Maryam Afshar, MD

Maryam Afshar, MD University of California, San Diego 2014 Research Grant Recipient


Research Grant Proposal

The Impact of Case-Based Education on Acne Guideline Knowledge and Implementation in Pediatricians and Pediatric Residents

Although acne is one of the most common skin conditions in children and adolescents, there is tremendous variation in acne treatment amongst health care professionals.1 In order to promote evidence-based practice, the American Acne and Rosacea Society published the first-ever evidence-based clinical guidelines for the diagnosis and treatment of pediatric acne in the May 2013 issue of Pediatrics.1 Unfortunately, research has shown than it can take approximately twenty years for guidelines to become integrated into clinical practice. Educational interventions can improve both professional practice and health outcomes. Interventions targeting specific providers are used to help accelerate this process, and have helped increase knowledge of both COPD guidelines2 and genetic testing3 in other educational intervention studies. In particular, adult learners participating in continuing medical education showed the most knowledge increase and retention with case-based, interactive format over a traditional didactic format.4 This study will identify practice gaps and evaluate the impact that an educational case-based intervention has on the knowledge and implementation of the newest acne guidelines from the American Acne and Rosacea Society. Pediatricians and pediatric residents will take a case-based test about acne before the educational intervention. Then, they will participate in a case-based lecture about acne. Another case-based exam will then be administered immediately and at 1 and 3 months to assess knowledge retention and query implementation of guidelines. The data will be analyzed to assess to what extent this intervention affected the knowledge and implementation of these guidelines.  By employing this format with pediatricians and pediatric residents, we hope to demonstrate an increase in both knowledge and implementation of acne guidelines for these practitioners. If successful, this could become a model for implementation of other dermatology guidelines in the future. References
1. Eichenfield LF, Krakowski AC, Piggott C, et al. Evidence-based recommendations for the diagnosis and treatmentof pediatric acne. Pediatrics. 2013;131;S163. 2. Drexel C, Jacobson A, Hanania N, et al. Measuring the impact of a live, case-based, multiformat interactive continuing medical education program on improving clinician knowledge and competency in evidence-based COPD care. Int J COPD 2011:6 297-207. 3. Carroll JC, Rideout AL, Wilson BJ, et al. Genetic education for primary care providers. Can Fam Physician. 2009; 55:e92-99. 4. Raza A, Coomarasamy A, Khan K. Best evidence continuous medical education. Arch Gynecol Obste. 2009:280;683-670.

Publications

Feldstein S, Afshar M, et al. Practice gaps between guidelines and clinical practice in the treatment of pediatric patients with acne: results of a single center, prospective study. 40th Annual Meeting of the Society for Pediatric Dermatology; Coeur d’Alene, U.S.; Jul 2014. View Society for Pediatric Dermatology poster presentation.

Feldstein S, Afshar M, et al. Improving Pediatric Acne Management and “Filling in Practice Gaps”: a Prospective Multicenter Study of Case-based Guideline Education. California Society of Dermatology and Dermatologic Surgery Annual Meeting; San Diego, U.S.; Sep 2014. View California Society of Dermatology and Dermatologic Surgery Annual Meeting poster presentation.

Feldstein S, Afshar M, et al. Improving Pediatric Acne Management and “Filling in Practice Gaps”: a Prospective Multicenter Study of Case-Based Education. Pediatrics. 2015. Submitted for Publication. View Dr. Afshar’s submitted manuscript.

Feldstein S, Afshar M, et al. Improving Pediatric Acne Management and “Filling in Practice Gaps”: a Prospective Multicenter Study of Case-based Guideline Education. American Academy of Dermatology 73rd Annual Meeting; San Francisco, U.S.; Mar 2015. View American Academy of Dermatology poster presentation.

Feldstein S, Afshar M, et al. Improving Pediatric Acne Management and “Filling in Practice Gaps”: a Prospective Multicenter Study of Case-Based Education. Society for Investigative Dermatology Annual Meeting; Atlanta,U.S; May 2015. View Society for Investigative Dermatology poster presentation.