Enterprise Microblogging to Augment the Subinternship Clinical Learning Experience: A Proof-of-Concept Quality Improvement Study

Abstract

BackgroundAlthough the Clerkship Directors in Internal Medicine (CDIM) has created a core subinternship curriculum, the traditional experiential subinternship may not expose students to all topics. Furthermore, academic institutions often use multiple clinical training sites for the student clerkship experience.ObjectiveThe objective of this study was to sustain a Web-based learning community across geographically disparate sites via enterprise microblogging to increase subintern exposure to the CDIM curriculum.MethodsInternal medicine subinterns used Yammer, a Health Insurance Portability and Accountability Act (HIPAA)–secure enterprise microblogging platform, to post questions, images, and index conversations for searching. The subinterns were asked to submit 4 posts and participate in 4 discussions during their rotation. Faculty reinforced key points, answered questions, and monitored HIPAA compliance.ResultsIn total, 56 medical students rotated on an internal medicine subinternship from July 2014 to June 2016. Of them, 84% returned the postrotation survey. Over the first 3 months, 100% of CDIM curriculum topics were covered. Compared with the pilot year, the scale-up year demonstrated a significant increase in the number of students with >10 posts (scale-up year 49% vs pilot year 19%; P=.03) and perceived educational experience (58% scale-up year vs 14% pilot year; P=.006). Few students (6%) noted privacy concerns, but fewer students in the scale-up year found Yammer to be a safe learning environment.ConclusionsSupplementing the subinternship clinical experience with an enterprise microblogging platform increased subinternship exposure to required curricular topics and was well received. Future work should address concerns about safe learning environment.

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“…This is not surprising as Anderson and colleagues also found concerns around microblogging and sense of a safe learning environment in senior medical students. 21 A strength of this curriculum is its focus on practical skill building to help mitigate distress given that the curriculum occurs during clerkship training. In addition, this workshop series allows students to create a shared experience and fosters an environment of peer support within clerkship training, which is often viewed as a more isolating time during medical school.…”

“…This is not surprising as Anderson and colleagues also found concerns around microblogging and sense of a safe learning environment in senior medical students. 21 …”

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