Meg G Keeley, M.D. - University of Virginia School of Medicine; CAROLINE R PAUL, MD - UNIVERSITY OF WISCONSIN SCHOOL OF MEDICINE AND PUBLIC HEALTH; Gregory S Rebella, MD, MS - University of Wisconsin; Craig L Gjerde, PhD - University of Wisconsin
Background: The AAP/AAFP guidelines recommend that "instruction in the proper examination of the child's ear should begin with the first pediatric rotation in medical school and continue throughout postgraduate training." Yet, competency-based curricula in pediatric otoscopy for all learner types remain limited.
Objective: For the purpose of curriculum development, we aim to perform a competency-based assessment for Pediatric residency interns (PI) and Emergency Medicine residency interns (EMI) at the start and the end of their intern year to identity needs including any differences between learners.
Methods: A preliminary assessment of all PI (n=14) and all EMI (n=6) was performed early in the intern year. Instruments included a written test with validated images and content (Pediatrics, 124:714-720 2009) and an OSCE with a validated ear model (Simulation in Healthc, 2011 Sept 21 Epub ahead of print) focusing on technique, cerumen removal, and pneumatic otoscopy . Prior to implementation, minimum passing levels (MPL) were established. Two-sample t-tests were used to compare mean scores and MPL with p<0.05 being considered statistically significant.
Results: 7% of PI and 17% of EMI reached the MPL for the written test with no significant differences (p=0.51) between groups. There was no significant difference (p=0.66) in mean scores between PI and EMI (19.9 vs. 21.0). There was no significant difference (p=0.25) in mean scores between PI and EMI (21.4 vs. 24.0) for the OSCE. The percentage of residents who reached the MPL for technique, cerumen removal and pneumatic otoscopy use was 7%, 0%, and 0% respectively for PI and 0%, 0%, and 0% for EMI with no significant difference (p=0.54-1.00) between groups.
Conclusions: Preliminary results indicate competency cannot be assumed per intern specialty further suggesting similarities amongst graduating medical students regardless of residency choice. Future plans include completion of this needs assessment with re-evaluation of this cohort at the end of their intern year and then development and implementation of a competency-based curriculum The curriculum's content and interventions should have broader applicability to learners of various specialties, faculty and to medical students.