iPadEMR Pain Management Simulator: Tablet-based Skills Development

描述（由申请人提供）：估计有1.16亿美国成年人患有慢性疼痛，估计成本为6350亿美元，不幸的是，现有的疼痛管理培训并没有充分准备卫生专业人员来解决这一领域的问题。为了解决这一问题，我们建议创建iPad EMR疼痛管理模拟器，这是一个基于iPad的应用程序，为健康专业学生提供学习和分享经验的环境，以提高他们的疼痛评估和控制技能。模拟的电子病历将反映临床实践中使用的任何电子病历的核心特征和目前的病例模拟。对于学习者来说，它将提供简单和负担得起的标准化的基于技能的疼痛管理培训。对于教师/教育工作者，它将评估：1)学生在诊断和治疗疼痛患者方面的临床能力和技能，同时2)减少阿片类药物滥用和转移的机会。对于每个iPad EMR模拟的疼痛管理案例，健康专业的学生将收集数据，检查患者，选择适当的行动方案，概述治疗计划，并收到反馈。选择和决策的反馈将以最佳实践为基础。教师将通过提供增加或减少临床信息、挑战、反馈或提示来控制应用程序的临床部分。第一阶段将开发一个原型，并根据不同目标受众的积极参与，对潜在的干预措施进行基本可用性测试：1)医学和护理专业的卫生专业学生，以及2)医学和护理教育工作者。第一阶段将进行精心规划的形成性分析，包括需求分析调查、半结构化访谈、顾问指导、原型体验的创建和可用性评估。第二阶段将完成该项目，并使用随机、交叉（等候名单对照）、前测后测设计对来自医学和护理的约60名参与者进行评估。我们将具体评估模拟学习和共享经验环境是否对目标临床技能产生积极影响，并提高与疼痛评估和治疗相关的核心能力。第三阶段将通过与Clinical Tools的现有和新的合作伙伴关系积极推广该产品。我们将进一步针对医生和护士以外的特定受众（如牙医、助理医师、理疗师等）定制内容。我们的解决方案将支持对培训的持续评估，以确定可以随着时间的推移而改进和改进的弱点领域。

DESCRIPTION (provided by applicant): An estimated 116 million US adults suffer from chronic pain at an estimated cost of $635 billion and, unfortunately, existing pain management training is not adequately preparing health professionals to address this area [1]. To address this gap we propose to create iPad EMR Pain Management Simulator, an iPad- based application to provide a learning and shared experience environment for health professional students to enhance their skills related to pain assessment and control. The simulated EMR will echo core features of any EMR used in clinical practice and present case simulations. For learners it will provide easy and affordable access to standardized skill-based pain management training. For faculty/educators it will assess: 1) a student's clinical competence and skills in diagnosing and treating patients with pain, while 2) decreasing the chance of opioid misuse and diversion. For each iPad EMR simulated pain management case, health professional students will collect data, examine the patient, choose the appropriate course of action, outline a treatment plan, and receive feedback. Feedback from choices and decisions made will be based on best practice. The instructor will have control over the clinical components of the application by providing increasing or decreasing clinical information, challenge, feedback, or prompts. Phase I will develop a prototype and perform basic usability of the potential intervention based on the active involvement of different target audiences: 1) health professional students in medicine and nursing, and 2) educators in medicine and nursing. Phase I will proceed with a carefully planned formative analysis involving needs analysis surveys, semi-structured interviews, guidance from consultants, creation of prototype experiences, and usability assessments. Phase II will complete the program and conduct an evaluation using a randomized, cross-over [wait-list control], pretest-posttest design with an estimated 60 participants from medicine and nursing. We will specifically assess if the simulated learning and shared experience environment positively impacts target clinical skills and increases core competencies related to assessment and treatment of pain. Phase III will market the product actively via existing and novel partnerships with Clinical Tools. We will pursue additional tailoring of the content to specific audiences beyond physicians and nurses such as dentists, P.A.s, physical therapists and others. Our solution will support ongoing assessment of the training to determine areas of weakness which can be refined and improved over time. PUBLIC HEALTH RELEVANCE: The agony that is life with chronic pain is made worse by a health care system ill-equipped to assist. The gap in quality care due to poor training of future health providers will remain until solutions are pursued. This product will enhance the education of health care providers via a simulated Electronic Medical Record (sEMR) environment that provides simulated patient experiences. Health professional trainees will develop proper pain management skills including screening, full assessment, treatment interventions, and making a referral to treatment when appropriate. Future health professionals who are more proficient in core competencies related to pain management will be better equipped to reduce the suffering and costs of inadequate pain treatment.