Disclosures: Annette Schwind, MS, CHCP: Nothing to disclose

Case Description: Patients with upper-limb spasticity (ULS) can benefit from treatment with injectable botulinum neurotoxin-A (BoNT-A) neuromodulators, but clinicians exhibit gaps in knowledge, competence, and performance regarding their optimal use. To address these gaps, 9 regional workshops were implemented, combining expert-led discussions, patient narratives, and small group hands-on lab exercises.

Setting: Continuing medical education workshops held in academic medical institutions, healthcare centers, and hotel venues.

Patient: 188 clinicians attended the workshops: 51% practicing physicians, 49% residents/fellows; 52% neurology specialists, 48% PM&R specialists.

Assessment/Results: Participants demonstrated gains in knowledge and competence from pretest to posttest, but the hands-on labs demonstrated that knowledge on pretest did not translate well from theory into practice. On average, faculty observations estimated learners incorrectly placed injections 58% of the time during the anatomy lab. Using a 4-point scale (1=Poor, 2=Fair, 3=Good, 4=Excellent), faculty observed learner skills and gave first attempts average ratings in properly reading ultrasound displays (1.7) and localizing target muscles (1.6) during the ultrasound lab. Following practice and feedback, the faculty average ratings increased to 3.1 on both items. Of the learners responding to a commitment to change question on postactivity evaluations, 100% intended to change their practice. Two months later, 100% of respondents to a follow-up survey indicated they had implemented practice changes based on what they learned in the workshops.

Discussion: The workshops created an environment where participants reviewed evidence-based best practices, engaged in exercises where they were confronted with their personal learning needs, given the opportunity to reflect, then practiced using those best practices. Participants were motivated to learn and subsequently modify their practice. Assessments by learners and faculty identified that further education, and specifically more hands-on practice, is needed to continue to improve clinicians’ knowledge and skills.

Conclusion: The CME workshop series provided an effective, engaging, educational experience that improved learner knowledge, competence, and performance.

Level of Evidence: Level V

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/designing-education-to-improve-clinician-performance-in-treating-upper-limb-spasticity-a-continuing-medical-education-case-report/