Direct-Acting Oral Anticoagulants: A Resident-Based Workshop to Improve Knowledge and Confidence

Introduction Direct-acting oral anticoagulant (DOAC) prescriptions have increased steadily since the first, dabigatran, was Food and Drug Administration-approved in 2010. They have multiple advantages over vitamin K antagonists including fixed dosing without coagulation lab monitoring, rapid onset a...

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Autores principales:	Irsk Anderson, Vineet M. Arora
Formato:	article
Lenguaje:	EN
Publicado:	Association of American Medical Colleges 2020
Materias:	Direct-Acting Anticoagulants Medical Residents Physician Internal Medicine Case-Based Learning Medicine (General) R5-920 Education L
Acceso en línea:	https://doaj.org/article/511b1d672fe740d8ae9695db81278f28
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spelling	oai:doaj.org-article:511b1d672fe740d8ae9695db81278f282021-11-19T14:47:51ZDirect-Acting Oral Anticoagulants: A Resident-Based Workshop to Improve Knowledge and Confidence10.15766/mep_2374-8265.109812374-8265https://doaj.org/article/511b1d672fe740d8ae9695db81278f282020-09-01T00:00:00Zhttp://www.mededportal.org/doi/10.15766/mep_2374-8265.10981https://doaj.org/toc/2374-8265Introduction Direct-acting oral anticoagulant (DOAC) prescriptions have increased steadily since the first, dabigatran, was Food and Drug Administration-approved in 2010. They have multiple advantages over vitamin K antagonists including fixed dosing without coagulation lab monitoring, rapid onset and offset of action, and fewer drug and food interactions. Patient-specific dosing, administration education, adherence, and monitoring are critically important. Many providers are unfamiliar with these concepts and too often use DOACs for off-label indications or at off-label dosing. A DOAC workshop was created to address knowledge gaps and improve internal medicine resident prescribing confidence. Methods One author (Irsk Anderson) conducted four 1-hour DOAC workshops with 49 total internal medicine residents rotating on their outpatient clinical rotation between October 2018 and November 2019. Residents performed small-group learning around four DOAC-specific cases, followed by a large-group report-out session. The residents completed pre- and postworkshop multiple-choice questions (MCQs) to assess knowledge as well as a postworkshop DOAC confidence self-assessment. Results Resident knowledge, assessed by percentage of residents answering correctly, improved significantly for all four MCQs after completing the workshop (all p <.003). Resident confidence, assessed on a 5-point Likert scale, improved significantly for all five themes (p <.001). Overall resident satisfaction was high (M = 4.2 on a 5-point Likert scale) and 85% desired further DOAC training. Discussion A 1-hour DOAC workshop was feasible and improved internal medicine resident knowledge and self-confidence. Future work should assess behavior change and patient clinical outcomes.Irsk AndersonVineet M. AroraAssociation of American Medical CollegesarticleDirect-Acting AnticoagulantsMedical ResidentsPhysicianInternal MedicineCase-Based LearningMedicine (General)R5-920EducationLENMedEdPORTAL, Vol 16 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	Direct-Acting Anticoagulants Medical Residents Physician Internal Medicine Case-Based Learning Medicine (General) R5-920 Education L
spellingShingle	Direct-Acting Anticoagulants Medical Residents Physician Internal Medicine Case-Based Learning Medicine (General) R5-920 Education L Irsk Anderson Vineet M. Arora Direct-Acting Oral Anticoagulants: A Resident-Based Workshop to Improve Knowledge and Confidence
description	Introduction Direct-acting oral anticoagulant (DOAC) prescriptions have increased steadily since the first, dabigatran, was Food and Drug Administration-approved in 2010. They have multiple advantages over vitamin K antagonists including fixed dosing without coagulation lab monitoring, rapid onset and offset of action, and fewer drug and food interactions. Patient-specific dosing, administration education, adherence, and monitoring are critically important. Many providers are unfamiliar with these concepts and too often use DOACs for off-label indications or at off-label dosing. A DOAC workshop was created to address knowledge gaps and improve internal medicine resident prescribing confidence. Methods One author (Irsk Anderson) conducted four 1-hour DOAC workshops with 49 total internal medicine residents rotating on their outpatient clinical rotation between October 2018 and November 2019. Residents performed small-group learning around four DOAC-specific cases, followed by a large-group report-out session. The residents completed pre- and postworkshop multiple-choice questions (MCQs) to assess knowledge as well as a postworkshop DOAC confidence self-assessment. Results Resident knowledge, assessed by percentage of residents answering correctly, improved significantly for all four MCQs after completing the workshop (all p <.003). Resident confidence, assessed on a 5-point Likert scale, improved significantly for all five themes (p <.001). Overall resident satisfaction was high (M = 4.2 on a 5-point Likert scale) and 85% desired further DOAC training. Discussion A 1-hour DOAC workshop was feasible and improved internal medicine resident knowledge and self-confidence. Future work should assess behavior change and patient clinical outcomes.
format	article
author	Irsk Anderson Vineet M. Arora
author_facet	Irsk Anderson Vineet M. Arora
author_sort	Irsk Anderson
title	Direct-Acting Oral Anticoagulants: A Resident-Based Workshop to Improve Knowledge and Confidence
title_short	Direct-Acting Oral Anticoagulants: A Resident-Based Workshop to Improve Knowledge and Confidence
title_full	Direct-Acting Oral Anticoagulants: A Resident-Based Workshop to Improve Knowledge and Confidence
title_fullStr	Direct-Acting Oral Anticoagulants: A Resident-Based Workshop to Improve Knowledge and Confidence
title_full_unstemmed	Direct-Acting Oral Anticoagulants: A Resident-Based Workshop to Improve Knowledge and Confidence
title_sort	direct-acting oral anticoagulants: a resident-based workshop to improve knowledge and confidence
publisher	Association of American Medical Colleges
publishDate	2020
url	https://doaj.org/article/511b1d672fe740d8ae9695db81278f28
work_keys_str_mv	AT irskanderson directactingoralanticoagulantsaresidentbasedworkshoptoimproveknowledgeandconfidence AT vineetmarora directactingoralanticoagulantsaresidentbasedworkshoptoimproveknowledgeandconfidence
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Direct-Acting Oral Anticoagulants: A Resident-Based Workshop to Improve Knowledge and Confidence

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