Background/Purpose: The Pediatric Rheumatology Learning Modules (PRML) were developed in 2015 as an academic curriculum for pediatric rheumatology fellowship training at a single center. With new discoveries and demand for use in different global contexts, we formed a virtual working group (WG) to update and modify content. We describe our process in adapting a learning resource, and our early experiences and feedback from piloting our work.

Methods: The WG (n=5) includes patients, trainees, and faculty from 5 countries and 4 continents. Literature reviews; the Textbook of Pediatric Rheumatology, 8th Edition; and ongoing user feedback on clarity and relevance, guide included content. Global adaptation draws on frameworks for internationalizing medical school curricula: plain language use, removal of cultural identifiers, generic drug names, practice variability due to resource inequity, e.g., biologics. We created faculty guides by request to address challenging questions and to include prompts for discussion. Strategies were discussed and refined after a pilot review of 3/37 modules including initial review, user feedback, learning objectives, references, literature review, and quizzes. Proposed changes are independently reviewed by group members; if universally agreed upon, they are accepted prior to a bi-weekly meeting where discrepancies are discussed. Final accepted changes require 75% consensus. 10-item multiple choice quizzes assess baseline knowledge and application of clinical knowledge. All work is facilitated online (virtual meetings, cloud-based file sharing, real-time group file editing). The updated PRLM are piloted as available at 2 pediatric rheumatology (PR) centers. Quiz results assess knowledge change and feedback from trainees and faculty are collated (email, comments on electronic documents) are used to refine the PRLM.

Results: The WG met 26 times over 18 months with 31 of the original 37 modules and quizzes revised. Two new modules were developed in response to gaps identified (transition, therapeutics). At the pilot centers, modules are reviewed weekly. Trainees (PGY4-6) complete quizzes then attempt module questions. Module answers are prepared for discussion with faculty, with the same module quiz repeated afterwards. Quiz answers are then discussed. Mean baseline quiz scores (n=240) from 13 trainees show pre- and post-modules scores of 71.6% and 91.6%, and 63.2% and 80.7% at centers 1 and 2. PGY-4 trainees gain more knowledge from training than PGY-6 trainees (23% vs 9%). Feedback from trainees and faculty includes ensuring quiz and module content align with learning objectives and ways to improve question clarity. Trainees prefer group discussion with PRLM to didactic teaching and feel modules help prepare them for board examinations.

Conclusion: The PRLM is the first evidence-based educational resource developed for PR trainees for teaching and learning in a group setting designed for any global context. Developing the PRLM requires time, learning, knowledge-sharing, and stable internet connections. Real-world user feedback was limited to 2 centers. More widespread use and assessment of PRLM as a tool are needed to make meaningful conclusions for future application.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/globalization-and-real-world-implementation-of-an-international-pediatric-rheumatology-learning-resource/