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DO INTERNAL MEDICINE RESIDENTS AND MEDICAL STUDENTS MEET LEARNING OBJECTIVES FOLLOWING A ROTATION IN GASTROENTEROLOGY?
L Gutierrez, H Fraser, M Raman
University of Calgary, Calgary, Alberta
Aims: Evaluations of internal medicine residents and medical students during their Gastroenterology (GI) rotation have historically been based on interactions during clinical experiences as opposed to objective testing of knowledge. Formal assessment of knowledge in gastroenterology post rotation is rarely assessed. Therefore, it is unclear whether trainees generally meet the requisite rotation specific objectives. A baseline assessment of knowledge in GI, followed by a post-rotation assessment would provide the opportunity to identify deficient areas of GI knowledge and assess the impact of the GI rotation on trainees' knowledge. If areas of deficiency persist at the end of the rotation, an educational intervention may address this gap.
Methods: A pre-rotation multiple choice assessment will be used to assess baseline GI knowledge in 5 clinical domains relevant to GI (In/Outpatient GI, Liver, IBD and Nutrition). A parallel post-rotation multiple choice assessment will assess the impact and subsequent knowledge gains from the rotation. Two independent raters will calculate the Minimum Performance Level (MPL), the mean of which will serve as the pass rate. Face and Content validity of the pre and post test have been established by three staff Gastroenterologists. Long-term knowledge retention will be assessed 3-months post rotation. Pearson Product Moment Correlations between current formative evaluations which are based on CanMEDS Physician Competency Framework and objective post-rotation multiple choice testing will be obtained. Paired t-test will be used to assess performance over time and p<0.05 will be considered significant.
Results: An initial six month period will be used to define the baseline assessment characteristics. Two training hospitals which include Internal Medicine and General Surgical residents and medical students will be included resulting in approximately twenty sets of assessments. Evaluation of the data will result in identification of knowledge gaps warranting an educational intervention based on the deficiencies noted. Standardized and informal presentations will be provided by GI fellows to the ensuing junior trainees aiming to correct these knowledge deficiencies in the second six month phase. Pre- and post-rotation assessments will monitor for any improvement in performance as a result of the educational intervention.
Conclusions: Objective testing of trainees' knowledge during the GI rotation is not formally assessed. A validated pre- and post-rotation test will identify deficient areas of GI knowledge which may lead to an educational intervention designed to fulfil these deficiencies. Post intervention testing will be used to indicate if an impact has been made both in the short and long-term. As well, correlation with current evaluation practices will be obtained.