Comparison of horizontal and traditional block family medicine curricula: Canadian study

Longitudinal curriculum model outcomes in postgraduate medical education are not well documented. The authors aimed to compare satisfaction, learning, clinical exposure, and practice intentions between longitudinal family medicine (FM) curricula and traditional rotational ("block") curricula.

This curriculum structure evaluation used a retrospective quasi-experimental study design using data from the College of Family Physicians of Canada Family Medicine Longitudinal Survey.

The project used data from 3 FM residency programs for the entry years 2014 to 2017.

A total of 1283 residents across 49 teaching sites were invited to participate at program entry (T1) and residency completion (T2).

Data were categorized by horizontal curriculum or block curriculum. The authors used the Kirkpatrick taxonomy to compare satisfaction with the curriculum, learning, behaviour (ie, clinical exposure), and results (practice intention). One-way analyses of variance (ANOVAs) tested the effect of curriculum model on satisfaction and clinical exposure. Analyses of covariance (ANCOVAs) tested the effect of curriculum model on the other outcomes.

Residents from 40 teaching sites provided answers to T1 and T2 surveys (N=385: 81 in the horizontal curriculum and 304 in the block curriculum). The average satisfaction score was lower in block curricula (4.28/5 [SD=0.47]) than in horizontal curricula (4.46 [SD=0.42]) (F _1,382=9.39, P=.002, η²=.02). The curriculum structure had no significant impact on learning and on most items in the clinical exposure or practice intention categories.

Longitudinal curriculum models in residency might be associated with better resident experience. However, curriculum models do not have a significant impact on most educational outcomes, and residents from all curriculum models feel similarly prepared for practice.