Implementation of the Personalized Automated Reading Delivery System as a Component of Precision Medical Education: Prospective Crossover Study.

BACKGROUND

Precision medical education (PME) is an emerging concept that aims to improve physician education by tailoring curricula specifically to each learner. The basic framework behind PME requires collecting data on each individual learner, identifying gaps in knowledge, and then applying direct educational interventions. However, logistical difficulties in the delivery of such interventions hinder the implementation of PME in existing academic programs.

OBJECTIVE

We developed the Personalized Automated Reading Delivery System (PARDS) software application to support a potential PME intervention, aiming to increase the volume of relevant scientific literature read by resident physicians. The PARDS analyzes surgical case lists for the following day, selects relevant scientific articles according to predetermined keywords, and delivers each article via email to an anesthesiology resident physician. This technology may assist in the application of personalized educational interventions, and we evaluated the feasibility of implementing the PARDS in a population of medical learners.

METHODS

From July 2018 to December 2018, a pilot prospective crossover study was performed with N=10 postgraduate year 2 (PGY2) anesthesiology residents in an academic medical center (response rate 10/10, 100%). Residents were randomly assigned to the PARDS intervention group for 2 of the 4 months of the study period. The primary outcomes were organizational viability (evaluated by successful delivery of selected articles by the PARDS, required faculty hours, and total expenses) and acceptability in the study population (assessed by the number of reported weekly reading hours). An analysis using a linear mixed model for repeating measures was performed to compare weekly reading hours between intervention and nonintervention conditions.

RESULTS

Total reported faculty time involvement for the study period was 24 hours. The cost estimate for implementation ranged from US $2360 to US $8360. The mean difference of recorded reading hours by residents while using the PARDS vs not using the PARDS for months 1, 2, 3, and 4 of the study was 2.56 (95% CI -0.03 to 5.15; P=.053), 0.44 (95% CI -2.15 to 3.03; P=.74), 0.99 (95% CI -1.38 to 3.36; P=.41), and 3.7 (95% CI 1.34 to 6.08; P=.002), respectively.

CONCLUSIONS

The PARDS was successfully implemented in an academic medical center. Calculated costs indicate that the PARDS is an inexpensive intervention compared to contemporary alternatives. The effect on resident reading requires further research.