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Resident individual interactive instruction preferences and activities

Andrew Grock, Adam Aluisio, Jay Khadpe.

Objective: The ACGME permits Individual Interactive Instruction (III) to fulfill twenty percent of emergency medicine
(EM) residents’ total education requirement. It is not known what type of curriculum or III activities residents prefer,
or which forms of III activities they choose to utilize. We sought to evaluate resident preferences between the three
different curricula used from 2011 and 2014 in the State University of New York (SUNY) Downstate EM program: one
without III, one with III and compulsory activities, and one with III and no compulsory activities. We hypothesized that
residents prefer an III curriculum without compulsory activities, and prefer online activities versus in-person activities.
Methods: In this observational, cross-sectional study at a large, urban, EM program, residents were sampled using a
structured questionnaire that collected data on III curriculum preferences and III activity preferences. All matriculating trainees
were eligible for inclusion. Residents graded each curriculum and activity on Likert scales. III activity logs were retrieved from
an online repository. Descriptive analyses were performed for the study population. Significant differences in performed III
activities were assessed based on year of training using one-way analysis-of-variance models with Bonferroni corrections.
Results: A convenience sample of 56 (69%) residents was obtained. Residents preferred a curriculum with III (83.9%)
more frequently than one without III (8.9%). The curriculum without III was more frequently disliked (75%) compared to the
curriculum with III (3.6%). Additionally, residents prefer an III curriculum without compulsory activities (75%) compared to
one with compulsory activities (7.1%). With regard to types of III, 48.2% prefer online activities compared to 10.7% prefer
in-person activities. The most frequently preferred activities were Evidence Based Medicine (EBM) reviews, Simulation,
and Journal Club. Board review was the least liked III activity with 44.7% disliking the modality. Residents participated
most frequently in the two online III opportunities despite the Online Literature Module (OLM) activity being less well liked
than other, in-person options. No significant differences in performed III activities were found based on year of training.
Conclusions: Residents prefer an III curriculum without compulsory III assignments. Importantly, residents most often
complete online activities, even if they are less well-liked than in-person activities. This data provides needed information
on resident preferences on incorporating III into the EM curriculum and can guide other residencies in determining their
III structure and activities.

Key words: Individual interactive instruction; Asynchronous; Resident Preference

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