Program Director’s Corner – August 2018
Practical Application of the APDEM Curriculum
Dr. Richard Comi, MD
Richard.J.Comi@hitchcock.org
Program Director, Endocrinology and Metabolism
Dartmouth Hitchcock Medical Center
The APDEM website contains a number of resources but it is always hard in a busy practice and program to be aware of or how to use every one. One resource I had not previously focused on was the APDEM curriculum When I finally reviewed it, I noted it was more of a list than a curriculum, but there was obviously a lot of work and thought invested in an attempt to be comprehensive. My own curriculum is written in a more narrative style. In comparing the two, I decided that the APDEM curriculum would be more useful than my own curriculum as a way to assess the comprehensiveness of my own program didactics in two ways. First, the listing approach made it convenient as a topic review – I was curious to know if my fellows recall a lecture or a patient that touched on every topic. Secondly, it was an opportunity for an objective “virtual outside reviewer” assessment of my program’s content, since several people outside my program had put this together .
I used the following process. First I printed out three copies of the curriculum, one for me and one each for the two second year fellows (in their 20th month of the 24 month fellowship). Each of us then went through the curriculum and used a marker to highlight topics we did not recall being covered by either lecture or patient experience. I then collated the three copies, focusing on topics highlighted by both the fellows and the program director – I assumed that these were topics not covered at all. Interestingly, I had highlighted more topics than the fellows, a reminder that many things, including many good things, go on beyond the awareness of the program director ! I also looked carefully at topics highlighted by the fellows but not me and included them as uncovered if I could not recall the specific place in the program where they were addressed.
Once I had a list of topics that apparently were not touched on during the course of the fellowship, I segregated them into topics by organ system and then notified the faculty member who lectured on that system in our didactics to ask them to include those specific topics. It was not a huge list – 4-8 topic areas per faculty member and most commonly a basic science topic like “embryology and development of the adrenal gland”.
I found this to be a very efficient way to review the knowledge content of my program in a way that engaged the learners, the recipients of that content. I plan to use this on an annual basis with the graduating fellows.