PEARLs of Wisdom: Impact of a New Block Conference on Pediatrics Resident Attendance, Satisfaction, and Learning

摘要

Introduction A traditional part of residency training has been didactic learning conferences. Conferences are intended to impart medical knowledge and present information in a way that can be understood and translated into patient care. Further, conferences must be presented at a time when residents can attend them and focus on the material being presented. The current medical model of didactic conferences includes morning report and topic-based conferences, such as morbidity and mortality conferences.1,2 In today's training environment, duty hour restrictions have shortened time available for conference attendance, and conference time must be used wisely to justify removing residents from clinical duties in their shortened workday. Many programs are considering new conference structures to maximize learning in available time. Previous work has suggested that block conferences are an innovative way to adapt to duty hour requirements.3 The University of Wisconsin-Madison Pediatrics Residency Program eliminated all noon conferences in 2010 and implemented a new bimonthly block conference called Pediatric Education and Active Resident Learning (PEARL). The conference provides a half-day of interactive case-based learning led by 2 faculty members per session, with focus on resident involvement and interaction. The purpose of this study was to assess whether changes in conference structure improved resident attendance, distractibility, satisfaction, perception of clinical relevance, and connection.;Methods Data were collected between May 2010 and August 2011 and received approval from the relevant Human Subjects Committee. We used a pre-post design to assess resident views on conference attendance and learning, and compared a noon conference setting to a block conference setting. Setting and Subjects Participants were pediatrics residents from 1 midsized Midwestern residency program. Residents from the classes of 2008–2010 were surveyed about noon conference experiences in May and June 2010. Noon conferences lasted an hour, 3?days a week. These conferences included both resident-led and faculty-led didactic teaching sessions in which topics were based on Residency Review Committee requirements. This study was approved by the Institutional Review Board at the University of Wisconsin-Madison. Beginning in July 2010, noon conferences were replaced with the PEARL conference held on Friday afternoons between 12:30 pm and 4 pm every other week. In July and August 2011, residents from the classes of 2009–2011 were surveyed about PEARL conference experiences (table?1). View larger version (11K) TABLE 1Structured Differences in Pediatric Education and Active Resident Learning (PEARL) Conferences;Results A total of 70 pediatrics residents participated in this study. This included 33 of 42 (78%) residents in the 2010 presurvey and 37 of 42 (88%) residents in the 2011 postsurvey. The total sample included all residency classes (table?2). View larger version (17K) TABLE 2Demographics Table;Discussion Findings suggest that PEARL conferences significantly improved resident attendance, lowered distractibility, and improved resident satisfaction. These findings show promise to improve attendance and focus in these learning environments. Given that conferences are the primary didactic teaching opportunities in residency, it is critical to maximize multiple educational and training goals. PEARL conferences also showed positive findings in contributing to residents' connection to their program, their faculty, and each other. Given that current training conditions and duty hours create a more fractured learning environment, these may be significant in improving residents' morale and reducing stress. Our findings are complemented by previous work that investigated challenges in reducing resident distractions during conference time. During a PEARL conference, the residents sign out their pagers to avoid distractions during the conference. This practice h