A call to action: The need for hepatology‐focused educational interventions in Internal Medicine Residency training

Mikolajczyk, Adam E.; Aronsohn, Andrew; McConville, John F.; Farnan, M.H.P.E. Jeanne M.

doi:10.1002/hep.27591

Cited by 5 publications

(12 citation statements)

References 4 publications

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“…Regardless of career interest, IM residents overwhelmingly view hepatology as being integral to their training. However, this study and our previous data show that only a minority of residents elect to rotate on hepatology in the traditional, learner‐centric system, which allows residents to choose their specialty exposures . In light of this disparity and the subsequent widespread deficit in our residents' knowledge of CLD, we designed our new rotation and curriculum to be nonelective.…”

Section: Discussionmentioning

confidence: 97%

“…It was determined that the main educational intervention of the curriculum would be participation in patient care, with careful attention to ensure that the residents independently worked through each of the four steps in Kolb experiential learning theory (e.g., concrete experience, reflective observation, abstract conceptualization, and active experimentation) in each patient encounter. Historically, the internal medicine (IM) residency program offered a 2‐week elective, inpatient hepatology consult rotation available for PGY‐1 through PGY‐3 medicine residents . However, at the start of the 2014‐2015 academic year, this was changed to a nonelective experience, in which one PGY‐2 or PGY‐3 medicine/medicine‐pediatrics resident or one PGY‐4 medicine‐pediatric resident was assigned every 2 weeks.…”

Section: Methodsmentioning

confidence: 99%

“…Historically, the internal medicine (IM) residency program offered a 2-week elective, inpatient hepatology consult rotation available for PGY-1 through PGY-3 medicine residents. (21) However, at the start of the 2014-2015 academic year, this was changed to a nonelective experience, in which one PGY-2 or PGY-3 medicine/medicine-pediatrics resident or one PGY-4 medicine-pediatric resident was assigned every 2 weeks. The resident was expected to care for a maximum of 6 patients, with no more than 3 new patients assigned in 1 day, in order to ensure conference attendance.…”

Section: The New Rotation and Its Curriculummentioning

confidence: 99%

“…Using data from our previous formal needs assessment, which was administered to 27 graduating PGY-3 residents (prior to the implementation of the new interventions), 11 core topics (Table 1) for the curriculum were identified. (21) At the beginning of the rotation, each resident was provided a collection of 12 landmark and review articles pertinent to the core topics. The attending physicians were also encouraged to lead several, brief didactic sessions per week on these core topics.…”

Section: Article Informationmentioning

confidence: 99%

“…(14)(15)(16)(17)(18)(19)(20)(21)(22) Furthermore, we have demonstrated that graduating postgraduate year (PGY) 3 residents did not frequently rotate on an elective hepatology rotation, despite viewing it as integral to their training. (21) Consequently, we established a novel, nonelective, inpatient hepatology rotation with a complementary curriculum that uses required modules in the ACT-First Hepatitis B and C curricula as well as in LiverLearning. This study sought to assess the educational effectiveness of this intervention in improving hepatology knowledge and to determine its impact on career interest in hepatology among residents.…”

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confidence: 99%

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Novel educational interventions in residency increase knowledge of chronic liver disease and career interest in hepatology

et al. 2016

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Our novel curriculum and nonelective hepatology rotation has effectively demonstrated improvement in internal medicine residents' comfort with and knowledge of CLD, and increased career interest in hepatology was also observed after completion of the curriculum, which suggests that more exposure to CLD could positively impact recruitment to the workforce; larger, multicenter studies are needed to validate these results. (Hepatology 2016;64:2210-2218).

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Section: Discussionmentioning

confidence: 97%

Section: Methodsmentioning

confidence: 99%

Section: The New Rotation and Its Curriculummentioning

confidence: 99%

Section: Article Informationmentioning

confidence: 99%

mentioning

confidence: 99%

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Novel educational interventions in residency increase knowledge of chronic liver disease and career interest in hepatology

et al. 2016

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The Time Is Now for Mandatory Liver‐Focused Clinical Experiences in Medical School

Pan

Feld²,

Farnan³

et al. 2019

Hepatol Commun

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The national burden of chronic liver disease is steadily increasing and is only expected to worsen with the ongoing obesity and opioid epidemics fueling growth in the prevalence of nonalcoholic fatty liver disease and a resurgence of new hepatitis C infections. Our letter highlights the disparity between the rising prevalence of chronic liver disease and the proportion of medical students who receive exposure to patients with liver disease as part of their medical education. A more comprehensive survey of clerkship directors is needed to further corroborate this data, which may lead to reforms in medical school curricula to better address the expanding burden of chronic liver disease.

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Mandatory Hepatology Education for Internal Medicine Residents: Long‐Term Effects and Implications for Workforce Needs

et al. 2021

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We previously created a mandatory, inpatient, hepatology resident curriculum that immediately improved comfort, knowledge, and career interest in chronic liver disease (CLD). The durability of these effects needs to be known to use this intervention to address the hepatologist shortage. Thus, we aimed to assess this curriculum's long-term outcomes on internal medicine (IM) residents' CLD comfort, knowledge, and career interest. From 2015 to 2019 at a single institution, one IM resident was always assigned to the rotation. Similar anonymous assessments were administered to incoming postgraduate year (PGY)-1 residents and graduating PGY-3 residents, including a historic control cohort that graduated in June 2015. At residency completion, the intervention cohort (n = 61) had significantly higher comfort (1, not at all comfortable/strongly disagree; 5, very comfortable/strongly agree) with both hepatology (e.g., hepatitis C, 2.5 vs. 3.3, P < 0.001) and common IM topics (e.g., heart failure, 3.6 vs. 4.8, P < 0.001) but not specialty topics lacking curricula (e.g., inflammatory bowel disease, 2.8 vs. 2.7, P = 0.54). Compared to the historic cohort (n = 27), the intervention cohort was more comfortable in several CLD topics (e.g., cirrhosis, 3.2 vs. 3.8; P = 0.005) and answered more questions correctly (65% vs. 55%; P = 0.04), but career interest was unchanged (1.9 vs. 1.8; P = 0.45). Many residents (33%) would consider a hepatology career if training were separated from gastroenterology. Conclusion: With the completion of a mandatory hepatology curriculum, residents' CLD comfort and knowledge durably improved and exceeded that of historic counterparts. Initial career interest was not sustained, perhaps due to prerequisite gastroenterology training. These findings suggest IM educational initiatives may better address hepatology workforce needs by generating comanagers than by recruiting trainees. (Hepatology Communications 2021;0:1-11).

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A call to action: The need for hepatology‐focused educational interventions in Internal Medicine Residency training

Cited by 5 publications

References 4 publications

Novel educational interventions in residency increase knowledge of chronic liver disease and career interest in hepatology

Novel educational interventions in residency increase knowledge of chronic liver disease and career interest in hepatology

The Time Is Now for Mandatory Liver‐Focused Clinical Experiences in Medical School

Mandatory Hepatology Education for Internal Medicine Residents: Long‐Term Effects and Implications for Workforce Needs

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