Background/Purpose:

Rheumatologists in academic settings strive to be excellent teachers and educators. The ACR reinforces this perspective by bestowing yearly education awards for outstanding clinician educators who assist in maintaining and increasing the workforce. The RIME method of evaluation is a teaching tool used to gauge medical students and residents in multiple clinical settings, focusing on whether a student has mastered the subjects of reporting and interpreting data followed by the ability to teach medical information. The ability to teach medical information enhances a student’s ability to recall information during standardized testing. The purpose of this study is to assess if rheumatology fellow performance on RIME evaluations can predict improvement in in-service examination scores from year 1 to year 2 of their fellowship.

Methods:

An evaluation tool using RIME format was adapted to assess four domains (presentation quality, presentation skills, analysis, critical thinking). Fellows were given a number score for each domain as well as a total score (1-does not meet expectations; 2-meets expectations; 3-exceeds expectations). Seven teaching faculty were trained on the use of the tool to determine a RIME designation of reporter, interpreter, moderator, or educator. Every presentation given during the two-year fellowship was evaluated. The in-service scores were from first and second year rheumatology fellow examinations. All fellows’ ITE scores improved in absolute numbers and percentile rank from year 1 to year 2. RIME scores for each domain were tabulated and compared to the in-service scores. The RIME score was calculated as the mean of the 4 separate domains using a 1-3 scale. The overall RIME score was calculated as the mean of the four sections scored. These scores were compared against the year 1, year 2, and the mean ITE scores for years 1 and 2. All presentations were completed and evaluated prior to the year 2 ITE. Statistical models used were generalized estimating equation models with an exchangeable variance structure to account for repeated measurements within fellows.

Results:

Data was collected on eight fellows over four years. There were a total of 34 encounters with an average of four encounters per fellow. This data was compared to in-service examinations from years 1 and 2. Year 1 ITE scores and mean year 1 and 2 ITE scores were not significantly associated with RIME scores (p=0.194; p=0.083). Year 2 ITE scores were significantly associated with RIME scores (p=0.036). RIME designations noted that of the 29 completed encounters, 21 presentations were marked as educator, 4 each as interpreter or moderator and none were marked as reporters. Five encounters were not completely scored and were excluded from the analysis.

Conclusion:

(1) Only the 2^nd year ITE scores were significantly associated with RIME scores.

(2) RIME scores for year 1 and the combined years 1 and 2 ITE scores did not correlate.

(3) This data would suggest that RIME feedback to the fellows during their training program prior to year 2 ITE (approximately 19 months), reinforces the skills needed to master, retain, and communicate medical knowledge.

(4) RIME, as well as ITE, is an important tool in the training and evaluation of rheumatology fellows.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/rime-reporter-interpreter-moderator-educator-evaluation-tool-to-assess-fellows-in-rheumatology/