Impact of a Virtual Patient Simulation on Clinical Decision Making for Pediatric Patients with ADHD

Objectives Attention-deficit/hyperactivity disorder (ADHD) is a common childhood disorder that can persist into adulthood in up to two-thirds of patients. ADHD is a heterogeneous disease, with a wide spectrum of symptoms and severity. Thus, ADHD presents diagnostic and treatment challenges for clinicians. This study utilized an online, virtual patient simulation (VPS)-based continuing medical education intervention to improve the ability of psychiatrists to diagnose, assess, and treat pediatric patients with ADHD. Methods A cohort of US-practicing psychiatrists who participated in the simulation-based education was evaluated. The simulation consisted of 2 patient cases that allowed learners to order lab tests, make diagnoses, and prescribe treatments in a manner matching the scope and depth of actual practice. Tailored clinical guidance (CG), based on current evidence and expert recommendation, was provided following each decision, followed by the opportunity for the learner to modify their decisions. Decisions were collected post-CG and compared with each user’s baseline (pre-CG) decisions using a McNemar’s test to determine P values (5% significance level, P <0.05 ). Data were collected from February 2022 through May 2022. Results The assessment sample consisted of psychiatrists (n=420 for case 1, n=358 for case 2) who made clinical decisions within the simulation and proceeded to the concluding debrief section. As a result of clinical guidance provided through simulation, significant improvements ( P <0.001) were observed in several areas of clinical care: • Assessing symptoms of ADHD using evidence-based tools/scales (70% relative improvement case 1; 100% relative improvement case 2) • Diagnosing ADHD and comorbidities across ages (162% relative improvement case 1; 370% relative improvement case 2)) • Ordering evidence-based treatments for ADHD based on individual patient presentation (71% relative improvement case 1; 53% relative improvement case 2) Conclusion VPS that immerses and engages specialists in an authentic, patient-based, practical learning environment can significantly improve evidence-based clinical decision making for the assessment and appropriate management of patients with ADHD to improve patient outcomes. Funding Medscape Education, Supernus