[529] Cytology of the Week Cases (COWs): Impact of a Longitudinal Educational Intervention on Cytopathology RISE Scores

Kristie White, Elham Khanafshar. University of California, San Francisco, CA

Background: The ACGME program requirements for anatomic pathology require that residents examine 1,500 cytology specimens over the course of residency training. In the era of duty-hour limitations and continually expanding medical knowledge, attainment of this goal is increasingly challenging for residency programs.
Design: To increase the number of cytology specimens for residents, our program instituted a longitudinal program, cytology of the week cases (COWs), in 2010. Images of 2-5 cases with a corresponding line of clinical information are sent to residents on a weekly basis by a cytopathologist. Cases are housed on a secure department server. In addition, a direct link to the cases is on the password-protected departmental website, to enable off-site access. Residents are given one week to respond via email with diagnoses. Correct answers to the cases are emailed to residents and published on the departmental website weekly. COWs participation is entirely voluntary. Collaboration and use of ancillary materials to arrive at a diagnosis is allowed. Rise scores were de-identified for analysis.
Results: An increase of 445% in mean points attempted (PA) was seen between the first and second year of the program (14.7 to 77.7).

Table 1: Participation
Academic YearN = ParticipantsMean Points Attempted (PA)SDRange (pts)

Dummy variables were created for PA below mean (0-77) and above mean (78-145) participation. Multiple regression analysis of 2012 PA on the cytopathology RISE percentile scores demonstrated an estimated mean RISE percentile score 33% higher for residents with above average participation in COWs compared to those with below average participation (p=.006, t=3.03, CI=11-56%). We controlled for year of training and for residents committed to a cytology fellowship in the regression analysis. The program's RISE national percentile score in cytopathology increased by 7% from 2011 to 2012; however, the difference is not statistically significant.
Conclusions: Participation in a longitudinal COWs program correlates with an increase in RISE cytopathology scores. COWs is a feasible educational intervention from a program perspective, and residents participate voluntarily. Pathology residency training programs can utilize COWs to meet ACGME training requirements and to effectively enhance cytopathology teaching. Additionally, data collected from COWs can be used to identify global areas of diagnostic weakness among residents for future intervention in cytology and may have applications in other areas.
Category: Education

Tuesday, March 5, 2013 9:30 AM

Poster Session III # 56, Tuesday Morning


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