Council on Medical Student Education in Pediatrics

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COMSEP Meeting in Ottawa, ON

Poster Presentation:


Analysis of Individualized Learning Plans in a Sub-intern Outpatient Pediatric Rotation: Do Students' Goals Match the ACGME Core Competencies?

Authors:
Daniel . Walmsley,Sidney Kimmel Medical College at Thomas Jefferson University/Nemours,Philadelphia,PA,Courtney Nelson,CHOP,Philadelphia,PA,Dustin Flannery,Sidney Kimmel Medical College at Thomas Jefferson University/Nemours,Philadelphia,PA,Alisa LoSasso,Sidney Kimmel Medical College at Thomas Jefferson University/Nemours,Philadelphia,PA,Vanessa Carlo,Sidney Kimmel Medical College at Thomas Jefferson University/Nemours,Philadelphia,PA,Mary Sammon,Sidney Kimmel Medical College at Thomas Jefferson University/Nemours,Philadelphia,PA,Judy Larkin,Sidney Kimmel Medical College at Thomas Jefferson University/Nemours,Philadelphia,PA,Judy Larkin,Sidney Kimmel Medical College at Thomas Jefferson University/Nemours,Philadelphia,PA

Background: The structure of the senior year of medical school is a common debate among medical educators. Some suggest that the 4th year should focus on preparing a student to be a resident, while others suggest a curriculum similar to the 3rd year. Individualized Learning Plans (ILPs) represent a method that could bridge these two differing opinions, but there is a lack of data on how best to employ ILPs by medical students, especially during sub-intern outpatient rotations.

Objectives: To assess the content, style, and terminology of ILPs for sub-interns in an outpatient pediatric rotation and compare the goals to the ACGME core competencies.

Methods: This mixed-methods study assessed ILPs written by sub-interns at an urban hospital-based clinic. A standardized ILP form and an article describing ILPs were given to the students as a guide. The ILPs were analyzed independently using grounded theory by the 7 authors until coding saturation was achieved. The authors then met to discuss the developed codes and agreed upon the themes and sub-themes that emerged. The frequency of each theme and sub-theme was calculated and compared to the ACGME core competencies.

Results: Atotal of 45 ILPs were analyzed in this study. Data saturation was achieved after 32 ILPs and the themes remained consistent in the subsequent 13 ILPs. Five major themes emerged. First, every student expressed a desire to improve their knowledge of general pediatrics by expanding differential diagnoses (79%), increasing knowledge about well child visits (63%) and improving their ability to create treatment plans (79%). Second, all students picked goals of improving efficiency in patient care. The third theme of mastering independent patient care was expressed by 88% of students and 54% used the word appropriate in describing that care. Fourth, improving communication skills was mentioned by 65% of students and most discussed either improving oral presentation skills (50%) or patient counseling (54%). Finally, in terms of learning methods, students most commonly mentioned direct patient care (92%) and technology (79%). All ACGME core competencies were found in every ILP except professionalism and system-based practice, which were found less frequently (5% and 3%).

Conclusion: During an outpatient pediatric rotation, sub-interns universally chose increasing their pediatric medical knowledge and efficiency as goals. ILPs may facilitate the tailoring of self-directed learning; however, oversight may still be required to ensure fulfillment of the necessary ACGME core competencies.