OBJECTIVES  •Explore the educational formats and resource preferences of house staff •Identify ICU topics thought to be important by experts in the field •Identify clinically relevant ICU topics •Build an interactive, standardized cognitive aid that serves both as an instructional resource for house staff and a prompt for those teachin

Grossman, Catherine

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Masthead LogoVirginia Commonwealth UniversityVCU Scholars CompassHealth Sciences Education Symposium School of Medicine2019Multimodal Needs Assessments for CurricularRefinement – Learner, Expert, EMRCatherine GrossmanVirginia Commonwealth UniversityFollow this and additional works at: https://scholarscompass.vcu.edu/med_eduPart of the Medicine and Health Sciences Commons© The Author(s)This Poster is brought to you for free and open access by the School of Medicine at VCU Scholars Compass. It has been accepted for inclusion in HealthSciences Education Symposium by an authorized administrator of VCU Scholars Compass. For more information, please contact libcompass@vcu.edu.Downloaded fromhttps://scholarscompass.vcu.edu/med_edu/73BACKGROUND• Internal Medicine Residents rotate through two medical ICUs: VCU MRICU and VA MICU• The fellows and faculty rotate on a schedule separate from the residents; teams dynamically change in the rotation• Residents have identified standardized curriculum coverage as a key area of need for their ICU learningMultimodal Needs Assessments for Curricular Refinement:Learner, Expert, EMRCatherine Grossman, MD, Thomas Iden, MD, Michael L’Heureux, MD, Cheryl Porter, ACNP, & Rebecca Potfay, MDResident Assessment Expert Modified Delphi SortEMR Query(in order of frequency)Short talks preferred Ventilator Basics Respiratory Failure(hypoxic & hypercapnic)Handouts for outside learningVentilator Advanced SepsisShared framework Sepsis ShockMultimedia learning Shock/Vasopressors Obstructive Lung DiseaseICU Toxicology Alcohol WithdrawalSedation/Delirium Electrolyte DisordersGastrointestinal HemorrhageGastrointestinal HemorrhageAntibiotics in the ICU CirrhosisARDS Acute Liver FailureAcid Base Diabetic KetoacidosisPalliative Care Acute Kidney InjuryFree Space for Rotation specific casesAltered Mental StatusOBJECTIVES• Explore the educational formats and resource preferences of house staff• Identify ICU topics thought to be important by experts in the field• Identify clinically relevant ICU topics• Build an interactive, standardized cognitive aid that serves both as an instructional resource for house staff and a prompt for those teachingMETHODS• Performed a learner-centered needs assessment exploring educational format preferences of house staff• Representative resident sample from different career tracks: generalist, hospitalist, and subspecialist• Gathered expert opinion to prioritize important ICU learning needs• VA MICU and VCU MRICU faculty, fellows, and advanced practice providers• Three-round modified Delphi sort1,2• 12 topics chosen• Determined which problems were most frequently encountered in the ICU• Collected and quantified 1 year of de-identified EMR data about reasons for MRICU consults• Coded by a single reviewer and listed in order of frequency• Created a standardized document as a cognitive aid and resource for ICU curriculum coverage• Combine Expert Delphi and EMR query into one, easy to use resourceREFERENCES1. Chan TM, Gottlieb M, Fant AL, Messman A, Robinson DW, Cooney RR, … Yarris LM (2016). Academic Primer Series: Five Key Papers Fostering Educational Scholarship in Junior Academic Faculty. Western Journal of Emergency Medicine, 17(5), 519–526. https://doi.org/10.5811/westjem.2016.7.311262. Chia-Chien Hsu, & Brian A. Sandford. (2007). The Delphi Technique: Making Sense of Consensus. Practical Assessment, Research & Evaluation, 12(10), 1-8.Learner-Centered Needs Assessment:EMR Query:DATA SUMMARYCONCLUSIONS• We successfully created a teaching curriculum to address a need identified by our residents• There was a discordance between expert and EMR-identified topics• Some topics are taught elsewhere in the learner’s residency• Many ICU problems develop after admission/initial consult• A two-week trial of the MRICU passport with non-EMR driven topics was performed• Resident Feedback:• Generally well received• Passport would take time to be fully adopted in ICU routine• Liked linking the topics to an online education resource• Expectations met with short lecture, high yield fact sheets, and links to further information• Faculty Feedback:• Passport served as a reminder of which topics had been covered and which were left to coverFinal Cognitive Aid:(embedded hyperlinks to resources omitted)FUTURE DIRECTIONS• Discordance of topics will be reassessed for opportunities to include EMR-driven, high-yield clinically encountered topics• Periodically review EMR for changes in practice and relevance• In-services for faculty and residents will be required to establish standard use as well as buy-in• Will evaluate the feasibility of launching an EMR query at the VA medical center• Goal is for this to be adopted as the standard curriculum for teaching across all ICU learning environmentsRound 3 VoteRound 2 VoteRound 1 VoteCall for Submission of TopicsModified Delphi Sort:Chalk Talks:5-10 minutes in lengthSummarized curated articlesHyperlinked Handouts to Videos & ArticlesTeam RoomTopic List Use Familiar (existing) ResourcesHigh Yield Fact Sheets (pearls)

Multimodal Needs Assessments for Curricular Refinement – Learner, Expert, EMR

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Multimodal Needs Assessments for Curricular Refinement – Learner, Expert, EMR

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