Introduction

Intestinal ultrasound (IUS) offers a number of advantages over endoscopy in monitoring and managing patients with inflammatory bowel disease (IBD) but despite the wide availability of IUS, it remains underused to support decision-making in clinical practice.

Aims & Methods

We aimed to determine whether online accredited education could improve gastroenterologists’ knowledge of best practice in the use of IUS to monitor and manage patients with IBD, and could enhance their confidence in using IUS in clinical practice.
Gastroenterologists participated in a 30-minute video lecture with synchronized slides and embedded IUS videos entitled ‘Gastrointestinal Ultrasound in the Management of IBD’. Responses to 3 multiple-choice, knowledge questions and 1 self-efficacy, 5-point Likert scale confidence question were analyzed. Educational effect was assessed using a repeated-pair design, pre-/post-assessment. A paired samples t-test was conducted for significance testing on overall average number of correct responses and for confidence rating. A series of McNemar’s tests were conducted at the question level (5% significance level, P <.05). Cohen’s d with correction for paired samples estimated the effect size of the education on number of correct responses (<.20 modest, .20-.49 small, .59-.79 moderate, ≥.80 large). The activity launched on 1 February 2021 with data collection through 12 April 2021.

Results

• Gastroenterologists (n=195) significantly improved their knowledge of the ECCO-ESGAR guideline recommendations on the use of IUS in IBD (54% correct responses at baseline rising to 65% post-activity; P <.01), that stool content going in both directions in IUS is indicative of stricture (55% correct responses at baseline rising to 70% post-activity; P <.001), and that bowel wall thickness >4mm in a patient with Crohn Disease is the most sensitive IUS parameter indicating active disease i.e. treatment failure (28% correct responses at baseline rising to 58% post-activity; P <.001)
• The proportion of gastroenterologists answering all 3 questions correctly rose from 9% at baseline to 35% post-activity
• The average percentage of correct responses increased from 46% at baseline to 64% post-activity (P <.001), and there was a moderate educational impact (Cohen’s d=0.60)
• After completing the activity, 44% of gastroenterologists reported improved confidence in in interpreting IUS images to support the management of patients with IBD, resulting in a notable confidence shift of 79%
• 92% of gastroenterologist responders felt the education would improve their performance, resulting in improved patient outcomes

Conclusion

This online activity significantly improved gastroenterologists' knowledge and confidence in the use of IUS in IBD management. Gastroenterologists would likely benefit from additional education to embed their knowledge on the use of IUS and improve their confidence in interpreting IUS images to support decision-making in clinical practice.