ABSTRACT #29

Workshops To Teach Internal Medicine Residents And Evaluate Their Ability To Treat Gastrointestinal Bleeding

Randy Leibowitz

PURPOSE AND GOALS: Gastrointestinal (GI) bleeding is one of the most common chief complaints internal medicine residents will encounter during inpatient training. However, a 2015 study found residents (42%) were more likely to identify stool as melena on a digital rectal exam when compared to GI fellows (12%). In turn, residents were more likely to identify a GI consult as emergent (13%) compared to fellows (4%).

The Accreditation Council for Graduate Medical Education (ACGME) outlines milestones for residents on a Dryfus rating scale ranging from novice to expert. Residents are expected to progress from being able to develop a differential diagnosis of GI bleeding, to eventually being able to properly evaluate patients with GI bleeding and develop accurate treatment options based on severity and prognosis.

METHODS: The GI bleeding workshops will be separated into two installments: lower GI and upper GI bleeding. The workshops will be performed with residents ranging from PGY-1 to PGY-3. Each installment will include a pre-survey and a post-survey one month after the workshop.

Both workshop lectures contain an evidence-based outline of the American College of Gastroenterology (ACG) Clinical Guidelines for the management of acute upper and lower GI bleeding. Within each section, data from the studies that influenced the guideline recommendations will be summarized and explained.

Each section will conclude with a peer-reviewed multiple choice question from the American College of Physicians Medical Education Division. At the end of each lecture an algorithmic diagram, either derived from or provided by the ACG Clinical Guidelines, will be administered

EVALUATION PLAN: Prior to the workshop and one month after, residents will be administered an identical comprehensive survey to assess their knowledge and attitudes towards treating GI bleeds. PGY-1 surveys will be evaluated separately from PGY-2 and PGY-3 to account for differences in experience level.

SUMMARY OF RESULTS: Knowledge will be assessed by responses to the peer reviewed questions. Residents will also be assessed on their confidence in evaluating and treating GI bleeds, as well as measuring residents’ progress against the ACGME milestones.

REFLECTIVE CRITIQUE: The aim of administering these two workshops is to assess the knowledge and attitudes of internal medicine residents in evaluating and treating GI bleeds, as well as assist them in advancing in the milestones set forth by the ACGME.