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Fellows-In-Training Self-Assessment: Use of a Self Perception of Competence (SPOC) Questionnaire
Abstracts AB177
564
Assessment of Resident Knowledge of Allergic and Immunologic Diseases (ARKAID)
Bharat Kumar, MD1, Sohaib Aleem, MD, MPH2, Manish Suneja1, and Benjamin P. Davis, MD, PhD3; 1University of Iowa Hospitals and Clinics, Iowa City, IA, 2South Bend Clinic, South Bend, IN, 3UIHC, Iowa City, IA. RATIONALE: Published evidence demonstrates a broad lack of familiarity that Internal Medicine (IM) physicians have for Allergy/ Immunology (A/I). We created a reliable survey instrument to gauge IM resident physician knowledge of A/I topics, and implemented this to assess longitudinal trends at two Midwestern academic and community-based programs. METHODS: 20 multiple-choice questions were drafted by 2 A/I fellows, 1 A/I faculty member, and 1 IM program director. Content was based on the 2015 American Board of Internal Medicine certification exam blueprint, and style was adopted from the National Board of Medical Examiners guidelines. The survey was administered to IM residents at the University of Iowa in Iowa City, IA and UnityPoint Health in Des Moines, IA. Descriptive statistics were calculated via Microsoft Excel. RESULTS: 76 out of 105 IM residents (72%) participated at the two sites. There were slightly more first-year residents than second- or third-year residents (41, compared to 36 and 28, respectively). The reliability index (Cronbach-alpha) of the survey instrument was 0.73. The mean score was 12.7 (63.5%), and were comparable between the two sites (12.8 at the University of Iowa and 12.5 at UnityPoint). There was a significant difference in mean scores between first- and third-year physicians (p50.008) and a decline in scores with each advancing year of training (15.2, 12.6, and 10.3, respectively). CONCLUSIONS: An instrument with high reliability was created to assess A/I knowledge among IM residents. Knowledge of A/I topics tends to actually decrease as residency progresses. This demonstrates an urgent need to highlight A/I in IM curricula.
565
Food Allergy Support and Education (FASE): A Comprehensive Approach to Improving Parental Understanding of Food Allergy
Sarah M. Boudreau-Romano, MD, and Suma Rao-Gupta, MPH; Ann & Robert H. Lurie Children’s Hospital, Chicago, IL. RATIONALE: Food Allergy Support and Education (FASE) is a novel, physician-led program developed to increase parental understanding of food allergy. It was hypothesized that parents would benefit from additional support and would be better prepared to respond to food allergy emergencies. METHODS: FASE utilizes parent workshops to promote greater understanding of food allergy. Analysis of surveys from attendees demonstrated that they had a better understanding of the following areas: science of an allergic reaction; emergency action plan (EAP); allergen avoidance; social/ emotional implications of food allergy; and when/how to use injectable epinephrine. RESULTS: 36 parents attended 8 workshops between February and August 2016. Of the 15 individuals who completed surveys, 93.3% strongly agreed they had a better understanding of the science of an allergic reaction; 93.3% strongly agreed/agreed they had a better understanding of the EAP; 86.3% strongly agreed/agreed they had a more complete understanding of allergen avoidance; and 80% strongly agreed/ agreed they had a better understanding of the social/emotional implications of food allergy. Finally, 100% of attendees had a better understanding of when/how to use injectable epinephrine. CONCLUSIONS: These results demonstrate that FASE is an essential part of a multidisciplinary approach to food allergy management. When parents have an improved understanding of food allergy, they are better able to avoid the allergen(s), to recognize an allergic reaction and to administer proper treatment. In the long term, the support and education provided by FASE may result in less morbidity and mortality among food allergic children.
566
Fellows-In-Training Self-Assessment: Use of a Self Perception of Competence (SPOC) Questionnaire
David M. Lang, MD, FAAAAI1, Lily Pien, MD, FAAAAI2, Linda Maurer3, and Xiaofeng Wang3; 1Cleveland Clinic, Respiratory Institute, Department of Allergy and Clinical Immunology, Cleveland, OH, 2Cleveland Clinic Foundation, Cleveland, OH, 3Cleveland Clinic, Cleveland, OH. RATIONALE: To assist in achieving ACGME competencies and milestones, self-assessment and external assessment are needed. In 2006, we introduced a fellows’ self-assessment questionnaire to support information from multi-source ‘‘360’’ evaluations. The Self Perception Of Competence (SPOC) instrument consists of 37 questions. Likert scale was used with the terms novice, advanced beginner, competent, proficient, and expert. Examples of the questionnaire items include: ‘‘My ability to order and interpret spirometry is:’’, and ‘‘My ability to present a topic independently at a seminar is:’’. We explored patterns of SPOC responses to highlight patterns of progression during training. METHODS: We retrospectively analyzed responses for 18 fellows who completed the SPOC questionnaire at the beginning of fellowship, and thereafter at time intervals of 3, 6, 12, 18, and 24 months. Statistical analysis was done using a linear mixed model with ANOVA. RESULTS: Statistically significant differences were observed in SPOC scores over time, from entry to completing the program (p < 0.0001) and during the 1st and 2nd years of training (p < 0.0001). There were statistically significant changes at each point of SPOC completion (p < .05). The maximal increase in perceived level of competence was observed during the first three months of fellowship (p<0.0001). CONCLUSIONS: We have found SPOC to be a useful learner selfassessment instrument for assessing progress in achieving ACGME competency-based programmatic goals and objectives during training. Response patterns in our program indicate that advances in fellows’ selfperceptions occurred in both the 1st and 2nd years, and were maximal in the first 3 months of training.
SUNDAY
J ALLERGY CLIN IMMUNOL VOLUME 139, NUMBER 2
564
Assessment of Resident Knowledge of Allergic and Immunologic Diseases (ARKAID)
Bharat Kumar, MD1, Sohaib Aleem, MD, MPH2, Manish Suneja1, and Benjamin P. Davis, MD, PhD3; 1University of Iowa Hospitals and Clinics, Iowa City, IA, 2South Bend Clinic, South Bend, IN, 3UIHC, Iowa City, IA. RATIONALE: Published evidence demonstrates a broad lack of familiarity that Internal Medicine (IM) physicians have for Allergy/ Immunology (A/I). We created a reliable survey instrument to gauge IM resident physician knowledge of A/I topics, and implemented this to assess longitudinal trends at two Midwestern academic and community-based programs. METHODS: 20 multiple-choice questions were drafted by 2 A/I fellows, 1 A/I faculty member, and 1 IM program director. Content was based on the 2015 American Board of Internal Medicine certification exam blueprint, and style was adopted from the National Board of Medical Examiners guidelines. The survey was administered to IM residents at the University of Iowa in Iowa City, IA and UnityPoint Health in Des Moines, IA. Descriptive statistics were calculated via Microsoft Excel. RESULTS: 76 out of 105 IM residents (72%) participated at the two sites. There were slightly more first-year residents than second- or third-year residents (41, compared to 36 and 28, respectively). The reliability index (Cronbach-alpha) of the survey instrument was 0.73. The mean score was 12.7 (63.5%), and were comparable between the two sites (12.8 at the University of Iowa and 12.5 at UnityPoint). There was a significant difference in mean scores between first- and third-year physicians (p50.008) and a decline in scores with each advancing year of training (15.2, 12.6, and 10.3, respectively). CONCLUSIONS: An instrument with high reliability was created to assess A/I knowledge among IM residents. Knowledge of A/I topics tends to actually decrease as residency progresses. This demonstrates an urgent need to highlight A/I in IM curricula.
565
Food Allergy Support and Education (FASE): A Comprehensive Approach to Improving Parental Understanding of Food Allergy
Sarah M. Boudreau-Romano, MD, and Suma Rao-Gupta, MPH; Ann & Robert H. Lurie Children’s Hospital, Chicago, IL. RATIONALE: Food Allergy Support and Education (FASE) is a novel, physician-led program developed to increase parental understanding of food allergy. It was hypothesized that parents would benefit from additional support and would be better prepared to respond to food allergy emergencies. METHODS: FASE utilizes parent workshops to promote greater understanding of food allergy. Analysis of surveys from attendees demonstrated that they had a better understanding of the following areas: science of an allergic reaction; emergency action plan (EAP); allergen avoidance; social/ emotional implications of food allergy; and when/how to use injectable epinephrine. RESULTS: 36 parents attended 8 workshops between February and August 2016. Of the 15 individuals who completed surveys, 93.3% strongly agreed they had a better understanding of the science of an allergic reaction; 93.3% strongly agreed/agreed they had a better understanding of the EAP; 86.3% strongly agreed/agreed they had a more complete understanding of allergen avoidance; and 80% strongly agreed/ agreed they had a better understanding of the social/emotional implications of food allergy. Finally, 100% of attendees had a better understanding of when/how to use injectable epinephrine. CONCLUSIONS: These results demonstrate that FASE is an essential part of a multidisciplinary approach to food allergy management. When parents have an improved understanding of food allergy, they are better able to avoid the allergen(s), to recognize an allergic reaction and to administer proper treatment. In the long term, the support and education provided by FASE may result in less morbidity and mortality among food allergic children.
566
Fellows-In-Training Self-Assessment: Use of a Self Perception of Competence (SPOC) Questionnaire
David M. Lang, MD, FAAAAI1, Lily Pien, MD, FAAAAI2, Linda Maurer3, and Xiaofeng Wang3; 1Cleveland Clinic, Respiratory Institute, Department of Allergy and Clinical Immunology, Cleveland, OH, 2Cleveland Clinic Foundation, Cleveland, OH, 3Cleveland Clinic, Cleveland, OH. RATIONALE: To assist in achieving ACGME competencies and milestones, self-assessment and external assessment are needed. In 2006, we introduced a fellows’ self-assessment questionnaire to support information from multi-source ‘‘360’’ evaluations. The Self Perception Of Competence (SPOC) instrument consists of 37 questions. Likert scale was used with the terms novice, advanced beginner, competent, proficient, and expert. Examples of the questionnaire items include: ‘‘My ability to order and interpret spirometry is:’’, and ‘‘My ability to present a topic independently at a seminar is:’’. We explored patterns of SPOC responses to highlight patterns of progression during training. METHODS: We retrospectively analyzed responses for 18 fellows who completed the SPOC questionnaire at the beginning of fellowship, and thereafter at time intervals of 3, 6, 12, 18, and 24 months. Statistical analysis was done using a linear mixed model with ANOVA. RESULTS: Statistically significant differences were observed in SPOC scores over time, from entry to completing the program (p < 0.0001) and during the 1st and 2nd years of training (p < 0.0001). There were statistically significant changes at each point of SPOC completion (p < .05). The maximal increase in perceived level of competence was observed during the first three months of fellowship (p<0.0001). CONCLUSIONS: We have found SPOC to be a useful learner selfassessment instrument for assessing progress in achieving ACGME competency-based programmatic goals and objectives during training. Response patterns in our program indicate that advances in fellows’ selfperceptions occurred in both the 1st and 2nd years, and were maximal in the first 3 months of training.
SUNDAY
J ALLERGY CLIN IMMUNOL VOLUME 139, NUMBER 2