P2.E100: Developing a NICU Course/Curriculum: Use of a Learning Management System for Self-Directed Learning

Background: Significant changes in resident physician training by the Accreditation Council for Graduate Medical Education (ACGME) include mandated 80-hour work week and maximum duty-length guidelines. The number of weeks pediatric residents rotate through the NICU is decreasing over time. Trainees are now required to do only ~8 weeks of NICU during their training. In our residency program, NICU education is provided during didactic sessions spread throughout the year which may or may not coincide with a trainee’s NICU rotation. To optimize learning of the trainee’s time in the NICU while balancing the demands of an ICU service, an innovative educational approach is necessary. The objective is to develop and provide access to self-guided, interactive instruction in the practical management of NICU patients through multidisciplinary team collaboration to improve resident knowledge.

Methods: The NICU course/curriculum was made available on a Learning Management System (LMS) and required over 200 hours to create. Selection of pertinent modules is made by trainees. Completion of 3-4 modules/week is recommended while on their rotation. Course provides educational material using instructional videos, slide presentations, 100+ practice questions with descriptive answers, and helpful websites/calculators. The site also provides a centralized resource for evidence-based (or unit-based) guidelines. Neonatologists, a NICU pharmacist and a dietitian collaborated for course creation. Content areas included in Table 1A and 1B. The course was available via desktop application initially with mobile access subsequently available. Trainees are given site access and information ~1 month prior to their initial NICU rotation. A secondary aim is to improve resident comfort in managing critically ill neonates.

Results: Trainees including 4th year medical students and residents (pediatric, internal medicine/pediatric and family medicine) were provided access (n=72). Due to a technical issue, data for 9 trainees was lost; 2 did not access the course. Total activity time was evaluated for remaining trainees (n=61) see Table 2A. Median time (IQR) spent of 305 (510) minutes. Test scores analyzed with paired t-test if both pretest and posttest were completed and minimum sample size of 10 available, see Table 2A. Statistically significant improvement seen in all modules. Feedback questionnaire was sent with response rate of 48.3% (28/58), 3 of the trainees had completed residency, therefore were not sent the questionnaire (see Table 2B). The results illustrate positive response to the course and examples of how the education was applicable to management of neonates. Feedback provided suggests guidance on prioritization of course modules may be helpful.

Conclusion: With current ACGME guidance leading to less resident time in the NICU, innovative ways to educate trainees are needed. An online NICU course along with a centralized location for evidence-based guidelines allows for self-directed learning.