A case-based approach for teaching professionalism to residents with online discussions

Introduction: Programs must demonstrate that their residentsare taught and assessed in professionalism. Most programsstruggle with finding viable ways to teach and assess this criticalcompetency. UTHSCSA Family and Community MedicineResidency developed an innovative option for interactive learningand assessment of residents in this competency which would betransferrable to other programs and specialties.Methods: The innovative approach uses an asynchronous onlineformat on Blackboard. Threaded discussions on Blackboardrequire thoughtful reflective writing after case assessmentand critical evaluation of other resident posts. Participation,content and progress of all resident postings are monitored byadministrative staff and faculty. Faculty can further engage theresidents at any point to deepen the discussion and learning.Results: 100% of all senior residents attained the required learningobjectives. All were actively engaged in the assignments. Six caseshave been developed using a Learning Matrix to demonstrateevaluation areas from the specialty specific competencies. Writtenfeedback from residents verified the validity of case content incontext of their current clinical practice. Postings by residentshave provided value and insight for the faculty to access theprofessional development of our Family Medicine residents. TheClinical Competency Committee evaluates all third year residentsusing this information specific to the professionalism milestones.By using an asynchronous online approach to case discussion, allresidents are involved with all aspects of this curriculum.Conclusions: More specific measurable learning outcomesare possible using this approach. Resident participation andengagement is easier to track and monitor than a lecture-basedformat and easier to capture valuable data than relying onevaluation feedback. Our Annual Review process will identifyareas for improvement in the existing cases and help createsupplemental cases based on a needs assessment by the faculty.Keywords: Milestones; Professionalism; Residency; e-learning