Background/Purpose
Rheumatology training programs rely on capable clinician scholar educators to sustain the rheumatology workforce. No program for rheumatology fellow clinician scholar educator (CSE) training has been described in the literature. We describe application of iterative cycles of Kolb’s experiential learning in a mentored rheumatology fellow CSE experience as a proof-of-concept model.
Methods
With mentorship from a faculty CSE, a second year rheumatology fellow at Hospital for Special Surgery contributed to implementation of a learning module on fracture risk for New York Presbyterian Hospital (NYPH) internal medicine (IM) residents.
Applying an experiential framework (learning through experience), the fellow refined the fracture risk module through cycles of Reflective Observation (review of faculty-led sessions), Abstract Conceptualization (identification of effective techniques), Active Experimentation (enactment of proposed teaching vignettes), and Concrete Experience (teaching parts of sessions).
The fracture risk module itself was built on the same experiential framework; IM residents recalled patients with fractures, identified fracture risk factors, formed clinical approaches, and estimated fracture risk. From July 2013-June 2014, IM residents completing a rheumatology rotation participated.
Following sessions, the fellow and faculty CSE reflected on module content and format, and on the teaching experience. Verbal and written prompts elicited impact, challenges, and key elements.
Results
The fellow attended 24/36 (66.7%) sessions, and taught in 21/24 (87.5%) of attended sessions.
The fellow found the experience valuable and feasible. Confidence related to clinical mastery and self-efficacy regarding curricular design and teaching abilities increased. The fellow cited increasing comfort and ease preparing to teach sessions and answering questions from IM residents.
The fellow’s suggestions were consistent with experiential learning techniques, demonstrating application of new knowledge. Greater knowledge of the clinical subject (fracture risk) was evident in increased ability to respond to residents’ questions. The fellow’s knowledge and scholarly approach resulted in publication of a review article.
Challenges included competing clinical and research demands. Key elements identified for the fellow’s learning included longitudinal faculty mentorship, establishment of fellow’s content expertise, shared curricular development, explicit application of an educational framework, iterative learning cycles around a recurring teaching module, and flexibility in involvement to allow for other research experiences.
Conclusion
This descriptive analysis demonstrates the utility and feasibility of rheumatology fellow CSE development. Application of an experiential framework to fellow teaching in a recurring teaching module promoted iterative cycles of learning. Fellow self-efficacy and knowledge related to both rheumatology and education increased. This model may be adapted to support rheumatology fellow CSE development more broadly and systematically as a programmatic element.
Disclosure:
R. Khianey,
None;
J. Berman,
None;
S. A. Paget,
None;
A. R. Bass,
None;
J. Aizer,
None.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/application-of-an-experiential-learning-framework-for-clinician-scholar-educator-training-in-a-rheumatology-fellowship/