Background/Purpose:  Immunologic mechanisms play an integral role in understanding the pathogenesis and management of rheumatic conditions. Currently, there is limited access to standardized formal instruction in immunology for rheumatology trainees across Canada. This is despite the belief that a comprehensive immunology curriculum is essential for adult rheumatology trainees to meet the competencies mandated by the Royal College of Physicians and Surgeons of Canada.  The goals of this project were (1) to describe the structure of current immunology curricula amongst adult rheumatology training programs across Canada and (2) to identify and compare the perceived learning needs of rheumatology trainees from the perspective of both the trainees and Program Directors.

Methods:  Rheumatology trainees and Program Directors from adult rheumatology programs across Canada completed an online questionnaire. Information on student demographics, past immunology training and overall satisfaction with current immunology training was collected in an anonymous manner. All participants ranked a comprehensive list of immunology topics by order of perceived importance. A modified two step Delphi approach was implemented to obtain consensus on immunology topics. 

Results:  15 Program Directors and 38 rheumatology trainees were contacted between March 2012 and May 2012. From this group, 42% of trainees and 66% of Program Directors responded, with a total 49% response rate. Of the rheumatology trainees, 67% had prior experience in immunology, consisting of undergraduate and graduate courses. Teaching format and formal teaching hours varied between sites. Notably, only 42% of Program Directors and 31% of trainees felt the current method of teaching immunology was effective. Results illustrate concordance between Program Directors and trainees for the highest ranked topics, which include innate immunity, adaptive immunity, and cells and tissues of the immune system. However, there was discordance amongst other topics. Notably, diagnostic laboratory immunology and therapeutics were ranked higher by Program Directors as compared to trainees. Part two of the modified Delphi was conducted amongst Program Directors and completed by December 2012. Only six of the original twelve Program Directors participated in the second phase of the Delphi. The results of round two demonstrated consistency with topic ranking generated from round one.

Conclusion: There is a need to improve immunology teaching in rheumatology training programs. Results illustrate high concordance between many of the topics ranked by trainees and Program Directors. However, discordance is seen with other topics, including diagnostic immunology and therapeutics. To our knowledge, this is the first study to examine perceived immunology education needs of adult rheumatology trainees at a national level. It provides the groundwork for further development of immunology curricula for rheumatology trainees.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/assessment-and-promotion-of-a-national-immunology-curriculum-for-adult-rheumatology-residents/