title: Novel educational interventions in residency increase knowledge of chronic liver disease and career interest in hepatology.
abstract: There is an increasing burden of chronic liver disease (CLD) in the United States but a significant shortage of hepatologists. Thus, it is necessary to develop new recruitment strategies to the field of hepatology as well as ensure that non-gastroenterology-trained physicians are able to capably assist in the care of CLD. We established a novel, nonelective, inpatient hepatology rotation that uses required modules in the American Association for the Study of Liver Diseases Curriculum and Training-First Hepatitis B and C curriculums as well as in LiverLearning. A paper-based anonymous assessment was distributed to the inaugural 25 postgraduate years 2 and 3 internal medicine residents before and after the 2-week rotation over the course of 1 year. Both the prerotation and postrotation assessments included validated multiple-choice questions and Likert-type questions, which evaluated self-perceived knowledge and comfort with managing CLD. The mean comfort level (1 = not at all comfortable/strongly disagree, 5 = very comfortable/strongly agree) of managing several common liver diseases increased significantly after completion of the rotation (i.e., cirrhosis 2.8 versus 3.8, P < 0.001; hepatitis B 2.4 versus 3.4, P = 0.001; hepatitis C 2.6 versus 3.7, P = 0.002; nonalcoholic steatohepatitis 3.0 versus 4.0, P < 0.001; liver transplant care 2.1 versus 3.4, P < 0.001). There was also a significantly increased interest in hepatology as a career (2.6 versus 3.0, P = 0.03). Finally, the mean percentage of multiple-choice questions answered correctly on the pretest was 62% and posttest was 77% (P = 0.02).
  
  
  
  Our novel curriculum and nonelective hepatology rotation has effectively demonstrated improvement in internal medicine residents' comfort with and knowledge of CLD, and increased career interest in hepatology was also observed after completion of the curriculum, which suggests that more exposure to CLD could positively impact recruitment to the workforce; larger, multicenter studies are needed to validate these results. (Hepatology 2016;64:2210-2218).
authors: Center for Liver Diseases, The University of Chicago Medicine, Chicago, IL.
authors: Adam E
authors: 0000-0001-6002-6489
authors: AE
authors: Mikolajczyk
authors: Internal Medicine Residency Program, The University of Chicago Medicine, Chicago, IL.
authors: Jeanne M
authors: JM
authors: Farnan
authors: Internal Medicine Residency Program, The University of Chicago Medicine, Chicago, IL.
authors: John F
authors: JF
authors: McConville
authors: Center for Liver Diseases, The University of Chicago Medicine, Chicago, IL.
authors: Donald M
authors: DM
authors: Jensen
authors: Center for Liver Diseases, The University of Chicago Medicine, Chicago, IL.
authors: K Gautham
authors: KG
authors: Reddy
authors: Center for Liver Diseases, The University of Chicago Medicine, Chicago, IL.
authors: Helen S
authors: HS
authors: Te
authors: Section of Hepatology, Rush University Medical Center, Chicago, IL.
authors: Nancy
authors: N
authors: Reau
authors: Center for Liver Diseases, The University of Chicago Medicine, Chicago, IL.
authors: Andrew I
authors: AI
authors: Aronsohn
mesh_terms: D002321:Career Choice; D002908:Chronic Disease; D002983:Clinical Competence; D003479:Curriculum; D005260:Female; D005762:Gastroenterology / Q000193:education*; D006801:Humans; D007388:Internal Medicine / Q000193:education; D007396:Internship and Residency; D008107:Liver Diseases; D008297:Male; D014481:United States