Utilizing gamification to educate internal medicine residents on managing lipids in patients with inflammatory conditions

Abstract

Background/Synopsis

Inflammatory conditions such as human immunodeficiency virus (HIV) and autoimmune diseases increase patients’ risk of atherosclerotic cardiovascular disease (ASCVD). Trainees in the primary care setting may not be familiar with management of ASCVD risk in the setting of these conditions. Gamification, a novel educational tool, can improve learners’ engagement and knowledge to help them better manage ASCVD risk for those living with inflammatory conditions.

Objective/Purpose

We studied the effectiveness of gamification in educating internal medicine residents on management of ASCVD in patients with inflammatory conditions.

Methods

At a single large academic internal medicine residency program, we compared a resident-led virtual gamified curriculum utilizing KAHOOT® to a traditional slide-based curriculum. All residents in the program received a 1-hour case-based session summarizing American College of Cardiology, National Lipid Association and American Heart Association guidelines on enhanced cardiovascular risk in the setting of HIV and autoimmune diseases. Pre-post-surveys included knowledge questions, 5-point Likert scales (1 to 5) assessing self-reported confidence in managing cardiovascular risk and referencing guidelines, motivation to adhere to guidelines, engagement, and format preference. Matched pre-post test data and unmatched Likert scale data were analyzed with two-tailed students’ t-tests.

Results

65/108 (60.2%) categorical internal medicine residents received the gamified format and 43/108 (39.8%) received the traditional format. 14/65 (21.5%) residents in the gamified group and 7/43 (16.3%) in the traditional group completed pre-post tests and were analyzed as matched pairs. There was a significant increase in test performance in the gamified (pre- 0.43 to post- 0.76, p<0.01) and traditional (pre- 0.55 to post- 0.81, p = 0.02) groups. There was no difference (gamified 0.33 vs. traditional 0.26, p = 0.52) in the post-pre change in test performance between groups. There were significant increases in Likert scale ratings of confidence in counseling patients and referencing guidelines in both gamified and traditional groups. There was a trend towards greater motivation to adhere to guidelines (gamified 4.5 vs. traditional 4, p = 0.06) in the gamified group. 15/21 (71.4%) of residents preferred a gamified format.

Conclusions

Both gamified and traditional lectures significantly improved residents’ knowledge of management of ASCVD in the setting of inflammatory conditions. Gamification was the favored method for lectures. Further research is needed to identify if gamification education on ASCVD risk in inflammatory disease can impact clinical practice and outcomes.