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不足以让卫生专业人员准备好应对这一领域[1]。为了弥补这一差距，我们建议创建iPad EMR疼痛管理模拟器，这是一款基于iPad的应用程序，为健康专业学生提供一个学习和分享经验的环境，以增强他们与疼痛评估和控制相关的技能。模拟的EMR将呼应临床实践中使用的任何EMR的核心特征，并提供病例模拟。对于学习者，它将提供轻松和负担得起的途径，以标准化的技能为基础的疼痛管理培训。对于教职员工/教育工作者来说，它将评估：1)学生诊断和治疗疼痛患者的临床能力和技能，同时2)减少阿片类药物滥用和转移的机会。对于每个iPad EMR模拟疼痛管理案例，健康专业学生将收集数据，检查患者，选择适当的行动方案，概述治疗计划，并接收反馈。做出的选择和决定的反馈将基于最佳实践。讲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组件。第一阶段将基于不同目标受众的积极参与，开发一个原型并执行潜在干预措施的基本可用性：1)医学和护理专业的健康专业学生，以及2)医学和护理教育工作者。第一阶段将继续进行精心计划的形成性分析，包括需求分析调查、半结构化访谈、顾问的指导、原型体验的创建和可用性评估。第二阶段将完成该计划，并使用随机、交叉[等待名单对照]、前测-后测设计进行评估，估计有60名来自医学和护理的参与者。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。第三阶段将通过与临床工具公司现有的和新的伙伴关系积极营销该产品。除了牙医、私人助理、理疗师等医生和护士之外，我们还将寻求针对特定受众的额外定制内容。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改进和改进的薄弱领域。 与公共卫生相关：长期疼痛的生活因医疗保健系统装备不足而雪上加霜。在寻求解决办法之前，由于对未来保健提供者的培训不足而造成的医疗质量差距将继续存在。该产品将通过提供模拟患者体验的模拟电子病历(SEMR)环境来加强医疗保健提供者的教育。健康专业实习生将发展适当的疼痛管理技能，包括筛查、全面评估、治疗干预，并在适当时转介至治疗。更精通与疼痛管理相关的核心能力的未来卫生专业人员将更有能力减少疼痛治疗不足的痛苦和费用。

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.