Improving resident education in ambulatory oncology: A novel flipped-classroom curriculum for internal medicine residents.

e21009 Background: There is a paucity of oncology curricula for internal medicine (IM) residents, particularly related to ambulatory practice. Adequate knowledge of oncology is crucial for internists as guideline-driven cancer screening and prompt diagnosis of new malignancy can improve patient outcomes. A targeted needs assessment of IM residents at Johns Hopkins Bayview (JHBMC) demonstrated that the majority of residents felt dissatisfied with current oncology curricula and did not feel confident in their knowledge of core topics in ambulatory oncology. Based on this data, an innovative educational curriculum in ambulatory oncology was developed for IM residents utilizing a flipped-classroom format. Methods: Using the results of a previously reported targeted needs assessment, a flipped-classroom curricular approach was administered to PGY-1 IM residents at JHBMC, consisting of 2 asynchronous videos followed by a synchronous session applying learned concepts in case-based scenarios. Videos were created to focus on high-yield oncology topics for internists using results of the needs assessment, ABIM Blueprint and ACP MKSAP. Topics included lung, breast and colon cancer screening, diagnostic work-up of suspected malignancy, and performance status evaluation. Knowledge assessment surveys consisting of validated questions from ACP MKSAP were administered pre- and post-curriculum. Residents were asked to rate their satisfaction with the curriculum and confidence in curricular areas after the session. Results: The curriculum was delivered to 22 IM residents. 68% (15/22) completed the pre- and post-curricular surveys. Knowledge improved from 61% to 73% ( p = 0.012) after delivery of the curriculum. Areas demonstrating the weakest baseline knowledge were lung cancer screening and diagnostic evaluation of lung and colon cancer in the primary care setting. 95% of residents felt “extremely satisfied” with topics covered and 90% felt “extremely satisfied” with the format. 71% felt “significantly more confident” in initiating a diagnostic work up of cancer in the ambulatory setting and 95% felt “slightly” or “significantly more confident” in the use of performance status evaluations in clinical practice. Conclusions: Our flipped classroom curriculum supports the use of asynchronous videos followed by a case-based discussion to teach ambulatory oncology topics to IM residents. This offers a novel opportunity to address the knowledge gap among IM residency curricula regarding the management of patients with solid tumor malignancies and improve confidence in the care of these patients.