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A Novel Approach to Pediatric Resident Education is Associated with Higher In-training Exam ScoresSarah Towner Wright¹, MLS, Sue Tolleson-Rinehart², PhD, William Henry Lagarde¹, MD, FAAP

¹Department of Pediatrics and ²School of Public Health, University of North Carolina, Chapel Hill, North Carolina

Objective

Methods Background Figure 2: Online Resident Survey ( administered through www.surveymonkey.com)

Conclusions

To determine the effect of a novel and dedicated clinical librarian program on pediatric resident education and learning.

In recent years, the rapid pace of medicine has placed increasing pressure on Pediatric residency training programs to provide up-to-date educational resources in an efficient and effective manner. To this end, a novel educational and informatics program called the London-Lynch Learning Center (LLLC) has been developed and integrated into the Pediatric and Medicine/Pediatric residency training programs at the University of North Carolina at Chapel Hill. The LLLC consists of: 1) a part-time Health Sciences Librarian who is available to assist with the learning needs of the residents, medical students, and faculty; 2) a physical learning center with resources including computers with internet access, a photocopier, scanner, color printer, and conference room with projector; and 3) continuous access online learning resources through a dedicated website www.uncpeds.org that contains links to electronic learning resources, rotation-related learning resources, presentations, and administrative documents including conference schedules, and call schedules.

Figure 1: London-Lynch Learning Center, UNC Department of Pediatrics. The physical resources of the London-Lynch Learning Center include computers with internet

access, a photocopier, scanner, color printer, and conference room with projector.

• The London-Lynch Learning Center (LLLC) was available to all residents from a three year Pediatric and four year Medicine/Pediatrics residency training program from July 1st, 2003 to June 30th, 2006.

• LLLC resources included: 1) a part-time clinical librarian with affiliation to an academic health sciences library located on campus; 2) physical learning center resources (Figure 1); and 3) Web-based learning resources available through the www.uncpeds.org web site.

• In June of 2005 and 2006, all residents were asked to complete a brief confidential 10-question online survey administered through www.surveymonkey.com (Figure 2).

• 2005 In-training exam (ITE) scores were obtained for all residents. ITEs are practice Pediatric certifying exams administered by the American Board of Pediatrics at the beginning of each year of pediatric residency training.

• ITE scores were stratified into two groups based upon LLLC use: daily to several times per month and monthly or less. A one-way ANOVA was used to test for differences in ITE scores between groups.

• The correlation coefficient (r) between different kinds of uses of the LLLC and ITE scores was determined and tested for significance.

1. How often do you use the London-Lynch Learning Center (the physical site) and/or its services/librarian assistance?

●Daily ● Once a Month● Once a Week ● Rarely● Several Times a Month ● Never

2. For what purpose(s) do you use the LLLC or librarian assistance? ● Pubmed Searching● Non-MEDLINE searching/computer use● Powerpoint/presentation preparation and assistance● Scanning documents● Photocopying

3. Please answer the following questions using this scale: 1-extremely important/helpful 4-somewhat important/helpful2-very important/very helpful 5-not at all3-important/ helpful 0-N/A

a. How HELPFUL is the LLLC to you in caring for your patients?b. How HELPFUL is the librarian in altering/changing how you would treat a patient

based on information provided by the librarian?c. How HELPFUL is having a librarian on rounds to enhance your patient care? d. How IMPORTANT is it that a librarian is available to assist you with clinical

questions/ research/rounding? e. How HELPFUL is the LLLC to you in assisting with clinical or other research? f. How HELPFUL has the librarian been in increasing your PubMed searching skills

during your residency? g. How IMPORTANT is the LLLC in recruiting new residents?

4. How often do you use the uncpeds.org web site?● Daily ● Once a Month● Once a Week ● Rarely● Several Times a Month ● Never

5. For what reasons do you use the uncpeds.org web site? ● Link to electronic resources ● Conference schedules● Clinic conference readings ● Subspecialty/rotation info and readings● Access to presentations ● Evaluations

6. What additional resources/links or changes to the uncpeds.org web site would you like to see? (open-ended question)

7. How useful is the uncpeds.org web site to you during your residency?● Extremely Useful ● Somewhat Useful● Very Useful ● Not at all Useful● seful ● I’ve never used the web site

8. What services would you like to see the LLLC provide that are not currently provided? (open-ended question)

9. How useful has the LLLC been to you during your residency?● Extremely Useful ● Somewhat Useful● Very Useful ● Not at all● Useful ● Never used the service

10. I am:● PL-1 ● MP-1● PL-2 ● MP-2● PL-3 ● MP-3

● MP-4

Results (continued)

Percent of Residents Who Say the London-Lynch Learning Center is Very or Extremely Useful

(4 or 5 on 5 point Likert Scale; n = 62)

To caring for patients 29.7

To altering treatment 28.1

Librarian helpful on rounds 42.2

Librarian helpful on clinical questions 54.7

Librarian helpful to clinical research 59.4

Increasing PubMed searching skills 36.0

To recruiting new residents 28.2

To my residency 50.8

Table 2: Resident Perception of London Lynch Learning Center

Learning Center Use Mean 2005 ITE Score

Daily to Several Times per Month 397.7

Monthly or Less Often 301.1

Mean 2005 pediatric in-training exam scores were compared by one-way ANOVA. There was a significant difference in scores between the two groups (n=43 surveys; p= 0.035).

●The London-Lynch Learning Center (LLLC) use is associated with improved pediatric resident education and learning.

● Residents perceive the LLLC as a valuable resource for their pediatric education.

●The description of the existence of a positive relationship between LLLC use and ITE performance is an vital step in establishing the importance of a dedicated librarian and Learning Center in Pediatric resident education.

● A prospective study is needed to determine if the association between LLLC use and improved ITE performance is a causal relationship.

UNC-Chapel Hill Department of Pediatrics Residency Web site: www.uncpeds.org

Residency Survey: Distributed through www.surveymonkey.com

● More frequent LLLC use is associated with significantly higher ITE scores (Table 1).

● The number of different kinds of uses of the LLLC is positively correlated with pediatric in-training exam scores (n=43, r= 0.337; p= 0.027).

● The LLLC is perceived by the residents to be very important to their pediatric education (Table 2).

Table 1: Mean 2005 Pediatric In-Service Exam Scores by Learning Center use

Results