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Dr. Anitha John, third from right, director of the Washington Adult Congenital Heart Program, hosts the eighth-annual “Adult Congenital Heart Disease in the 21st Century” conference

CME spotlight: Treating adult congenital heart disease

Dr. Anitha John, third from right, director of the Washington Adult Congenital Heart Program, hosts the eighth-annual “Adult Congenital Heart Disease in the 21st Century” conference

Dr. Anitha John, third from right, director of the Washington Adult Congenital Heart Program, hosts the eighth-annual “Adult Congenital Heart Disease in the 21st Century” conference, which takes place Oct. 4-5, 2019.

A two-day continuing medical education (CME) conference for physicians and clinicians treating patients with adult congenital heart disease (ACHD) takes place Oct. 4-5, 2019, at the Bethesda Marriott in Bethesda, Maryland.

The eighth-annual conference, “Adult Congenital Heart Disease in the 21st Century,” hosted by Children’s National Health System and MedStar Washington Hospital Center provides a comprehensive review of the evaluation, diagnosis and management of ACHD, including guidelines to help ACHD patients manage a healthy pregnancy and clinical guidance about the progression of congenital heart disease (CHD) treatment from adolescence through adulthood.

Two tracks accommodate these themes, with the first focusing on a multidisciplinary approach clinicians can use to help ACHD patients assess risks for pregnancy complications, while planning and managing a healthy pregnancy, with input from cardiologists, anesthesiologists and maternal fetal medicine specialists. The second focuses on cardiac defects, starting with anatomical cardiac lessons with 3D heart models, then moves to imaging review, examining echocardiograms and MRI’s, and ends with clinical management review.

“This conference brings the best science and the most innovative approaches to treatment with questions doctors receive in the exam room,” says Anitha John, M.D., Ph.D., the conference organizer and director of the Washington Adult Congenital Heart program at Children’s National. “We’re inviting patients to join the afternoon of the second day of the CME conference again this year to support shared knowledge of these concepts, which supports lifelong treatment and education.”

Dr. John planned this year’s conference with the November 6 ACHD board exams in mind, integrating topics that will appear on the third ACHD certification exam issued by the American Board of Internal Medicine.

At this year’s CME conference, more than a dozen faculty members, including several physicians and nurses from Children’s National, will guide lectures to help attendees meet 13 objectives, from understanding the prevalence of congenital heart disease and its complications to learning about when surgical interventions and referrals to specialists are necessary.

Attendees will review new and innovative PAH therapies, mechanical support therapies, catheter-based interventional procedures and appraise the use of pacemaker and defibrillator therapy among adults with CHD.

Patients and families attending the patient sessions, held from 12:30 to 3:45 p.m. on Saturday, October 5, have a chance to participate in three sessions that support the medical and social needs of ACHD patients. Topics range from workshops that address the neurodevelopment and psychosocial factors of living with a congenital heart defect to sessions that focus on reproductive options for patients and personalized lifestyle recommendations, including fitness and exercise guidelines.

“To support cardiovascular health throughout the lifespan, it helps to educate patients about their heart’s structure and unique needs,” notes Dr. John. “We want to spark a dialogue now and have future conversations with patients, especially while they are young.”

The American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines updated ACHD treatment recommendations in August 2018, the first time in 10 years, and many of these guidelines manifest as panel discussions and interactive lectures presented at the 2019 Adult Congenital Heart Disease in the 21st Century conference.

Attendees can receive up to 12.5 credits from the Accreditation Council for Continuing Medical Education, the Accreditation Council for Pharmacy Education, the American Nurses Credentialing Center and the American Academy of PAs.

Those interested in starting their own ACHD program can attend an evening symposium, entitled “ACHD Program Building 101,” hosted by representatives from the Mid-Atlantic ACHD Regional Group. Topics in the six-session panel range from managing ACHD patients in a pediatric hospital setting to the role of clinical nurse coordinators in ACHD care.

To learn more about or to register for the conference, visit CE.MedStarHealth.org/ACHD.

e-learning

Gamifying e-learning for medical education

e-learning

Computer-based learning simulations and training modules hold the promise to create “virtual patients,” enhancing opportunities for real-time learning and evaluation in medical education.

Today’s e-learning platforms are often static, one-way programs or web pages that ask passive users to read text or watch a video on screen. However, the emerging generation of e-learning features dynamic visualizations and interactions that immerse the user in real-time settings. Military pilots and vehicle operators, for example, still log hours in traditional ways, such as hands-on simulation and flight time, but now also sit in front of a computer and practice tackling unique scenarios designed to challenge and improve their real-time decision making under pressure.

In medical education, computer-based learning simulations and training modules have the promise to create “virtual patients,” giving trainees and physicians the opportunity for real-time evaluation and application of evidence-based care models. Mary Ottolini, M.D., M.P.H., M.Ed., vice chair of medical education and designated institutional official, and Jeff Sestokas, M.Ed., director of the E-Learning Center, are at the forefront of developing these types of training modules for a wide variety of users with variable experience and specialty/sub-specialty expertise in pediatric medicine.

Instructional technologists, multimedia developers and members of the Children’s Academy of Pediatric Educators (CAPE) – some of the nation’s best pediatric clinicians and medical educators – all work collaboratively to design programs that achieve specific educational goals. Each platform resides in a responsive template, making it accessible on a variety of devices and highly customizable to the needs of specific learners. A multitude of online communication and educational tactics are available to enhance learning, including live and archived lectures, forums, blogs, wikis, documents, training modules, virtual simulations, quizzes, podcasts and videoconferencing. Within each platform, individual educators have the ability to customize learning experiences even further, selecting specific modules and specialty content.

“We’re taking these tools to people where they are, and delivering the content in ways that really embrace how this latest generation of trainees receives and processes information,” says Sestokas.

Designed for Children’s National and sites around the country, the majority of the 25 plus platforms and portals created so far focus on what Children’s experts know best – the unique challenges and needs of pediatric patients and their families.

Mary Ottolini

Mary Ottolini, M.D., M.P.H., M.Ed.

For example, clinical scenarios encompass more than simple clinical evaluation and diagnosis. The learning module BEARScalpel teaches surgical residents with limited prior exposure to pediatric care how to address common communication challenges that arise when interacting with pediatric patients and their families. Maybe the “digital” family has a language barrier or a child is in more grave condition than it appears and the trainee has to decide when and how to escalate the issue to an attending physician.

Another module asks participants to diagnose a three-dimensional nonverbal “digital” infant, based on visual and audio cues such as type of cry, skin tone and overall responsiveness.

This type of case-driven learning is relatively new in the universe of electronic medical education, but is showing early promise to improve students’ analytical thinking and problem solving skills.

“There is a lot of medical e-learning available,” Sestokas adds. “But not much e-learning is case-based. That’s something we’re doing that few others do, even in adult-focused medical education.”

A recently published study measured the success of one platform at achieving its educational goals. Participants had higher satisfaction, reported higher impact on knowledge and demonstrated higher scores on metrics assessing behavior change in a virtual environment when compared to the traditional format of reading. The results suggest that interactive modules are not only a preferred method of content delivery but also more likely to improve resident performance. This assessment was made possible by sophisticated tracking systems built into each platform. The data collection provides a steady stream of intelligence about user interaction with presentation format and content, and the material’s contribution to learning goals.

“These systems augment the long standing medical education practices of hands-on simulation and bedside patient care rotations, to allow us to expose trainees and physicians to more scenarios, more complications, and more challenging decisions. We know that the value of a trainee’s education is based on the quality of the cases they are exposed to,” says Dr. Ottolini. “Our goal is to equip these trainees with tools to care for pediatric patients in the future, but to also improve their ability to care for patients today, while they continue to learn.”

As a result of this innovative work, Children’s National is one of seven institutions, and the only children’s hospital, selected to receive an Accreditation Council for Graduate Medical Education (ACGME) Innovation Award that will develop next generation of learning resources for faculty and trainees around the country.

“We have the opportunity to ensure that we are doing the best possible job of training and continuously developing pediatric experts in a field that is rapidly changing and adapting,” concludes Dr. Ottolini. “The best way to do this is to develop flexible training systems that engage users, establish a habit of lifelong learning, and instill a desire for clinical care improvement.”

 


One patient-focused module creates a virtual grocery store to help patients
and families with celiac disease learn how to identify gluten-free food.