969. Gamification for Infectious Diseases Medical Education: Creating a Videogame to Teach COVID 19 Diagnosis and Treatment to Medical Students

Abstract Background Brazillian authorities reported a total of 16.3 million cases and 454.000 deaths during COVID-19 pandemic in Brazil by may 2021. It became necessary to educate healthcare professionals on diagnosis and treatment of the syndrome. Game based learning surfaced as an effective alternative, since it promotes critical thinking and problem solving skills. A team of Brazilian and Peruvian students, physicians, designers and programmers gathered to create a decision based computer game that simulates a hospital scenario and allows medical students to analise, make decisions and receive feedback. This work describes the creative process and showcase the initial version of the software. Methods Professors and students of Medicine, Information Technology (IT), Design and Architecture from Brazil and Peru assembled a team in order to develop the computer game. Clinical cases were created by the medical students and professors, comprising medical procedures for the treatment and management of COVID 19, and a video game script was developed exploring gamification principles of challenge, objectivity, persistence, failure, reward and feedback. Algorithms (image 1) were created, under supervision of professors of Medicine, to define possible courses of action and outcomes (e.g. gain or loss of points, improvement or worsening of the patient). Students of Design created artistic elements, and IT students programmed with a game engine software. This fluxogram, written in portuguese, describes in detail all the possible courses of actions that can be exercised by the player. It is created by a team of Professors of Medicine and medical students, in accordance with evidence-based guidelines. Primarily, this document guides the programmers and designers throughout the development phase of the game. Results Initially, an expandable minimum viable product was obtained. The game, visualized on image 2, consists in a non-playable character and a playable character (i.e. doctor), with a scenario and a dialogue script simulating a clinical examination of a COVID 19 patient. The player can interact with certain elements within the game, e.g. the computer and other characters, to retrieve test results or start dialogues with relevant information. Hospital scenario and dialogue window between doctor (player in black) and patient (non playable character) are displayer in the game engine software (Unity 2D). On the bottom half of the screen, the dialogue box allows the player to collect the patient’s medical history. The player can interact with certain elements to obtain relevant information to make decision and progress in the game. Conclusion The game allows medical students to practice diagnosis and treatment of COVID 19. Future versions will include assessment reports of player’s actions, and a new score system will be implemented. New diseases will be incorporated in the gameplay to match the variety of scenarios offered by real hospitals and patients. Artificial intelligence will be employed to optimize gameplay, feedback and learning. Disclosures All Authors: No reported disclosures

Background. Probiotics are increasingly being used in healthcare. As the number of probiotic options and their potential uses increase, it has become more challenging to make an informed selection for a given disease state. This study assessed the ability of digital education to improve Infectious Disease (ID) specialists' knowledge regarding the use of probiotics in preventing Clostridioides difficile infection (CDI) and antibiotic-associated diarrhea (AAD).
Methods. A CME/ABIM MOC certified, educational program featuring a panel of 3 expert ID faculty was developed. The program sought to clarify the role of different probiotic strains in the prevention or treatment of different disease states. Educational effectiveness was assessed with a repeated-pairs pre-/post-assessment study design; each individual served as his/her own control. A chi-square test assessed changes pre-to post-assessment. P values < 0.05 are statistically significant. Effect sizes were evaluated using Cramer's V (< 0.05 modest; 0.06-0.15 noticeable effect; 0.16-0.26 considerable effect; > 0.26 extensive effect). The activity launched on a website dedicated to continuous professional development. Data for this matched-learner analysis were collected through 09/09/20.
Results. To date, 7122 HCPs, including 5068 physicians, have participated in the activity. Data from the subset of ID specialists (n=235) who answered all pre-/ post-assessment questions during the initial study period were analyzed. Following activity participation, significant improvements were observed in the proportion of ID specialists who answered assessment questions correctly (47% pre vs 69% post; P < .0001; V=.22). Improvements were also observed in several specific areas of assessment (Table) and confidence in their ability to select a probiotic-based on strain-and disease-specific efficacy (36% increase).

Conclusion.
Participation in this online educational program significantly improved ID specialists' understanding of the interplay between strain-and disease-specificity in the context of probiotics. These findings highlight the potential for well-designed online education to positively impact physicians' knowledge and confidence Disclosures. All Authors: No reported disclosures This fluxogram, written in portuguese, describes in detail all the possible courses of actions that can be exercised by the player. It is created by a team of Professors of Medicine and medical students, in accordance with evidence-based guidelines. Primarily, this document guides the programmers and designers throughout the development phase of the game.
Results. Initially, an expandable minimum viable product was obtained. The game, visualized on image 2, consists in a non-playable character and a playable character (i.e. doctor), with a scenario and a dialogue script simulating a clinical examination of a COVID 19 patient. The player can interact with certain elements within the game, e.g. the computer and other characters, to retrieve test results or start dialogues with relevant information.
Hospital scenario and dialogue window between doctor (player in black) and patient (non playable character) are displayer in the game engine software (Unity 2D). On the bottom half of the screen, the dialogue box allows the player to collect the patient's medical history. The player can interact with certain elements to obtain relevant information to make decision and progress in the game.
Conclusion. The game allows medical students to practice diagnosis and treatment of COVID 19. Future versions will include assessment reports of player's actions, and a new score system will be implemented. New diseases will be incorporated in the gameplay to match the variety of scenarios offered by real hospitals and patients. Artificial intelligence will be employed to optimize gameplay, feedback and learning.
Disclosures. Background. The medical field's response to the Coronavirus Disease 2019 (COVID-19) pandemic required a multifaceted approach. Medical students were often excluded from the initial phases of pandemic response, resulting in feelings of disengagement. This study aimed to determine if offering educational experiences on current events related to the COVID-19 pandemic could increase medical students' understanding of, and engagement with, the pandemic.
Methods. In Fall 2020, an elective course reviewing several aspects of the COVID-19 response was implemented. Preclinical medical students attended a discussion-based seminar series given by expert faculty on a variety of topics including pathophysiology, vaccine development, telemedicine, and others. Upon course completion, students were asked to complete a survey quantifying their understanding of the overall COVID-19 response, understanding of various individual facets of the response, and feelings of personal engagement on a Likert scale from 1-5, with 5 representing the most understanding or engagement. The differences in pre-course and post-course mean scores were compared using a Wilcoxon matched-pairs signed rank test for each question.
Results. A total of 65 students completed the course; 35 (54%) students filled out the final course survey. Results showed significant improvement in students' perceived holistic understanding of the pandemic response (2.67 pre-course vs. 4.36 post-course; p < 0.001), and their feelings of personal engagement (3.06 pre-course vs. 4.33 postcourse; p < 0.001). Students also reported significantly increased feelings of understanding for each individual facet of the pandemic response reviewed during the course (8 questions total, all p-values < 0.001).
Conclusion. Preclinical medical student participation in a course reviewing COVID-19 pandemic response significantly increased feelings of engagement with and understanding of the medical field's response to the pandemic. Students showed improved understanding of each aspect of the pandemic response that was covered in the elective. Therefore, it appears that seminar-and discussion-based electives can be a useful tool for fostering preclinical student engagement in current events in medicine.

Online Medical Education Improves Knowledge of Data on Appropriate and Timely Use of Influenza Antiviral Medications to Patients at High Risk for Influenza-Related Complications and Morbidity
Allison Armagan, PharmD; Roderick Smith, MS; Medscape, New York, New York

Session: P-54. Infectious Diseases Medical Education
Background. Many patients are at a higher risk of influenza complications because of age and comorbidities. We sought to assess whether online education, focused on appropriate and timely use of influenza antiviral medications to patients at high risk for influenza-related complications and morbidity, could improve knowledge, competence, and confidence of clinicians.
Methods. Primary care physicians (PCPs) and pediatricians participated in a 30-minute video lecture with synchronized slides. Educational effect was assessed using a repeated-pairs design with pre-/post-assessment. Three multiple choice questions assessed knowledge/competence, and 1 question assessed confidence. Statistical tests to assess significance: Paired samples t-test for overall average number of correct responses and for confidence rating; McNemar's test for individual questions (5% significance level, P < .05). Cohen's d estimated the effect size impact on number of correct responses (< .20 modest, .20-.49 small, .59-.79 moderate, ≥.80 large). Data were collected from 10/28/20 to 12/23/20.
Results. Average knowledge/competence improved from 29% to 43% (N=430, P< .001, Cohen's d = 0.46) among primary care physicians and from 31% to 43% (N=226, P< .001, Cohen's d = 0.38) among pediatricians. Post participation, 12% more PCPs and pediatricians answered all questions correctly. Relative improvements post-participation in specific areas were as follows (P< .001): (i) 105% improvement among PCPs and 100% improvement among pediatricians in findings associated with the efficacy of treatment with antivirals for influenza in hospitalized patients. (ii) 117% improvement among PCPs and 104% improvement among pediatricians in identifying the antiviral with the greatest activity against influenza B viral strain as reported in a phase 3 clinical trial. (iii) 34% of PCPs and 46% of pediatricians had a measurable improvement in confidence after completing the program.
Conclusion. This study demonstrated the success of a video lecture with synchronized slides at improving PCPs and pediatricians knowledge, competence and