Case-based peer teaching for pain medicine fellows: a curriculum for diverse residency backgrounds

Pain medicine is an advanced medical subspecialty incorporating trainees from diverse primary disciplines. A curriculum that does not assess or promote the trainees' differential expertise developed from their primary specialties may silo instead of promoting collaborative learning in a multidisciplinary subspecialty.

We created a Kern-guided curriculum for the pain medicine fellowship utilizing case-based modules and a novel note-taking and knowledge-sharing format. Nine faculty-led, case-based modules of increasing complexity were developed based on pain medicine competency content. Pain medicine fellows were instructed to actively designate prior and new knowledge into 4 categories: prior knowledge that is accurate and relevant, inaccurate prior knowledge, new knowledge gained from peers, and new knowledge for all trainees. After each case study, each fellow acknowledged "new knowledge gained from peers" and prepared a brief teach-back of "new knowledge for all trainees" at the beginning of the next session. Fellow participants were assessed for their reactions to the curriculum via anonymized surveys.

The curriculum was implemented at a single institution pain medicine fellowship from 2021 to 2023. At the end of this curriculum, 90% of participants reported improved knowledge retention through participating in this case-based curriculum compared to the traditional didactic format, and 80% of participants reported increased respect for their peers.

We created a novel note-taking and knowledge-sharing platform, anchored by a well-established case-based educational strategy, to improve the learning environment and knowledge retention for multidisciplinary trainees with heterogeneous baseline knowledge.