Impact of An Annual Hematology/Oncology Fellow Wet Laboratory Program On Fund of Biomedical Knowledge.

Abstract 246

Biologically based diagnostics and therapeutics underpin the field of hematology and oncology. During clinical fellowship training, biological and biochemical concepts have typically been presented in lecture formats and research electives. Based on trainee serial subjective self-assessments of knowledge (SAK) and graduate surveys, traditional pedagogy were deemed inadequate in supporting contemporary training and practice needs. Optimal assimilation of knowledge requires clinical context, experience, and performance. It was thus hypothesized that an active training method providing first-hand participation, such as a wet laboratory (wetlab), would increase fund of biomedical knowledge in hematology and oncology. Single-day wetlab sessions were developed, incorporating hands-on laboratory procedures linked to clinical vignettes. The procedures were designed to expose the molecular and biochemical basis, utility and limitations of current laboratory tests, such as coagulation monitoring, electrophoresis, flow cytometry and DNA-based assays. The curriculum rotated each of the three years so that each fellow would participate in all laboratory assays throughout fellowship training. Between July 2004 and June 2009, all fellows completed serial subjective SAKs (score 1–5) at 6-month intervals. SAKs inquire about all cognitive and procedural-based individual knowledge based on ASH and ASCO core curriculum, but only data relevant to basic science concepts and laboratory assays were included in this analysis. Midway through this time period, the wetlab curriculum was implemented. Fellows were given pre- and post-lab tests to assess their baseline and acquisition of biomedical knowledge. All results were compared between those who randomly did or did not participate. Fellow evaluation of the wetlab was also collected. Sixteen individual fellows (10 female; 6 male) were included in the analysis. Only one had significant pre-fellowship lab experience. Wetlab participation was mandatory, but randomly assigned during the course of each trainee's time. All but one fellow participated at least once during their training. SAK scores were significantly increased for those fellows who participated (mean 3.23 vs. 2.73; P<0.045), independent of fellow year (P=NS). Pre- and post-wetlab testing reflected increased objective assimilation of molecular biology knowledge for all participants (64% vs. 80%; P<0.014). Test scores for both groups improved over the course of each academic year (P=NS). Participants uniformly rated the wetlab experience as positive with 100% desiring to repeat it again the following year and recommending it to a peer who was not in attendance. In-training exam scores reflected outstanding overall performance for fellows in the Basic Science category (Hematology mean 74%; Oncology mean 73%). All board eligible fellows from this analysis have subsequently achieved Board Certification as first time test takers (100%). Implementation of an annual hematology and oncology biomedical wetlab for clinical fellows is feasible and results in significant improvement in trainee subjective knowledge and confidence gained. Objective measures of biomedical fund of knowledge appear increased as a result of this intervention. This method of teaching may advance understanding of relevant diagnostic tests utilized in the clinical practice of hematology and medical oncology.