Implementation of a Foundational Online Resident-as-Teacher Program for All First-Year Residents

Abstract

Purpose/Background Residents are expected to teach medical students, and yet few enter post-graduate training programs prepared to do so. Each year at the Indiana University School of Medicine, 400 first-year residents (PGY1s) from multiple specialties begin their post-graduate training. Our goal was to implement a school-wide Resident-as-Teacher (RasT) curriculum for all incoming PGY1s to provide them with the requisite pedagogical skills and self-confidence to teach effectively.1 Design/Methods We required that our curriculum be delivered asynchronously and on-demand to avoid having to schedule numerous in-person training activities across multiple teaching hospitals. We used the A3 problem-solving process2 to create a series of online training modules delivered via Canvas from 2017 to 2021. These modules focused on our institutional and clerkship learning objectives and incorporated videos of best practices for teaching in the clinical environment. Prior to the start of the course, the PGY1s completed a self-assessment of their teaching ability (pre-test) and again 7-8 months after completing the course (post-test). Outcomes/Results Of the 1,091 residents who completed the pre-test, 421 also completed the post-test (38.6%). Analysis was limited to 421 respondents who completed both the pre-test and post-test (paired data). According to the McNemar-Bowker Test, there was a statistically significant improvement in the teaching self-ratings from pre-test to post-test, e.g., 31% self-rated above average/excellent versus 53% self-rated above average/excellent (p < 0.0001). Moreover, the PGY1s self-reported significant improvements in 3 teaching skills: Teaching Strategies, Individualized Teaching, and Providing Feedback (p < 0.01). Strengths/Limitations Our findings suggest that an online RasT curriculum can produce lasting benefits in PGY1’s self-confidence as teachers (Kirkpatrick levels 1 and 2a) but is limited by the inability to assess higher-order benefits like behavioral change (Kirkpatrick levels 2b, 3, 4).3 This online approach to RasT training is feasible to administer, fulfils LCME requirements, and can easily be replicated.