Adaptive expertise for medical oncology fellows: How to foster evidence-based medicine mastery.

Abstract

e23015 Background: Adaptive expertise (AE) describes a physician’s ability to effectively apply pre-existing knowledge to unfamiliar clinical situations. This skill relies on understanding not just “how” solutions work, but instead developing a framework of “why” a specific decision is correct for a particular situation. Acquiring this skillset enables one to rely on foundational knowledge, while simultaneously reaching for novel information in order to make the best clinical decision. Given the expansion of primary literature and evolving treatment options in oncology, development of AE is critical for fellows to provide high level patient care. There is limited research focused on oncology trainee development of AE and evidence-based medicine (EBM) mastery. Methods: We designed an observational cohort study of ten first-year medical oncology fellows at Johns Hopkins during the 2021-2022 academic year (IRB00293232). Fellows were required to attend a case-based, faculty moderated EBM peer-teaching curriculum. A validated, ten question Likert scale AE questionnaire (Carbonell instrument) was administered to each fellow at baseline. Data collection from weekly questionnaires measuring efficiency and innovation in case preparation and presentation is ongoing. These data will be quantitatively summarized and correlated with the baseline AE instrument to evaluate change and development of AE over the academic year. Results: Ten learners have participated in the curriculum as of February 2022. All questions in the baseline AE instrument had a 100% response rate. Selected results are presented in Table.While all participants “strongly agree” that knowledge in their discipline keeps on developing, only 50% “strongly agree” that they are able to apply knowledge in new and unfamiliar situations with a degree of success, highlighting the need for a curriculum focused on AE for trainees. Conclusions: AE utilizing EBM in medical oncology is an essential skill for trainees to acquire. Next steps will include moderated focus groups at the 6 month and 10-month time point, followed by analysis of the weekly questionnaires, which will allow for formal assessment of this curriculum. Future directions will include expansion to include other institutions and adaption for different learner levels.[Table: see text]