The ability to effectively practice consultative medicine is increasingly important. The increase in medical specialization, as well as an increasing number of providers responsible for patient care, makes this particularly evident in inpatient settings. Indeed, a dedicated consultation rotation is required of every internal medicine residency program. Few formal curricula for teaching consultative medicine have been reported in the literature, and medical educators often rely on their own experience to develop content and methods, or they inherit curricula passed down from rotation directors past. Although common, this approach may lead to instruction that is neither optimal nor complete. For the past 3 years, we have undertaken the task of developing a curriculum for the PGY3 consultative medicine rotation based on principles of evidence‐based instructional design.
To describe the process and products of efforts to actively incorporate principles of educational psychology and instructional design into the development of a new curriculum for consultative medicine.
Our goal was to design a formal curriculum that was a valid representation of the domain of consultative medicine. In particular, we wanted to ensure that our content was current, comprehensive, and generalizable to other health care settings. We began by assembling evidence‐based resources from the consultative medicine literature. Peer‐reviewed articles were assessed for quality using principles of evidence‐based practice (population, control, external validity, etc.). The resulting 20 articles, covering the most common consultative medicine issues, became the foundation for the creation of a course curriculum. Course content was mapped onto a matrix using body system and Bloom's Taxonomy as primary dimensions. Thus, each learning objective can be described in terms of content and taxonomic level. For example, under the heading of thromboembolism, “prevention options” is a knowledge issue, “perioperative warfarin management” is an application issue, and “valve risk strata” is a synthesis issue. Using the matrix as a guide, test questions were written to assess knowledge, application, synthesis, and evaluation aspects of the curriculum as appropriate. Using this strategy allows us to identify specific areas of difficulty (e.g., knowledge vs. application; pulmonary vs. hepatic) at the individual resident and curriculum levels. The ability to appropriately apply these concepts in the clinical setting is also stressed, and residents' performance in personal communications and documentation is routinely assessed for clarity and specificity of recommendations.
Resident evaluation of the new curriculum has been very positive. The instructional design and strategy employed allow us to evaluate very specific areas of requisite knowledge and identify deficits and to adjust the curriculum accordingly. Assessment of the curriculum's external validity is ongoing.
To cite this abstract:Moreland C, Wang E, Simon B, Leykum L. An Evidence‐Based Approach to Curriculum Development in Consultative Medicine. Abstract published at Hospital Medicine 2013, May 16-19, National Harbor, Md. Abstract 183. Journal of Hospital Medicine. 2013; 8 (suppl 2). https://www.shmabstracts.com/abstract/an-evidencebased-approach-to-curriculum-development-in-consultative-medicine/. Accessed July 23, 2019.