Hi, my name is Katie Burlacher. I'm the program director at the University of Pittsburgh Medical Center. I'm here today to talk to you about curriculum innovation strategies. By the end of this module, we hope that you can be able to answer why you should do curriculum innovation, when you should do it, who should do it, and how to do it. So let's get started with the why. First, education like medicine is constantly changing and improving. Our understanding of adult learning continues to evolve. Thus, we too must evolve how we best apply this understanding of learning to cardiology trainees. Secondly, curricular innovation can really help you. It allows you to correct some of the learning gaps and weaknesses in your program. Next, when you innovate, oftentimes learners and leaders become engaged, which is always a good thing. And finally, we hope that this innovation will lead to better learning, which eventually leads to better patient care, which as you know, is the ultimate outcome of all medical education. Now that I've convinced you that curricular innovation is a good thing for all programs and program directors to do, let's talk about the best time to do it. So while you could argue that you can do curricular innovation anytime, anywhere, I actually think that it's best done after needs assessments. And by this, I don't mean a new needs assessment that gets added to your list of things to do. Rather, it should be after the things that you are already doing. Don't recreate the wheel here. Use what you already have and build from it. So this means using program specific evaluations, such as rotation and conference evaluations, or alumni surveys, or using the national data that you have to get every single year from the ACGME survey or in training exams. Most of the time, you're required to respond to review all of these things after you receive the results. So it's a really great time to take just a few more steps to solidify plans for improvement. Are there any other times? Well, I like to say whenever opportunity arises, take advantage of it. So reframe something that's potentially disruptive, such as a faculty member leaving or joining. Think about it when conference times or schedules change. And then whenever a gift drops in your lap, such as an aspiring educator needs a project or funding becomes available. Now that you've identified an opportune time, let's talk about who should do it. Program directors and associate program directors are the obvious choices. But I'd like to argue that also rotation directors and fellows are really great options, too. These two groups may need some oversight or help with structuring and implementation, but take advantage of their energy and experience if given the opportunity. Lastly, anyone who's engaged really should be invited to be part of the team of curricular innovations. This includes other educators in your system that are outside of your department, other trainees like internal medicine fellows, as well as non-medical colleagues, such as those that are in master's programs or community programs. Finally, the meat of it, how do we get to do curricular innovation? Good news. If you've done what's on the past few slides, you're off to a great start. So as we discussed, the first step is to identify the need or opportunity. Second step would be to figure out who's involved and importantly of that group, identify the champion of the curricular innovation. Next, work on getting buy-in from leaders and learners. This is really important because if you don't get their buy-in, the curricular innovation may fall flat on its face when it comes to implementation time. Next, before getting started, make sure that you state one clear objective for the curriculum. It should be actionable as well. Define a related outcome by which you'll be able to measure whether or not your objective has been achieved. With those in mind, then you can design and implement the new curriculum. For details on this, please see the curriculum design module that Dr. Asiyan has designed. As you implement, remember to start measuring or re-measuring your outcome. All right, so let's pull all of this together in a case and see if we can tease out each of these important steps to come up with a plan for curricular innovation. First, a case. A few years ago, your associate program director overhauled the division's journal club. Instead of reviewing big studies from the most recent JAC or CIRC journal, the conference was structured around learners exploring and understanding newer and more challenging research methods. Each month, a specific method was assigned to the presenting fellow. The fellow was then responsible for finding a study that used the assigned method and working with a statistician to explain the method to the division while discussing the article. The changes to journal club were largely well-received by both faculty and fellows, as documented by the evaluations that you collected at the annual evaluation of the conference, but there were multiple comments made by fellows that they said they don't feel like they get the chance to collectively discuss landmark studies of the field anymore. You're the program director. What is your response to the fellows? Well, first, remember to thank them for their honest feedback and congratulate yourself and your APD for creating a fellowship where your learners are engaged and hungry to learn. This is a relatively reasonable request. It's not whiny, so don't overreact. The journal club is working. It just created a new gap that you didn't predict, so no need to overhaul the successful journal club. Simply reframe this potentially negative feedback as an opportunity to innovate. Let's go through those steps to get this done. So your opportunity is that fellows want more at journal club. Your champion innovators are your fellows. The objective here is to review landmark cardiology articles in a systematic way. The outcome that you come up with could be that fellows cite landmark articles when leading conference and making clinical decisions. So your fellows then come up with a curriculum called rapid fire journal club. They have devised that two fellows take responsibility for one noon conference once every other month. During that time, the fellows choose and briefly review top five impactful articles in a specific area of cardiology, EP or nuclear preventive interventional. They decide that their measure is going to be evaluations from journal club and rapid fire journal club, and then their bonus measure is that they quantify the actual number of landmark articles cited in conferences for the following year as well as in consult notes. This ends up being a QI project that one of your chief fellows does. So overall, a really successful curricular innovation that the fellows put together that they now measure and have implemented. To review the why, when, who, and how of curricular innovation, you should do this because it increases engagement, learning, and care of patients. Think about it after a needs assessment is available or when opportunity arises. Your program directors and APDs should most certainly be involved in this. Don't forget about faculty, fellows, and other collaborators. When you sit down to actually do this, make sure that you tease out who your champion will be as well as the need. State your objective and outcome before you design and implement, and then don't forget to measure. Again, thank you so much for listening. I hope this allows you for great curricular innovations in the future.

curriculum innovation

medical education

adult learning

learning gaps

timing