Effectiveness of a Cardiology Review Course for Internal Medicine Residents Using Simulation Technology and Deliberate Practice

Background: Objective evaluations of residents' clinical skills reveal serious deficits. Purpose: To develop, implement, and evaluate outcomes from a review course in cardiology bedside skills for internal medicine residents. Methods: We used a 1-group pretest-posttest design with historical comparisons.The study was conducted at the University of Miami School of Medicine as part of the internal medicine residency program from July 1999 to June 2000. A total of 67 2nd- and 3rd-year medicine residents received an educational intervention involving deliberate practice using simulation technology. A total of 155 4th-year medical students in one intervention and one comparison group (n = 53) served as historical comparisons. Outcome measures were a reliable computer-delivered pretest and posttest that evaluate cardiology bedside skills. Results: Residents who received the review course and medical students who received a comparable educational intervention showed large and statistically significant pretest-to-posttest improvement in bedside skills. These 2 groups are also significantly and substantially different at posttest from a comparison group of 4th-year medical students that did not receive a specific educational intervention. Conclusion: Educational interventions using simulation technology that engage learners in deliberate practice of clinical skills produce large improvements in a relatively short time, with little faculty involvement.

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