Competency in practice‐based learning (PBL) requires deliberately and rigorously questioning current practice, locating and accurately interpreting relevant literature and incorporating evidence into clinical decision‐making.
Our hospital medicine faculty, in collaboration with the internal medicine residency program and experienced medical informationinsts (medical librarians), develop our internal medicine residents to attain PBL knowledge, skills and behaviors for successful lifelong learning through a multi‐step, layered curriculum in evidence based medicine (EBM) spanning the 3‐year residency training.
Our EBM curriculum includes intern year pre‐ and post‐assessments of online searching, with structured feedback. Interns also participate in approximately 20 hours of interactive didactic instruction and actively supervised literature critical appraisal. Each junior‐level resident receives faculty mentorship to individually prepare and facilitate a structured and systematic journal club workshop among peers, students and faculty. Senior residents prepare a one‐hour grand rounds style presentation utilizing EBM skills to incorporate key clinical evidence to answer focused clinical question(s). Other PBL activities span the course of residency training, including multiple‐per‐week interactive and interdisciplinary resident reports where clinical questions lead to evidence sought and reported back through a resident report blog. Monthly resident‐led journal clubs at each of our clinical sites reinforce literature interpretation skills.
Assessments of effective searching skills (PGY1); journal club presentation and facilitation (PGY2); and high‐quality grand rounds presentation (PGY3) are integrated into PBL evaluation and promotion criteria to the PGY2 year; PGY3 year; and graduation, respectively. Searching post‐assessments over 2 years confirm that online searching skills have significantly improved from pre‐intern year to post‐intern year in both individual search techniques as well as searching for specific article types. Searching skills improved significantly more in interns receiving the structured EBM curriculum compared to active controls (Transitional and Prelim interns) who did not receive the structured curriculum (p=0.017).
Our multi‐tiered model permits graduate trainees to attain competency in PBL through online assessments, formal instruction and facilitated learning and teaching. Incorporating active learning methods throughout the curriculum has supported objective improvement in resident searching skills. Next steps in our curriculum include formal pre‐ and post‐assessment of literature interpretation skills, initiated in 2013‐2014 academic year. A structured, multifaceted EBM curriculum intercalated within a graduate medical education program actively develops knowledge, skills and attitudes that support career‐long practice based learning.
To cite this abstract:Dressler D, Allison A, Getselman A, Smith D, Adhyaru B, DiFrancesco L. A Multi‐Faceted Model to Achieve Competency in Practice Based Learning in Graduate Medical Education. Abstract published at Hospital Medicine 2014, March 24-27, Las Vegas, Nev. Abstract 182. Journal of Hospital Medicine. 2014; 9 (suppl 2). https://www.shmabstracts.com/abstract/a-multifaceted-model-to-achieve-competency-in-practice-based-learning-in-graduate-medical-education/. Accessed April 1, 2020.