Evaluation of a Case-Based Primary Care Pediatric Conference Curriculum

Abstract

Background Our goal was to assess the impact of a standardized residency curriculum in ambulatory pediatrics on residents' participation, satisfaction, and confidence. Methods A case-based curriculum for weekly primary care conference was developed to replace the existing free-form review of topics at the Yale Pediatrics Residency Program. Before the curricular switch, faculty preceptors and members of the academic year 2005–2006 intern class completed surveys designed to measure conference occurrence and resident attendance, participation, satisfaction, and confidence in clinical skills. One year after the curricular switch, identical surveys were completed by faculty preceptors and members of the academic year 2006–2007 intern class. Results Faculty surveys indicated that conferences took place significantly more often after the curricular switch. The number of residents at conference each day (3.18 vs 4.50; P < .01) and the percentage who actually spoke during conference (45% vs 82%, P < .01) significantly increased. There were 18 demographically similar interns in each of the 2 classes. Members of the academic year 2006–2007 intern class, having trained exclusively with the standardized curriculum, were significantly more likely to respond favorably to survey items about participation, satisfaction, and confidence. In addition, they were more likely to endorse survey items that reflected explicit goals of the standardized curriculum and the Accreditation Council for Graduate Medical Education core competencies. Conclusion Implementation of a structured curriculum for ambulatory care improved interns' self-reported participation, satisfaction, and confidence. The primary care conference occurred more dependably after the curricular change, and improvements in attendance and participation were documented. Pediatric residency programs may make better use of conference time in the ambulatory setting through the use of structured, case-based educational material.

Evaluation of a staged case‐based discussion curriculum in standardized residency training

“…The basic premise of the CBD is an in‐depth discussion between a trainee and a trainer to explore the trainee's clinical knowledge and reasoning around a specific topic or patient encounter. CBD provides a chance for asking relevant questions to obtain the patient history and develop physical examination skills in a sympathetic manner . Cases are generally shown as problems to provide the student with a complete background and the clinical situation of the patient.…”

“…A CBD is a structured interview conducted by a supervisor and a trainee in a focused manner around the actual written case records a trainee presents. Well‐constructed cases serve to engage learners effectively in discussion and simulate the complexities encountered in actual practice . It is a process that has both a grading element and a feedback function.…”

“…CBD provides a chance for asking relevant questions to obtain the patient history and develop physical examination skills in a sympathetic manner. 5 Cases are generally shown as problems to provide the student with a complete background and the clinical situation of the patient. CBD is a viable approach to help initiate the shift to more active learning and encourage critical thinking.…”

“…Well-constructed cases serve to engage learners effectively in discussion and simulate the complexities encountered in actual practice. 5 It is a process that has both a grading element and a feedback function.…”

Use of extramural ambulatory care curricula in postgraduate medical training

“…Historically, residency programmes have struggled to provide training in ambulatory care; training remains inpatient-centric [ 2 , 3 ]. Programmes have continued to find ways to shift the emphasis to improve training in ambulatory care, and the development of ambulatory care curricula is part of the response to address the imbalance [ 2 , 5 ].…”