COMPETENCY-BASED EDUCATION IN CARDIOLOGY: IS IT TIME?

Abstract

educate both medical students and internal medicine residents have shown promising results. The optimal duration and methodology for teaching HHCU skills has not been established. Our objective was to assess the effectiveness of two condensed educational programs occurring over a single clinical rotation to teach internal medicine residents diagnostic and technical skills of HHCU. METHODS: Over a one-year period, internal medicine residents were recruited during their cardiology ward rotation into a single-centre, non-blinded, randomized trial. The two condensed teaching strategies were: a conventional ward-based program and a technology driven (simulation-based) strategy. In the conventional group, residents were given one hour of ward-based teaching for a total of 4 sessions. Residents in the technology arm of the study also completed 4 teaching sessions, but used only an online module-based education program and a virtual trainer (CAE Healthcare, Quebec). Outcomes were evaluated using both a). An OSCE to evaluate interpretation ability (assessing both Type I and Type II error rates) and b). Demonstration of HHCU acquisition skills graded by two Level-III echocardiographers. RESULTS: Twenty-four internal medicine residents were recruited (13 in the conventional and 11 in the technology arm). Characteristics and baseline ability to interpret HHCU images were similar. After teaching, the conventional group had a significant relative increase in the ability to make a singular correct diagnosis (156%, p<0.001). In the technology arm, making a singular correct diagnosis increased 169% from baseline (p1⁄40.001). Interpretation skill was not significantly different between groups (Table 1). Both groups, however, significantly increased their falsepositive rate (type II error), from 30% to 44% (p1⁄40.079) and from 29% to 45% (p1⁄40.008). Lastly, diagnostic quality ultrasound images were more likely to be acquired from participants in the conventional ward-based program (53.8%) than in the technology-driven group (13.6%, p1⁄40.006). CONCLUSION: Our findings suggest that HHCU interpretation and acquisition skills improve following both a conventional ward-based and technology-driven approach. However, our study emphasizes the important limitations of simulation-based teaching of HHCU skills since acquisition skill was superior following conventional ward-based teaching. Lastly, we detected a significant increase in the false positive rate following both teaching programs. This suggests that a short duration of training may not be sufficient for HHCU to be performed in a safe and appropriate manner. 503 COMPETENCY-BASED EDUCATION IN CARDIOLOGY: IS IT TIME?