Formation and Evaluation of an Academic Elective for Residents in a Combined Internal Medicine-Pediatrics Residency Program.

Benjamin M Drum,Casey Gradick,John Mulcaire-Jones,Clinton R Sheffield

doi:10.7759/cureus.16287

Abstract

BackgroundRecently, there has been increasing focus on skills that are crucial for success in residency that is not explicitly taught. Specifically, the four domains of teaching skills, evidence appraisal, wellness, and education on structural racism have been identified as topics that are important and underrepresented in current resident education curriculums, largely due to time constraints.MethodsA task force consisting of one post-graduate year 2 (PGY-2) resident, one PGY-4 resident, the Associate Program Director, and the Program Director of the Internal Medicine-Pediatrics residency program was formed to explore current deficiencies in resident curriculum and to research possible solutions. As an intervention, we created and executed a four-week academic elective with dedicated time for upper-level residents to learn and explore the four domains of resident teaching, evidence-based clinical practice, wellness, and anti-racism work. The elective included several clinical sessions dedicated to implementing the skills taught in the elective. The month-long elective completed in January 2021. All residents evaluated each lecture or experience based on how valuable it was to their education on a Likert scale from 1 to 7, with 1 defined as “not valuable at all” and 7 defined as “extremely valuable.”ResultsResidents rated the overall value of teaching in each domain highly. Education and activities in wellness lectures were found to have the highest value-added material (6.20 ± 0.41, n = 18), followed by residents-as-teachers lectures (5.93 ± 0.25, n = 48), anti-racism (5.57 ± 1.11, n = 9), and evidence-based clinical practice (5.18 ± 0.50, n = 43). In addition, each domain was found to have at least one high-yield topic.ConclusionsWe were able to create and execute an academic elective with dedicated time for upper-level residents to develop and utilize valuable skills in teaching, evidence appraisal, wellness, and anti-racism. Future work will focus on refining the curriculum based on resident evaluations and expanding this elective to the Internal Medicine and Pediatrics categorical programs at our institution.

Highlights

Future work will focus on refining the curriculum based on resident evaluations and expanding this elective to the Internal Medicine and Pediatrics categorical programs at our institution
Medical residency is a complex educational process, where a resident experiences graduated autonomy over the course of several years with the goal of mastering six domains defined as core competencies by the Accreditation Council on Graduate Medical Education (ACGME): medical knowledge, interpersonal and communication skills, professionalism, systems-based practice, patient care and procedural skills, and practice-based learning and improvement [1]
Regulatory bodies including the ACGME and the Liaison Committee on Medical Education require that residents assume teaching roles, there is limited preparation for teaching in medical school and no standardized curriculum in residency, with many programs not offering Residents as Teachers (RaT)

Summary

Introduction

Medical residency is a complex educational process, where a resident experiences graduated autonomy over the course of several years with the goal of mastering six domains defined as core competencies by the Accreditation Council on Graduate Medical Education (ACGME): medical knowledge, interpersonal and communication skills, professionalism, systems-based practice, patient care and procedural skills, and practice-based learning and improvement [1]. There has been increasing focus on skills that are crucial for success in residency that is not explicitly taught, including teaching skills, evidence appraisal, wellness, and education on structural racism. These domains have been accepted as important, programs have struggled to incorporate curricula explicitly addressing these concepts in residency [2,3,4,5]. The four domains of teaching skills, evidence appraisal, wellness, and education on structural racism have been identified as topics that are important and underrepresented in current resident education curriculums, largely due to time constraints

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