Background/Purpose: Though trainees see patients at varying stages of their diagnostic course on subspecialty electives, there is often no organized opportunity for residents to follow these patients after the elective has ended. Furthermore, the lack of longitudinal follow-up on subspecialty cases may hamper the educational experience of trainees and future interest in a particular area. There is paucity of literature on strategies to foster trainee experience including increasing continuity in care (Francis, Journal of Graduate Medical Education, 2018). Herein we present preliminary results of needs assessment and virtual systematic intervention in a rheumatology elective. This intervention was designed and implemented to bolster education and continuity in an asynchronous format after the elective concluded.

Methods: Informed consent was obtained from all rotating residents in the rheumatology elective from August 2020 to April 2021. Residents completed a pre-intervention survey for needs assessment delineating current perceptions of continuity, level of exposure in their subspecialty clinics, and willingness to participate in the follow-up intervention. Participating residents chose a patient case they had seen while on the elective to discuss at a scheduled virtual meeting 4-6 weeks following the end of their elective with a rheumatology faculty member. Participating residents completed a post-intervention survey assessing their satisfaction, changes in perception and medical knowledge, and impact on their choice of subspecialty as a career option. Descriptive statistics and one-sided Fisher exact test were undertaken.

Results: Of the 49 residents that completed the needs assessment pre-survey, 85.7% stated they never had structured continuity in their subspecialty clinics, 75.5% were interested in a structured way to follow-up patients, and 77.6% were open to the intervention. Twenty-six residents completed the intervention and post-survey, which revealed 69.2% of residents felt the intervention added to their medical knowledge and clinical experience with 26.9% felt it helped somewhat; 65.4% of the residents believed this intervention created a positive change in perception of this subspecialty rotation while none noted a negative assessment of the intervention. All trainees (n=7) that noted a positive change in perception of the subspecialty clinic following the intervention, also reported an increased consideration for rheumatology as a career (p < 0.05)

Conclusion: Needs assessment confirmed there is lack of structured programs to provide trainees with longitudinal follow-up on patient encounters seen in a rheumatology elective. There was a high level of interest in an asynchronous intervention strategy to improve longitudinal learning that resulted in increased continuity, medical knowledge, clinical experience, and consideration for the subspecialty as a career. This novel intervention maximizes the use of experiential learning trainees have within their rheumatology rotation even after it has concluded; continuing such measures in the future may enhance subspecialty ambulatory training as the realm of virtual learning continues to be an integrated part of education for trainees.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/a-new-virtual-reality-needs-assessment-and-gains-in-current-trainees-experience-with-a-novel-video-based-post-rheumatology-rotation-intervention/