Multicenter implementation of a shared graduate medical education resource

Background: The Accreditation Council of Graduate Medical Education (ACGME) is changing residency program assessment to include education outcomes assessment, challenging resources of residency training programs. The internet is a means of sharing education resources among training programs. Methods: A multicenter survey was distributed to leaders of 80 internal medicine residency training programs that shared an online medical knowledge curriculum that included education outcomes assessment. Program characteristics, curriculum implementation methods, and use of educational outcome assessment were analyzed to determine how implementation differed among programs. Results: Seventy-four programs (92%) completed the survey. The programs vary in medical school affiliation, number of house staff, and proportion of students who specialize on graduation. They most commonly use the curriculum to augment a preexisting curriculum (37 programs [50%]); 41 programs (56%) use the curriculum to comply with ACGME requirements. The programs differ in how they adapt the curriculum to their needs, most commonly by discussing modules with house staff (47 programs [63%]). In 61 programs (82%), module completion is mandatory. Thirty-five programs (47%) use penalties to encourage module completion, most commonly poor evaluation scores (15 programs [20%]) or withholding of promotion (12 programs [16%]). Nearly all programs (71 [97%]) track module completion; 34 programs (47%) track group performance on learning objectives; and 8 programs (11%) alter their educational curriculum based on group performance. Conclusions: A medical knowledge curriculum that includes education outcome assessment can be adapted at a range of residency training programs, helping them to comply with ACGME requirements. However, most residency training programs are not using outcomes data to their full potential.