Spaced Education to Optimize Prostate Cancer Screening

Study Overview
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Brief Summary
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Two memory research findings (the spacing and testing effects) can dramatically improve retention of learning, but they have largely have been ignored by educators. The researchers have developed a novel form of online education (termed 'spaced education') based on these two effects which has been shown in randomized trials to improve knowledge acquisition and boost learning retention. Using prostate cancer screening as an experimental system, the researchers investigated whether spaced education could durably improve clinicians' behaviors, not just their knowledge.

Official Title
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Spaced Education to Optimize Prostate Cancer Screening

Conditions
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Prostate Cancer

Intervention / Treatment
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* Behavioral: Online spaced education


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Primary care providers (physicians, nurse practitioners, and physician assistants) from the 8 Veterans Affairs (VA) hospitals in the New England region (Veterans Integrated Service Network 1 [VISN-1]) were eligible to enroll. Exclusion Criteria: Primary care providers (PCPs) who ordered PSA as a screen for prostate cancer less than 10 times each year were excluded.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Spaced education clinicians - cohort 1<br>Spaced education clinicians receive four isomorphic cycles of 9 spaced education emails over 36-weeks (0-2 emails per week). Each email contained one question-explanation. | Behavioral: Online spaced education<br>* Spaced education is currently delivered via periodic emails that contain clinical case scenarios and multiple-choice questions. Upon submitting answers to each question online, clinicians receive immediate feedback and educational material. The questions are then repeated over spaced intervals of time to harness the pedagogical benefits of the spacing effect.<br>|
| No Intervention: Control clinicians - cohort 2<br>Control clinicians received no intervention | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Percentage of inappropriate prostate-specific antigen (PSA) screening performed by clinicians | The primary outcome measure was the difference in the percentage of inappropriate PSA screening performed by clinicians in the spaced education and control cohorts. Based on published clinical guidelines and reports, inappropriate PSA utilization was defined as the use of PSA for prostate cancer screening in patients >76 or <40 years old, or with an estimated life expectancy of less than 10 years. | Weeks 1-108 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in test scores between cohorts measured in weeks 1-36 |  | Weeks 1-36 | 
| Change in spaced education performance measured in weeks 1-36 |  | Weeks 1-36 | 
| Clinicians' intention to participate in future spaced education programs | Assessed on end-of program survey at week 36 | Week 36 | 
| Time required by clinicians to complete the spaced education questions-explanations | Assessed on end-of program survey at week 36 | Week 36 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Medical Education, Educational Technology, Clinical Practice Guideline, Prostate specific antigen