah E
SE
Peyre
John F
JF
Helfrick
Kaitlin R
KR
Vogelgesang
Erin
E
Graydon-Baker
Yves
Y
Chretien
Elizabeth J
EJ
Brown
James C
JC
Nicholson
Jeremy J
JJ
Heit
John Patrick T
JP
Co
Tejal
T
Gandhi
D001900:Boston; D002405:Catheterization, Central Venous / Q000379:methods*; D057186:Comparative Effectiveness Research; D020375:Education, Distance / Q000379:methods*; D004501:Education, Medical / Q000379:methods; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007396:Internship and Residency / Q000592:standards*; D007591:Joint Commission on Accreditation of Healthcare Organizations; D019982:Organizational Case Studies; D061214:Patient Safety / Q000592:standards*; D016544:Patient Simulation; D015397:Program Evaluation; D036301:Qualitative Research; D013337:Students, Medical / Q000523:psychology; D011795:Surveys and Questionnaires; D014481:United States