Introduction of Supplemental Cardiology Didactics to Pediatric Resident Night Float Education

Background: Recent changes to the pediatric cardiology rotation at our institution, including expansion of the cardiac intensive care unit, the integration of inpatient cardiology advanced practice providers, and limitations imposed by resident work hour regulations, has resulted in significant changes to the resident training experience. In response, a nocturnal cardiology curriculum was instituted through weekly didactic sessions for night float residents, led by on-call cardiology fellows. In addition, to provide a bidirectional education experience for the cardiology fellows a medical education lecture series was created. The primary objectives were to improve resident knowledge of pediatric cardiology and positively impact their relationship with pediatric cardiology fellows.

Methods: A survey to assess baseline perceptions was sent via email to all pediatric residents (n=121) in June 2020. Weekly didactic sessions were held every Thursday night starting August 2020. The sessions reviewed content identified as material tested by the American Board of Pediatrics (ABP) and were structured as informal discussions or case-based learning modules. Residents were asked to evaluate fellow teaching after each session. Follow-up surveys were distributed to all residents at 6-month and 12-month follow-up intervals. In addition, Cardiology fellows participated in a longitudinal ‘fellow as teacher’ series throughout the year.

Results: 95 of 121 residents (79%), 93 of 121 residents (77%), and 53 of 121 (44%) responded to the baseline, 6-month, and 12-month follow-up surveys, respectively. Pre-intervention, 68% (n = 65) of residents were dissatisfied with existing cardiology educational experiences, 65% (n = 62) felt their cardiology knowledge was less than expected given their current level of training, and 61% (n = 58) rated their relationship with cardiology fellows as below average. When comparing these results to the 6-month and 12-month follow-up surveys, we found significant intervention effects. Post-intervention, residents reported significantly increased perceived knowledge of pediatric cardiology (F(2,214)=11.93, p<0.001), higher satisfaction with cardiology educational opportunities (F(2,214)=12.85, p<0.001), and improved relationships with cardiology fellows (F(2,214)=20.73, p<0.001). Moreover, residents reported significantly increased comfort with applying existing cardiology knowledge to patients presenting with cardiac issues both in the inpatient (F(2,214)=12.29, p<0.001) and outpatient (F(2,214)=10.64, p<0.001) settings.

Conclusion: The creation of a weekly fellow-led didactic curriculum of ABP cardiology topics resulted in significant improvements in pediatric resident self-reported knowledge of pediatric cardiology, comfort managing cardiac patients in various care settings and overall satisfaction with their educational experience. These didactics also provided new opportunities for resident-fellow interactions, which likely contributed to the significant improvement in relationships with cardiology fellows. This educational module enhances resident education, fosters resident-fellow collaboration, and provides opportunities for fellows to enhance their skills as medical educators.