Confidence-weighted Testing as an Impactful Education Intervention within a Pediatric Sepsis Quality Improvement Initiative. Issue 5 (September 2021)

• Record Type: Journal Article
• Authors: Nathaniel, Emma D.; Scott, Halden F.; Wathen, Beth; Schmidt, Sarah K.; Rolison, Elise; Smith, Carter; Hays, Matthew J.; Lockwood, Justin M.
• Is Part Of: Pediatric quality & safety. Volume 6:Issue 5(2021)
• Publication Date: 2021-09
• Subjects: Pediatric nursing -- Periodicals; Pediatrics -- Periodicals; Patients -- Safety measures -- Periodicals; Children -- Hospital care -- Periodicals; 618.92
• DOI: 10.1097/pq9.0000000000000460
• Languages: English
• ISSNs: 2472-0054

Abstract

Abstract : Introduction: Confidence-weighted testing assesses learners' beliefs about their knowledge and skills. As part of a hospital-wide quality improvement initiative to enhance care for pediatric patients with suspected sepsis, we developed a novel intervention using confidence-weighted testing to identify institutional areas of misinformation and knowledge gaps while also providing real-time feedback to individual learners. Methods: We developed pediatric sepsis eLearning modules incorporating confidence-weighted testing. We distributed them to nurses, advanced practitioners, and physicians in emergency departments and acute care/non-intensive care unit inpatient settings in our hospital system. We analyzed completion and response data over 2 years following module distribution. Our outcomes included completion, confidently held misinformation (CHM; when a learner answers a question confidently but incorrectly), struggle (when a learner repeatedly answers a question incorrectly or with low confidence), and mastery (when a learner initially answers a question correctly and confidently). Results: Eighty-three percent of assigned learners completed the modules (1, 463/1, 754). Although nurses had significantly more misinformation and struggled more than physicians and advanced practitioners, learners of all roles achieved 100% mastery as part of module completion. The greatest CHM and struggle were found in serum lactate interpretation's nuances and the hemodynamic shock states commonly seen in sepsis. Conclusions: Our novel application of confidence-weighted testing enhanced learning by correcting learners' misinformation. It also identified systems issues and institutional knowledge gaps as targets for future improvement. Abstract : Supplemental Digital Content is available in the text.