458 Implementation and Analysis of an Online Esophageal Motility Curriculum for Gastroenterology Fellows

Abstract

INTRODUCTION: Compared with endoscopic training, motility education of gastroenterology (GI) fellows is limited at many training centers. To better prepare fellows for treating patients with esophageal motility (EM) disorders, an understanding of EM is essential. Novel educational technology may facilitate dissemination of standardized curricula to train GI fellows at programs lacking strong motility presence. METHODS: A pretest survey assessing comfort level and baseline interpretation of EM studies was sent to UCSF GI fellows in July 2017. An online application called Qstream was then implemented which sent 1-2 questions per week out of a specially designed question bank. Questions, with detailed explanations, were repeated or retired depending on response accuracy. A post-curricular test was sent in June 2018 to gather quantitative and qualitative data. The Qstream software was also mined for data on correct responses across multiple attempts at answering questions. Analysis was performed using qualitative assessment of feedback from participants and comparative statistics using a paired- t test with unequal variance and Chi-square test. RESULTS: Nine trainees completed a pretest survey and 6 trainees completed the posttest. Initially, only 33.3% of fellows were comfortable in interpreting EM studies, whereas following the curriculum 83.3% felt comfortable in their abilities (P = 0.097). Trainees' accuracy in interpreting and answering clinical questions increased from 77.8% to 80% on the posttest (P = 0.43). However, when using data obtained directly from the Qstream software, there was relative improvement (26.9%) from fellows' first attempt at answering questions to their final attempt. Trainees found the following aspects of the curriculum to be valuable: the ease of usability of the online questions, the flexibility in pacing, and the real time explanations of questions. CONCLUSION: A technology based curriculum was effective and efficient in educating GI fellows on core concepts of EM. The online nature of the curriculum was critical in accommodating the busy clinical schedules of our trainees. Fellows reported increased comfort in interpreting EM studies after completing the curriculum; lack of improvement on the post-test likely reflects their high performance on the pre-test, which was not very complex. We plan to continue offering this curriculum with increasingly challenging questions to allow for further stratification of data and overall improved competency in EM among GI trainees.