1128. Online Spaced Education to Teach Microbiology to Medical Students in a Threaded Medical School Curriculum

BACKGROUND: A strong foundation in microbiology continues to be essential for physicians-in-training. Little research exists examining pre-clinical microbiology education in undergraduate medical education (UME) curricular structures. Further, no study has evaluated the use of a spaced repetition model for pre-clinical UME students studying microbiology in a threaded curriculum. METHODS: We conducted a prospective cohort design study and enrolled 81 out of 154 (53%) first-year medical students at Oregon Health & Science University from August 2018 through December 2019. The first 18 months of the UME curriculum is organized by organ system blocks with end-of-block exams including retired National Board of Medical Examiner (NBME) questions. Participants were invited to complete 10 microbiology questions using the spaced practice online platform QSTREAM weekly. Performance between participants and non-participants on end of block NBME exams were compared using t-tests for categorical variables. RESULTS: At the conclusion of the study, 42.5% of participants were “very active” (questions in < 2 days), 7.5% of participants were “active” (questions in 3-7 days), and 50.0% of participants were “inactive” (questions in >7 days). Student performance on second-pass questions improved by 41%, and NBME end-of-block exams demonstrated improved performance in each block compared to non-participants. Specifically, performance in the Skin, Bones, and Musculature end-of-block exam and Developing Human end-of-block exam was significantly (p=0.0001, 0.008, respectively) improved, and study participants outperformed non-participants on topics practiced in the study. CONCLUSION: As more medical schools move to a threaded curriculum, with many of these programs proposing fewer contact hours, innovative methods targeting microbiology education should be explored for pre-clinical medical students. Online spaced practice in a threaded curriculum could provide a feasible and acceptable pedagogical technique for UME and add to the discourse around microbiology curriculum development. With initial start-up costs, sustaining such a program across medical school curricula is an inexpensive, innovative, technologically-savvy approach to medical education. DISCLOSURES: All Authors: No reported disclosures