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Article Review: Online curriculum for non-EM residents in the ED

Posted Jan 24 2011 12:00am

In many academic Emergency Departments, there are "off-service" or non-EM residents rotating in the department. They are sometimes invited to the EM residency conference series for the month. Often times though, they have too many departmental didactic events and obligations of their own that they don't have time to attend formal EM didactics.

This is the perfect opportunity for an online didactic curriculum, which can be viewed at the residents' own time. The faculty at Northwestern designed such a curriculum, called the Northwestern University Rotating Resident Curriculum (NURRC). The curriculum consists of 6 voiceover lectures
  • ENT and Ophthalmology
  • Environmental
  • Obstetrics and Gynecology
  • Orthopedics
  • Toxicology
  • Trauma and Wound Care
Methodology
The NURRC team conducted a 9-month, prospective, randomized study of 54 rotating residents (internal medicine and surgical subspecialties). All residents took one of two 42-question tests (A or B) as a pretest. The residents were then randomized into the control (no formal didactics) or experimental group (NURRC access). 

At the 2-week mark, both groups took the other test as a post-test (A or B). NURRC access was then made available to the control group as well. At the end of the 4 weeks, both groups completed an anonymous satisfaction survey. All residents who completed study participation received a $10 gift card to a local cafe.

Results
  • 54 of 58 residents completed the study (92%)
  • There was no difference in pretest scores between groups (52.6% controls, 50.8% NURRC group)
  • The post-pre test score difference was 1.6% (control) and 17.3% (NURRC group)
  • 43 of the 54 resident completed the survey (79.6% response rate)
  • All lectures received at least a 80% approval rating.
My Thoughts
Although this study had a relatively small sample size (n=54), there were things that the investigators did right:
  • Although 5 of the NURRC group admitted to not viewing the online modules, they were kept in the study group based on the intention-to-treat model.
  • There was a great participation rate (92%) and survey response rate (79.6%). I'm guessing the gift card made a big difference.
  • A linear regression analysis was performed to show that test version (A vs B) and resident specialty did not impact the study results.

Reference
Branzetti JB, Aldeen AZ, Foster AW, Mark Courtney D. A Novel Online Didactic Curriculum Helps Improve Knowledge Acquisition Among Non-Emergency Medicine Rotating Residents. Acad Emerg Med. 2010, 18:53–59. PMID: 21175925
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