Residency spiral concussion curriculum design

Author:

Kam Alice Sau Han1234ORCID,Zhao George5ORCID,Huang Ching‐Lung5,Husain Aisha6,Nyhof‐Young Joyce67,Summers Alyson8,Fernandez Nicolas910,Richardson Denyse11112

Affiliation:

1. Division of Physical Medicine and Rehabilitation, Department of Medicine University of Toronto Toronto Ontario Canada

2. Toronto Western Hospital University Health Network Toronto Ontario Canada

3. North York General Hospital Toronto Ontario Canada

4. Toronto Rehabilitation Institute University Health Network Toronto Ontario Canada

5. Temerty School of Medicine University of Toronto Toronto Ontario Canada

6. Department of Family and Community Medicine University of Toronto Toronto Ontario Canada

7. Academics Program and Family Practice Health Centre Women's College Hospital Toronto Ontario Canada

8. Department of Anthropology University of Toronto Toronto Ontario Canada

9. Department of Family Medicine and Emergency Medicine, Faculty of Medicine Université de Montréal Montreal Quebec Canada

10. Department of Psychopedagogy and Andragogy, Faculty of Education Université de Montréal Montreal Quebec Canada

11. Department of Physical Medicine and Rehabilitation Queen's University Kingston Ontario Canada

12. Providence Care Hospital Kingston Ontario Canada

Abstract

AbstractBackgroundResident‐focused concussion curricula that measure learner behaviours are currently unavailable. We sought to fill this gap by developing and iteratively implementing a Spiral Integrated Concussion Curriculum (SICC).ApproachProgramme elements of the concussion curriculum include academic half‐days (AHDs) and three half‐day clinics for first‐ and second‐year family medicine residents. Our SICC utilises social cognitive learning principles, the constructivism paradigm and utilisation‐focused evaluation.EvaluationA mixed‐method evaluation with a pre‐/post‐test design and interviews was utilised. Surveys and knowledge tests were used to measure knowledge and confidence pre‐AHD and 6 months post‐AHD. Interviews at 6 months explored programme perception and behaviour change. Of the 141 programme attendees, 114 (80%) participated in the pre‐intervention knowledge test and 33 completed the pre‐ and post‐AHD test. Immediate pre‐/post‐testing demonstrated statistically significant improvement in knowledge (p = 0.042). At 6 months post‐AHD, residents in Cycle 1 (n = 5) had a knowledge decrease of 3.33% (p > 0.05). Residents in Cycle 2 (n = 7) had a knowledge increase of 11.6% (p > 0.05). Both cycles of residents had an increase in confidence (Cycle 1: 65.0% [p = 0.025]; Cycle 2: 62.8% [p = 0.0014]). Residents (5 out of 6) reported positive behavioural changes at 6 months. Valued programme elements included concussion diagnosis and management, the self‐study guide resource and the organised structure.ImplicationsThe SICC enriched these residents' learning and fostered sustained knowledge improvement and behavioural change at 6 months post‐intervention. This approach may provide a workable design for future competency‐based curriculum development.

Publisher

Wiley

Subject

Review and Exam Preparation,General Medicine

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