Online Medical Education Improves Clinician Knowledge and Confidence in the Management of Uncontrolled Hypertension

Objective: To evaluate whether an online educational program improves clinician knowledge and confidence in the management of patients with uncontrolled hypertension. Design and method: This outcomes analysis evaluated an online educational activity focused on contemporary challenges in uncontrolled hypertension, including phenotype recognition and aldosterone dysregulation. Educational impact was assessed using a repeated-pairs pre- and post-activity design with three multiple-choice questions and a confidence measure. Only participants completing both pre- and post-assessments were included in the linked learner analysis. Statistical significance of changes in knowledge was assessed using McNemar's test, with overall educational effect size calculated using Cohen's d with paired correction. Changes in confidence were analyzed using paired-samples testing. Statistical significance was defined as P < 0.05. Results: A total of 1,720 clinicians with paired assessment data were included, comprising cardiologists (n=751), nephrologists (n=496), and primary care physicians (n=473). Across all specialties, mean correct response rates increased significantly from pre- to post-education (all P < 0.001). The proportion of participants answering all assessment questions correctly increased from 27% to 66% among cardiologists, from 42% to 84% among nephrologists, and from 24% to 51% among primary care physicians. Large educational effects were observed for cardiologists (Cohen's d=0.88), nephrologists (Cohen's d=0.84), and primary care physicians (Cohen's d=0.75). For Q1, assessing identification of patients prioritized for screening for aldosterone dysregulation, baseline performance was high across specialties and improved significantly following education. For Question 2, evaluating understanding of the clinical implications of aldosterone dysregulation in patients receiving multiple antihypertensive therapies, significant post-education improvements were observed across all clinician groups. For Question 3, assessing understanding of the role of aldosterone dysregulation in uncontrolled hypertension, correct responses increased from approximately three-quarters at baseline to more than nine-tenths post-education across specialties (all P < 0.001). Mean self-reported confidence in managing hypertension increased significantly across all clinician groups following education (all P < 0.001). Conclusions: This study demonstrates that online education significantly improves knowledge and confidence in the management of uncontrolled hypertension across multiple specialties. These findings support the role of targeted digital education in addressing persistent knowledge and practice gaps in hypertension care.