1. Resident-Driven Curriculum Development and Ultrasound Curriculum Needs Assessment Lynnea Mills, MD April 9, 2013

2. Overview, part I Review of literature on housestaff- led curricula Novel approach to curriculum development, designed to facilitate resident involvement

3. Overview, part II Description of our assessment of residents’ needs for future instruction on bedside ultrasound Selected results from needs assessment

4. Part I

5. Lit Review: Housestaff involvement in peer curricula Residents teach faculty- developed curricula Peds residents teach mock code sessions EM senior residents teach interns bedside skills IM residents teach med students on wards Sweeney A, et al. Senior pediatric residents as teachers for an innovative multidisciplinary mock code curriculum. J Grad Med Educ. 2011 Jun;3(2):188-95. Boehm KM. Commentary on medical student education improvement using a resident- driven student rotation. South Med J. 2012 Feb;105(2):71. Adler AC, Homayounrooz FF. Medical student education improvement using a resident- driven student rotation. South Med J. 2012 Feb;105(2):68-70.

6. Lit Review: Housestaff involvement in peer curricula Residents design and teach courses for peers Psych residents teach a course on major depression Psych residents teach a review course for ITE Deligiannidis KM, et al. Psychiatry resident/fellow- initiated and -designed multi-modal psychopharmacology curriculum for major depression. Acad Psychiatry. 2012 Sep 1;36(5):414-8. Vautrot VJ, Festin FE, Bauer MS. The feasibility and effectiveness of a pilot resident-organized and -led knowledge base review. Acad Psychiatry. 2010 Jul- Aug;34(4):258-62.

7. Lit Review: Housestaff involvement in peer curricula Educators design programs to facilitate residents’ involvement in curriculum development

8. Barriers to resident participation in curriculum development Lack of knowledge about curricular opportunities Inadequate understanding of the curriculum development process (lack of standardization of the process) Relative lack of good models in literature Lack of mentors Lack of time to commit to a long-term project with inflexible scheduling

9. A common model for curriculum development Proficiency Lesson on skillset 4 Lesson on skillset 3 Lesson on skillset 2 Lesson on skillset 1 Curriculum Designer

10. An alternative model for curriculum development Conceptual Understanding

11. Curriculum Designer #1 An alternative model for curriculum development Curriculum Designer #2 Curriculum Designer #3 Curriculum Designer #4 Curriculum Designer #5 Conceptual Understanding

12. Curriculum Designer #1 An alternative model for curriculum development Curriculum Designer #2 Curriculum Designer #3 Curriculum Designer #4 Curriculum Designer #5 Conceptual Understanding

13. Our model Individual or group identifies multi-faceted curriculum need Develops infrastructure and sustainable layout Writes a large bank of research questions

14. Our model, cont’d Future educators choose sub- topics and develop discrete courses using existing structure Use existing question bank to study course efficacy

15. Conclusions There’s little documented resident involvement in curriculum development, and no documented planning to engage residents in curriculum development. Our approach of standardizing and “modularizing” a curriculum development process may serve as a model for facilitating resident participation in curriculum development by eliminating several barriers to involvement.

16. Part II

17. Needs assessment Internet survey sent spring 2012 to all new matches and current residents (R1-R4) 34-37 forced-choice questions + free text 55 new match respondents (85%) 81 current resident respondents (~60%) Perceived importance of ultrasound Confidence/experience with ultrasound for basic IM procedures Areas of desired instruction

18. Not all residents know how to use ultrasound for required procedures Percentage of respondents who “know” how to use ultrasound for procedure

19. Many respondents “would like more training” on ultrasound use for procedures

20. Some residents are uncomfortable supervising interns who are not trained on US

21. Nearly all residents prefer interns receive more training on US

22. Respondents willing to spend own time on further US training Percent of respondents willing to commit own time

23. Respondents willing to spend own time on further US training Percent of respondents willing to commit own time

24. Conclusions New matches are less comfortable and skilled with ultrasound, but even current residents still feel inadequately trained in multiple areas of bedside ultrasound use. All participants are interested in obtaining further formal training.

25. Many thanks to… Tom DeCato, MD Sirisha Narayana, MD Nina Saxena, MD Amy Morris, MD Jennifer Best, MD Ken Steinberg, MD Renata Thronson, MD

30. Curriculum Designer #1 An alternate model for curriculum development Curriculum Designer #2 Curriculum Designer #3 Curriculum Designer #4 Curriculum Designer #5 Conceptual Understanding

31. Bibliography Adler AC, Homayounrooz FF. Medical student education improvement using a resident-driven student rotation. South Med J. 2012 Feb;105(2):68-70. Backes CH, et al. Fellows as teachers: a model to enhance pediatric resident education. Med Educ Online. 2011;16. Boehm KM. Commentary on medical student education improvement using a resident-driven student rotation. South Med J. 2012 Feb;105(2):71. Deligiannidis KM, et al. Psychiatry resident/fellow-initiated and -designed multi-modal psychopharmacology curriculum for major depression. Acad Psychiatry. 2012 Sep 1;36(5):414-8. Keating EM, O'donnell EP, Starr SR. How we created a peer-designed specialty-specific selective for medical student career exploration. Med Teach. 2013;35(2):91-4. Laiteerapong N, et al. A resident-led quality improvement initiative to improve obesity screening. Am J Med Qual. 2011 Jul-Aug;26(4):315-22. Sweeney A, et al. Senior pediatric residents as teachers for an innovative multidisciplinary mock code curriculum. J Grad Med Educ. 2011 Jun;3(2):188-95. Vautrot VJ, Festin FE, Bauer MS. The feasibility and effectiveness of a pilot resident-organized and -led knowledge base review. Acad Psychiatry. 2010 Jul-Aug;34(4):258-62.