Rapid development of an outpatient‐to‐inpatient crash curriculum for COVID‐19 providers

1. WHAT PROBLEMS WERE ADDRESSED?

The coronavirus disease 2019 (COVID‐19) pandemic has caused critical staff shortages thus requiring innovative approaches to bring providers into the hospital workforce, ¹ including those who may not have performed inpatient general medicine care for many years. Our educational group felt an urgent need to create educational content to re‐familiarise these anxious providers with common inpatient scenarios. Our goal was to rapidly author and distribute high‐yield educational resources to non‐inpatient medical providers who could be pulled to cover inpatient general medicine services.

2. WHAT WAS TRIED?

We attempted to adhere to a few principles. We knew that time was of the essence, and in this scenario, fast was better than perfect. We prioritised simplicity and digital ergonomics, including a minimalist website design, and a standard template for each topic, irrespective of the author. Our target users were outpatient and subspecialty medicine providers. One of the editing team was an outpatient general internist, so as to try and ensure that the material was at the right level of sophistication, and to maximise accessibility, we placed the material on multiple platforms. Our two watchwords were 'concise' and 'practical,' and our goal was therefore to include only the very high‐yielding material, and focus heavily on 'what to do,' rather than on physiology or background information.

We established a rapid 2 week timeline for completion and posting of materials. We recruited a large team of residents, chief residents, ward‐savvy ex‐residents and junior hospitalists. The project manager and educational team members reached an iterative consensus via email and an online video meeting for 17 critical clinical and administrative topics to cover (eg, chest pain, how to admit and discharge, etc). Teams of 1‐2 drafted topic summaries, which were formatted as single‐page documents including four sections: Assessment; Treatment; Considerations, and When to Ask for Help. Each draft was fact‐checked and edited by the project manager and a senior faculty member. Any points of disagreement were discussed with the drafting team to reach a mutual consensus on the final product. No major errors have been discovered to date. We made items available on a rolling basis, posting completed work immediately after review and editing (typically within 24 hours of receipt of the first draft).

We organised the summary topics within a simple WordPress blog. The site was then replicated within the Department of Medicine's internal network within 48 hours and made available to the whole department, then copied into the hospital‐wide intranet so other departments could access it. Additionally, all staff were granted access to Box folders containing the resources, and links were both emailed department‐wide and posted on the website (https://uwmadison.box.com/s/br7hzuqgh51cwg24egvbkon4u7ia4h4m). The curriculum is voluntary, with the assumption that providers will review the materials relevant to his or her learning needs. The first materials were posted 14 days after programme inception, and the entire curriculum was fully available 19 days after inception. Within 2 weeks of posting the material, there had been 258 views of the content by 98 unique viewers.

3. WHAT LESSONS WERE LEARNED?

We were able to create and deploy this crash course content in a rapid time frame. We ran into security concerns about our initial posting platform and would encourage others to involve his or her local information technology groups at the outset. We found that one effective technique that expedited our process was to eschew the standard ‘track changes’ one would usually use when co‐editing a document, and instead agree that any changes deemed worthy by one editor would be implemented. We also noted early on that authors were using varying formats, and we quickly established a common format that yielded better homogeneity amongst the topic summaries. Further evaluation will be needed to understand to what extent these materials improved patient care.