Interactive Didactic Sessions Research Articles

Development of a Clinical Trial Methodology and Appraisal Curriculum for Hematology Fellows

Background: The past few decades have seen dramatic clinical advances in benign and malignant hematology. From genomically-targeted diagnostics and therapeutics to novel cellular and immune-based therapies, scientific concepts move to investigational products with astonishing speed. In parallel, clinical trials have become more complex, reflecting both the increasing complexity of the clinical landscape as well as improvements in trial design and standards. To effectively practice in this environment, hematology fellows need to develop a functional understanding of clinical trial methodology and appraisal. However, whereas there are many educational materials focused on content knowledge of hematology topics, there is a paucity of formal resources for better understanding trial methodology. We report the development of a longitudinal, multimodal clinical trial methodology curriculum for hematology fellows grounded in Self-Determination Theory (SDT). Methods: We developed a longitudinal clinical trial methodology curriculum for hematology fellows. The multimodal curriculum consists of both interactive didactic sessions as well as longitudinal integration of methodology teaching into the existing fellow-led journal club. Within the framework of SDT, the curriculum is designed to move fellows from stages of extrinsic motivation to understand and implement critical appraisal (e.g., avoidance of shame) to intrinsic motivation, i.e., integrating critical appraisal into one's professional identity and practice (Th.J. ten Cate et al., Medical Teacher 2011) Conceptually, this is effected by providing adequate content knowledge, a safe space to practice and explore difficult concepts, and serial reinforcement of both the cognitive and social nature of critical appraisal through fellow-led journal club. Progress will be assessed through the first 3 stages of the Kirkpatrick model: reaction, learning, behavior. Results: The concept, teaching modalities, assessment schema and theoretical underpinnings were developed through the ASH MEI program over the 2022-2023 academic year. Iterative review of the course content and modalities occurred through both ASH MEI small group meetings throughout the year, as well as with the directors of the UW Madison Hematology/Oncology fellowship program. Three of the didactics focus on content knowledge, starting with general methodology principles (e.g., validity) before focusing on the hematology-specific challenges of implementing and balancing these principles in therapeutic trials (e.g., enrollment criteria, endpoint selection, etc.) The final didactic is a guided review of a cooperative group trial protocol by clinical trialists from UW Madison, focusing on practical aspects of trial design and implementation. The journal club curriculum includes a methodology rubric trainees can apply during the development of their journal club presentation, as well as a one-on-one debrief session with faculty after their presentation to discuss challenges. Evaluations throughout the curriculum include pre/post survey of learners' comfort and identification with critical appraisal, as well as pre/post knowledge assessment with multiple choice test at beginning and end of curriculum. Conclusion: This curriculum is a proof-of-concept theory-based methodology curriculum for hematology/oncology fellows. The curriculum is being implemented in the first half of the 2023-24 academic year and will report out initial results by ASH 2023. If successful, this curriculum could potentially be expanded to a more extensive array of methodology topics within hematology/oncology and be applied on a larger scale.

An Advanced, Risk-Driven Sexual Health Curriculum for First-Year Internal Medicine Residents.

Despite recommendations for annual chlamydia screening for young, sexually active females, chlamydia rates continue to increase nationally. Medical school students often receive limited training in obtaining comprehensive, risk-based sexual histories, leading to less screening for sexually transmitted illnesses (STIs). Consequently, many internal medicine (IM) residents feel unprepared for advanced sexual history taking and site-specific STI testing based on sexual practices. We developed a case-based interactive didactic session for IM and med/peds residents. We focused on more advanced topics, such as comprehensive sexual history taking, secondary site testing for STIs, and patient counseling. Based on pre- and postcurriculum surveys, interns reported increases in comfort (scale: 1 = very low comfort, 5 = very high comfort) with counseling after positive STI results (Ms: pre = 2.9, post = 3.5, p < .01) and providing education on safe sex practices (Ms: pre = 3.0, post = 3.6, p < .01) and modest improvement in comfort with expedited partner therapy (EPT; Ms: pre = 2.1, post = 2.5, p = .06). An increase in self-reported confidence with collecting site-specific testing (composite Ms: pre = 2.7, post = 3.5, p < .01) was also seen. Percentage correct on knowledge questions increased from 48% to 78% postcurriculum (p = .01). This curriculum demonstrated improvement in knowledge and comfort with sexual history taking, STI screening, and counseling. Comfort also improved with EPT counseling, but not significantly, which could be addressed in future iterations of the curriculum.

Reuniting Long Lost Cousins: a Novel Curriculum in Imaging Informatics for Clinical Informatics Fellows.

We developed a curriculum of imaging informatics for clinical informatics fellows. While imaging informatics and clinical informatics are related fields, they have distinct bodies of knowledge. The aim of this curriculum is to prepare clinical informatics fellows for questions regarding imaging informatics on the clinical informatics board certification examination, prepare fellows to handle issues and requests involving imaging informatics in their future roles as clinical informaticists, and develop sufficient knowledge and skills in order to interface with imaging and radiology domain experts. We mapped ACGME core competencies for clinical informatics and the clinical informatics skills and attributes to topics covered in this curriculum. Topics covered included orders vs. encounter-based workflow, understanding imaging informatics operations and the differences between an IT department leading digital image management and the radiology department, clinical decision support for radiology, procuring and integrating new modalities into a PACS system, troubleshooting slow application performance in a PACS environment, imaging sharing, artificial intelligence (AI) in imaging including AI bias, validation of models within home institution and regulatory issues, and structured reporting vs. Natural Language Processing to mine radiology report data. These topics were covered in interactive didactic sessions as well as a journal club. Future work will expand to include hands-on learning and a formal evaluation of this curriculum with current fellows and recent graduates.

CASCADE your teaching session!

Medical education has seen a shift toward interactive teaching in small groups that actively involves students in learning. However, didactic teaching, despite drawbacks such as student isolation and low stimulation of critical thinking, is still a very commonly used teaching method. For didactic teaching to be effective, teachers must possess strategies and skills that enable them to teach effectively in large groups and increase students' knowledge retention. This can be achieved if class sessions are planned in advance with the aim of making them interactive and engaging with all students. In the following article, I write about my experiences using the CASCADE method, an acronym of the words "create," "assess," "sequence," "charisma," "activate," "discussion," and "e-device," which creates interactive didactic sessions.

Feasibility and Effectiveness of a Quality Improvement Curriculum for Combined Medicine Subspecialty Fellows.

The Accreditation Council for Graduate Medical Education (ACGME) requires training in quality improvement (QI) yet many programs struggle to incorporate appropriate content. Small fellowship programs may find it particularly difficult, limited by a lack of well-trained faculty. We report on the feasibility and effectiveness of a consolidated curriculum for subspecialty fellowship programs. Two QI experts were identified to design a curriculum. Interactive didactic sessions were created to guide development and implementation of fellow QI projects. All projects culminated in abstract/poster presentation. Seven of 10 eligible fellowships participated. Twenty-four projects were completed with 70% reaching improvement in process measures. Trainees improved confidence in 11 of 12 QI domains. Program directors stated enhancement in QI education with 100% recommending program continuation. Consolidating teaching efforts with existing QI experts can lead to an effective QI curriculum for fellowship programs. This model can be expanded to other graduate medical education trainees as a means to increase QI proficiency.

25014 Interactive didactic session for residents and medical students on dermatologic care for lesbian, gay, bisexual, and transgender patients

Introduction: Despite increasing emphasis on lesbian, gay, bisexual, and transgender (LGBT) health in medical education across specialties, evidence-based training on LGBT patient care in dermatology is lacking. Our study assessed the effectiveness of an interactive didactic session on dermatologic care of LGBT patients in improving participants’ clinical preparedness, attitudinal awareness, and basic knowledge of LGBT patients in a dermatologic setting.

Spiritual Care Training for Palliative Care Fellows (QI726)

1.Describe a systematic approach to Spiritual Care (SC) Training for Palliative Care (PC) Physician Fellows.2.Describe the Integration of the Systematic Approach to Spiritual Care (SC) Training into the Palliative Care (PC) Fellowship. Despite evidence and guidelines identifying it as a core dimension of Palliative Care (PC), Spiritual Care (SC) may be the least developed dimension of PC for physicians. The authors developed a SC curriculum for PC fellows to improve their training in spiritual dimensions of care. The goal of the rotation was to 1) gain understanding of PC fellows’ SC experiences and clinical skills over time and 2) identify curricular elements with the most impact on PC fellows. PC Fellowship at Northwestern Feinberg School of Medicine and Northwestern Memorial Hospital (NMH) located in Chicago. This was required, longitudinal nine-month SC curriculum based on literature review, prior experience from both the Palliative and Spiritual Care Teams, and a needs assessment of PC Fellows. The curriculum began and ended with three six-hour days of focused work and met bi-weekly for an hour a total of fourteen times during the academic year. The curriculum included five topics (introduction to SC, conducting a spiritual history, spirituality in self-care and patient care, spiritual-existential distress, and miracle literacy). Fellows participated in interactive didactic sessions, small group discussions, clinical with chaplains, interfaith site visits, synchronized virtual sessions, and experiential and reflective activities. Fellows completed pre and post surveys using a competency scale (Leeuwen et al., 2009), Likert-rated statements, and narrative responses via an exit interview. Fellows reported an increase in perceived competence taking a spiritual history, comfort in working with hospital chaplains, comfort engaging in SC issues with patients and their families, including addressing miracles, and addressing spiritual-existential distress with patients/surrogates. This pilot rotation demonstrated the effectiveness of a required longitudinal SC curriculum as part of a PC fellowship. We believe that this approach can help provide fellows with the tools, skills, and support they need to approach generalist-level spiritual care with their patients and their families.

Implementation and evaluation of a novel subspecialty society fellows robotic surgical course: the SGO minimally invasive academy surgical curriculum.

ObjectiveTo evaluate the utility of a society-based robotic surgery training program for fellows in gynecologic oncology.MethodsAll participants underwent a 2-day robotic surgery training course between 2015–2017. The course included interactive didactic sessions with video, dry labs, and robotic cadaver labs. The labs encompassed a wide range of subject matter including troubleshooting, instrument variation, radical hysterectomies, and lymph node dissections. Participants completed a pre- and post-course survey using a 5-point Likert scale ranging from “not confident” to “extremely confident” on various measures. Statistical analysis was performed using SPSS Statistics v. 24.ResultsThe response rate was high with 86% of the 70 participants completing the survey. Sixteen (26.7%) of these individuals were attending physicians and 44 (73.3%) were fellows. In general, there was a significant increase in confidence in more complex procedures and concepts such as radical hysterectomy (p=0.01), lymph node dissection (p=0.01), troubleshooting (p=0.001), and managing complications (p=0.004). Faculty comfort and practice patterns were cited as the primary reason (58.9%) for limitations during robotic procedures followed secondarily by surgical resources (34.0%).ConclusionIn both gynecologic oncology fellows and attendings, this educational theory-based curriculum significantly improved confidence in the majority of procedures and concepts taught, emphasizing the value of hands-on skill labs.

Teaching Trauma-Informed Care: A Symposium for Medical Students.

A large body of evidence links exposure to childhood trauma with negative health outcomes. Training future physicians to recognize and respond to trauma is paramount, and engaging medical students in the preclinical years affords the opportunity to foster the development of a trauma-informed lens that can then be solidified during clinical clerkships. We developed and implemented a 4-hour trauma-informed care (TIC) symposium for 179 second-year medical students at the George Washington University School of Medicine and Health Sciences during the Patients, Populations, and Systems course. The symposium included three interactive didactic sessions focusing on the connection between trauma and health and TIC principles. A facilitated small-group discussion allowed students to apply TIC principles to a patient case, followed by reflection and evaluation. The overall rating of the TIC symposium was 4 out of 5. Strengths included integration of a small-group case with discussion on application of TIC in practice, experience of the lecturers and small-group facilitators, and review of research relating adversity to specific health outcomes. Suggestions for improvement included incorporating role-play and standardized patients. Content analysis of student reflections mapped to the domains of physician competency. A 4-hour symposium can affect student knowledge and understanding of TIC. Teaching TIC presents an opportunity to prepare medical students for a career in medicine through cultivation of required physician competencies. Next steps include enhanced opportunities to practice TIC and follow-up analysis of participants to determine behavior change during clinical years.

Continuing Medical Student Education During the Coronavirus Disease 2019 (COVID-19) Pandemic: Development of a Virtual Radiation Oncology Clerkship

PurposeOur institution cancelled all in-person clerkships owing to the coronavirus disease 2019 pandemic. In response, we designed a virtual radiation oncology medical student clerkship. Methods and MaterialsWe convened an advisory panel to design a virtual clerkship curriculum. We implemented clerkship activities using a cloud-based learning management system, video web conferencing systems, and a telemedicine portal. Students completed assessments pre- and postclerkship to provide data to improve future versions of the clerkship. ResultsThe virtual clerkship spans 2 weeks and is graded pass or fail. Students attend interactive didactic sessions during the first week and participate in virtual clinic and give talks to the department during the second week. Didactic sessions include lectures, case-based discussions, treatment planning seminars, and material adapted from the Radiation Oncology Education Collaborative Study Group curriculum. Students also attend virtual departmental quality assurance rounds, cancer center seminars, and multidisciplinary tumor boards. The enrollment cap was met during the first virtual clerkship period (April 27 through May 8, 2020), with a total of 12 students enrolling. ConclusionsOur virtual clerkship can increase student exposure and engagement in radiation oncology. Data on clerkship outcomes are forthcoming.

Teaching dermatology to the millennial learner

Millennial learners have educational needs and preferences that differ from those of prior generations. They prefer learning from online resources, appreciate interactive didactic sessions, and desire frequent feedback and guidance. Understanding and adapting to these learner attributes may allow for optimization of the educational environment for members of this generation. The following recommendations were developed to advance a dermatology residency program’s curriculum to accommodate the modern learner. Although the efficacy of these teaching tips has yet to be fully established, they are grounded by theory and are evidence-informed. Medical educators who are able to employ these strategies are likely to be successful in teaching and engaging the millennial learner.

An Interactive Process for Delivering Pharmacologic Interventions for Migraine Headache to First-Year Medical Students.

This interactive didactic session is designed for first-year medical students to explore the common clinical symptom of headache and its various management strategies. The session provides an opportunity to cover a variety of drugs, mechanisms of action, drug-drug interactions, and routes of administration in a single 50-minute time frame. Using a modified case-based approach, we designed an interactive session for 41 first-year medical students. Students prepared for the session using basic learning objectives and a table of drugs that treat headache pain. In class, we distributed a patient scenario and a series of discussion questions to explore headache management. We assessed student performance using questions purchased from the National Board of Medical Examiners and student perceptions using both qualitative and quantitative data collected from faculty and end-of-block evaluations. Student performance on purchased questions related to content was significantly increased when compared to the national average (n = 5; 90.6% ± 6.0% vs. 82.6% ± 8.5%; p = .0052). Student perceptions of the overall quality of the faculty, content presentation, and material were positive (4.4 out of 5.0). Two themes emerged in the end-of-block evaluations: Students commented positively on the prereading materials, and students commented on the need to address underlying physiology associated with the discussed pharmacology. This flexible activity can be delivered in a short time (50 minutes) by a single faculty member in a variety of curricular structures. Our data demonstrate strong student performance and suggest that incorporating additional content would enhance delivery.

You Should Probably Write This Down: Effective Documentation in Communication Skills Training (FR482C)

•Describe the ASCEND pathway of communication.•Explain how documentation is an essential final step of effective communication.•Compose documentation that effectively communicates patient's goals, values, and next steps. Critical conversations on serious diagnoses, goals of care, and end of life planning rely on effective communication. Communication skills training programs emphasize interpersonal communication, though studies repeatedly indicate that patients retain very little of what is said in medical encounters. Provide formal teaching on how to effectively document critical conversations. Target audience are resident and fellowship level learners. These skills were taught using a combination of teaching modalities including several interactive didactic sessions describing the ASCEND pathway and a pocket guide that was created for clinicians. Primary outcomes were competency in running family meetings, documentation, and learner's satisfaction with the training. 18 learners from Memorial Sloan Kettering Cancer Center were taught how to use the ASCEND pathway. By the end of the academic year all learners demonstrated proficiency in documenting family meetings. Clinicians are rarely, if ever, provided formal guidance on how to effectively document critical conversations. In an era of increasing patient access to electronic documentation and increased use of visual communication and culturally aligned educational materials, skillful use of documentation methods cannot be excluded as a communication skill. The ASCEND pathway builds on recommendations and research in advance care planning, breaking bad news, and other clinical communication. The pathway is unique in its inclusion of documentation as a vital step in effective communication. Next steps would be obtaining buy in from established clinicians who may not necessarily see the benefit of improving their documentation skills.

EMPOWERING OLDER ADULTS IN HEALTHCARE SETTINGS: COMMUNICATION SKILLS TRAINING FOR SURGICAL RESIDENTS

Older adults often perceive themselves as stigmatized and powerless in healthcare settings. Communication with them is complicated by age-related issues and negative stereotypes about older adults and aging. It is therefore vital for physicians and surgeons, who encounter the most vulnerable elderly, to communicate successfully with this population, who wish to maintain quality and dignity in their lives. Successful patient communication leads to better recall of information, compliance, adherence to medications, satisfaction, and overall better outcomes. We developed a two-part training program comprised of small group interactive didactic sessions on aging issues with third year surgical residents, and workshop demonstrations given by the residents to a group of older adults, followed by a question and answer session. Residents were assessed using a 22-item pre–post questionnaire covering medical knowledge of aging, attitudes toward older adults, and personal anxiety about aging. Since its inception, the program has reached 88 residents and 711 older adults. For residents, knowledge scores (p ≤ 0.001), six of nine attitude items (p ≤ 0.01) and one of four anxiety items (p ≤ 0.001) improved significantly. This is notable as well since attitudes and anxiety levels are attributes that are deep-seated and hard to change. For older adults, post surveys showed that 96% strongly agreed/agreed that residents had demonstrated sensitivity toward them and 96% were very satisfied/satisfied with the program. Our replicable, low-cost program enables residents to learn and realistically practice universal underlying communication skills in order to maintain effective and sensitive communication with this vulnerable population.

Implementation and evaluation of a novel subspecialty society fellows robotic surgical course: The SGO Minimally Invasive Academy surgical curriculum

Objective To evaluate the utility of a society-based robotic surgery training program for fellows in gynecologic oncology. Methods All participants underwent a 2-day robotic surgery training course between 2015-2017. The course included interactive didactic sessions with video, dry labs, and robotic cadaver labs. The labs encompassed a wide range of subject matter including troubleshooting, instrument variation, radical hysterectomies, and lymph node dissections. Participants completed a pre- and post-course survey using a 5-point Likert scale ranging from not confident to extremely confident on various measures. Statistical analysis was performed using SPSS Statistics v. 24. Results The response rate was high with 86% of the 70 participants completing the survey. Sixteen (26.7%) of these individuals were attending physicians and 44 (73.3%) were fellows. In general, there was a significant increase in confidence in more complex procedures and concepts such as radical hysterectomy (p=0.01), lymph node dissection (p=0.01), troubleshooting (p=0.001), and managing complications (p=0.004). Faculty comfort and practice patterns were cited as the primary reason (58.9%) for limitations during robotic procedures followed secondarily by surgical resources (34.0%). Conclusion In both gynecologic oncology fellows and attendings, this educational theory-based curriculum significantly improved confidence in the majority of procedures and concepts taught, emphasizing the value of hands-on skill labs.

Education Empowers Emergency Department Nurses During Pediatric Traumas.

In January 2017, the Emergency Trauma Advocate (ETA) program was piloted at our Level 1 trauma center to promote patient advocacy, particularly in pediatric patients. The goal was to empower emergency department nurses by improving their knowledge base through interactive didactic sessions. This study reviews the preliminary findings of the program. Surveys were administered after each teaching session to participating ETA nurses to determine their personal academic interests and how to improve the program. We then performed a retrospective review of pediatric trauma admissions from January 2017 through April 2017 to delineate the most common injury patterns. Survey responses demonstrated the greatest nursing interest in learning critical care (n = 11), orthopedic management (n = 11), and neurosurgical trauma education (n = 9). During this study period, 113 pediatric patients arrived and had a mean age of 7.8 ± 5.2 years. The most common injury patterns were orthopedic (n = 38) and neurosurgical (n = 28), and 35 patients required critical care management. Bivariate analysis revealed a significant and positive relationship between injury frequency and educational interests (R = 98.8%, p = .0057). A nurse's interest in educational topics directly correlates with recent pediatric trauma injury patterns. Future work should focus on determining what impact the ETA program has had on pediatric outcomes.

A Need for Contouring Education in Latin America: Evaluating an E-contouring Experience with Novel Reporting of DICE Metrics

As the technology for radiation oncology advances, therapy is able to be delivered in a more conformal fashion with a goal of both greater targeting of the tumor as well as avoidance of healthy structures. However, greater conformality requires the ability to correctly identify and contour both tumor volumes and organs at risk. One method of delivering content, particularly for practitioners abroad, is through e-contouring sessions. E-contouring allows for interactive didactic sessions allowing participants to see contouring of structures in real time. This represents the first international education intervention in Latin America utilizing e-contouring reporting DICE coefficients. An e-contouring workshop was undertaken in Lima, Peru at the 2018 eCancer conference. Registered students had access to an online platform beginning two weeks before the workshop along with case vignettes. Seven cases were presented with indications for radiation: locally advanced lung, lung SBRT, post-operative cervix, anaplastic astrocytoma, hippocampal sparing whole-brain, and two cases of linear accelerator based stereotactic radiosurgery for brain metastases. Each case listed various structures to contour for designated slices. Concordance of student responses with educator contours was measured using DICE coefficients. Post-educational intervention, students were given two weeks to redo homework assignments with intent to compare DICE coefficients with paired t-test. Fifty-five people registered for the contouring workshop and 13 (24%) completed homework pre-workshop. For the four non-palliative cases, the total mean DICE coefficient was 0.58. Average DICE scores pre-workshop for the entire case, which included organs at risk, and tumor volumes, are shown in the table. Of the 13 students who completed homework pre-workshop, only one student attempted the post-intervention homework with no significant change in DICE score. We present the first e-contouring experience with DICE coefficients in Latin America. Approximately a quarter of the registered students completed homework. The remaining pre-intervention scores serve as a diagnostic and highlight the importance of a need for contouring education with a majority of scores below 0.70. Unfortunately, participation in pre-assessment homework was low and post-assessment homework was minimal which does not allow for meaningful assessment of retained knowledge. Future e-contouring courses in Latin America would benefit by completing post-assessments at the time of workshop.Abstract TU_3_2919; Table 1CaseDICE scoreLocally Advanced Lung Cancer0.52GTVp0.85GTVn0.48SBRT Lung0.63ITV0.49Post-op Cervix0.52CTV0.45Anaplastic Astrocytoma0.66CTV0.74 Open table in a new tab

Using Immersive Simulation to Engage Pediatric Residents in Difficult Conversations and the Disclosure of Patient Safety Events.

BackgroundFull disclosure of patient safety events (PSE) is desired by patients and their families, is required by the Joint Commission and many state laws, and is vital to improving patient outcomes. A key barrier to consistent disclosure of patient safety events is a self-reported lack of proper training. Physicians must be trained to recognize when a PSE has occurred and effectively carry out disclosure, all while caring for a patient who is actively experiencing the consequences of an unintended outcome. Immersive simulation provides the opportunity to practice this complex skill.ObjectiveTo develop and evaluate a simulation-based workshop for pediatric residents on the disclosure of patient safety events.MethodsA workshop in PSE disclosure was developed according to literature review, expert consultation, and feedback from hospital administration. The three-hour workshop included a simulated PSE with a subsequent standardized debriefing, interactive didactic session, and additional simulation-based hands-on practice in disclosure. Participants completed an anonymous survey at one-week and three-months post workshop, assessing workshop satisfaction, subsequent clinical experience, and perceived change to their practice.ResultsDuring the one-year study period, 27/31 (87.0%) second year residents completed the workshop. At the one-week follow-up, all study participants reported increased confidence and preparedness in their ability to lead the initial disclosure conversation. All study participants felt that the simulated scenarios were realistic and relevant to their current clinical duties and 33.3% (n=9) stated that they would like to repeat this workshop prior to completion of their training. At the three-month follow-up, 29.6% (N=8) of study participants reported involvement in the disclosure of a patient safety event since the workshop with all eight reporting feeling adequately prepared by the workshop for this experience. Study participants indicated that post training they were more likely to engage the attending physician, risk management and patient relations in the disclosure conversation (p <=0.05). The estimated cost of this simulation training for 27 residents was $6,993, not accounting for the 39 hours per clinician facilitator.ConclusionsImmersive simulation is uniquely suited for teaching difficult conversation skills that are encountered during acute care, including the disclosure of patient safety events. While hands-on practice is critical, faculty and simulation resources required for continued implementation may not be sustainable long-term. Future training curricula should leverage creative and innovative adult-learning techniques to reach a wide range of members of the care team with less resource utilization.

Development of a Commercial Reference Laboratory Elective Rotation for Residents in Clinical Pathology

To develop a curriculum for a commercial reference laboratory clinical pathology training elective. A 4-day elective at Quest Diagnostics was developed. The elective included 32 sessions composed of interactive didactic sessions and laboratory tours/demonstrations. Ten residents who attended the elective completed a written evaluation and scored each component of the curriculum. Written comments were very positive and demonstrated the goals of the elective were achieved. Laboratory tours and one-on-one sessions with the medical directors were especially well received. Most of the residents stated that the rotation gave them exposure to an area of laboratory medicine that they were not familiar with. The elective provided a resident training experience that was highly regarded and exposed residents to an area of laboratory medicine not encountered in most pathology training programs. Our curriculum could serve as a model for establishing a similar elective in other training programs.

The Pediatric Resident Teaching Group: the Development and Evaluation of a Longitudinal Resident as Teacher Program

Residents serve as teachers in both formal and informal settings in medicine. As a result, the Accreditation Council for Graduate Medical Education (ACGME) requires the development of teaching competency. However, many residency programs lack Resident as Teacher (RAT) curricula; those that do have variable content and structure. Based on established conceptual frameworks, we created a longitudinal pediatric resident teaching group (PRTG). The members were self-selected pediatric residents who participated in faculty-led interactive didactic sessions focused on teaching skill development and were linked with resident-led teaching and mentoring of preclinical medical students in pediatrics. To assess program efficacy, residents completed a self-assessment of teaching skills prior to and at the end of each year of the program, and students completed evaluations of the residents’ teaching abilities. PRTG residents reported a significantly increased usage of teaching skills, as well as increased confidence and comfort teaching. Students assessed the residents to be “good” or “above average” teachers and found their learning “equivalent to” or “better than” when taught by an attending. PRTG residents found the program to be a feasible time commitment with the didactic skills session content useful and easily integrated into their teaching practice. The PRTG curriculum provides a consistent longitudinal framework for teaching skill acquisition that can enhance existing RAT programs to foster residents’ comfort teaching and skill usage.