resident-driven curriculum development and ultrasound curriculum needs assessment lynnea mills, md...
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Resident-Driven Curriculum Development
andUltrasound Curriculum Needs
Assessment
Lynnea Mills, MDApril 9, 2013
Overview, part I
• Review of literature on housestaff-led curricula• Novel approach to curriculum
development, designed to facilitate resident involvement
Overview, part II
• Description of our assessment of residents’ needs for future instruction on bedside ultrasound• Selected results from needs
assessment
Part I
Lit Review: Housestaff involvement in peer curricula
Residents teach faculty-
developed curricula
Peds residents teach mock code
sessions
EM senior residents teach interns bedside skills
IM residents teach med students on
wards
Sweeney A, et al. Senior pediatric residents as teachers for an innovative multidisciplinary mock code curriculum. J Grad Med Educ. 2011 Jun;3(2):188-95.
Boehm KM. Commentary on medical student education improvement using a resident-driven student rotation. South Med J. 2012 Feb;105(2):71.
Adler AC, Homayounrooz FF. Medical student education improvement using a resident-driven student rotation. South Med J. 2012 Feb;105(2):68-70.
Lit Review: Housestaff involvement in peer curricula
Residents design and teach
courses for peers
Psych residents teach a course on major depression
Psych residents teach a review course for ITE
Deligiannidis KM, et al. Psychiatry resident/fellow-initiated and -designed multi-modal psychopharmacology curriculum for major depression. Acad Psychiatry. 2012 Sep 1;36(5):414-8.
Vautrot VJ, Festin FE, Bauer MS. The feasibility and effectiveness of a pilot resident-organized and -led knowledge base review. Acad Psychiatry. 2010 Jul-Aug;34(4):258-62.
Lit Review: Housestaff involvement in peer curricula
Educators design programs to facilitate
residents’ involvement in curriculum development
Barriers to resident participation in curriculum development
• Lack of knowledge about curricular opportunities
• Inadequate understanding of the curriculum development process (lack of standardization of the process)
• Relative lack of good models in literature• Lack of mentors• Lack of time to commit to a long-term project
with inflexible scheduling
A common model for curriculum development
Proficiency
Lesson on skillset 4
Lesson on skillset 3
Lesson on skillset 2
Lesson on skillset 1
Curriculum Designer
An alternative model for curriculum development
Conceptual
Understanding
Curriculum Designer #1
An alternative model for curriculum development
Curriculum Designer #2
Curriculum Designer #3
Curriculum Designer #4
Curriculum Designer #5
Conceptual
Understanding
Curriculum Designer #1
An alternative model for curriculum development
Curriculum Designer #2
Curriculum Designer #3
Curriculum Designer #4
Curriculum Designer #5
Conceptual
Understanding
Our model
Individual or group identifies multi-faceted curriculum need
Develops infrastructure and sustainable layout
Writes a large bank of research questions
Our model, cont’d
Future educators choose sub-topics and develop discrete courses using existing structure
Use existing question bank to study course efficacy
Conclusions
• There’s little documented resident involvement in curriculum development, and no documented planning to engage residents in curriculum development.
• Our approach of standardizing and “modularizing” a curriculum development process may serve as a model for facilitating resident participation in curriculum development by eliminating several barriers to involvement.
Part II
Needs assessment
Internet survey sent spring 2012 to all new matches and current residents (R1-R4)
34-37 forced-choice questions + free text
• 55 new match respondents (85%)• 81 current resident respondents (~60%)
• Perceived importance of ultrasound• Confidence/experience with ultrasound for basic IM
procedures• Areas of desired instruction
Not all residents know how to use ultrasound for required procedures
CVC Arterial line Paracentesis Thoracentesis0
20
40
60
80
100New Matches
Residents
Perc
enta
ge o
f res
pond
ents
who
“kn
ow”
how
to u
se u
ltras
ound
for p
roce
dure
Many respondents “would like more training” on ultrasound use for procedures
CVC Arterial line Paracentesis Thoracentesis0
10
20
30
40
50
60
70
80
90
New MatchesResidents
Some residents are uncomfortable supervising interns who are not trained on US
Comfortable82%
Not com-fort-able18%
Nearly all residents prefer interns receive more training on US
Agree93%
Disagree7%
Respondents willing to spend own time on further US training
New matches Residents0
20
40
60
80
100
Pe
rcen
t of r
espo
nden
ts
will
ing
to c
omm
it ow
n tim
e
Respondents willing to spend own time on further US training
New matches Residents0
20
40
60
80
100
Pe
rcen
t of r
espo
nden
ts
will
ing
to c
omm
it ow
n tim
e
Conclusions
• New matches are less comfortable and skilled with ultrasound, but even current residents still feel inadequately trained in multiple areas of bedside ultrasound use.
• All participants are interested in obtaining further formal training.
Many thanks to…
Tom DeCato, MD
Sirisha Narayana, MD
Nina Saxena, MD
Amy Morris, MD
Jennifer Best, MD
Ken Steinberg, MD
Renata Thronson, MD
Curriculum Designer #1
An alternate model for curriculum development
Curriculum Designer #2
Curriculum Designer #3
Curriculum Designer #4
Curriculum Designer #5
Conceptual
Understanding
BibliographyAdler AC, Homayounrooz FF. Medical student education improvement using a resident-driven student rotation. South Med J. 2012 Feb;105(2):68-70.
Backes CH, et al. Fellows as teachers: a model to enhance pediatric resident education. Med Educ Online. 2011;16.
Boehm KM. Commentary on medical student education improvement using a resident-driven student rotation. South Med J. 2012 Feb;105(2):71.
Deligiannidis KM, et al. Psychiatry resident/fellow-initiated and -designed multi-modal psychopharmacology curriculum for major depression. Acad Psychiatry. 2012 Sep 1;36(5):414-8.
Keating EM, O'donnell EP, Starr SR. How we created a peer-designed specialty-specific selective for medical student career exploration. Med Teach. 2013;35(2):91-4.
Laiteerapong N, et al. A resident-led quality improvement initiative to improve obesity screening. Am J Med Qual. 2011 Jul-Aug;26(4):315-22.
Sweeney A, et al. Senior pediatric residents as teachers for an innovative multidisciplinary mock code curriculum. J Grad Med Educ. 2011 Jun;3(2):188-95.
Vautrot VJ, Festin FE, Bauer MS. The feasibility and effectiveness of a pilot resident-organized and -led knowledge base review. Acad Psychiatry. 2010 Jul-Aug;34(4):258-62.
