iNvestigate: an Online Resource for Learning about the Rational Use of Investigations

Background: Factors influencing test ordering behaviour include education at critical training points; opportunities to compare a trainee's own knowledge, understanding and approach with that of experts; opportunities to practice in an environment without adverse consequences of error; and convenient access to educational resources. Description: We developed an online learning resource, as a partnership between UNSW and RCPA, funded by the Quality Use of Pathology Program of the Australian Government. In this case-based simulation environment, there is progressive revelation of case information and investigation results. Test ordering is linked to data from key existing resources, including the RCPA Manual for Pathology test information, Inside Radiology for information about imaging, and the Medicare Benefits Schedule for progressive indication of costs. At the end of each case, users are provided feedback via comparison with an expert’s approach. Results: An initial set of 22 cases was developed for PGY1 trainees. Over 1,000 users have accessed the cases. Ongoing incremental enhancement of the software has ensured a high-quality interface for both users and educators. The interface is designed to allow easy addition of useful cases targeted to specific audiences. The resource is freely available at investigate.med.unsw.edu.au. A derivative of the site has also been created with cases for UNSW medical students. Issues for Discussion: Dissemination of information about the site to prevocational trainees has been hindered by the loss of continuing funding for the Australian Curriculum Framework for Junior Doctors project. Meanwhile, iNvestigate is now being further developed for general practice registrars and specialist trainees.