Using a simulated practice to improve practice management learning

Practice management education is required in family medicine residencies, and requirements have recently been expanded. Surveys show that graduates feel unprepared to address practice management after graduation, so it is an aspect of training in need of improvement.

We substituted a "simulated practice" for part of an established didactic program in practice management. The curriculum included 20 modules with specific practice management tasks to be completed by the residents. An objective examination covering a broad range of practice management topics was created and given twice to residents, once early in their second year and again at the end of third year. One group of residents participated in the simulated practice curriculum, and a comparison group participated in a standard didactic curriculum.

Our pre-test and post-test examinations each produced reliable data. Residents with simulated practice training had statistically significant increases in exam scores while the comparison group did not. The simulated practice group also increased scores on every subsection of the exam, while the comparison group increased scores on only half of the subsections. However, only one resident (in the intervention group) achieved >60% correct answers on the post-test examination.

The increased learning demonstrated by improved test performance suggests that a simulated practice approach is more helpful than a standard didactic curriculum for teaching residents about practice management, but it still does not yield knowledge scores at an optimal level.