From the Guidelines
To best compensate for knowledge gaps in residency, actively identify your weak areas and create a structured learning plan to address them, as recommended by the 2023 ACC/AHA/SCAI advanced training statement on interventional cardiology 1. This approach is crucial for improving knowledge, skills, and performance. The key steps include:
- Identifying personal knowledge gaps and seeking educational and training opportunities to improve knowledge, skills, and performance
- Utilizing clinical practice guidelines, appropriate use criteria, and other information tools at the point of care to improve clinical decision-making
- Maintaining current standards of care by performing literature searches, interpreting data, and applying results to clinical care
- Soliciting and incorporating feedback from patients, colleagues, and other healthcare team members to improve clinical performance
- Developing the practice of lifelong learning, including regular review of journals and practice guidelines/appropriate use criteria/consensus statements and attendance at scientific and continuing medical education meetings
The most recent and highest quality study, the 2023 ACC/AHA/SCAI advanced training statement on interventional cardiology 1, emphasizes the importance of practice-based learning and improvement, which includes identifying personal knowledge gaps and seeking educational and training opportunities to improve knowledge, skills, and performance. Some key evaluation tools to assess knowledge gaps and learning progress include:
- Case logs
- Chart review
- Conference presentation
- Direct observation
- Multisource evaluation
- Quality improvement project
- Reflection and self-assessment
By following these steps and using the recommended evaluation tools, residents can effectively compensate for knowledge gaps and improve their overall performance and patient care. Developing good habits for continuous learning is more valuable than trying to know everything immediately, and it is essential to prioritize lifelong learning and professional development throughout one's medical career 1.
From the Research
Identifying Knowledge Gaps
- Entering residents have variable medical school experiences and differing knowledge and skill levels, making baseline assessment of individual resident's knowledge and skills necessary 2.
- Residents self-assess their competencies in the 6 Accreditation Council for Graduate Medical Education (ACGME) competency areas, with systems-based practice and medical knowledge competencies often being self-assessed as lower 3.
Compensating for Knowledge Gaps
- The Postgraduate Orientation Assessment (POA) provides a feasible format to measure initial knowledge and skills and identify learning needs, with 81% of residents recommending the POA 2.
- Resident self-assessment and learning goal development can help identify important gaps in learning between medical school and residency, with senior residents more likely to develop learning goals in areas where they self-assess as weaker 3.
- Trial and error is often used by residents to find learning strategies to help them manage the systemic challenges encountered when transitioning from medical school to residency, with success tied to learners' efficacy with self-regulated learning concepts 4.
Factors Contributing to Knowledge Gaps
- Personal factors, such as internal motivation, learning style, and attitude, can contribute to the knowledge-practice gap 5.
- Educational structure, including clinical instructor role, preceptor effect, and curriculum, can also contribute to the knowledge-practice gap 5.
- Organisational characteristics, such as resources, clinical setting features, and staffing, can also play a role in the knowledge-practice gap 5.
- Residents may not receive adequate training during residency on when to refer patients and what clinical information to provide at the time of referral, leading to a discrepancy between the amount of information residents believe they should provide and the amount they actually provide 6.