Background/Purpose: The majority of internal medicine trainees complete residency with little exposure to rheumatology. We aimed to create a validated, self-directed, web-based, core curriculum in rheumatology for residents. The first module focused on gout. We also aimed to assess the efficacy of this educational product utilizing the script concordance testing (SCT) method. SCT assesses clinical data interpretation and decision making.
Methods: We obtained IRB exemption to perform this study that included internal medicine trainees at the University of Maryland Medical Center. Pre-test and post-test questions were examined for item validity. Pre- and post-test scores were compared to the scores of the expert panel, which was made up of 2 rheumatology fellows, 9 academic rheumatologists, and 1 community rheumatologist. Baseline knowledge was assessed via a pre-test on the Blackboard learning management system, followed by the educational intervention, an interactive didactic presentation on gout. The module included gout pathophysiology, clinical presentation, and therapeutic management. Immediate post-testing was performed. An ANOVA was used to compare trainee and expert groups as well as pre- and post-test scores. Cronbach’s alpha was used to calculate test reliability. An effect size was calculated using Cohen’s d.
Results: Ten trainees completed paired pre-and post-tests for analysis. The 20-case SCT achieved high reliability (Cronbach alpha for all 20 cases > 0.75). At baseline, the trainees’ average SCT score was 32 points (M=32.45, SD=1.99); whereas the experts’ average SCT score was 40 points (M=40.65, SD=1.72). After the didactics, trainees’ SCT scores increased by an average of 2.83 points F (1, 18) = 9.33; (p<.01). Cohen’s d showed a strong effect size (d=1.13). Expert SCT scores were an average of 8.2 points (SD = 0.81) higher than trainee pre-test scores. Expert SCT scores were an average of 5.4 (SD = 0.84) points higher than trainee post-test scores. Both of these differences were statistically significant (p<.0001).
Conclusion: Trainee test scores significantly increased after the educational intervention in this pilot study. Expert SCT scores were higher at baseline and remained higher after the didactics, which lends support to the construct validity of the tool as the experts had higher clinical competence. The effect of the educational intervention will be tested on a larger group of internal medicine trainees. Future plans include subgroup analysis by post-graduate year, implementation of self-efficacy evaluations, and possible re-testing at 6 or 12 month intervals to assess durability of knowledge. Additional modules for the core curriculum will be developed.
Disclosure:
B. Siaton,
None;
E. Clayton,
None;
A. Kueider,
None;
M. Rietschel,
None.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/pilot-study-of-a-web-based-module-on-gout/