Development and Implementation of a Novel Curriculum for Emergent Management of Adults with Congenital Heart Disease.

The number of adults with congenital heart disease is rapidly increasing, resulting in more emergency care needs of this unique population. Concomitantly, the number of physicians trained in adult congenital heart disease (ACHD) care is insufficient, leading to physicians with limited experience assuming primary responsibility for the management of acute illness. We developed a simulation-based curriculum consisting of three cases and linked assessment instruments for fellows in multiple training programs to enhance their experience in this growing field. A 40-min asynchronous didactic presentation on ACHD emergencies was provided between pretests and posttests. Each participant was given checklist, global, and timeliness scores, and a second rater scored a subset to assess inter-rater reliability. Twenty-two participants across multiple disciplines completed the study. Our results demonstrate a significant and meaningful improvement in checklist scores, as well as a significant improvement in the secondary measures of global and efficiency performance from the first simulation to the second. Comfort levels for trainees improved significantly on post-test surveys. Inter-rater reliability was greater than 0.6 for all assessments. In conclusion, our novel simulation-based educational curriculum improved trainee performance in managing emergencies in adults with congenital heart disease, and we provide validity evidence for use of our checklist in training fellows for formative feedback.

Core Cardiology Training Symposium (COCATS) Standards and Board Certifications: Implications for Fellows-in-Training Seeking Employment.

The Core Cardiology Training Symposium (COCATS) standards are recommendations endorsed by the American College of Cardiology to assist cardiology fellowship program training directors in curricular design. In addition to seeking COCATS standards as evidence of proficiency in cardiovascular skills, Fellows-In-Training (FITs) often pursue board certifications to maximize their hiring potential. The costs and barriers with COCATS standards and board certification processes are not insignificant, however the degree to which the job marketplace demands them has not been well characterized. The intent of this investigation study was to estimate the demand for COCATS standards and board certification in cardiology job advertisements. We conducted a cross-sectional survey of job listings on the American College of Cardiology's "Cardiology Careers" page, to establish how often advanced COCATS standards and certifications are requested. Of a total of 314 total cardiology job postings (including 133 academic positions), only eight (2.5%) job postings explicitly noted COCATS standards. Aside from American Board of Internal Medicine subspecialty certification, only 8.60% required certification in another cardiology related board certification. Despite the perception that COCATS standards and subspecialty certifications are vital to the cardiology job application process, our analysis suggests that few job postings require them. Concern regarding COCATS standards and subspecialty certification of FITs may be out of proportion to the relevance of these achievements on the current job market.

Medical education in pediatric and congenital heart disease: A focus on generational learning and technology in education.

Medical education is a complex interplay between teacher and trainee with the ultimate goal of producing competent physicians who provide excellent patient care. Physician education has evolved over centuries, from the apprenticeship of barber-surgeon through generations of bedside teachers and now evolving use of technology based instruction. All of these educational practices are based on expert assessment of effective techniques for imparting experience and knowledge to a new group of learners, the young doctor. In the past several decades, exponential growth in both medical innovation and technology development has occurred, leaving the current landscape of medical education with a substantial amount of medical data as well as innovative platforms for information access and distribution. These rapid changes have led to stark differences between medical educators and learners in their world views and preferences relating to teaching and learning. Therefore, understanding how the current generation of medical trainees perceives the world, accesses and retains information is imperative to effective education. The concept of generational learning can be used as a framework to identify teaching and learning preferences and help build relevant and effective educational content. This review article aims to outline our current understanding of generational characteristics, learning styles, and preferences. Using this framework, we will explore innovative educational content relevant to pediatric cardiology. Finally, we propose that a methodical approach to curriculum development will forge this generational gap and lead to even more effective and sharable educational content within our field.

Predicting Quality of Clinical Performance From Cardiology Fellowship Applications.

Variables in cardiology fellowship applications have not been objectively analyzed against applicants' subsequent clinical performance. We investigated possible correlations in a retrospective cohort study of 65 cardiology fellows at the Mayo Clinic (Rochester, Minn) who began 2 years of clinical training from July 2007 through July 2013. Application variables included the strength of comparative statements in recommendation letters and the authors' academic ranks, membership status in the Alpha Omega Alpha Honor Medical Society, awards earned, volunteer activities, United States Medical Licensing Examination (USMLE) scores, advanced degrees, publications, and completion of a residency program ranked in the top 6 in the United States. The outcome was clinical performance as measured by a mean of faculty evaluation scores during clinical training. The overall mean evaluation score was 4.07 ± 0.18 (scale, 1-5). After multivariable analysis, evaluation scores were associated with Alpha Omega Alpha designation (ß=0.13; 95% CI, 0.01-0.25; P=0.03), residency program reputation (ß=0.13; 95% CI, 0.05-0.21; P=0.004), and strength of comparative statements in recommendation letters (ß=0.08; 95% CI, 0.01-0.15; P=0.02), particularly in letters from residency program directors (ß=0.05; 95% CI, 0.01-0.08; P=0.009). Objective factors to consider in the cardiology fellowship application include Alpha Omega Alpha membership, residency program reputation, and comparative statements from residency program directors.