Atul Jaidka
Cardiologist | Unity Health - St. Joseph's Hospital
CardioGuide: A Novel Competency-Based Continuing Professional Development Curriculum for Cardiology
______________________________
Atul Jaidka, Daniel Durocher, Pavel Antiperovitch
Disclosures
Disclosures
- “I have not in the past 2 years, had a financial interest, arrangement or affiliation with one or more organizations that could be perceived as a direct/indirect conflict of interest in the content of the subject of this or any other program.” -Atul Jaidka
Conflict of Interest
- None except I co-created CardioGuide along with Pavel Antiperovitch and Daniel Durocher
Funding
- Self-funded
- Grant received but funds yet to be used from Western University CPD program
Rationale
Rationale
- Competency by design is becoming standard practice in medical education
- Current educational programs in Cardiology are limited by:
- Cost
- Wide breadth of the field
- Rapid changes in clinical practice guidelines
- Current Cardiology education for IM residents depends on in-person teaching during academic half days, morning teaching, and ad-hoc teaching by fellows and staff which is limited by:
- Infection risk
- Vacations
- Lack formal curriculum
Objective
- Our goal is to design a online competency based Cardiology curriculum starting with Internal Medicine Residents with future expansion to fellows, other specialities and Royal College certified physicians
Feedback
Narrative Feedback
- We read through rotation surveys from January 2019-April 2020
- Qualitative feedback from 193 residents (PGY 1-3)
- 40% of learners reported wanting more structured topic teaching
- Three key themes emerged:
- Clinical services are becoming busier, limiting time for teaching
- Residents want more education systemically covering the breadth of the speciality, ECGs and uncommon pathology
- Covid-19 pandemic severely limited opportunities for in-person teaching
Feedback
- “Very high volume of patients does not allow for adequate teaching both as a learner and as a senior resident.”
- “Lesser volume would allow for more formal teaching”
- “Definitely more teaching needed. I would have liked more time getting teaching about ECGs, pathophysiology, echos.”
- “Unfortunately given COVID precautions, formalized teaching in the form of morning rounds and grand rounds were cancelled. This was a loss but naturally not the fault of the rotation organization.”
- "We were very busy for a lot of the rotation (> 30 patients at times). It would have been nice to have more teaching time, but I understand that this cannot be controlled”
Program Design
Program Design
- Curriculum based on the competency-based continuing professional development framework (CB-CPD) recommended by the Royal College
- Key principles:
- Data to identify learning needs
- Opportunities for self directed learning
- Innovative methods for providing feedback
- Creation of content and assessments used the Royal College Cardiology objectives for Internal Medicine residents
Implementation
- Content delivery: free, mobile friendly open-access website
- Summarizes lengthy guidelines into practical summaries using graphics and visual aids
- CardioGuide.ca
- Competency assessment: peer-reviewed case-based questions
- Provides direct feedback with a learning plan
- eval.CardioGuide.ca
Showcase
Insights
Website Usage
- July 2020: 590 users and 1764 page views
- April 2021: 1581 users and 3160 page views
Website
Usage
Website Usage
- Reach across Canada
Website Usage
- Top 10 pages
Curriculum Usage
- From July 1-April 5 (10 blocks)
- Mandatory IM Curriculum: 128 learners with 100% completion rate
- UH CCU: 36
- UH Ward: 51
- VH CCU: 41
- Mix of Internal Medicine, Radiology, Anaesthesia, Neurology and Family Medicine
Curriculum Analytics
- Level 1 CAD (Stable CAD, NSTEMI/UA, Post-MI Care, Drive and Fly)
- Level 2 CAD (STEMI, Complications of MI)
- Level 1 Heart Failure (Acute HF, Chronic HF, Pericarditis)
- Level 1 Arrhythmia (Atrial Arrhythmias, Syncope, Driving Guidelines)
Curriculum Analytics
- Arrhythmia
- SVT (59%)
- Atrial Fibrillation (72%)
- Syncope (54%)
- Driving Guidelines (66%)
Future Directions
Future Directions
- CardioGuide for IM residents at Western - IMGuide
- Other Canadian schools are considering, beta-testing CardioGuide
- Planned collaborations with National Cardiology organizations to develop CPD
- CPD programs for Royal College certified physicians to obtain MOC credits as part of a Western University Continuing Professional Development grant
- Research platform for medical education insights
Conclusion
Conclusion
- Era of increasing patient volumes and a pandemic, trainees report a significant deficit in teaching
- We created a novel CB-CPD based program delivered through a FOAMed website for content and a quiz platform for standardized assessments
- Post pandemic times, it is critical to enable self-directed, distance educational opportunities.
Questions?
Cardio Resident Research Day 2021
By Atul Jaidka
