January 15, 2007

St. Anthony's Hospital, Family Medicine Residency, is located in Oklahoma City, Oklahoma. The Program Director is Cheyn Onarecker, MD, and the Associate Director is Robert Rader, MD. The residency has 27 enrolled residents and purchased our CPR Library installation last year.

Dr. Rader was the driving force in bringing CPR™ to St. Anthony's. His motivation arose from the national interest by the family medicine discipline in looking for innovative ways to enhance the curriculum for residency training.

The faculty in the residency at St. Anthony's has replaced their traditional didactic component—the lecture series—with the Challenger content library. They began by going through half a dozen major family medicine textbooks and old board exams to come up with the 120 core subject areas that their program wanted to focus on. They then matched Challenger modules from a variety of courses with the subjects that they identified from the textbooks and old exams. They assigned 10-12 hours for each module. Now, over the course of the three year rotation, St. Anthony's assigns specific topical modules for each rotation. The assigned topics are the equivalent of what the faculty previously spent on lectures (10-12 hours per four week block).

Why does St. Anthony feel that this is a better approach than the traditional lecture format? There are a variety of reasons:

1. CPR™ allows them to be more flexible with their duty hours because they do not all have to conform to one meeting time.
2. Residents can work from anywhere—the faculty dedicates 3 afternoons per week per resident for working on Challenger, but the residents don't necessarily have to work from the hospital.
3. One full time faculty member, Jan Miller, MD, is responsible for didactic issues, primarily the integration of the Challenger system. She lives in Dallas, Texas, and can do all of her work and planning remotely.
4. CPR™ captures the philosophy and theory of adult learning—residents can work at their own speed—if they get done early, they have more time off.
5. The CPR™ reporting systems make it easier to validate competency—the faculty does not have to create a pre-test and post-test for every lecture and then grade each one.
6. It is possible to tie the rotation topic for each resident to the didactic information assigned for each week, so that the didactic information reinforces the residents' clinical learning.
7. CPR™ has bought the program one half day clinic per week. That is, they can stagger the afternoon assignments for Challenger on different days of the week instead of having to have one afternoon per week off for everyone at once for a lecture—the clinical service can actually stay open an extra half day.
8. The program can show the RRC and other bodies the exact information that residents are exposed to and their level of competency.

Where does St. Anthony go from here with CPR? Here is a brief menu of their planned activities:

1. The faculty will evaluate results from their in-training scores to use in putting together a RAP presentation about their didactics with Challenger.
2. They are seeking approval from the RRC for this nontraditional methodology in the calendar year 2007.
3. The faculty is working on the other significant portion of their curriculum design involving procedures—they will be using all of the Challenger procedural modules and also integrating some outside sources to do so. CPR's flexibility permits the easy integration of user-authored content or other external links and resources.
4. St. Anthony's will design an easy to follow set of implementation steps to help new programs transition to this alternative form of didactics and away from the normal paradigm of lectures.
5. The faculty is working with Challenger to improve and enhance reporting capabilities to focus on comparing specific performance measures by residents and highlighting weak areas for individual residents.