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. 2021 Aug 26;6(5):e460.
doi: 10.1097/pq9.0000000000000460. eCollection 2021 Sep-Oct.

Confidence-weighted Testing as an Impactful Education Intervention within a Pediatric Sepsis Quality Improvement Initiative

Emma D Nathaniel  1 , Halden F Scott  2 , Beth Wathen  3 , Sarah K Schmidt  2 , Elise Rolison  4 , Carter Smith  4 , Matthew J Hays  5 , Justin M Lockwood  1
Affiliations

Confidence-weighted Testing as an Impactful Education Intervention within a Pediatric Sepsis Quality Improvement Initiative

Emma D Nathaniel et al. Pediatr Qual Saf. .

Abstract

Introduction: Confidence-weighted testing assesses learners' beliefs about their knowledge and skills. As part of a hospital-wide quality improvement initiative to enhance care for pediatric patients with suspected sepsis, we developed a novel intervention using confidence-weighted testing to identify institutional areas of misinformation and knowledge gaps while also providing real-time feedback to individual learners.

Methods: We developed pediatric sepsis eLearning modules incorporating confidence-weighted testing. We distributed them to nurses, advanced practitioners, and physicians in emergency departments and acute care/non-intensive care unit inpatient settings in our hospital system. We analyzed completion and response data over 2 years following module distribution. Our outcomes included completion, confidently held misinformation (CHM; when a learner answers a question confidently but incorrectly), struggle (when a learner repeatedly answers a question incorrectly or with low confidence), and mastery (when a learner initially answers a question correctly and confidently).

Results: Eighty-three percent of assigned learners completed the modules (1,463/1,754). Although nurses had significantly more misinformation and struggled more than physicians and advanced practitioners, learners of all roles achieved 100% mastery as part of module completion. The greatest CHM and struggle were found in serum lactate interpretation's nuances and the hemodynamic shock states commonly seen in sepsis.

Conclusions: Our novel application of confidence-weighted testing enhanced learning by correcting learners' misinformation. It also identified systems issues and institutional knowledge gaps as targets for future improvement.

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Figures

Fig. 1.
Fig. 1.
Core learning objectives common to all three sepsis modules with the % of learners fulfilling criteria for CHM, learner struggle, and mastery.
See this image and copyright information in PMC

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