Restructuring Ambulatory Curriculum
Omar J, Heidemann DL, and Haftka AC. Restructuring Ambulatory Curriculum. J Gen Intern Med 2019; 34(2):S842-S843.
J Gen Intern Med
Needs and Objectives: During the 2017-2018 academic year, the curriculum for ambulatory medicine consisted mainly of discussion of clinical trials from scholarly journals. Results of both the mid-year and end of the year survey administered to residents showed dissatisfaction with the educational session, due to emphasis on clinical trials and lack of discussion regarding medical management of common outpatient pathology. This prompted restructuring of the curriculum with the goal of improving resident satisfaction, providing more management guidelines, and better preparing residents for board exams. Setting and Participants: Ambulatory education in our institution takes place prior to our residents' traditional half-day continuity clinic. Small groups of up to 10 residents and 4 faculty participate in a "flipped classroom" format. Description: In the 2018-2019 academic year, our ambulatory curriculum underwent several key changes. First, educational sessions were shifted to focus more on guidelines and medical management of outpatient conditions. Second, each month a subspecialty topic was assigned that paralleled our inpatient educational noon conference. In this format, the outpatient curriculum built on concepts and topics addressed in our inpatient curriculum. Third, we utilized our in-training Results to help optimize topic selection to help residents focus on areas where scores tend to be lower. At the end of each month we had a resident-lead board review session to review key points and answer questions as a group. Evaluation: Mid-year surveys identical to the previous academic year were used to assess the resident and preceptor response to changes in the curriculum. 77% of residents rated the curriculum as good or excellent, a 30% increase from the year prior. 23% of residents rated it as fair/poor, a 30% decrease from the year prior. When asked about board review content, 56% of residents felt there were enough board review questions, a 38% increase from the year prior. Preceptors also felt their residents were more engaged during the sessions then they had been previously. D I r e C t r e s I d e n t feedback has been positive, including comments that they appreciate the synchrony of the inpatient and outpatient curriculum Discussion/Reflection/Lessons Learned: Resident satisfaction with the ambulatory curriculum has improved with the recent curriculum changes, leading to increased engagement in our educational sessions. Residents prefer broad discussions about clinic management rather than discussing clinical trials. By organizing these discussions to supplement the inpatient curriculum, residents felt they had a more structured educational experience. Board review questions help to reinforce the monthly topic while simultaneously preparing the residents for the ABIM. Choosing topics that are relevant and enjoyable to the targeted learners help enrich the ambulatory educational experience through increased participation and learning opportunities.