Arthritis & Rheumatism, Volume 60,
October 2009 Abstract Supplement

The 2009 ACR/ARHP Annual Scientific Meeting
Philadelphia October 16-21, 2009.


An Instrument to Provide Documentation (iPROD) of Practice-Based Learning and Improvement (PBLI): A Pilot Trial Conducted by the Carolinas Fellows Collaborative

O'Rourke1,  Kenneth S., Bolster2,  Marcy B., Criscione-Schreiber3,  Lisa G., Jonas4,  Beth L.

Wake Forest University School of Medicine, Winston-Salem, NC,
MUSC, Charleston, SC,
Duke University Med Ctr, Durham, NC,
Univ of North Carolina, Chapel Hill, NC

Purpose:

Since 1999 the ACGME Outcome Project has required programs to assess trainee skills in PBLI – the ability of the fellow to improve patient care practices and appraise and assimilate scientific evidence into practice. Assessment of these activities has typically required mining information from multiple tools (e.g. patient logs, performance ratings, records review) as few individual tools evaluate all the essential components of PBLI: independent learning, self-evaluation of performance, and incorporation of feedback into improvement of clinical activity.

Method:

Our collaborative group created a one-page, online form (iPROD) for fellow self-completion of PBLI activity. The form is divided into three sections: (1) summarization of the issue being addressed and site where it developed (e.g., clinic patient encounter), (2) results and resources used to resolve the issue, and (3) a description of how the results were applied. The form was piloted at a single institution over 7 weeks. Participants were to complete at least one form per week. A seminar was held once weekly during which all participants each presented the contents of one completed form over 3–5 minutes followed by a short 1–2 minute discussion with annotation. Hard copies of the forms were (1) indexed and placed in a binder as a resource for future use, and (2) incorporated into the fellow's portfolio. Issues raised in the iPRODs will serve as a source for locally-generated 'inservice' questions.

Results:

Three fellows and two faculty submitted a total of 23 forms. Issues involved questions of clinical manifestations or disease pathophysiology (n=9), pharmacology (5), diagnostic testing (4), therapy (4) and differential diagnosis (2). Two forms incorporated a systems-based practice concern. The majority (17/23) of issues originated from clinic encounters, and information learned in all cases was applied directly to patient care. Completion of the iPROD was straightforward and relatively rapid. Group discussion provided for feedback and reinforcement of major teaching points.

Conclusion:

This pilot trial demonstrated the feasibility of a simple online tool, supplemented by presentation and discussion, to document and evaluate all essential components of PBLI. A larger study among all sites in our collaborative is planned.

To cite this abstract, please use the following information:
O'Rourke, Kenneth S., Bolster, Marcy B., Criscione-Schreiber, Lisa G., Jonas, Beth L.; An Instrument to Provide Documentation (iPROD) of Practice-Based Learning and Improvement (PBLI): A Pilot Trial Conducted by the Carolinas Fellows Collaborative [abstract]. Arthritis Rheum 2009;60 Suppl 10 :1224
DOI: 10.1002/art.26298

Abstract Supplement

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2009 ACR/ARHP