Improving Resident Engagement with a Program-Sponsored Online Curriculum

TITLE: A Program-Sponsored Online Curriculum Improves Resident Engagement With Didactic Education and Assessment
AUTHORS (FIRST NAME INITIAL LAST NAME): A. Sidhu1, K. Zechar1, G. Krishnamoorthy1
Needs and objectives:
Graduate Medicine Education (GME) programs struggle to establish and maintain adequate levels of learner engagement with didactic activities. With lectures being demonstrated as ineffective towards positive educational outcomes in literature, web and software-based tools have emerged as promising modalities of evidence-based learning but are not commonly used. We aim to evaluate and improve both perceptions of and engagement with online learning environments while clarifying the requirements of effective online curricular interventions, thereby providing a framework for wider implementation.

Setting and participants:
PGY1, 2, and 3 residents (n=50) at a community Internal Medicine program during the 2019-2020 academic year.

Learners were surveyed at the start and midpoint of the year regarding study habits, relative value of self-directed study materials, and engagement with program-sponsored didactics hosted online. Throughout the intervention period participants are notified of new monthly interactive content and self-testing tools leveraging evidence-based learning strategies (e.g. active recall, testing effect). Learner engagement is tracked by post intervention surveys, participation in self-assessments, didactic attendance and website traffic analysis.

Survey data shows overall 102% improvement in learner-reported use of the platform (average 1.4 hrs/week to 2.9). Improved platform use is corroborated by an increase in cumulative tracked online viewing hours (0.65 hrs to 5.8) and participation with assigned monthly assessments (from 77% to 83%). Daily conference attendance remained stable and residents’ perception that online learning discourages in-person attendance decreased (2.2 to 1.9 weighted average on a Likert scale). Learner-reported confidence towards clinical duties varied following exposure to interactive scenarios–PGY2 residents reported an increase in confidence towards rapid response scenarios (4 to 4.33) while PGY1 residents reported a decrease (4 to 3.85). On end of year evaluation, 30% of residents did not meet required in-person didactic attendance, however when online didactic attendance was counted (based on viewing hours) only 15% of residents were required to make up didactic attendance. Conversely, 26% of residents exceeded 100% of assigned didactic attendance when both in-person and online engagement were tracked.

Discussion / reflection / lessons learned:
GME faces unique challenges training and evaluating learners adapted to learning environments incongruent to current standards in medical pedagogy. In contrast to commercial products, program-sponsored web platforms can stand as cost-effective, evidence-based modalities to improve learner engagement, examine their performance, and tailor curricula to specific needs. Further, our data suggests serial monthly online interventions can be an effective curricular design that augments traditional learning modalities and mitigates the ineffectiveness of lectures. With established engagement with core material and self-assessment tools, future studies will examine the impact of the platform on learner performance, such as board certification rates and in-training exam scores.

Online resource URL (optional):
Impact: Adopting web-based educational interventions in GME is beneficial as traditional modalities have variable appeal and efficacy, and online tools are effective conduits for evidence-based learning practices. Program sponsored online learning platforms appeal to modern learners and can be a sustainable source of self-directed learning and standardized test preparation. When provided with both online and traditional didactic activities, residents increased their cumulative academic hours; this challenges the perceived limits of learner educational time and may improve the efficacy of lecture-based curricula.
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