Implementation of a Novel, Resident-Led, Nocturnal Curriculum

Golbus, Jessica R.; Manly, David A.; Wonneberger, Katherine A.; Hanff, Thomas C.; Murphy, Kathleen M.; Wang, Daniel S.; McKee, Steven; Bellini, Lisa M.

doi:10.4300/jgme-d-14-00735.1

Cited by 12 publications

(14 citation statements)

References 16 publications

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“…1 These factors increase demands on attending and resident physicians, leading to an overall less formalized educational experience-less face to face interaction with attending physicians, decreased bedside teaching, and limited direct observation of patient care. 4 Just-in-Time Teaching (JiTT) is an andragogic strategy used primarily in classroom-based settings to promote improved opportunities for active learning. JiTT uses Web-based and other teaching modalities to optimize and diversify out-of-class preparation to establish a strong foundation upon which meaningful in-class experiences can be structured.…”

Section: Because Of Changes In Modern Medicinementioning

confidence: 99%

Exploring the Value of Just-in-Time Teaching as a Supplemental Tool to Traditional Resident Education on a Busy Inpatient Pediatrics Rotation

Mangum

Lazar

Rose

et al. 2017

Academic Pediatrics

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BECAUSE OF CHANGES in modern medicine 1 and evolving requirements mandated by the Accreditation Council for Graduate Medical Education, 2 residency programs have sought to develop innovative curricular programs and teaching modalities to ensure high-quality resident education in an ever-changing environment. 3 More stringent work hour restrictions, busy inpatient censuses, and increased demands of the electronic health record are a few of the obstacles limiting opportunities for direct resident teaching, lectures, and/or seminars. 1 These factors increase demands on attending and resident physicians, leading to an overall less formalized educational experience-less face to face interaction with attending physicians, decreased bedside teaching, and limited direct observation of patient care. 4 Just-in-Time Teaching (JiTT) is an andragogic strategy used primarily in classroom-based settings to promote improved opportunities for active learning. JiTT uses Web-based and other teaching modalities to optimize and diversify out-of-class preparation to establish a strong foundation upon which meaningful in-class experiences can be structured. 5 This teaching/learning strategy has had limited implementation in residency program curricula with 1 report that detailed improvements in learner participation, time spent learning, and overall retention. 6 The limited literature investigating the effect of JiTT in clinical settings focuses on improving technical skill in infrequently performed procedures (lumbar punctures, 7 tracheal intubation, 8 volar splinting, 9 mock code scenarios 10 ) and has shown mixed results. Using Kern's 6-step approach to curricular development 11 and a logic model framework, we sought to create and implement JiTT in a busy inpatient pediatrics clinical setting. A logic model is a graphical/visual representation of a program, illustrating the relationship among available resources, activities necessary for the process, and outcomes desired. 12 We identified an educational gap in the multifactorial reduction in direct face-to-face teaching and learning opportunities between faculty and resident learners, and the need for alternative learning opportunities. Our logic model is illustrated in the Figure. We aimed to investigate whether a JiTT educational approach could be effectively used as a supplemental tool to help residents better prepare for, and formally learn within, a busy clinical rotation and whether this approach would be perceived as a worthwhile educational resource by residents. METHODS SETTING AND PARTICIPANTSOur educational intervention was implemented in a large (464-bed) pediatric tertiary care hospital. The pediatric residency program is comprised of 147 residents-107 Pediatrics and 40 Internal Medicine-Pediatrics residents. Because of its high census and complex and significantly ill patients, our inpatient pediatric hematology/oncology ward is generally recognized as one of the most demanding resident services, with 1644 admissions in 2014, and an average daily census of 24 patients....

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Section: Because Of Changes In Modern Medicinementioning

confidence: 99%

Exploring the Value of Just-in-Time Teaching as a Supplemental Tool to Traditional Resident Education on a Busy Inpatient Pediatrics Rotation

Mangum

Lazar

Rose

et al. 2017

Academic Pediatrics

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“…To this end, the app did positively influence the frequency and duration of resident-led teaching. A possible advantage of our model, then, is that it may allow residents to learn teaching skills by discussing, answering questions, and engaging in a meaningful way with near-peer learners [ 20 , 31 , 34 , 37 ].…”

Section: Discussionmentioning

confidence: 99%

Teaching scripts via smartphone app facilitate resident-led teaching of medical students

et al. 2021

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Background Previous studies have suggested that resident physicians are the most meaningful teachers during the clinical clerkships of third-year medical students (MS3s). Unfortunately, residents often feel unprepared for this crucial role. The pediatrics clerkship at our institution identified a paucity in the frequency of resident-led teaching with MS3s. Lack of confidence, suboptimal teaching space, and insufficient time were cited as the most significant barriers. To enhance resident-led teaching of MS3s, we created teaching scripts of general pediatrics topics accessible via a smartphone application (app). Methods Prior to the implementation of the app, MS3s and pediatric residents were surveyed on clerkship teaching practices. From May 2017 through July 2018, pediatric residents working with MS3s were introduced to the app, with both groups queried on resident teaching habits afterward. We compared pre-intervention and post-intervention data of time spent teaching, teaching frequency, and a ranking of pediatric resident teaching performance compared to residents of other MS3 core clerkships. Results 44 out of 90 residents (49%) responded to a pre-intervention survey on baseline teaching habits. 49 out of 61 residents (80%) completed our post-intervention survey. Pre-intervention, 75% (33/44) of residents reported spending less than 5 min per teaching session on average. Post-intervention, 67% (33/49) reported spending more than 5 min (p < 0.01). 25% (11/44) of residents reported teaching at least once per day pre-intervention, versus 55% (27/49, p = 0.12) post-intervention. Post-intervention data demonstrated a statistically significant correlation between app use and increased frequency of teaching (p < 0.01). The MS3 average ranking of pediatric resident teaching increased from 2.4 to 3.4 out of 6 (p < 0.05) after this intervention. Conclusions Residency programs looking to reform resident-led teaching, particularly of residents early in their training, should consider our novel approach. In addition to addressing barriers to teaching and creating a platform for near-peer teaching, it is adaptable to any specialty or learner level. Future direction includes developing objective measures for teaching performance and content proficiency to better assess our intervention as an educational curriculum, as well as further investigation of the intervention as a controlled trial.

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“…We found agreement between both faculty and trainees that nighttime sessions should be brief, case-based, chalk talks, occurring between 10 pm and 2 am. Our high-yield teaching topics overlap with prior literature [ 8 ], but have the added benefit of perspective from trainees at varying levels of seniority in addition to that of practicing overnight faculty.…”

Section: Discussionmentioning

confidence: 99%

“…Studies demonstrate negative housestaff perceptions of the educational value of night float rotations [ 5 - 6 ]. Recent investigation into improving overnight trainee education has focused on formalizing resident-led curricula [ 7 - 8 ], without considering the role nocturnists can play in enhancing nighttime learning. This is despite evidence that residents find increased educational value to nighttime rotations when working alongside overnight faculty [ 9 - 10 ].…”

Section: Introductionmentioning

confidence: 99%

Shining a Light on Overnight Education: Hospitalist and Resident Impressions of the Current State, Barriers, and Methods for Improvement

Sani

Wistar

et al. 2018

Cureus

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Introduction: Restrictions on resident work hours and increased requirements for resident supervision have led to night float rotations overseen by overnight hospitalists (nocturnists). The educational value of night float rotations for residents has traditionally been low and studies have yet to elucidate the optimal role of nocturnists in resident education.Methods: We performed a cross-sectional survey of all residents within our training program and attending hospitalists in the department of medicine at our three teaching medical centers. Questions sought to investigate the current state of overnight education within an internal medicine residency program, understand barriers to overnight education, and define best practices for nighttime teaching.Results: Both attending and resident physicians reported low satisfaction with the current state of overnight education, while simultaneously expressing high levels of interest in performing and receiving dedicated nighttime teaching. Attending and resident physicians identified similar barriers to overnight teaching (clinical work, time coordination, provider fatigue) and agreed on the ideal format for overnight didactics (case-based, chalk-talk, 20-minute duration between 10 pm to 2 am).Conclusion: Our study identifies a desire by both faculty and trainees for increased overnight teaching and offers a simple initial framework for programs to improve overnight housestaff education utilizing nocturnist providers.

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Implementation of a Novel, Resident-Led, Nocturnal Curriculum

Cited by 12 publications

References 16 publications

Exploring the Value of Just-in-Time Teaching as a Supplemental Tool to Traditional Resident Education on a Busy Inpatient Pediatrics Rotation

Exploring the Value of Just-in-Time Teaching as a Supplemental Tool to Traditional Resident Education on a Busy Inpatient Pediatrics Rotation

Teaching scripts via smartphone app facilitate resident-led teaching of medical students

Shining a Light on Overnight Education: Hospitalist and Resident Impressions of the Current State, Barriers, and Methods for Improvement

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