bluuebunny/crossref_metadata_2025_split huggingface dataset:
759. Gaps on Lyme Disease Knowledge Among Healthcare Providers in an Endemic Area: a Call for Educational Programs
Authors: GARY E V A N , Lamba Pooja , Handel Andrew S , Saldivar Miguel A , Marcos Luis A 
Published: November 2023

Abstract

Background
Lyme disease (LD) is hyperendemic in Long Island, NY. Identifying the practices of healthcare providers regarding LD epidemiology, clinical features, diagnosis, and treatment is crucial to continue improving patient care. Our study aims to assess the general understanding of LD among front line healthcare providers in order to identify knowledge gaps and produce targeted educational materials.

Methods
A 20-question IRB-approved online survey on LD prevention, diagnosis, and treatment practices based on IDSA national multidisciplinary LD guidelines was developed. From January to April 2023, this survey was sent to front line providers including physicians, residents, nurse practitioners, and physician assistants at Stony Brook Medicine. A p-value &lt; 0.05 was considered significant using SPSS software.
IRB-approved survey for Lyme disease.

Results
Out of 140 respondents, 93 (66%) fully completed the survey (72% female). Regarding years in training, 53 (57%) reported being in practice for &gt;5 years post-training, 15 (16%) were 1-5 years post-training, and 25 (27%) were still in training. Participants practiced the following specialties: Emergency Medicine 25% (n=23), Internal Medicine (IM) 15% (n=14), Pediatrics (Ped) 54% (n=50), and combined IM/Ped 6 % (n=6). Regarding knowledge of LD: 69% (n=64) of participants correctly identified the tick associated with LD, 48% (n=45) knew the correct description of erythema migrans, 75% (n=70) correctly identified the guideline recommendation for single dose doxycycline prophylaxis after a high-risk tick bite, 68% (n=63) offer single dose doxycycline prophylaxis after any tick bite, 35% (n=33) answered that a 7-10 day course of doxycycline for prophylaxis is indicated after a high-risk bite and only 3% (n=3) correctly identified the CDC-recommended testing strategies for the diagnosis of LD. In regression models, age, gender, specialty, or years in practice did not improve knowledge in these variables.
Demographics table.

Conclusion
Our pilot study found numerous important knowledge gaps among the surveyed providers regarding the current recommendations for prevention, diagnosis and treatment of LD. Based on these findings, we plan to create targeted educational efforts in order to improve mainly two areas on LD: diagnosis and management.

Disclosures
All Authors: No reported disclosures
761. Provider Perceptions of Antimicrobial Use and Educational Needs at Two Community Hospitals Within a Health System
Authors: Greenfield Adam , Sims Kathy M , Sastry Sangeeta , Bearman Gonzalo , Doll Michelle , Rittmann Barry 
Published: November 2023

Abstract

Background
Variability in ASP practices was identified across sites within a recently consolidated health system. A needs assessment was developed to identify knowledge gaps in infectious diseases management and antimicrobial stewardship practices at non-academic, resource-limited community sitesto tailor educational initiatives and promote practice changes.

Methods
A survey was conducted among physicians, pharmacists, advanced practice providers (APPs), and nurses at 2 rural, community hospitals in Virginia containing 80 and 70 beds respectively. The questionnaire contained 6 parts encompassing three domains: confidence in management of infectious diseases, antimicrobial stewardship practices, and educational needs.

Results
The survey was distributed to 134 individuals. A total of 42 respondents completed the survey (response rate 31.3%) including 10 physicians/APPs, 11 pharmacists, 19 nurses, and 2 others.
The most commonly encountered infectious disease syndromes treated in patients is represented in Figure 1. Sepsis and pneumonia were identified as the most common clinical syndromes treated. Overall confidence in managing ID syndromes in accordance with national guidelines was high, particularly among physicians (Figure 2). Pooled results demonstrated greatest confidence in managing urinary tract infection (mean rating 7.8/10) and least confidence in managing organ space/deep surgical site infections (mean 6.7/10).
80% of clinical providersreported evaluating the necessity of antimicrobials dailyand 70% reported utilizing minimal durations of therapy. The most requested topics of education on antimicrobials were: optimization of dosing in special populations, dosing of high-risk medications and strategies for de-escalation. The preferred choice for content delivery was live webinar (36.8%) followed by an online module (31.6%). Newsletter and in-person presentations were less popular (2% each).

Conclusion
Among healthcare professionals practicing in rural community settings, sepsis was the most common treated syndrome with high confidence in treating all infectious disease syndromes in accordance with guidelines. Future education should focus on both self-reported and demonstrated needs.

Disclosures
Michelle Doll, MD, MPH, Molnlycke: Grant/Research Support
762. Conversations that Matter: Developing an AI-Based Training Algorithm to Improve Provider Competence to Work with SGM Youth
Authors: Hanshaw Brady , Rachal Laura , Gross Jessica , Finacchio Zachary , McElroy Sarah , Noble Skyler , Espada Joshua , Shen Thomas , Lina Rosengren A 
Published: November 2023

Abstract

Background
Cultural incompetence hinders the engagement of sexual and gender minority (SGM) youth in the HIV prevention and care continuum. Improving providers’ cultural competence is critical to reducing HIV health inequities. Medical education lacks opportunity for practice and SGM perspectives. We are developing an AI training app that uses virtual patients and a framework of educational and behavior change theory to increase provider clinical and communication competence with SGM youth. SGM youth and healthcare providers have unique knowledge about provider bias and stigma barriers to care, which can inform intervention content.

Methods
From Twitter's API, 42,213 Tweets were iteratively sampled by 11 SGM youth (the “YAB”) and analyzed thematically. These themes were combined with current clinical care guidelines for SGM youth to generate 111 stigma barriers to care agreed upon by the YAB by consensus. These themes were edited and ranked by importance by the YAB using a modified Delphi method. Using this content as a starting point, we held workshops with providers and the YAB to develop a comprehensive list of scenarios where providers noted deficient training in providing culturally competent care to SGM youth. Prioritized training scenarios selected from this list were developed into detailed scripts for AI virtual patient encounters.

Results
Using a model of social media mining informed by SGM youth and provider collaborative work, training scenarios were developed for integration into a GPT/AI provider training app. Scenarios address topics selected by SGM youth that are particularly salient to this population based on social media conversations around provider stigma and the YAB members’ lived experiences. Scenarios will progress from basic to advanced topics to train providers in culturally appropriate language and foster competent care for SGM youth.

Conclusion
SGM youth have deep insight into their care needs and lived experiences of healthcare trauma. Understanding these care needs and building provider competence is critical to reduce HIV inequities among SGM youth. Our data provide new insight into how interactions between providers and SGM youth may improve. Future research will test the app’s effect on the clinical care behaviors of providers in a randomized control trial.

Disclosures
All Authors: No reported disclosures
764. Return to the Roundtable: A Clinical Case Discussion Curriculum for Infectious Diseases Fellows
Authors: Hillenbrand Molly , Perez Reinaldo , Shoff Christopher , Maziarz Eileen K , Sparks Matthew A 
Published: November 2023

Abstract

Background
The Accreditation Council for Graduate Medical Education (ACGME) and the Infectious Diseases Society of America (IDSA) require infectious diseases fellowship programs to include a core curriculum as part of their requirements for clinical training, though recommendations regarding content and structure are limited. Despite advances in online tools available for asynchronous learning in medical education, there remains a scarcity of published ready-to-teach content. We hypothesized that case-based clinical reasoning sessions covering core clinical topics would improve the attitudes and confidence of infectious diseases fellows.

Methods
We conducted an informal needs assessment of current fellows, reviewed published recommendations and other fellowship curricula. Then, we developed a series of case-based clinical reasoning sessions for clinical and research fellows based on constructivist theory and emphasizing adult learning principles. Topics were rooted in published guidelines and evidence-based practice, prioritizing complex and high-yield clinical topics. Content was peer-reviewed by faculty and sessions were facilitated by senior fellows. Facilitation guides were created to allow for dissemination in the future. Faculty and pharmacists attended the sessions as expert discussants. Fellows completed anonymous surveys assessing attitudes and confidence after each session.

Results
Three sessions covering Endemic Mycoses, Non-tuberculous Mycobacteria, and Toxoplasmosis were completed with 6-8 fellows in attendance at each. Surveyed fellows felt that the sessions were valuable and improved their confidence in clinical management of the topics presented (Figure 1). Participants also provided narrative feedback (Table 1).
Post-session Survey ResultsFigure 1.Post-session survey results from Likert-scale questions assessing attitudes and confidence, n=11 surveys completed by infectious diseases fellows.
Post-session Narrative FeedbackTable 1.Narrative feedback from fellows who completed the post-session surveys.

Conclusion
This curriculum represents a novel initiative by trainee physicians to create a series of peer-facilitated, discussion-based sessions for learners at the level of subspecialty fellowship. We demonstrated that these sessions improve the attitudes and confidence of fellows in a single-program pilot. Future directions will include studying the intervention in other fellowship programs and sharing this program broadly within the infectious diseases education community.

Disclosures
Eileen K. Maziarz, MD, Karius, Inc: Advisor/Consultant
767. Impact of Standardized Patient Simulation on Pharmacy Students' Confidence and Perceptions in Community-Acquired Bacterial Meningitis Management
Authors: Kufel Wesley D , Mastro Keri , Blaine Bruce 
Published: November 2023

Abstract

Background
Limited data describes the use of standardized patient simulation (SPS) for infectious disease (ID) education, particularly among pharmacy students. We sought to assess the impact of SPS on pharmacy students’ knowledge and confidence of community-acquired bacterial meningitis (CABM), and to evaluate students’ perceptions of SPS.

Methods
This single-center, cross-sectional, voluntary, anonymous survey was conducted among second-year Doctor of Pharmacy students (n=69). CABM education was initially delivered via didactic, large classroom instruction, which occurred 1.5 weeks prior to the SPS. The pre-SPS survey asked students to assess their confidence in CABM. The confidence questions focused on pathophysiology, microbiology, clinical presentation, diagnosis, and empiric/targeted management. The SPS included two group graded sections: a rounding experience focused on patient assessment, clinical presentation, and empiric management (Figure 1) followed by a microbiology lab simulation, targeted management, and duration/monitoring. A post-SPS survey was distributed, which included the same pre-survey questions and questions related to perceptions of SPS. All survey confidence and perception questions were evaluated using a Likert scale from strongly disagree (1) to strongly agree (5). Descriptive statistics and Student’s t-test were used.
Standardized Patient Simulation Rounding Experience
Student group engaged in the standardized patient simulation rounding experience (all individuals pictured gave permission for the use of this picture).

Results
Sixty-three students fully completed the pre- and post-SPS surveys (91.3% response rate), and pre-post responses were matched. Overall mean (+SD) confidence in CABM management was significantly higher following SPS (4.3+0.5 vs. 3.5+0.7; p&lt; 0.001). A statistically significant mean increase was also observed for each individual confidence item following SPS. Mean (+SD) perceptions following SPS for feeling more comfortable with patient interaction skills, preferring SPS compared to written case-based instruction, and having interest in more ID SPS were 4.2+0.8, 4.2+0.9, and 4.3+0.9, respectively.

Conclusion
SPS was associated with increased confidence in CABM management among pharmacy students. Students appeared to have a positive impression of SPS and are interested in future ID SPS. SPS appears to be an effective educational modality for CABM and should be assessed among other student clinicians for ID.

Disclosures
Wesley D. Kufel, Pharm.D., BCPS, BCIDP, AAHIVP, Merck & Co.: Grant/Research Support
772. Learning from our patients: An exploratory study to inform the development of a case tracking dashboard for subspecialty fellows
Authors: Minter Daniel J , Frank Annabel K , Schwartz Brian S , Narayana Sirisha 
Published: November 2023

Abstract

Background
Educators identify case tracking (following-up prior patient encounters) as a valued practice to cultivate physician expertise. Much of the existing research has focused on the practices of general medicine providers, where challenges include insufficient time and difficulty tracking patients in the electronic health record (EHR). Subspecialty fellows constitute a group of advanced learners who see a high volume of patients and need to quickly become subject matter experts, yet little is known about their particular needs and motivations around case tracking. In this study, we performed a needs assessment with fellows to inform the design of an EHR-based case tracking dashboard that can facilitate learning from prior patient encounters.

Methods
We conducted semi-structured interviews with 22 medicine subspecialty fellows (including 4 Infectious Diseases [ID] fellows) at a single academic medical center that explored participants’ motivations, preferences, and practices around case tracking. Interview transcripts were coded and analyzed with directed qualitative content analysis. Results of this analysis will be used to inform the design of a subspecialist EHR-based case tracking dashboard.

Results
Participants were motivated to engage in case tracking, with curiosity regarding patient outcomes as a strong motivator. Although some attempted to track all consults, most focused on subsets of patients, feeling that not all encounters were of equal educational value. Participants highlighted particular results, specialty-specific notes, and major outcomes as the most useful information. ID fellows specifically were interested in post-discharge ID clinic encounters, send-out tests, and outcomes of their management decisions. Despite widespread motivation to engage in case tracking, manually adding patients to lists and remembering to follow up poses logistical and time barriers.

Conclusion
An ideal EHR case-tracking dashboard would automatically keep a list of patients cared for by fellows and provide easy access to own-specialty notes, specific results of interest, and information on the global clinical course. The ability to highlight specific cases anticipated to have more educational value would also be of benefit.

Disclosures
All Authors: No reported disclosures
775. Needs Assessment to Support Continuing Education and Training Modalities for High-Consequence Pathogen Preparedness in Pediatric and Obstetric Populations
Authors: Mowrer Clayton , Fischer Laura J , Horton John , Huff Nichole L , Imonugo Chimora , Shane Andi L , Stone Lisa , Simonsen Kari 
Published: November 2023

Abstract

Background
High-consequence pathogens present complex challenges in United States (US) healthcare, with knowledge gaps existing in the provision of safe and effective treatment. The National Emerging Special Pathogens Training and Education Center (NETEC) aims to standardize guidance and care coordination across the healthcare continuum for suspected or confirmed infection with high-consequence pathogens through education, training, research, monitoring, evaluation, and funding. The NETEC Special Populations Committee applies this mission to pediatric and obstetric care.
We conducted a needs assessment to optimize education and training opportunities for healthcare teams related to high-consequence pathogen preparedness for children and pregnant women.

Methods
Stakeholders received a needs assessment survey via email, social media, and NETEC website from 10/3/22-11/15/22. Questions targeted demographics, topics of interest for continuing education within the special populations: pathogen awareness, frontline care, infection prevention, and emergency preparedness, and learning modality preferences.

Results
Of the 20,600 impressions, the survey was completed by 145 persons (with 97 additional partial completions). The use of targeted emails had the highest engagement, with a 25% open rate (29% industry average) and click-through rate of 18% (5% industry average). Respondents were located across the US, mainly in academic healthcare settings (46%). Infection Preventionists (30%) represented the greatest proportion, but many institutional roles were reported (Table 1). Responses to educational topics were widely distributed (Table 2). Webinars (77%), in-person training (64%), and brief written summaries or updates (54%) were the most common preferred learning modalities (Figure 1).

Conclusion
Myriad healthcare team members are involved in the care of pediatric and obstetric patients with high-consequence pathogens. They represent an engaged group of NETEC stakeholders that, despite recent experience with the SARS-CoV-2 pandemic, express interest in continuing education on topics related to high-consequence pathogens across the care continuum via interactive, engaging, and collaborative learning modalities, led by subject matter experts.

Disclosures
Andi L. Shane, MD, MPH, MSc, International Scientific Association for Probiotics and Prebiotics: Travel and lodging support to attend an international meeting June 2022|Pediatric Infectious Disease Society (PIDS): Stipend for serving as Deputy Editor Kari Simonsen, MD, MBA, Astra-Zeneca: Grant/Research Support|Melinta Therapeutics: Grant/Research Support|Pfizer: Grant/Research Support
780. A Quality Improvement Initiative to Identify and Close Gaps in Rapid Initiation of Antiretroviral Therapy (ART)
Authors: Colasanti Jonathan , Rana Aadia I , SAWYER J E W E L , Rodriguez Melissa , Meza Jimenez Jenniffer A , Carter Jeffrey D , Corona Abigail K , Simone Laura , Molloy Leah 
Published: November 2023

Abstract

Background
Treatment guidelines recommend prompt ART initiation after HIV diagnosis, but implementation barriers persist. This project aimed to identify gaps and improve clinical practices surrounding rapid ART initiation in the US.

Methods
Baseline surveys were completed by 130 healthcare professionals (HCPs) in 8 HIV clinics assessing knowledge and practice around ART initiation. Responses informed the development of interactive, live virtual audit-feedback sessions at 8 clinics from 5/2022 – 8/2022. Pre and post-program surveys were administered, team-based action plans developed, and HCPs completed 60- and 120-day follow-up surveys.

Results
Top reported challenges impeding rapid ART initiation were medication adherence for patients with unstable housing/substance use disorders (SUD) (63%), incomplete lab results (33%) and co-infections/opportunistic infections (28%). Knowledge was assessed using case vignettes. For a patient with hepatitis C and SUD, 45% of learners correctly chose to promptly start ART, which improved to 94% after the sessions (p&lt; .001). More HCPs were confident initiating ART for patients with unstable housing/SUD (70%) and before confirmatory HIV testing (74%) after the sessions than before (38% and 39%, respectively, p&lt; .001 each).
Follow-up surveys noted a 10% increase in proportion prescribing ART within 7 days of a positive screening test (32% to 42%) along with increased ART prescribing the same day as a positive test and before additional test results, Figure 1. Action plans implemented after the sessions included coordination with off-site labs, new intake forms, and staff training. HCPs self-reported improvements including appropriate prompt ART initiation (81% and 88%), integrating new patients to avoid loss to follow-up (85% and 88%), and alignment with guidelines (88% and 91%). HCPs identified care coordination (31%) and identifying candidates for rapid ART initiation (31%) as areas of need to improve rapid ART initiation. Challenges reported included scheduling conflicts, timely lab results and coordination with case management.Figure 1.Proportion of HCPs reporting ART initiation practices occurring for &gt;75% of their patients

Conclusion
Tailored implementation discussion with live audit-feedback and action planning led to measurable practice improvements. These outcomes may inform other practice-changing implementation needs.

Disclosures
Jonathan Colasanti, MD, MSPH, DKB MED LLC: Honoraria|Prime Education LLC: Advisor/Consultant Aadia I. Rana, MD, Merck: Grant/Research Support JEWEL SAWYER, PA-C, MSHS, AAHIVS, Janssen: Speakers Bureau|Prime Education: Speakers Bureau