Integration of a podcast curriculum (PC) to improve hematology oncology fellow (HOF) knowledge: A multi-center cluster randomized control trial.

Abstract

9001 Background: Medical podcasts are widely used as learning resources, yet their integration into fellowship curricula remains unstudied. We present the final analysis of a multicenter cluster randomized trial comparing a supplemental PC with the standard curriculum (SC) to SC alone for HOFs. Methods: Twenty-seven U.S. HOF programs were randomized to receive a novel PC with SC (podcast arm) or SC alone (control arm). The PC arm accessed a website with links to podcast episodes (PEs) and show notes covering breast cancer (BC), myeloma (MM), bleeding disorders (BD), and heparin induced thrombocytopenia (HIT). PEs were developed by The Fellow on Call and Two Onc Docs podcasts. Show notes were developed by The Fellow on Call . Pre- and post-intervention qualitative surveys (QS) and knowledge assessments (KA) were administered via REDCap. HOFs rated their comfort managing topics using a 7-point Likert scale. The KA was a 16-question multiple-choice test. ANCOVA analysis was used to compared post-intervention results. This study was powered for dual primary endpoints of mean QS improvement by 0.5 and KA improvement by 10% as previously published. Results: Pre-intervention QS and KA were completed by 220 (52%) and 187 (45%) HOFs, respectively. Post-intervention, 53/107 (49%) HOFs in the podcast arm and 46/113 (40%) in the control arm completed assessments. PGY distribution was similar between podcast and control arms: PGY 4 25% and 37%, PGY 5 32% and 30%, and PGY 6+ 43% and 33% (p=0.38). At baseline, 37 (69%) podcast-arm and 24 (52%) control-arm HOFs listened to medical podcasts. Detailed didactic characteristics for each institution and HOF learning preferences were previously presented. Baseline mean comfort levels (±SD) were comparable in podcast vs. control: BC (4.4±1.5 vs. 4.5±1.4), MM (4.5±1.2 vs. 4.4±1.4), BD (3.9±1.2 vs. 3.7±1.2), and HIT (5.5±1 vs. 5.5±1). Post-intervention paired mean comfort level difference (±SD) significantly improved in the podcast vs. control across topics (p<0.01): BC (1.4±0.4 vs. 0.9±0.2), MM (1.5±0.4 vs. 0.9±0.3), BD (1.6±0.3 vs. 1±0.2), and HIT (1.2±0.6 vs. 0.8±0.4). Composite mean KA improved from 39.7%±18.9 to 62%±19.2 in the podcast arm vs. 43.5%±19.2 to 50.3%±19.8 in the control arm. The podcast arm had significantly greater improvement with an adjusted mean difference of 15.5% (p<0.01). In the podcast arm, 44 (83%) utilized >50% of show notes and found them helpful, and 47 (89%) planned to continue using these podcasts. Results were not impacted after adjusting for baseline podcast use. Conclusions: To our knowledge, this is the largest cluster randomized trial of a pragmatic educational intervention in graduate medical education. The study met its dual primary endpoints, demonstrating that the podcasts significantly improved fellow comfort and knowledge in representative topics. Despite limitations of dropout and respondent bias, findings support integrating these podcasts as a recommended resource in hematology oncology education.