Fellow Boston Children's Hospital Boston, Massachusetts, United States
Background: Virtual learning was necessitated by the COVID-19 pandemic; as precautions lessened, learning experiences evolved into a mixed in-person and virtual hybrid format but how best to teach and learn in a hybrid setting is underexplored. At Boston Children’s Hospital Pulmonary Medicine Fellowship, fellow and attending physicians participate in a now-hybrid weekly case conference wherein a fellow presents a patient case for discussion. The hybrid format is not optimized for participation and learning; a needs assessment survey of fellows found that it lacked structure to encourage online participation and facilitate case discussion. Thus, this conference was selected as a test case to further explore how to structure and enhance hybrid learning. Objective: To develop a structure for case conference with adaptations specific to hybrid learning that promote participation and facilitate discussion. Design/Methods: Using Kern's 6-step approach, we conducted a literature review on best practice for 1. case conference and 2. virtual learning, and used it to develop a needs assessment survey that explored hybrid participation, facilitation, and learning. Identified areas for improvement included encouragement of fellow participation, incorporation of facilitation strategies, and an improved structure for case delivery. We developed and implemented a model, “PRESENT” to address these points. PRESENT incorporates apprenticeship theory and cognitive load reduction, and includes seven interactive steps to facilitate hybrid learning. We designed an evaluation using the Kirkpatrick model, which includes a re-assessment survey after 6 months of utilization (Jan. 2024). Responses will be summarized by frequency and percentages for comparison to our initial assessment. We will conduct focus groups to understand how PRESENT influences fellow learning (Feb. 2024). Inductive coding and thematic analysis of focus group transcripts will be performed (Mar. 2024). We secured institutional grant funding to support qualitative data collection and analysis and obtained IRB exemption for this research.
