On-shift resident education about hematologic and oncologic emergencies: A needs-based assessment.

Abstract

9020 Background: Hematology/oncology (H/O) is a fundamental topic for the American Board of Internal Medicine (ABIM); however, there are few resources designed for resident-level education. While asynchronous approaches have gained popularity, there can be a synergistic effect to cementing understanding during clinical exposure. Rotations provide this opportunity, but limited tools exist to augment practice-based learning. Multimodal approaches, such as self-directed text and near-peer educational models, are rarely accessible on shift. The breadth and depth of such resources can make it difficult for users to distill salient information during patient care. This needs-based assessment (NBA) sought to characterize residents’ attitudes towards on-shift learning as well as their comfort with diagnosing and treating 3 common H/O emergencies. Methods: An NBA survey was sent to 104 internal medicine (IM) and medicine-pediatrics (MP) residents at an academic medical center. Descriptive statistics are reported. Results: Fifty-five of 104 residents completed the survey, for a response rate of 53%. Forty-seven percent were post-graduate year (PGY) 1, 25.5% were PGY-2, 25.5% were PGY-3 and 2% were PGY-4. While 98% of respondents use educational resources on shift, only 6% had a H/O specific resource. The most used resources were Up-to-Date (98%), the Mass General Hospital WhiteBook (75%), PubMed (47%), and artificial intelligence (AI) (47%). The biggest barriers to resource utilization were lack of time due to clinical responsibilities (76%) and length of resource (69%). Ninety-one percent indicated interest in a resource designed for shift-based learning and would most value guideline inclusion (80%). While most residents (62%) were comfortable diagnosing tumor lysis syndrome (TLS) and febrile neutropenia (FN) (69%), they were neutral/uncomfortable with diagnosing hyperleukocytosis (71%). Most were comfortable treating FN (53%) but were neutral/uncomfortable with treating TLS (60%) or hyperleukocytosis (96%). There was a statistically significant difference between PGY-1 and PGY-2+ in comfort with diagnosis (p=.0018) and treatment (p<.001) of FN as well as the treatment (p=.0132) of TLS. There was no significant difference in comfort with TLS diagnosis, or hyperleukocytosis diagnosis or treatment among PGY. Conclusions: This assessment demonstrates an overwhelming interest in an easily accessible, guidelines-based, electronic resource for residents to utilize during clinical care. Though a medical emergency, hyperleukocytosis is a H/O diagnosis that our program’s residents are not comfortable identifying or managing. These results highlight the opportunity for growth in H/O education of IM/MP residents and will guide the design of a digital education resource, as well as its implementation and evaluation at our institution.