Using Electronic Health Data to Deliver an Adaptive Online Learning Solution to Emergency Trainees: Mixed Methods Pilot Study
Bibliographic record
Abstract
Background: Electronic medical records (EMRs) are a potentially rich source of information on an individual's health care providers' clinical activities. These data provide an opportunity to tailor web-based learning for health care providers to align closely with their practice. There is increasing interest in the use of EMR data to understand performance and support continuous and targeted education for health care providers. Objective: This study aims to understand the feasibility and acceptability of harnessing EMR data to adaptively deliver a web-based learning program to early-career physicians. Methods: The intervention consisted of a microlearning program where content was adaptively delivered using an algorithm input with EMR data. The microlearning program content consisted of a library of questions covering topics related to best practice management of common emergency department presentations. Study participants were early-career physicians undergoing training in emergency care. The study design involved 3 design cycles, which iteratively changed aspects of the adaptive algorithm based on an end-of-cycle evaluation to optimize the intervention. At the end of each cycle, an online survey and analysis of learning platform metrics were used to evaluate the feasibility and acceptability of the program. Within each cycle, participants were recruited and enrolled in the adaptive program for 6 weeks, with new cohorts of participants in each cycle. Results: Across each cycle, all 75 participants triggered at least 1 question from their EMR data, with the majority triggering 1 question per week. The majority of participants in the study indicated that the online program was engaging and the content felt aligned with clinical practice. Conclusions: The use of EMR data to deliver an adaptive online learning program for emergency trainees is both feasible and acceptable. However, further research is required on the optimal design of such adaptive solutions to ensure training is closely aligned with clinical practice.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.022 | 0.020 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".