The use of outcome measures to evaluate clinical rheumatology curriculum changes.

Abstract

Five years ago we sought to change the comprehensive educational program of our rheumatology clinical training period for internal medicine residents and develop a model to measure the outcome of the curriculum change. During the month-long clinical training period in rheumatology, internal medicine residents participated in 10 interactive lectures on basic rheumatology with the faculty and worked through 26 case studies and radiographs of different rheumatic diseases with the faculty. Separate pre and posttests were developed and administered to the residents, both as evaluative and educational tools. Residents' performance on the rheumatology questions on the American Board of Internal Medicine (ABIM) examination were compared before and after the curriculum change. Comparison of pre to posttest results documented significant (p < 0.0001) improvement in the average resident score. Resident performance on the rheumatology questions of the ABIM examination improved markedly (average percentile rank for the 3 years before this change--55.7% versus the first 4 years after the change--82.5%; p < 0.05). This comprehensive educational program for internal medicine residents during the rheumatology clinical training period resulted in significant short and longterm increases in rheumatology knowledge base.