Background/Purpose: All Internal Medicine (IM) physicians should be competent in gout diagnosis and management. The purpose of this study is to assess learner engagement with a voluntary online gout diagnosis and management curriculum and to assess the impact on their knowledge and skills in the treatment of patients with gout.

Methods: We developed an online interactive module, comprised of clinical vignettes related to the diagnosis and management of gout for IM residents (hereafter described as trainees). The curriculum was published via QuizTime and delivered to trainees during their two-week outpatient or elective rheumatology rotation. QuizTime is an online platform created at Vanderbilt University Medical Center that delivers to learners one teaching quiz question at a set interval (1-2 questions per day) via an email or text link. Learners click the link and are taken to the platform with the clinical vignette quiz and possible answers. If a learner selects a correct response, they are directed to a screen confirming the correct choice and a detailed explanation. If an incorrect answer is chosen, the correct response is displayed along with the same explanation and an option to reengage with the question for up to 48 hours to reinforce new knowledge. Thus, QuizTime employs spaced interval learning and “test-enhanced learning” to reinforce concepts. The module is a supplement to standard teaching including attending clinics with preceptors, suggested readings and core IM didactics.

Half of the trainees received access to the module while the control group received standard teaching only. Pre and post rotation assessments were distributed to all trainees rotating on rheumatology and were used to compare gout knowledge between the two groups. This study was IRB exempt as it involved normal educational practices that was unlikely to adversely impact learners.

Results: Nine trainees received standard teaching in addition to access to the QuizTime Module. Ten trainees were assigned to the control teaching group. Of the nine that received access, only five answered any questions (56%). The five trainees that interacted with the module answered between 1 and 5 out of the 18 questions (2.8 to 5.6%). Three of these five trainees read any explanations (up to 50% of the questions they answered). None of the trainees that were given access to the QuizTime module took the post rotation assessments at the time of abstract submission limiting the evaluation of efficacy of the curriculum.

Conclusion: Approximately half of IM housestaff rotating on Rheumatology accessed a voluntary, online, quiz-based learning module on gout. Of the trainees that engaged with the module, very few questions were answered (2.8 to 5.6%). Data on the efficacy of the curriculum is limited by poor engagement with pre and post assessments. It is disappointing that so few engaged with a voluntary curriculum. This may be due to lack of interest in the topic, competition for housestaff time and attention, feeling that current teaching is sufficient for gout management and/or difficulty engaging with the QuizTime platform. Further study and data collection of knowledge retention is ongoing.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/voluntary-online-gout-module-housestaff-utilization-and-efficacy/