Use of a Crowdsourced Needs Assessment to Create An Innovative Microlearning Program to Address Healthcare Professionals’ Misunderstandings in Applying Hepatitis B Virus Treatment Guidelines

Patient variables that inform hepatitis B virus (HBV) treatment candidacy and treatment selection are complex and interconnected, making management challenging for healthcare professionals (HCPs). We developed a point-of-care app—the Hep B Consult—where HCPs can enter specific patient characteristics and receive American, European, or Asian Pacific guideline recommendations tailored to specific patient characteristics.

By letting the HCPs tailor their own cases, we were able to crowdsource the identification of competence gaps by examining which patient and disease characteristics were entered most often and which cases most often led to HCPs planning a management strategy that differed from the guidelines. Overall, HCP use of the tool demonstrated that, in 43% of cases entered, the HCPs’ chosen management strategies differed from the recommendation from HBV guidelines.

After using the tool to crowdsource these cases, we further analyzed the tool data to characterize the specific competence gaps in detail, identifying the exact mismatches in chosen vs guideline-recommended management of patients with HBV. Then, to pinpoint teaching to those precise gaps, we developed a separate series of targeted microlearning activities in our program titled, “Addressing Misunderstandings in Applying HBV Treatment Guidelines.”

The goal of creating targeted microlearning was to improve HCPs’ competence in applying guideline-based care in the management of patients with HBV by addressing the most common mistakes identified throughout the Hep B Consult tool. Expected outcomes were an increase in knowledge post engagement with the education.

Educational Strategy:

After crowdsourcing data via the tool, we analyzed the management choices in 12,061 cases entered by HCPs to identify key practice gaps. We identified the most common gaps, which included:

1. Determining HBV treatment candidacy


2. Optimal monitoring of patients and drug therapies


3. Selection of HBV treatment based on individual patient factors

Next, we created a follow-up CE-certified educational program tailored to address these specific gaps. The education included:

• Short (5- to 10-minute) multimedia presentations with accompanying downloadable slidesets to address each HBV practice gap


• Blog-style commentaries focused on how expert faculty interpret key guidelines


• Short (15-minute) “sharing session” podcast conversations between HCPs and patients, in which faculty and their patients discuss effective collaboration to overcome these specific gaps in HBV care

Each deliverable within the educational program was a highly digestible microlearning installment aimed at supporting the HCP’s education with flexible and engaging educational formats with repeated exposure to key learnings that were easy to fit into their schedules. Each microlearning installment was focused, was accessible from any device, was available on demand, and targeted the gaps identified.
To assess changes in HCP competence, we employed level 4 outcomes in our CE-certified deliverables by evaluating test scores pre and post education.

Patient-Level Outcome(s) Measured:

Between February 2021 and December 2021, the targeted microlearning program reached 15,408 learners. Learners were predominantly physicians (65%); 34% were hepatologists or gastroenterologists, and 37% were US based.

The subset of HCPs who completed the pre/post assessment questions (n = 574) demonstrated improved understanding of the key practice gaps that affected HBV treatment candidacy, treatment selection, and patient and drug therapy monitoring.

The program had a positive educational impact, with 95% of HCPs reporting that the education confirmed their current practice or encouraged them to update their clinical practice based on knowledge gained. The greatest improvement in competence was in the evaluation of fibrosis and inflammation in the educational section focused on US HBV guideline application (17% pre to 65% post; P < .0001).

The patient-level impact also was impressive. Based on HCP participation in our program, we estimate that >43,000 patients will benefit from improved HCP education.

Our innovative approach in creation and implementation of a targeted microlearning program to address misunderstandings in the application of HBV guidance—that was crowdsourced and identified using our Hep B Consult app—was successful in its reach, educational delivery, and improvement in HCP understanding and application of international guidelines for patients with HBV. This model could be adapted and applied to other therapeutic topics.