Longitudinal Evaluation of Pediatric Residency Didactics Transition from Noon Conference to an Academic Half Day

BACKGROUND: In 2009, the UNM Pediatric Residency transitioned program didactics from noon conference to an academic half day. Immediate evaluation of resident and faculty satisfaction, resident attendance, board exam pass rate and In-Training-Exam (ITE) scores showed improvements with this change. OBJECTIVE: Investigate the longitudinal impact of the academic half day at UNM on resident and faculty satisfaction, resident attendance and clinical knowledge in the form of standardized exam results. METHODS: In this mixed-methods study, surveys regarding satisfaction were conducted of current pediatric residents (n=32) and faculty (n=32) at UNM. To assess clinical knowledge, quantitative measures such as senior resident ITE scores and pediatric board exam pass rate will be evaluated. Finally, focus groups were conducted with pediatric residents and faculty separately to evaluate concepts related to resident autonomy, competence and engagement with the academic half day. RESULTS: Preliminary review of survey data shows 88% and 63% overall satisfaction with the academic half day format from residents and faculty respectively, consistent with 2012 study results. Similar to prior, residents feel that the academic half day does not interfere with clinical education (97%) or patient care duties (83%). Pediatric Board exam pass rate from 2015-2017 is 65% which is similar to pass rates prior to the academic half day. Senior resident ITE scores and resident attendance rates are currently being compiled. Initial review of focus groups shows preference for academic half day in relation to decreasing interruptions to patient care and increase in resident autonomy in clinical areas. CONCLUSIONS: Preliminary data shows sustained overall satisfaction amongst residents and faculty. Board exam pass rates are unchanged, focus groups have identified further areas of intervention including increased resident engagement in didactics

Detection of drug resistance mutations at low plasma HIV-1 RNA load in a European multicentre cohort study

Guidelines indicate a plasma HIV-1 RNA load of 500-1000 copies/mL as the minimal threshold for antiretroviral drug resistance testing. Resistance testing at lower viral load levels may be useful to guide timely treatment switches, although data on the clinical utility of this remain limited. We report here the influence of viral load levels on the probability of detecting drug resistance mutations (DRMs) and other mutations by routine genotypic testing in a large multicentre European cohort, with a focus on tests performed at a viral load <1000 copies/mL