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J Grad Med Educ. 2014 Dec;6(4):721-5. doi: 10.4300/JGME-D-14-00257.1.

An Effective Multimodal Curriculum to Teach Internal Medicine Residents Evidence-Based Breast Health.

Abstract

BACKGROUND:

Breast health is an area fraught with controversy and missed opportunities to meet women's needs, and the state of internal medicine residency training in this area is inadequate.

OBJECTIVE:

Our objective was to develop, implement, and evaluate a curriculum to equip internal medicine residents with the knowledge and skills to deliver high-quality, comprehensive breast health care.

METHODS:

We developed a 4-hour curriculum for internal medicine interns. It incorporated a team-based learning format and used MammaCare breast model software to teach and evaluate the clinical breast examination. We compared interns' precurriculum and postcurriculum test results to a historical comparison group of postgraduate year (PGY)-2 interns who did not complete the curriculum. We retested interns as PGY-2s to assess knowledge retention.

RESULTS:

A total 41 of 52 interns (79%) completed the curriculum. Their average MammaCare scores improved from 63% to 91%. Scores on a knowledge-based assessment improved from 47% on the pretest to 85% on the posttest (P < .001). Comparison PGY-2s who did not complete the curriculum averaged a score of 52% (P < .001). When retested 9 months after exposure to the curriculum, participants' mean score was 63% (compared to historical comparison PGY-2 group, P < .001). Only 9% of interns who retook the test as PGY-2s reported having received any breast health training subsequent to curriculum completion.

CONCLUSIONS:

A targeted half-day, low-cost breast health curriculum significantly improved knowledge and skills in multiple domains, and these improvements were retained in subsequent assessment despite minimal reinforcement in residency training.

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