Background: Transitioning from medical school to internship is challenging; prior investigations have evaluated pre-graduation or early internship boot camps, but there is no previously described curriculum for the time gap between Match Day and start of internship. We designed a curriculum for implementation during this time gap using the social media platform Slack, envisioned to refresh clinical knowledge with collaborative learning via clinical cases. Our hypothesis was that the Slack curriculum would increase self-reported comfort of newly matched interns with seven clinical objectives.
Methods: This is a prospective observational pilot study of 36 newly matched EM interns at three residency programs. The curriculum is published at (https://jetem.org/socialmedia_inn/). Subjects completed a pre survey using a Likert scale to assess comfort with the clinical objectives. (The objectives were determining necessity of diagnostic studies; interpreting radiographs, ultrasounds, and CT images; constructing a differential diagnosis; identifying airway anatomy and physiology; and describing basic biostatistics principles.) The curriculum was implemented in spring of 2018. Interns completed a post survey which re-assessed comfort. Data was analyzed with the unpaired t-test.
Results: There were no exclusion criteria, and participation was voluntary. All 36 interns completed the pre survey and 26 completed the post survey. Participants reported statistically significant increase in comfort with identifying airway anatomy and physiology (p=0.01). Mean comfort increased, but was not statistically significant, for 5 of the 6 remaining objectives. One objective (interpreting radiographs) showed no change. Of the 26 post survey participants, 16 agreed that Slack was an effective way to present the curriculum, and 5 disagreed.
Conclusion: The Slack curriculum significantly increased intern comfort with identifying airway anatomy and physiology. A majority of interns felt that Slack was an effective way to present the curriculum. This pilot study was limited by small sample size, making type II error likely because it was underpowered. Interns who found the curriculum less useful may also have been less likely to complete the post survey. The study was not designed to measure clinical knowledge improvements. Future directions will address these issues.