An Effective Multimodal Curriculum to Teach Internal Medicine Residents Evidence-Based Breast Health

Breast health is an area fraught with controversy and missed opportunities to meet women's needs, and the state of internal medicine residency training in this area is inadequate.

Our objective was to develop, implement, and evaluate a curriculum to equip internal medicine residents with the knowledge and skills to deliver high-quality, comprehensive breast health care.

We developed a 4-hour curriculum for internal medicine interns. It incorporated a team-based learning format and used MammaCare breast model software to teach and evaluate the clinical breast examination. We compared interns' precurriculum and postcurriculum test results to a historical comparison group of postgraduate year (PGY)-2 interns who did not complete the curriculum. We retested interns as PGY-2s to assess knowledge retention.

A total 41 of 52 interns (79%) completed the curriculum. Their average MammaCare scores improved from 63% to 91%. Scores on a knowledge-based assessment improved from 47% on the pretest to 85% on the posttest (P < .001). Comparison PGY-2s who did not complete the curriculum averaged a score of 52% (P < .001). When retested 9 months after exposure to the curriculum, participants' mean score was 63% (compared to historical comparison PGY-2 group, P < .001). Only 9% of interns who retook the test as PGY-2s reported having received any breast health training subsequent to curriculum completion.

A targeted half-day, low-cost breast health curriculum significantly improved knowledge and skills in multiple domains, and these improvements were retained in subsequent assessment despite minimal reinforcement in residency training.