Background/Purpose:

The pediatric rheumatology (PR) academic half-day (AHD) is a weekly 2-hour block of protected time in our training program for trainees to discuss topics relevant to their future practice. Topics reflect the Royal College of Physicians and Surgeons of Canada’s (RCPSC) objectives of training and are covered in a 1-year curriculum. Instructional formats vary with trainees’ preference. Weekly topics are assigned to trainees who lead discussions using PowerPoint, cases, or articles with faculty supervision. Medical education practices recommend regular evaluation of curricula to ensure they meet objectives and align with educational theory and evidence-based patient care. As part of a medical education quality assurance exercise, we aimed to:

1) Evaluate a PR AHD curriculum.

2) Make evidence-based recommendations for AHD program development using feedback from curriculum analyses and an instructional design model.

Methods:

The AHD program was evaluated using Posner’s framework for curriculum analysis to determine its strengths and weaknesses. Data collected: curriculum descriptions (origin, content), program evaluations, and interviews with staff and trainees regarding teaching and learning experiences. Hidden curricula and epistemological assumptions were elicited.

Feedback from analyses was used to guide plans for a formally structured AHD program based on the Dick and Carey instructional model (instructional goals, learner characteristics, performance objectives, instructional strategy).

Results:

Strengths: flexible learning formats, identified core topics, learner independence, regular assessments.

Weaknesses: inconsistent structure, lack of level-specific tasks for junior/senior learners, vague performance objectives.

A revised AHD program was developed around a 2-year spiral curriculum based on RCPSC core topics. Topics are organized into units of 1-4 modules, e.g., a lupus unit includes modules on neonatal lupus, lupus nephritis, outcome measures, and cutaneous disease. Modules are case-based to situate learning, have junior/senior-level goals, and include performance objectives based on authentic tasks, requiring learners seek out the latest evidence behind practice.

E.g., You are a pediatric rheumatologist recommending a joint injection for a child with monoarticular juvenile idiopathic arthritis. What drug will you use to inject and what risks/benefits will this have for the child?

Modules end with a quiz based on the principle that assessment drives learning. Each AHD session concludes with a request for staff and trainees to write instructional objectives and questions on the current topic. In this way, the AHD modules are continuously updated and participants are engaged in the development of the curriculum.

Conclusion:

Regular curriculum analyses can reveal strengths and weaknesses of programs to guide revision of instructional strategies. The caveat exists that new instructional designs undergo piloting and evaluation for efficacy (improved knowledge, patient care) and acceptability, and are regularly revised to maintain currency.

ACR Meeting Abstracts - https://acrabstracts.org/abstract/an-evidence-based-analysis-and-revision-of-a-pediatric-rheumatology-academic-half-day-program/