Resident-Driven Curriculum
Development
and
Ultrasound Curriculum Needs
Assessment
Lynnea Mills, MD
April 9, 2013
Overview, part I
• Review of literature on housestaffled curricula
• Novel approach to curriculum
development, designed to facilitate
resident involvement
Overview, part II
• Description of our assessment of
residents’ needs for future
instruction on bedside ultrasound
• Selected results from needs
assessment
Part I
Lit Review: Housestaff involvement in
peer curricula
Residents teach
facultydeveloped
curricula
Peds residents
teach mock code
sessions
EM senior residents
teach interns
bedside skills
IM residents teach
med students on
wards
Sweeney A, et al. Senior pediatric residents
as teachers for an innovative
multidisciplinary mock code curriculum. J
Grad Med Educ. 2011 Jun;3(2):188-95.
Boehm KM. Commentary on medical student
education improvement using a residentdriven student rotation. South Med J. 2012
Feb;105(2):71.
Adler AC, Homayounrooz FF. Medical student
education improvement using a residentdriven student rotation. South Med J. 2012
Feb;105(2):68-70.
Lit Review: Housestaff involvement in
peer curricula
Residents design
and teach
courses for
peers
Psych residents
teach a course on
major depression
Deligiannidis KM, et al. Psychiatry resident/fellowinitiated and -designed multi-modal
psychopharmacology curriculum for major depression.
Acad Psychiatry. 2012 Sep 1;36(5):414-8.
Psych residents
teach a review
course for ITE
Vautrot VJ, Festin FE, Bauer MS. The feasibility and
effectiveness of a pilot resident-organized and -led
knowledge base review. Acad Psychiatry. 2010 JulAug;34(4):258-62.
Lit Review: Housestaff involvement in
peer curricula
Educators design
programs to facilitate
residents’ involvement
in curriculum
development
Barriers to resident participation in
curriculum development
• Lack of knowledge about curricular
opportunities
• Inadequate understanding of the curriculum
development process (lack of standardization
of the process)
• Relative lack of good models in literature
• Lack of mentors
• Lack of time to commit to a long-term project
with inflexible scheduling
A common model for
curriculum development
Lesson on skillset 1
Lesson on skillset 2
Lesson on skillset 3
Lesson on skillset 4
Proficiency
Curriculum
Designer
An alternative model for
curriculum development
Conceptual
Understanding
An alternative model for
curriculum development
Curriculum Designer #1
Curriculum Designer #2
Conceptual
Understanding
Curriculum Designer #3
Curriculum Designer #4
Curriculum Designer #5
An alternative model for
curriculum development
Curriculum Designer #1
Curriculum Designer #2
Conceptual
Understanding
Curriculum Designer #3
Curriculum Designer #4
Curriculum Designer #5
Our model
Individual or group identifies
multi-faceted curriculum need
Develops infrastructure and
sustainable layout
Writes a large bank of
research questions
Our model, cont’d
Future educators choose subtopics and develop discrete
courses using existing structure
Use existing question
bank to study course
efficacy
Conclusions
• There’s little documented resident involvement in
curriculum development, and no documented
planning to engage residents in curriculum
development.
• Our approach of standardizing and
“modularizing” a curriculum development
process may serve as a model for facilitating
resident participation in curriculum development
by eliminating several barriers to involvement.
Part II
Needs assessment
Internet survey sent spring 2012 to all new matches
and current residents (R1-R4)
•55 new match respondents (85%)
•81 current resident respondents (~60%)
34-37 forced-choice questions + free text
•Perceived importance of ultrasound
•Confidence/experience with ultrasound for basic IM
procedures
•Areas of desired instruction
Not all residents know how to use
ultrasound for required procedures
Percentage of respondents who “know”
how to use ultrasound for procedure
100
New Matches
Residents
80
60
40
20
0
CVC
Arterial line Paracentesis Thoracentesis
Many respondents “would like more
training” on ultrasound use for
procedures
90
80
70
60
50
New Matches
40
Residents
30
20
10
0
CVC
Arterial line
Paracentesis
Thoracentesis
Some residents are uncomfortable supervising
interns who are not trained on US
Not comfortable
18%
Comfortable
82%
Nearly all residents prefer
interns receive more training on US
Disagree
7%
Agree
93%
Respondents willing to spend own
time on further US training
Percent of respondents
willing to commit own time
100
80
60
40
20
0
New matches
Residents
Respondents willing to spend own
time on further US training
Percent of respondents
willing to commit own time
100
80
60
40
20
0
New matches
Residents
Conclusions
• New matches are less comfortable and skilled
with ultrasound, but even current residents
still feel inadequately trained in multiple areas
of bedside ultrasound use.
• All participants are interested in obtaining
further formal training.
Many thanks to…
Tom DeCato, MD
Amy Morris, MD
Sirisha Narayana, MD
Jennifer Best, MD
Nina Saxena, MD
Ken Steinberg, MD
Renata Thronson, MD
An alternate model for curriculum
development
Curriculum Designer #1
Curriculum Designer #2
Conceptual
Understanding
Curriculum Designer #3
Curriculum Designer #4
Curriculum Designer #5
Bibliography
Adler AC, Homayounrooz FF. Medical student education improvement using a resident-driven student rotation. South
Med J. 2012 Feb;105(2):68-70.
Backes CH, et al. Fellows as teachers: a model to enhance pediatric resident education. Med Educ Online. 2011;16.
Boehm KM. Commentary on medical student education improvement using a resident-driven student rotation. South
Med J. 2012 Feb;105(2):71.
Deligiannidis KM, et al. Psychiatry resident/fellow-initiated and -designed multi-modal psychopharmacology curriculum
for major depression. Acad Psychiatry. 2012 Sep 1;36(5):414-8.
Keating EM, O'donnell EP, Starr SR. How we created a peer-designed specialty-specific selective for medical student
career exploration. Med Teach. 2013;35(2):91-4.
Laiteerapong N, et al. A resident-led quality improvement initiative to improve obesity screening. Am J Med Qual. 2011
Jul-Aug;26(4):315-22.
Sweeney A, et al. Senior pediatric residents as teachers for an innovative multidisciplinary mock code curriculum. J
Grad Med Educ. 2011 Jun;3(2):188-95.
Vautrot VJ, Festin FE, Bauer MS. The feasibility and effectiveness of a pilot resident-organized and -led knowledge base
review. Acad Psychiatry. 2010 Jul-Aug;34(4):258-62.