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Review
. 2016 Apr:174:129-37.
doi: 10.1016/j.ahj.2016.01.013. Epub 2016 Jan 23.

Rationale and methodology of a collaborative learning project in congenital cardiac care

Michael J Wolf  1 , Eva K Lee  2 , Susan C Nicolson  3 , Gail D Pearson  4 , Madolin K Witte  5 , Jeryl Huckaby  6 , Michael Gaies  7 , Lara S Shekerdemian  8 , William T Mahle  9 ; Pediatric Heart Network Investigators
Affiliations
Review

Rationale and methodology of a collaborative learning project in congenital cardiac care

Michael J Wolf et al. Am Heart J. 2016 Apr.

Abstract

Background: Collaborative learning is a technique through which individuals or teams learn together by capitalizing on one another's knowledge, skills, resources, experience, and ideas. Clinicians providing congenital cardiac care may benefit from collaborative learning given the complexity of the patient population and team approach to patient care.

Rationale and development: Industrial system engineers first performed broad-based time-motion and process analyses of congenital cardiac care programs at 5 Pediatric Heart Network core centers. Rotating multidisciplinary team site visits to each center were completed to facilitate deep learning and information exchange. Through monthly conference calls and an in-person meeting, we determined that duration of mechanical ventilation following infant cardiac surgery was one key variation that could impact a number of clinical outcomes. This was underscored by one participating center's practice of early extubation in the majority of its patients. A consensus clinical practice guideline using collaborative learning was developed and implemented by multidisciplinary teams from the same 5 centers. The 1-year prospective initiative was completed in May 2015, and data analysis is under way.

Conclusion: Collaborative learning that uses multidisciplinary team site visits and information sharing allows for rapid structured fact-finding and dissemination of expertise among institutions. System modeling and machine learning approaches objectively identify and prioritize focused areas for guideline development. The collaborative learning framework can potentially be applied to other components of congenital cardiac care and provide a complement to randomized clinical trials as a method to rapidly inform and improve the care of children with congenital heart disease.

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Figures

Figure 1
Figure 1
Collaborative learning process.
Figure 2
Figure 2
Clinical practices considered for collaborative learning initiative.
Figure 3
Figure 3
Map of study centers for rotational site visits. Total distance traveled: 4500 miles/7242 km.
Figure 4
Figure 4
Timeline for collaborative learning project development.
See this image and copyright information in PMC

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