Educational intervention improved internal medicine residents' knowledge of chronic liver disease

SAN FRANCISCO — A pilot implementation of a novel curriculum involving a non-elective hepatology consult rotation at the University of Chicago improved internal medicine residents’ comfort, interest and knowledge of chronic liver disease, according to a poster presentation at The Liver Meeting 2015.

“Our traditional model … was an elective model in regards to choosing consult rotations, [and] we had previously shown that graduating third-year residents often did not elect to rotate on any GI rotation at all, and definitely not a liver rotation,” Adam E. Mikolajczyk, MD, from University of Chicago, told Healio Gastroenterology. They were not comfortable or knowledgeable with liver disease, “which is concerning, because you want your general internist to have some conception of hepatitis C, hepatitis B, NASH, and things like that, that they’re going to encounter in the clinic. So we decided to implement a new curriculum centered around a new rotation that became somewhat mandatory.”

Adam E. Mikolajczyk

Mikolajczyk and colleagues developed a novel, non-elective, inpatient hepatology consult rotation that included elements from ACT-First curricula and LiverLearning modules.

Every 2 weeks a new resident now rotates through the hepatology rotation, Mikolajczyk said.

To determine the effectiveness of this intervention, Mikolajczyk and colleagues administered an anonymous survey to postgraduate year 2 and 3 internal medicine residents both before and after their 2-week rotation to assess knowledge and comfort with managing chronic liver disease.

“We essentially showed … that residents felt significantly more comfortable caring for a wide variety of liver disease, and their knowledge improved following completion of the rotation,” Mikolajczyk said.

Among the 18 residents who completed the rotation so far, mean comfort level in managing cirrhosis (P = .0006), hepatitis B (P = .0092), hepatitis C (P = .002), NASH (P = .0012), and liver transplant care (P = .0002) significantly increased compared to other topics not encountered on the rotation. There was also increased career interest in hepatology (P = .0736) and improved self-perceived knowledge in most core topics. The mean proportion of correct answers on the pre-test was 52% compared with 70% on the post-test (P = .0243), and for questions that appeared on both tests, a correct answer was given 79% of the time after the intervention.

“We are the only program in the top 25 that has this type of model,” which is a unique and novel way of approaching education in hepatology, Mikolajczyk said. – by Adam Leitenberger

Reference:

Mikolajczyk AE, et al. Abstract 544. Presented at: The Liver Meeting; Nov. 13-17, 2015; San Francisco.

Disclosures: Mikolajczyk reports no relevant financial disclosures. Please see the abstract for a full list of all other researchers’ relevant financial disclosures.