Samira Adus, Christina Ma, Faiza Khokhar
Objectives Rheumatology is a broad medical specialty with multiorgan involvement. The care of patients with rheumatic disease requires both rheumatologists as well as non-rheumatologist physicians. Needs assessments at other centers have consistently demonstrated low confidence among family doctors and internal medicine residents in managing patients with rheumatologic presentations.[1] At McMaster University, Ophthalmology, Family Medicine, Physiatry, Neurology, and Internal Medicine residents have the opportunity to rotate through a four-week rheumatology rotation. The objective of our study is to improve the educational experience of the residents rotating through rheumatology, while avoiding unintended negative impacts on the function of the rheumatology department, using a quality improvement approach. Methods In this 2 phase study, subjects were recruited via a convenience sample of non-rheumatology residents participating in the rheumatology rotation. Phase one consisted of a needs assessment, where surveys were conducted employing open-ended questions as well as quantitative questions using a 5-point Likert scale. Fishbone analysis was completed with relevant stakeholders to outline possible barriers to implementation. Phase 2 consisted of the creation, implementation, and assessment of a novel formal asynchronous learning module using pre and post-completion surveys to obtain qualitative and quantitative feedback to complete a PDSA cycle. Results In phase one, 15 residents were surveyed. Over 50% of participants reported both not being exposed to formal teaching during their rotation and not feeling that they had enough formal teaching during their rotation. Basic teaching on common rheumatologic presentations was suggested as the most beneficial topic for teaching. Fishbone analysis (Figure 1) revealed lack of educator’s time, difficulty with scheduling and heterogeneous learning needs as major factors that pose challenges to the implementation of formal teaching that would need to be addressed. In phase 2, preliminary data from 6 residents demonstrated that over 60% of participants rated the content as helpful during their clinical rotation and impacting their clinical practice. Suggested areas for further improvement included the enhancement of topics reviewed and the integration of subspecialty expert opinions. Conclusion Historically, non-rheumatology residents have received limited formal teaching during their rheumatology rotations. The implementation of an asynchronous rheumatology curriculum serves as a tool to provide long-term sustainable education to rotating residents. Future work will involve continuing to build curriculum content, and the integration of subspecialist input with iterative PDSA cycles. References [1.] Katz SJ. Clin Rheumatol 2011;30:1081-93.