When Dr. Kristin Sokol, a board certified allergist/immunologist and pediatrician, was given the option as part of her coursework with the AAAAI Leadership Institute to complete a project with a mentor that would improve the field in some way, she immediately thought of her work with Choosing Wisely.
Sokol had experience in educating residents, fellows, and other allergists and providers about the recommendations of the American Academy of Allergy Asthma & Immunology–she was a AAAAI Choosing Wisely Champion in 2016. So she expanded on that work by creating an online course that integrates Choosing Wisely and provides continuing medical education (CME) credits.
For the course, she and Ellen Price, Program Manager for e-Learning at AAAAI, focused on three recommendations that they thought were most relevant to daily clinical practice – food allergy testing, chronic hives, and seafood allergic patients who require radiocontrast procedures.
“When I was in Boston, I had this conversation with patients daily, multiple times per day,” said Sokol, referring to when patients truly required testing for food allergies. She was an assistant professor at Beth Israel Deaconess Medical Center before her current position as a staff clinician in the lab for allergic diseases at the National Institute of Allergy and Infectious Diseases.
She said that even other physicians asked her frequently about seafood allergies and things they have been taught that are invalid, adding that her vision is to develop similar online courses for maintenance-of-certification credit for all 10 of AAAAI’s Choosing Wisely recommendations.
It took Sokol and Price more than a year to design the online courses, working with a group of editors and content reviewers. The courses use a series of interactive simulations to take learners through the process of understanding the recommendations and how best to share that information with patients.
The courses, which launched in February, offer varying amounts of CME credit, with 2.00 MOC Part IV credits available to providers who complete all three courses in the series. Sokol said the decision to provide maintenance-of-certification credit for the courses came out of a discussion with AAAAI leaders about how to get the society’s recommendations more broadly recognized.
“MOC is kind of an incentive for practicing allergists to easily learn about the Choosing Wisely campaign and how to address these recommendations with their patients,” Sokol said, noting that often busy clinicians don’t have time to attend society meetings or read the society’s quarterly Impact newsletter that publicizes new information in the field.
The course combines three ways of learning about the recommendations: printable handouts, a video of actors identifying key communications points with patients, and an interactive simulation in which the learner has to answer questions based on a patient case and interaction. The handout also doubles as patient brochures.
Both Sokol and Price believe the course will be attractive to practicing allergists because of the different methods of learning, particularly since physician education more often relies on lectures and didactics.
“We wanted to provide a platform where allergists could apply what they were learning and not just read about the recommendations,” Price said, noting that patient simulations are an ideal way to re-create environments in which physicians are seeing real patients.
Assessment questions are built into the simulations to provide immediate feedback, particularly if learners provide an incorrect answer. The courses take at least 30 minutes, with a self-assessment at the end that asks physicians to identify a past patient experience where the recommendations could have been applied to achieve a better outcome as well as practice changes they could make going forward that would improve care.
Once all three modules are completed, physicians can begin the 30-day wait period before completing a more in-depth self-assessment for MOC credits. The self-assessment asks physicians to detail a patient encounter in which they applied the recommendations or a patient interaction when they did not apply the recommendations and realized they should have.