274 - Enhancing the Effectiveness of the Pediatric Resident Evidence-Based Medicine Curriculum through Team-Based Learning

Poster Number: 274
Publication Number: 274.420

Shabana Yusuf, Baylor College of Medicine, Houston, TX, United States; Susan B. Torrey, Baylor College of Medicine, Houston, TX, United States; Gal Barak, Baylor College of Medicine, Houston, TX, United States; Elizabeth A. Camp, Baylor College of Medicine, Houston, TX, United States; Sowdhamini S. Wallace, Baylor College of Medicine, Houston, TX, United States

Background: Evidence-based medicine (EBM) is a core ACGME competency that requires an EBM curriculum to be taught during residency. In our program, first-year residents (PGY-1s) complete a 2-hour instructor led course (Pedi 101). Feedback from residents has been poor regarding the method of teaching, lack of interactivity, and large volume of content. To address these concerns, we developed a team-based blended learning (TBL) curriculum with input from residency leaders, past resident participants, instructors and previous session evaluations (Table 1).

Objective: To compare the acquisition of EBM knowledge and skills between the new TBL and the previous instructor-led curricula using the Fresno test, a validated test of evidence-based knowledge that is widely used in medical education.

Design/Methods: We performed a single center cluster randomized trial of participating PGY-1s during their Pedi 101 block. Each block was randomized to either the intervention (TBL) or the instructor-led formats (Table 1).  The primary outcome was the Fresno score, measured immediately post-session and 3 months afterward. Secondary outcomes included EBM knowledge, attitudes and literature search behaviors, measured via the validated KACE questionnaire given pre-, post- and 3 months’ post-session. Inferential statistics were used to compare outcomes, including the Related-Samples Friedman’s Two-Way Analysis of Variance by Ranks to analyze Likert scale responses and a two-way, repeated measures ANOVA to assess the effect of study groups on repeated test scores.

Results: Between 2.25.20 and 9.30.20, 36 residents participated with 18 in each group. All were US medical school graduates, predominantly female with prior course work in statistics (Table 2). Groups did not differ in immediate post-session Fresno scores (Table 3). The intervention group had higher 3 month-post Fresno scores (Table 3). There was no statistical difference between the groups EBM attitudes or literature search behaviors at pre, post and 3 months. Individual EBM knowledge significantly increased between pre- and post-session. There was no difference between study groups. Conclusion(s): Although knowledge gains and Fresno scores were similar between groups post-session, EBM skills were better sustained in the TBL intervention group three months afterward. Further studies are needed to evaluate the role of TBL instruction in enhancing retention of EBM skills.
Table 1Comparison between Team-Based Learning (intervention) and Instructor-Led (control) Curricula
Table 2Academic background of pediatric residents (N = 36).