Case study: University of Washington
The University of Washington is equipping Medical Residents, one text at a time.
The University of Washington is home to one of the top-ranked medical schools in the country.
The UW Medicine Healthcare system is home to one of the top-ranked medical schools in the country, an internationally recognized research center, and thousands of remarkable healthcare professionals working to put patient needs above all else.
Nick Burns, a second-year fellow in maternal-fetal medicine at the University of Washington, is no stranger to studying. After four intense years of medical school, Burns completed his OB/GYN residency at Brown University, where he was forced to find time to study while completing an 80 hour workweek. Watching his fellow residents face the same struggle, he began to wonder what new forms of educational resources could change residency education from an impossible task to a seamless integration.
"Particularly for my target audience, medical residents, they're just busy humans who do not have time to learn traditionally. But yet, in medical education, that's often how they insist on teaching them...Arist provided a very simple way to try and break up the monotony of what is current medical education."
THE NEED FOR DIGESTIBLE LEARNING
Burns began addressing the issue by launching a podcast called CREOGS Over Coffee. The goal was to compress the dense textbook chapters used to prepare for residents’ annual CREOG exam into digestible 15-minute segments. But while CREOGS Over Coffee served as an excellent study tool, it only solved a part of the problem. Residents still had to take the initiative to find the episodes, determine the concepts they needed to review and focus in on the material delivered. When Burns’ podcast co-host, a maternal-fetal medicine fellow at the University of Pennsylvania, mentioned hearing about Arist, both fellows immediately saw an opportunity to widen their scope of residency education reform.
"Arist gave us the ability to have something that's very casual and serves the learner that we were looking for, but also it's something that was trustworthy and that I was able to get such robust data back out from. It was a really, really valuable tool."
OVERCOMING LEARNING CHALLENGES VIA TEXT
Putting the course together
Burns initially piloted Arist by designing a 45-day CREOG review course aimed at UW residents. Each day, the residents would receive one multiple choice question. When a resident texted back their answer, they immediately received feedback with links to resources to further understand that day’s review topic. “The residents loved it,” Burns recalled. Whether in the middle of a night shift or a hectic clinic day, each resident was able to spare a minute to answer the question and read through the feedback as soon as they had a break.
Excited by these results, Burns turned towards a larger audience: OB/GYN interns nationwide. Interns, or first year residents, come from a wide array of backgrounds and previous experiences. Despite receiving similar medical school training, interns varied undergraduate and early education often leaves foundational knowledge gaps that can make their initial year of residency a challenging learning experience. To help close these gaps, Burns worked with a team of medical educators and residents at UW, the University of Pennsylvania, and the University of Michigan to design a pre-residency text message course. This 25-day course covered foundational topics in obstetrics and gynecology, getting new residents ready to take care of patients on day one of their career as doctors.
"I think the really exciting piece of this in our context is that we were asking medical students in the month of free time that they had before starting residency to come do this learning course with us. So it was like, ‘It's my summer vacation and I'm going to do this text message course.’ And I got them to complete it 82% of the time."
A meaningful impact
Out of the 1400 OB/GYN interns in the US, Burns and the UW team saw a remarkable 1100 interns register for their text message course, with 82% of those interns completing the entire course. Despite the vast majority of these interns never participating in a prior text message course, 93% of participants described it as “extremely enjoyable.” In a post-assessment survey, the team found that those who completed the course improved their scores on a knowledge assessment by 12%, with more substantial gains for those who had performed more poorly prior to the course.
Perhaps even more impactful than the education was the data this course provided for Burns and his team. This spring, the team will be presenting key findings from this data to help identify and support interns coming from disadvantaged backgrounds or unsupportive education environments.