Enteral nutrition (EN) provides nutrients through a feeding tube for individuals who cannot meet their nutrition needs orally yet retain adequate digestive and absorptive function. Research has identified numerous medical, nutrition, and cost benefits when EN is used appropriately. However, enterally-fed patients are vulnerable to adverse events when obtaining enteral access or during the delivery of EN (e.g. infectious, metabolic, gastrointestinal, and nutrition complications), which can result in increased morbidity and mortality. Unfortunately, many healthcare practitioners lack up-to-date training to deliver EN in the safest and most effective manner, in part because mastery of evidence-based knowledge and specialized skills can be challenging and time consuming; and a comprehensive, interdisciplinary EN training program is not widely available. The development of the Enteral Nutrition Practitioner Tutorial - An Online Case-Based Learning Program is proposed as a strategy to overcome these challenges. ? ? Phase I was highly successful and resulted in: 1) the development of the proposed course curriculum; 2) identification of software features to maximize pedagogical effectiveness, 3) a content development plan for Phase II; 4) creation of the prototype content delivery platforms, with sample content for demonstration; and 5) two rigorous research designs to be conducted in Phase II. ? ? For this Phase II SBIR project, MD Informatics (MDI), a medical education technology R&D company, will collaborate with the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N., a professional nutrition support society) to develop the Enteral Nutrition Practitioner Tutorial (ENPT) courseware. MDI will then collaborate with Intermountain Healthcare to validate ENPT's pedagogical approach for effectiveness in long-term knowledge retention and improvement in clinician practice behavior. Completion and evaluation of ENPT in Phase II will provide a much-needed EN training resource for interdisciplinary healthcare practitioners and fulfill the goals of: 1) promoting safe practices to maximize the potential benefits and reduce preventable EN-related complications, and 2) providing a research opportunity to identify educational methods that most effectively influence EN practice behaviors. This proposal is consistent with the mission of NIH by applying medical and behavioral research to reduce the nation's burden of illness. Furthermore, this proposal offers an innovative approach to help fulfill the key healthcare aims set forth by the Institute of Medicine's (IOM) Quality Chasm reports by promoting safe, effective, patient-centered, timely, efficient, and equitable care to the increasing number of patients who require EN in institutional and home care settings.
A fundamental objective of medical education is to assure that healthcare practitioners incorporate best practice research into routine patient care in a timely manner. The product to be developed, an Enteral Nutrition Practitioner Tutorial (ENPT), will offer innovative computer-assisted instruction (CAI) to facilitate healthcare practitioners' ability to translate evidence-based EN research into practice behaviors and system-wide protocols and guidelines. MD Informatics (MDI) believes that: 1) the public health implications of the proposed ENPT will be to maximize the potential benefits, while reducing the incidence of preventable adverse events associated with the delivery of EN, and 2) research conducted in Phase II will demonstrate that use of the tutorial leads to favorable effects on long-term knowledge retention and clinician practice behavior. ? ? ?
