Implementation Science

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Curricula for teaching the content of clinical practice guidelines to family medicine and internal medicine residents in the US: a survey study

Elie A Akl1,2*, Reem Mustafa1, Mark C Wilson3, Andrew Symons2, Amir Moheet4,5, Thomas Rosenthal2, Gordon H Guyatt7,6 and Holger J Schünemann7

Author Affiliations

1 Department of Medicine, State University of New York at Buffalo, NY, USA

2 Department of Family Medicine, State University of New York at Buffalo, NY, USA

3 Department of Internal medicine, University of Iowa, IA, USA

4 Department of Medicine, Rochester General Hospital, Rochester, NY, USA

5 Department of Medicine, University of Rochester, NY, USA

6 Department of Medicine, McMaster University, Hamilton, ON, Canada

7 Department of Clinical Epidemiology & Biostatistics, CLARITY Research Group, McMaster University, Hamilton, ON, Canada

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Implementation Science 2009, 4:59 doi:10.1186/1748-5908-4-59

Published: 21 September 2009

Abstract

Background

Teaching the content of clinical practice guidelines (CPGs) is important to both clinical care and graduate medical education. The objective of this study was to determine the characteristics of curricula for teaching the content of CPGs in family medicine and internal medicine residency programs in the United States.

Methods

We surveyed the directors of family medicine and internal medicine residency programs in the United States. The questionnaire included questions about the characteristics of the teaching of CPGs: goals and objectives, educational activities, evaluation, aspects of CPGs that the program teaches, the methods of making texts of CPGs available to residents, and the major barriers to teaching CPGs.

Results

Of 434 programs responding (out of 839, 52%), 14% percent reported having written goals and objectives related to teaching CPGs. The most frequently taught aspect was the content of specific CPGs (76%). The top two educational strategies used were didactic sessions (76%) and journal clubs (64%). Auditing for adherence by residents was the primary evaluation strategy (44%), although 36% of program directors conducted no evaluation. Programs made texts of CPGs available to residents most commonly in the form of paper copies (54%) while the most important barrier was time constraints on faculty (56%).

Conclusion

Residency programs teach different aspects of CPGs to varying degrees, and the majority uses educational strategies not supported by research evidence.