1118. Development of a Curriculum for Internal Medicine Residents on Latent and Active Pulmonary TB: A Targeted Needs Assessment

BACKGROUND: Internal medicine (IM) residents have previously been found to have significant knowledge and practice gaps in tuberculosis (TB) diagnosis, but it is unknown whether these gaps vary based on geography or TB incidence. San Francisco has the highest incidence of TB of any US city. UCSF IM residents encounter TB throughout their clinical training; however, the residency program does not have a dedicated TB curriculum. Following the Kern model of curriculum development, the aim of this project was to conduct a targeted needs assessment of UCSF IM residents regarding the need for and format of a TB curriculum. METHODS: An anonymous survey was sent to residents in February 2020 to assess their confidence in multiple domains in the diagnosis and management of latent and active pulmonary TB and gauge their preferences for the format and timing for delivery of a TB curriculum. All questions used a five-point Likert scale. Chi-squared test was used to compare confidence levels between interns and residents. The study received UCSF IRB approval. RESULTS: Seventy-five IM residents completed the survey (41% of residency; 32% interns and 68% residents). More than 50% of respondents reported that they were quite or extremely confident in only 1 of 14 domains assessed. Residents demonstrated significantly increased confidence compared to interns in only 4 of 14 domains. IM residents felt that a TB curriculum of a short video series, online videos interspersed with questions, or a house-staff handbook would be most useful, with more than 50% stating that these formats would be quite or extremely useful. While lectures and Powerpoint slides are common teaching methods, residents felt these formats were less useful. IM residents also felt they would be more likely to access a TB curriculum during ID elective or while caring for patients on wards and less likely on own time. CONCLUSION: IM residents demonstrated lack of confidence in multiple domains in the diagnosis and management of latent and active pulmonary TB. Confidence did not markedly improve between interns and residents despite increased experience in a high TB incidence clinical setting, highlighting the need for a TB curriculum to address this gap. This curriculum should avoid lecture format and be integrated within relevant clinical time to maximize utility. DISCLOSURES: All Authors: No reported disclosures