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Open Access Publications from the University of California

Learning Silos: Are we adequately preparing our residents for clinical practice?

Creative Commons 'BY' version 4.0 license

Learning Objectives: Audience members will learn how to implement experiential teaching strategies/modalities that diminish learning silos and allow for integrated learning to meet the educational objectives of varying residency requirements (EM milestones, EM boards, and clinical practice).

Introduction: Traditional conference format provides instruction on core EM content to help residents meet EM milestones. Independent board review questions allow residents to practice EM board questions. Clinical practice allows for the application of some EM knowledge to actual patients. However, these learning silos may prevent higher level cognitive integration of EM knowledge to adequately prepare our residents to care for patients in the real world while simultaneously achieving their career milestones.

Curricular Design: Our leadership team developed theme-based experiential conference with an integrated and innovative system for active learning to remove segregated teaching of EM milestones, board knowledge and clinical practice. For each theme (eg. renal disease), we used a semi-competitive game style online learning platform for oral board review to provide high yield facts which were then reinforced by case-based small group oral board style education. Building on the former two educational activities, the residents learned nuances of clinical practice taught through asynchronous independent interactive learning modules (eg. CT or not in renal colic). All teaching modalities took place within a 4 week block and this concept was repeated with different themes throughout the academic year. With this teaching strategy, integration of all acquired knowledge occurred before reaching the clinical environment and was intended to augment clinical practice.

Impact: Implementation of this innovation has improved resident engagement with nearly 100% active participation (of those in attendance) in didactics. Residents have also provided positive feedback during weekly conference evaluation regarding the integration, active learning, and asynchronous activities. Future implementation may include senior residents as small group facilitators and more focused quantitative evaluation.

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