1826 - Assessing and Enhancing Internal Medicine Residents’ Understanding of Physical Medicine & Rehabilitation: A Quality Improvement Project

Physical Medicine & Rehabilitation (PM&R) optimizes function, recovery, and post-acute care, yet exposure is limited in undergraduate medical education. Because exposure is not mandatory nor universally available across academic institutions, young physicians, more specifically, internal medicine (IM) residents, remain with PM&R knowledge gaps. This study aimed to assess baseline knowledge of PM&R among IM residents and evaluate whether a targeted educational intervention can improve knowledge and interdisciplinary care.

Design: This quality improvement project was conducted at Mayo Clinic Florida and included PGY-1 (preliminary and categorical) through PGY-3 IM residents. A five-question baseline survey was distributed via the residency WhatsApp group and announced at noon conference. Questions assessed knowledge of the acronym PM&R, relevant disorders, comfort consulting PM&R, discharge planning, and interest in learning. The planned intervention is a brief educational video shown during SIM Lab covering PM&R’s philosophy and goals, disorders, and post-acute care. A follow-up survey will be administered to assess the effectiveness of the video. 

Results: 38 residents completed the survey, with a 68% response rate among PGY-1s. 63% of respondents correctly identified “PM&R”, while 11% of respondents interchanged “Pain” for “Physical”. When asked to select conditions PM&R physicians see, 61% of respondents recognized all conditions (95% CI: 45-74%). The least recognized were cancer (71%) and osteoarthritis (76%). Data suggests discomfort consulting PM&R, with 68% selecting unsure or uncomfortable with consults. When provided a patient scenario, PGY-2/3’s demonstrated higher accuracy than PGY-1s with discharge to the appropriate setting (88% vs 67%). 

Conclusions:

Baseline results reveal decreased Physical Medicine and Rehabilitation knowledge among IM residents. Residents exhibited a moderate lack of knowledge across all domains assessed, rather than specific strengths/ weaknesses. A standardized educational video intervention may address these deficits. The ultimate goal will be to improve appropriate consultations and enhance interdisciplinary care.