Kidney Week

Abstract: FR-PO018

Curricular Innovation to Improve Performance on Internal Medicine In-Training Exam Nephrology Items

Session Information

• Classroom to Bedside: Transforming Medical Education
  October 25, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Educational Research

• 1000 Educational Research

Authors

• Bhutani, Gauri, University of Wisconsin System, Madison, Wisconsin, United States

Gauri Bhutani, MBBS, FASN

• Strennen, Samantha J., University of Minnesota Twin Cities, Minneapolis, Minnesota, United States

Samantha J. Strennen

• Floden, Sarah L., University of Wisconsin System, Madison, Wisconsin, United States

Sarah L. Floden, MD

• Coyle, Andrew, University of Wisconsin System, Madison, Wisconsin, United States

Andrew Coyle, MD

• Norby, Suzanne M., University of Wisconsin System, Madison, Wisconsin, United States

Suzanne M. Norby, MD, FASN

Background

Performance on the Internal Medicine In-Training Exam (IM-ITE) is one method by which both resident knowledge and residency program effectiveness is measured. In 2020, our program’s aggregate score for all post-graduate years (PGYs) on Nephrology (Neph) specific items was <50^th percentile (%ile). Since Nephrology is not a required rotation in our program, a curricular innovation (CI) was developed to be available to all residents to help improve residents’ Nephrology specific knowledge.

Methods

Case scenarios based on Nephrology topics with lower % correct score with 3- tier questions for knowledge and difficulty level were disseminated bimonthly to IM residents via e-mail and Twitter (X) as free open access meducation (FOAMed).The questions were also open to any interested online viewers. Answers were submitted via a Qualtrics survey tool with options for anonymity and feedback. A robust in-person didactic curriculum was present in all years, though the delivery of this curriculum changed with a transition to an X+Y model in academic year (AY) ’22-23 which did lead to a decrease in the number of unique Nephrology sessions from 16 in AY ’21-22 to 7 in ’22-23. Additionally, PGY1s did not take the IM-ITE after 2021 as part of IM residency program changes.

Results

Over AYs ’20-21 to ’22-23, a total of 17 CI sessions were disseminated with average resident engagement of 25 (19-31) per question and a class size of 25-32 PGY per year. Most participants (94%) felt they learnt new information. Percent of Nephrology IM-ITE questions answered correctly (% correct) and %ile over time are reported in Table.

Conclusion

Aggregate performance for all PGYs improved on the 2021 examination. 2022 and 2023 data by PGY level shows inconsistent trends, with higher percentiles in 2022 as compared to 2020, and higher percent correct in 2023. These changes occurred in the background of other curricular and ITE utilization changes in the IM residency program and thus, direct correlations between CI implementation and IM-ITE performance cannot be made presently and a longer observation period is needed.