A Mixed-Methods Program Evaluation of a Self-directed Learning Panel Management Curriculum in an Internal Medicine Residency Clinic

Abstract

Background: Panel management (PM) curricula in internal medicine (IM) residency programs often assign performance measures which may not address the varied interests or needs of resident-learners. Aim: To evaluate a self-directed learning (SDL)–based PM curriculum. Setting: University-based primary care practice in Burlington, Vermont. Participants: Thirty-five internal medicine residents participated. Program Description: Residents completed a PM curriculum that integrated SDL, electronic health record (EHR)–driven performance feedback, mentorship, and autonomy to set learning and patient care goals. Program Evaluation: Pre/post-curricular surveys assessed EHR tool acceptability, weekly curricular surveys and post-curricular focus groups assessed resident perceptions and goals, and an interrupted time series analysis of care gap closure rates was used to compare the pre-intervention and intervention periods. Majority of residents (28–32 or 80–91%) completed the surveys and focus groups. Residents found the EHR tools acceptable and valued protected time, mentorship, and autonomy to set goals. A total of 13,313 patient visits were analyzed. There were no significant differences between rates between the pre-intervention period and the first intervention period (p=0.44). Discussion: A longitudinal PM curriculum that incorporated SDL and goal setting with EHR-driven performance feedback was well-received by residents, however did not significantly impact the rate of care gap closure.