1. Dynia: combining webinars, virtual patients & forums for KT in chronic pain David Topps, Heather Armson, Paul Taenzer, Eloise Carr, Ashi Mehta, Rachel Ellaway Medbiq Conference, 2014 No conflict of interest to declare

2. The Problem Poor uptake of CPGs despite great effort – Well-written – Well-publicized as part of TOP guidelines Knowledge translation – KT interventions incorporating interactive education in chronic noncancer pain led to positive effects on patients' function and knowledge about pain (Ospina et al, 2013) Measurable change in physician behavior Potential professional isolation for rural practices

3. Approach Webinars for small group learning – Distributed rural sites – Highly interactive sessions – No ‘sage-on-stage’ effect Virtual patients with SCT – More tuned to experienced docs – Detailed metrics Online forums – Pre & post webinar discussions

4. SCT pattern design examples

5. Two SCT Designs Traditional Script Concordance Testing – Stem, hypothesis given, then does data confirm…? – Avoids best-of-five; all answers reasonable – Better correlation with experience Modified SCT Design – Stem as usual – Prioritized choice of hypotheses, + data confirm…? – Rapid Reporting Real-time Responses (4R)

6. Example case - Kendal

7. Scenario Based Design ‘Scenario-Based eLearning Design’ – R Colvin Clark – Based on SBL workshop from Medbiq 2013 Blended PBL & other activities Subject matter experts – For case design & webinar presentation Cases authored by VP experts – based on SME content – mini-series to illustrate changed thinking

8. OLab3 as SBL Design tool Use Visual Editor map to link cases & activities Similar to LAMS – www.lamscommunity.org www.lamscommunity.org – but simpler and more flexible

9. Scenario Manager in OLab3 Scenario Manager: control over who gets to play what when

10. Scenario Manager in OLab3 Scenario Manager: view progress during play

11. Secure Forum To guard against confidentiality lapses – Only 3 data points to make a case identifiable Single sign-on Tight linking with cases and nodes Very useful for collaborative authoring IMS-LTI integration with Entrada – Considered at that point – Timeline constraints

12. Results Very high engagement – Despite being conceptually demanding Few technical glitches – Echo with many machines in same room Quotes and comments – Esp from SME about doing the cases so quickly Low traffic on Forums – Did not have critical mass

13. Results Example of 4R report graph Failure on 2 nd webinar was big disappointment

14. SCT Results Concordance lower than other SCT papers But cases designed to be challenging & controversial rather than an exam

15. Pathway analysis

17. PARTICIPANT PHA TE YUAN REFERENCE

18. Exploring ADL-xAPI Manual data analysis very time consuming Experience API very applicable – Export to Learning Record Store – Detailed analysis of metrics through 3 rd party tools

19. Conclusions Highly engaging combination SCT approach preferred by docs in practice Subtle shift in practice over series – Not as great as expected – But purposively sampled highly-updated sites