by Beth A. Damitz, MD, Medical College of Wisconsin, Department of Family and Community Medicine, Milwaukee, WI; All Saints Family Medicine Residency Program, Milwaukee, WI

Background

Delivering residency education is a resource-intense endeavor—mainly time and people. The Medical College of Wisconsin’s Department of Family and Community Medicine created a multiresidency, longitudinal educational curriculum to combat this challenge. Our three family medicine residency programs and a fourth program with another organization collaborated to create CURE: Coordinated Units of Residency Education.

Codirectors analyzed common program needs. Each program was surveyed to identify programmatic gaps such as knowledge, faculty expertise, rotational experiences, and meeting Accreditation Council for Graduate Medical Education requirements. Women’s Health was chosen as the 2018-2019 theme.

Each theme runs on a 3-year cycle with each year comprising 7 monthly sessions lasting 3-4 hours. Each year, codirectors design, create, and execute the cycle.

Intervention

CURE runs from September to May. As this theme occurred prior to the COVID pandemic, residents from all four programs met at a central site and were assigned to small groups. During COVID, the residents joined virtually with no group assignment. All sessions began with a prequiz on the topics that would be discussed that day and ended with a postquiz/evaluation. The entire curriculum was evaluated at the end of the year.

To add an element of real life, we wanted to link the sessions to a specific decade. In the first session, lectures were based on the preteen/teen age group, and advanced a decade with each session.

In addition, we wanted to format the sessions like real office visits. Since patient time is limited, physicians want to cover at least one prevention/health maintenance issue, chronic diseases, explore behavioral health concerns, and perhaps have time for one more concern. Therefore we decided each session would contain four specific focuses: prevention/health maintenance, chronic care, behavioral health, and a special topic of the codirector’s choosing.

As an example, our first session, the preteen/teen decade included the elements shown in Table 1.

Table 1: Preteen/Teen Decade Session

Abbreviation: USPSTF, United States Preventive Services Task Force

Results

A preevaluation was given at the start of each session and the same evaluation was given at the end to assess effectiveness. We used a 6-point Likert scale, with 1= no experience or knowledge and 6= exceptional experience or knowledge. Scores increased on the posttest (Table 2).

Table 2: Pretest/Posttest Comparison

Regarding our overall evaluation of satisfaction with curricular components and methods, residents liked the inclusion of behavioral health topics and organizing the information by age (Table 3).

Table 3: Curricular Satisfaction Ratings

(Likert scale: 1 = very unimportant/ineffective to 6 = very important/effective.)

Conclusions

Our innovative CURE curriculum is an effective way to collaborate and accomplish mutual educational goals across organizations. The incorporation of the four specific focuses at each session modeled how a patient encounter may be executed. The use of age-specific sessions advancing over time created a framework for these focuses and was well received by our learners.

In addition to the educational success, the collaborative, multiresidency approach maximized time. In a traditional lecture model, giving 3 hours of lecture for 7 sessions across four programs would equal 84 hours of lecture time. But with our CURE model, 3 hours of lecture for 7 sessions at one combined site equals 21 hours of lecture time. This provides 63 hours for other educational activities.

References

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2. Armstrong E, Parsa-Parsi R. How can physicians’ learning styles drive educational planning? Acad Med. 2005;80(7):680-684. doi:10.1097/00001888-200507000-00013
3. Privett N, Guerrier S. Estimation of the time needed to deliver the 2020 USPSTF preventive care recommendations in primary care. Am J Public Health. 2021;111(1):145-149. doi:10.2105/AJPH.2020.305967