Background/Purpose: Medical knowledge is evolving at a fast pace, and it is important for medical students and residents to develop self-directed learning skills that will help them apply evidence-based medicine (EBM) in their clinical practice. As future practicing physicians, they should be able to incorporate new literature and updated guidelines into everyday clinical decisions. For that reason, there is a huge emphasis on introducing self-directed learning into undergraduate and medical school curriculums. In fact, the Liaison Committee on Medical Education (LCME) now requires medical schools to engage their students in self-directed learning activities. In this study, we aim to develop an interactive module that briefly covers important concepts and treatment guidelines on a specific topic. We will then assess learners’ knowledge acquisition and their ability to apply these concepts in their clinical decision making.

Methods: The study was conducted at Virginia Commonwealth University Health Systems (VCUHS). We developed a module on calcium pyrophosphate deposition (CPPD), and internal medicine residents were asked to complete it as part of their rheumatology rotation. The module included a pre-test, followed by a PowerPoint presentation with case scenarios and interactive questions. Learners were then asked to solve a post-test immediately after finishing the presentation. Same questions were included in both tests, and they were presented in the same order. This process did not include directed learning methods. Data was analyzed using a student’s t-test. We compared pre and post-test mean scores for every participant, and further analyzed the percentage of learners answering each question correctly before and after the completing the module (Figure 1).

Results: A total of 10 internal medicine residents completed our pilot module and filled the pre and post-tests. 8 learners were 2^nd year internal medicine residents, and 2 learners were 3^rd year residents. The tests were comprised of 10 multiple choice questions including 3 case scenarios and 3 EBM questions. There was a significant improvement among learners when comparing their pre and post-test mean scores (30% increase in mean scores with p< 0.0001). We also compared the number of learners answering each question correctly in the pre and post-tests. Overall, the percentage of learners choosing the correct answer significantly increased in the post test (p< 0.0001). Improvement was mainly noticed in case scenarios (Q8 and Q10), and EBM based concepts (Q2 and Q3).

Conclusion: This study suggests that integrating self-directed learning modules in the rheumatology curriculum of our internal medicine residency program can help residents improve their knowledge base and comfort level with EBM and case-based concepts. The next step is to include medical students rotating on our rheumatology rotation into the participating pool of learners, with the hope that it could be integrated into their own curriculum. A larger group analysis of multiple modules will help develop a comprehensive learning course for all our rotating medical students and residents.

A: Percentage of learners with a correct answer on each question before and after completing the module; B: Total score (out of 100) of pre and post-tests among different learners.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/self-directed-learning-among-internal-medicine-residents-incorporating-a-new-teaching-module-on-calcium-pyrophosphate-deposition-in-the-rheumatology-curriculum/