Council on Medical Student Education in Pediatrics


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COMSEP 2012 Indianapolis Meeting

Platform Presentation:

Comprehensiveness and Feasibility of the COMSEP/APPD Subinternship Curriculum

Linda Tewksbury, MD - New York University; Cristina Tuluca, B.S. - New York University; Lyuba Konopasek, M.D. - Weill Cornell Medical College in Qatar; Sandra Sanguino, M.D. - Northwestern University; Janice Hanson, Ph.D. - University of Colorado

Background: The COMSEP/APPD Pediatric Subinternship (CAPS) Curriculum recommends using Individualized Learning Plans (ILPs) and includes a consensus list of competency-based learning objectives to guide self-directed learning.  Little is known about how subinterns use ILPs, objectives they focus on, or curriculum feasibility.

Objectives:  1. Determine which learning objectives (LOs) pediatric subinterns select when provided the CAPS Curriculum and identify implications for the curriculum.  2.  Determine feasibility of using ILPs with the CAPS Curriculum during subinternship.

Methods:  4th-year students from 9 medical schools with IRB approval completed a standardized ILP during pediatric subinternship.  Students listed at least 3 LOs using the CAPS Curriculum as a guide and review with a faculty mentor.   Mentors completed questionnaires regarding time/effort spent discussing ILPs with students.   LOs on de-identified ILPs were mapped to specific objectives in the CAPS Curriculum with consensus by 4 reviewers, and categorized: 1. Patient Care (PC), 2. Medical Knowledge (MK), 3. Communication Skills (CS), 4. Professionalism (Prof), 5. Practice-Based Learning and Improvement (PBLI), 6. Systems-Based Practice (SBP).  LOs and responses to faculty questionnaires were summarized with descriptive statistics.

Results:  97 students (2-28 students per school) documented 369 LOs. Most faculty (89%) spent 0.5-1hr (range 0.5-3hrs) discussing student ILPs; 90 (92.8%) students required little or no help completing ILPs.  Reviewers mapped student LOs to 51 of the 69 (73.9%) specific objectives listed in the CAPS Curriculum.  LOs were categorized as 42.8% PC; 22.2% MK; 23.0% CS; 2.4% Prof; 9.2% PBLI; 3.0% SBP (some overlap).  The most commonly selected LOs focused on physical exam skills; management plans; delivering hand-offs. 61 (16.5%)  LOs did not match objectives in the CAPS curriculum (42 more specific; 13 more general; 6 new).  New LOs focused on cost, nightfloat, development, and nutrition.  

Conclusions: Students chose a wide range of LOs when provided the CAPS Curriculum, with most focused on patient care and few on professionalism or SBP.  Revision of the CAPS Curriculum to incorporate new and more specifically defined LOs would enhance the comprehensiveness of the curriculum.  Using the curriculum with an ILP is feasible, with most students successfully identifying LOs independently or with limited faculty assistance.