Microlearning in Sickle Cell Disease for Clinicians: A Practical Tool for Everyday Practice
Authors: Thordardottir Thorunn H. , Allen Eva K. , Curran Wendy , Duncan-Dietrich Hanna , Takahashi Naomi , Hollnagel Fauzia , Nazeef Moniba 
Published: December 2024

Introduction: Patients with Sickle Cell Disease (SCD) endure debilitating pain, organ dysfunction, and reduced life expectancy, often compounded by suboptimal care and societal stigma. Limited knowledge and understanding among healthcare staff perpetuate these disparities. Following a successful educational intervention for nursing staff, we developed a concise microlearning tool to address knowledge gaps among providers caring for our underserved patient population.

Methods: We conducted a needs assessment via an anonymous survey among clinicians and trainees in Hematology/Oncology, Internal Medicine, Hospital Medicine and Family Medicine. Based on responses, with grant support from the Department of Medicine and feedback from content experts, we developed evidence based, interactive educational modules using the concept of microlearning. Each topic review was designed to take 3-12 minutes to maximize engagement and retention, while fitting in daily workflows. Topics included pain management; severe complications (acute chest syndrome, infections, stroke, multi-organ failure syndrome); hepatic, renal, and splenic complications; transfusions; disparities and bias; pearls on admission and discharge and SCD in pregnancy. We used clinical cases and short quizzes to enhance comprehension and assess knowledge pre- and post-education. We designed infographics for each topic as a quick reference. Modules were uploaded to the hospital's virtual training platform and shared via program leadership and Best Practice Alerts. Participants replied to immediate post-surveys for feedback with planned 3-month post-surveys, and received a small gift card as an incentive. The Plan-Do-Study-Act methodology guided the test of change. Pre-and post-scores were compared via paired t-test.

Results: A total of 116 providers who regularly care for patients with SCD responded to the needs assessment where 89.7% (n=104) reported inadequate knowledge of SCD and only 24.1% (n=28) were satisfied with their comfort level in providing care. The majority (97.4%, n=113) were in support of SCD education. Of 44 participants who have signed up thus far, 59% (n=26) have completed the modules and a post-survey. The program was overall rated positively; 92.3% (n=24) found it very or extremely beneficial, 96.2% (n=25) felt the estimated time given for each module very or extremely consistent with the microlearning approach, 76.9% (n=20) felt the education extremely or very convenient to fit into their workflow and 92.3% (n=24) were very or extremely satisfied with the topics covered. The topics most likely thought to lead to practice change included transfusions in SCD (rated by 92.3%), severe complications (84.6%), pain management (80.8%) and admission and discharge pearls (69.2%). Infographics were rated by 44% (n=11) to be very or extremely helpful and moderately by 52% (n=13).

Post-education, 42.3% (n=11) of participants felt very or extremely confident in their overall knowledge of SCD and 57.7% (n=15) moderately confident. Participants' comfort level in caring for patients with SCD also improved with 38.4% (n=10) feeling very or extremely comfortable and 57.7% (n=15) moderately comfortable with their care. As a result of the program, 46.2% (n=12) believed patients will receive much better care and 53.8% (n=14) believed care will be somewhat better. Participants' knowledge ratings on a 0-10 scale improved from a mean score of 4.12 (SD 1.4) pre-intervention to 7.35 (SD 0.8) post-intervention (p&lt;0.001). Objective knowledge assessment, conducted pre- and post-education, demonstrated statistically significant improvements in the domains of transfusions (mean pre-score 30.8%, post-score 69.2%, p&lt;0.001), admission and discharge (mean pre-education score 48.1%, post-score 96.2%, p&lt;0.001) and severe complications (mean pre-score 32%, post-score 84.6%, p&lt;0.001).

Conclusion: Clinicians report low knowledge and comfort when managing patients with SCD. The microlearning approach effectively addressed these gaps, by integrating practical education into busy schedules and promoting evidence-based, compassionate care. The positive reception of the program, with significant improvements in knowledge, confidence and practice, indicates its effectiveness. Future efforts will focus on increasing clinician participation and regional dissemination.