ABSTRACT #17

A Targeted Needs Assessment For Designing A Telemetry Curriculum For Internal Medicine Residents

Arpanjeet Kaur, Joseph Elias, Nebojsa Markovic, Roberto O. Jimenez, Michel Skaf, Robert Abed, Deepika Misra, Edgar Argulian, Kiran Mahmood, Jacqueline Tamis-Holland, Forough Hakimzada, Vasundhara Singh

PURPOSE AND GOALS: Telemetry monitoring is used to detect a wide range of arrhythmias in patients at high risk of cardiac events. Internal medicine (IM) residents should be able to interpret and interrogate telemetry to identify and characterize arrhythmias and differentiate these from artifacts. Misinterpretation can lead to adverse patient outcomes, increased hospitalization costs and inappropriate interventions. However, there are no widely accepted curricula for IM residents on inpatient telemetry. To address this gap in graduate medical education, we hope to design telemetry curriculum for IM residents. Following the Kern method of curriculum development, we performed a targeted needs assessment to guide our curriculum design.

METHODS: A web-based survey was sent to current IM residents at Mount Sinai Morningside/West. The survey collected data regarding residents’: (1) Prior telemetry training (2) Preferred method of learning, (3) Preferred learning environment. Using a Likert-type scale ranging from 1( no knowledge) to 5 (extremely knowledgeable), residents were also asked to rate their knowledge for: a) Indications of telemetry b) Reviewing telemetry alarms c) Navigation of telemetry-monitors ,d) Identifying true arrhythmias versus artifacts.

EVALUATION PLAN: From the data collected, we assessed residents’ preferred medium of learning: selfpaced videos vs. hands-on training vs. didactics and their preferred learning setting: inpatient rotation vs. academic half days vs. simulation training.

SUMMARY OF RESULTS: A total of 73of 152 (48%)responses were recorded. 79.5% residents had no prior training in telemetry interpretation. Hands-on training alone or in combination with other options (i.e. didactics and/or self-paced videos) was the most popular choice, accounting for 84.9% of all the responses. Further analysis showed that 27.4% preferred hands-on training alone, 21.9% preferred hands-on training and didactics, and 19.1% preferred a combination of hands-on, didactics, and self-paced study. 72.6% of residents preferred the curriculum to be implemented during inpatient rotation alone or in combination with academic half days and/or simulation training (17.8% chose inpatient rotation only, 17.8% preferred inpatient rotation and simulation training, and 21.9% preferred inpatient rotation and academic half day). Analyzing residents’ self-assessment of telemetry skills, 40.4%thought they had slight knowledge across the four mentioned categories of telemetry review. When stratified by training year, 50% of PGY-1s felt having slight knowledge, 43.4% of PGY2 rated having moderate knowledge and 56.8% of PGY3 assessed themselves as being very knowledgeable.

REFLECTIVE CRITIQUE: This study highlights the need for a structured telemetry curriculum for IM residents and provides data on residents’ baseline knowledge and preferred learning technique. This information can guide educators to develop a standardized curriculum to enhance learning of IM residents on inpatient telemetry floors and to contribute to high-value patient care