Implementing Perioperative Cardiac Risk Assessment in an Internal Medicine Residency Program: Experience from a Community Hospital

Abstract

BackgroundACGME requires all Internal Medicine training programs to structure the curriculum to optimize resident educational experiences, including perioperative medicine. Teaching residents about perioperative risk management is challenging in a community hospital with limited resources and low surgical volume.ObjectiveOur goal was to introduce an interactive educational module on perioperative cardiac risk assessment and management in a community residency training program.MethodsThe study was a single-center online education-based intervention from September 2020 to January 2021. 24 categorical internal medicine residents at MetroWest Medical center were included. A self-paced online education program followed by two sessions of a 30-minute, group modulated review and discussion were provided monthly. The pre- and post-evaluation with 20 questions were conducted to assess perioperative cardiac risk assessment and peri-operative cardiac risk management before and after education.Results20 out of 24 residents (83%) were included in the analysis. Medicine residents performed significantly better after involvement with the educational module by comparing the pre- and post-evaluation score (10.7 ± 2.7 vs. 13.8 ± 1.8, p < 0.001, respectively). The most significant improvement was noticed in postgraduate year PGY-1 residents (5.1 ± 2.5, p < 0.001), followed by PGY-2 (2.7 ± 1.6, p = 0.004), but not significant in PGY-3 residents (1.6 ± 2.3, p > 0.05).ConclusionImplementing an interactive multi-modular curriculum in a community hospital increased residents’ awareness and knowledge of perioperative cardiac risk assessment and management. We are confident that this will result in improved performance on the consult services.