An Andragogic Model Curriculum for One-Year, ACGME-accredited Fellowship Programs (Preprint)

BACKGROUND The number of one-year ACGME fellowships continues to annually grow. The ACGME recommends a holistic curriculum with several non-clinical domains, as well as work hour limitations, inclusive of educational sessions. Given the competing demands between clinical skill development, educational pursuits, and work-hour restrictions within a one-year program, we propose an andragogic curriculum using pediatric anesthesiology as the model fellowship. OBJECTIVE The primary objective was to improve fellows’ perceptions of their educational experience during their fellowship year after implementing an andragogic, holistic curriculum. Secondary objectives assessed improvements in Diversity Equity and Inclusion (DEI) training and resources. METHODS This was a single-center, educational improvement project completed at Lucile Packard Children’s Hospital Stanford. Data were collected between 2014-2024. The new curriculum was introduced in 2021-2022 and involved 12 different teaching modalities rooted in andragogic principles. A statistical process control (SPC) p-chart analyzed the primary outcome based on the ACGME annual program evaluation. Outcomes were analyzed using censored regression modeling or t-test depending on the presence of ceiling effects. RESULTS From 2014-2024, 58 pediatric anesthesiology fellows completed the ACGME survey (97%). A break in the SPC p-chart for Educational Content scores occurred during 2021-2022, when the new curriculum was introduced. The mean difference was 0.89 (p=0.0009). Scores in DEI improved with a mean difference of 0.52 (p=0.03) and no difference was noted in Resources [-0.13 (p=0.98)]. CONCLUSIONS Introduction of an andragogic curriculum into a pediatric anesthesiology fellowship program was associated with improved fellow perception of educational content and DEI training.