CardioGuide: A Novel Competency-Based Continuing Professional Development Curriculum for Cardiology

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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

Cardio Resident Research Day 2021

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