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Replacing noon conference with a half day of didactics
Beyond a curricular design of convenience: Replacing the noon conference with an academic half day in three internal medicine residency programs. Batalden MK et al. Academic Medicine 2013; 88: 644-651.
Reviewed by Cynthia Christy

What was the study question?
This is a descriptive study of the institution of a weekly Academic Half Day program (AHD) at three residency programs to replace daily noon conferences.

How was the study done?
Independently, leaders of three residency programs (Cambridge Health Alliance, University of Cincinnati, New York Presbyterian/Weill Cornell Internal Medicine Programs) sought to improve the delivery of core curricula with a weekly academic half day instead of the daily noon conference The authors first describe the limitations of noon conference and then three approaches to develop AHD's. Curriculum design included protected time to facilitate learning, efforts to nurture active learning, optimization of curricular content, faculty development, resident preparation, and a continuous improvement approach to curriculum development and evaluation. Retrospective comparative review of the three programs reveals instructive similarities and differences that could help other program directors.

What were the results?
Transition from traditional noon conference to an AHD may increase conference attendance (21-33% pre and over 80% post AHD intervention at 2 of the sites), improve resident and faculty satisfaction with the curriculum, and improve resident performance on the In Training Examination (up 1.2 and 2.7 mean individual change after AHD initiation, at Cambridge Health Alliance and University of Cincinnati, respectively).

What are the implications of these findings?
The traditional lecture-based noon conference series has limitations reviewed in the paper. The Academic Half day programs allow innovation, increased time for the residents and chief residents to be active participants in the curriculum, and helps the residents develop habits of inquiry.

Editor's note: This is a thought-provoking paper that details all the drawbacks of the traditional noon conference didactic session and how a rethinking and restructuring of didactics can address some of those drawbacks. The changes met resistance at each of the three programs but the continuous improvement efforts managed to address most of that resistance (RR).Win – win! More students scheduled, and they do well!

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