Understanding Resident Learning Preferences Within an Internal Medicine Noon Conference Lecture Series: A Qualitative Study

摘要

What was known While lectures are commonly used for noon conference presentations, there is conflicting evidence about the effectiveness of this format.;What is new Focus groups with postgraduate year (PGY)–1 through PGY-4 internal medicine residents identified factors motivating or discouraging their noon conference attendance.;Limitations Single-institution, single-specialty study may limit generalizability.;Bottom line Lectures were perceived to be more effective when they addressed clinically relevant and readily applicable topics, were presented succinctly, and offered in a safe learning environment.;Editor's Note: The online version of this article contains the focus group guide used in this study, and a table presenting resident learning preferences applied to principles of adult learning.;Introduction The Accreditation Council for Graduate Medical Education (ACGME) mandates that residency programs provide regularly scheduled didactic sessions.1 While there is flexibility in this process, a review of family medicine residency programs found that most programs offered 60-minute lectures during the noon hour an average of 3 times per week.2 The lecture remains popular because it is an efficient and inexpensive way to disseminate medical knowledge to a large group of residents. Yet, studies show that lectures demonstrate short-term knowledge gains but no long-term retention.3–8 Several studies report a variable correlation between residents' conference attendance and scores on specialty-specific national in-training examinations.9–14 Because of variability in the evidence supporting the use of the lecture format, it is not clear whether the lecture format should be improved or replaced with another learning modality.15 With changes in residency education from duty hour reforms and the ACGME's Next Accreditation System, educators need to provide optimal learning opportunities for residents to achieve the complex medical knowledge Milestones.16 It is important to understand the unique challenges of teaching residents, including resident-specific learning preferences and their learning environment. To explore the richness and depth of internal medicine residents' perspectives on noon conference, we used a qualitative design to identify (1) motivations for attending conferences, (2) appropriate content, (3) effective teaching methods, and (4) attitudes about enhancing active learning.;Results Forty-one internal medicine, medicine-pediatrics, preliminary, and transitional year residents participated in 1 of 7 focus groups; 17 (41%) were PGY-1 and 24 (59%) were PGY-2 through PGY-4 residents. Twenty-two (54%) were men. We identified central themes on resident learning preferences and categorized them into 4 domains: (1) motivations for attendance; (2) appropriate content; (3) effective teaching methods; and (4) perspectives on active participation during noon conference. Motivations for Attendance External Factors. The main external factor motivating conference attendance was the opportunity for a break in the day and time to eat lunch; these motivations were discussed as often as intrinsic attributes of the conference. First-year residents also discussed their appreciation of an attendance requirement. The main external factor that affected nonattendance was workload, including being on a busy rotation (ie, inpatient floor or intensive care unit) or rotating at an off-site location. Residents also discussed needing to leave conference if they received multiple pages about clinical care.;Discussion The results of these focus groups demonstrate important concepts to drive innovation in residency education. Awareness of residents' motivation for attending or not attending noon conference, their perception of topics as clinically relevant and readily applicable, and their desire for shorter sessions and a safe learning environment may contribute to creating an effective learning experience. In an era of duty hour limits, educators n