Web-based curriculum improves residents' knowledge of health care business

Curricular options for teaching and evaluating surgery residents' outcomes in systems-based practice are limited. A Web-based curriculum, MDContent, developed collaboratively by experts in business and surgery, provides learning experiences in the business of health care. The purpose of this study is to describe surgery residents' experience and learning outcomes associated with the curriculum.

Twenty-eight PGY3 to 6 general and plastic surgery residents were enrolled in the Web-based curriculum. Twenty-two residents (79%) completed the pretest, 11 modules, the post-test, and the course evaluation by the end of 1 year. The pretest and the post-test were 30-item multiple-choice exams based on a blueprint of the curricular objectives. Descriptive statistics were calculated on course evaluation and module completion data. Paired t-tests were used to compare pre- and post-test performance. Content analysis was performed on course evaluation written responses.

Residents' performance on the multiple choice exam improved significantly (p = 0.0001) from the pre-test (mean 59%, SD 12.1) to the post-test (mean 78%, SD 9.4), with an average gain of 19 percentage points. Participants rated their Web-based learning experience as very positive, with a majority of residents agreeing that the content was well organized, relevant, and an excellent learning experience around content not taught elsewhere in medical school or residency.

Participation in a Web-based curriculum on health care business improves surgery residents' knowledge about health care business concepts and principles. Residents with varying levels of interest in health care business provide positive ratings about their learning experience and indications that lessons learned would be applied in their clinical practice. MDContent is a feasible and effective method for teaching and assessing systems-based practice concepts.