Clinical trial NCT00123396: VHA Clinicians and Bioterror Events: Interactive Web-based Learning
Official title: VHA Clinicians and Bioterror Events: Interactive Web-based Learning
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Smallpox
Anthrax
Keywords: Bioterrorism
Education, Medical, Continuing
Internet
Lead sponsor: VA Office of Research and Development
Sponsor class: FED
Collaborators: name: University of Alabama at Birmingham
First posted: 2005-07-22
Enrollment: 15
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL

Brief summary: Our 4-year project uses public domain software and content developed by a University of Alabama at Birmingham (UAB) team and updates, refines, and tailors it to the unique clinician populations and electronic educational applications of VAMCs We are testing an innovative, web-based intervention adapted specifically for the VA to increase syndromic recognition, treatment, and post-exposure prophylaxis of biological warfare agents at multiple VA sites via a randomized controlled trial (RCT). Ultimately, we will disseminate the intervention throughout the entire VA system.

Detailed description: Background:

Because of VA's long history in disaster preparedness, and the crucial role VA providers will play, the VA medical system has the potential to make an enormous difference in outcomes following a bioterror attack or infectious outbreak. A 2002 AHRQ report reviewed 60 studies and found that very few bioterrorism preparedness training programs were rigorously evaluated. Our project was the first effort to formally test and implement a bioterrorism preparedness intervention in the VA healthcare system. Because Internet-delivered interventions have the potential for wide dissemination, we used the Internet to implement the Intervention.

Objectives:

1. To develop, tailor, and continuously update and validate evidence- and scenario-based electronic teaching and testing modules to increase VA clinicians' knowledge of Category A biological warfare agents. We refer to these instruments as Bioterrorism Case Analysis and Skills Enhancement Sessions (BioCASES) and Bioterrorism Skills Test Sessions (BioTESTS).
2. To test the effectiveness of the BioCASES teaching modules by way of a randomized controlled trial of VAMCs using the BioTESTS to evaluate their effectiveness for increasing and sustaining VA clinician knowledge, skills, and ability to respond to bioterrorism events.
3. To continue to develop and adapt BioCASES and BioTESTS for use in VA CME programs. Ultimately, we will disseminate the intervention throughout the entire VA system.

Methods:

Our project team developed or refined and updated a total of 12 educational modules focusing on CDC's Category A agents and other emerging infectious diseases. We developed post-test instruments and case-based scenarios germane to the VA patient population for anthrax and smallpox. Materials were designed specifically for the unique clinician populations and electronic educational applications available in VAMCs. Website functionality and content were refined using the nominal group technique and "thinking aloud" protocols. We tested our innovative, web-based educational intervention at fifteen VA facilities via a randomized controlled trial (RCT).

Status:

The intervention has been completed. Fifteen sites were randomized and completed the study processes.

Eligibility criteria: Inclusion Criteria:

Clinicians at participating facilities who work in a primary care setting (ED, MOD, general medicine, primary care, or CBOC).

Exclusion Criteria:

Facilities will be excluded from the project that 1)choose not to participate, or 2)do not have the minimum number of clinicians needed.

Primary outcomes:
measure: The outcome measure will be performance on post-test administered immediately and at 3 months and 6 months post intervention. Performance on the post-test administered at three months will be considered the main outcome of the study.
timeFrame: 3 months
Secondary outcomes:
measure: The 6-month tests will be given to demonstrate the sustainability of the intervention (prevention of decay effect).
Other outcomes:
Locations:
city: Birmingham
country: United States
facility: Birmingham VA Medical Center, Birmingham, AL
state: Alabama
city: Phoenix
country: United States
facility: Phoenix VA Health Care System, Phoenix, AZ
state: Arizona
city: Loma Linda
country: United States
facility: VA Loma Linda Healthcare System, Loma Linda, CA
state: California
city: Tampa
country: United States
facility: James A. Haley Veterans' Hospital, Tampa, FL
state: Florida
city: Bedford
country: United States
facility: Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA
state: Massachusetts
city: Ann Arbor
country: United States
facility: VA Ann Arbor Healthcare System, Ann Arbor, MI
state: Michigan
city: Albuquerque
country: United States
facility: New Mexico VA Health Care System, Albuquerque, NM
state: New Mexico
city: Syracuse
country: United States
facility: Syracuse VA Medical Center, Syracuse, NY
state: New York
city: Nashville
country: United States
facility: Tennessee Valley Healthcare System Nashville Campus, Nashville, TN
state: Tennessee
Study officials:
affiliation: Birmingham VA Medical Center, Birmingham, AL
name: Catarina I. Kiefe, PhD MD
role: PRINCIPAL_INVESTIGATOR
affiliation: Birmingham VA Medical Center, Birmingham, AL
name: Thomas K Houston, MD MPH
role: PRINCIPAL_INVESTIGATOR
References:
citation: Abdolrasulnia M, Strasser S, Pryor E, Terndrup T, Weissman NW, Williams M, Heck E, Casebeer L. Spatial Patterns Representing the Geographic Impact of Physician Participation in an Online CME Bioterrorism Course Following the Anthrax Events of 2001. Medinfo. 2004 Dec 1; 2004(CD):1498.
citation: Bennett NL, Casebeer LL, Kristofco RE, Strasser SM. Physicians' Internet information-seeking behaviors. J Contin Educ Health Prof. 2004 Winter;24(1):31-8. doi: 10.1002/chp.1340240106.
citation: Terndrup T, Nafziger S, Weissman N, Casebeer L, Pryor E. Online bioterrorism continuing medical education: development and preliminary testing. Acad Emerg Med. 2005 Jan;12(1):45-50. doi: 10.1197/j.aem.2004.08.040.
citation: O'Byrne WT, Terndrup TE, Kiefe CI, Weissman NW. A Primer on Biological Weapons for the Clinician, Part I. Johns Hopkins Advanced Studies in Medicine. 2003 Feb 1; 3:75-86.
citation: O'Byrne WT, Terndrup TE, Kiefe CI, Weissman NW. A Primer on Biological Weapons for the Clinician, Part II. Johns Hopkins Advanced Studies in Medicine. 2003 Mar 1; 3:157-167.
citation: Casebeer LL, Strasser SM, Spettell CM, Wall TC, Weissman N, Ray MN, Allison JJ. Designing tailored Web-based instruction to improve practicing physicians' preventive practices. J Med Internet Res. 2003 Jul-Sep;5(3):e20. doi: 10.2196/jmir.5.3.e20. Epub 2003 Sep 25.
citation: Filoromo C, Macrina D, Pryor E, Terndrup T, McNutt SD. An innovative approach to training hospital-based clinicians for bioterrorist attacks. Am J Infect Control. 2003 Dec;31(8):511-4. doi: 10.1016/s0196-6553(03)00699-0.