Liver Disease Mini-Residency

Abstract

Abstract Introduction Liver and biliary symptoms led to over 450,000 outpatient clinic visits per year in the US in 2009. By default, primary care providers (PCPs) in rural or underserved communities often manage liver disease without ready access to specialist support. Standardized needs assessment of PCPs in the Veterans Affairs (VA) Northwest region revealed both lack of knowledge and poor self-reported comfort surrounding basic care for patients with liver disease. Based on the needs assessment results, we created a 4-day Liver Disease Mini-Residency to target specific areas of concern to rural PCPs. Methods The four 1-day modules focused on hepatitis C virus, ESLD/liver transplant, liver tumors, and evaluating patients with abnormal liver function tests. Each multidisciplinary module contains one or more didactic sessions, a clinical observation component, and small-group case discussions. The material is pitched at the level of the practicing PCP. The modules may be implemented individually as 1-day sessions or in a 4-day block. Results The Mini-Residency in Liver Disease was extremely well received by learners. We performed pre- and postprogram assessments of liver-related knowledge based on a previously published assessment tool. Follow-up evaluation after the Mini-Residency demonstrated significantly improved self-reported comfort and knowledge regarding liver disease, with an average improvement of 36% on the knowledge questionnaire score. Nine (out of 10 respondents) reported satisfaction with the learning activity and 10/10 would recommend the learning activity to others. Discussion Few liver-related training programs specifically target practicing PCPs, especially those from rural areas. This learning resource provides a significant new offering for PCPs who manage liver disease outside tertiary centers or major metropolitan areas. Our curriculum is a tested, comprehensive approach to liver disease education for rural PCPs, targeted to address PCPs self-reported areas of concern.

Keywords

• Primary Health Care
• Health Equity Research
• Liver Diseases
• Rural Health
• Primary Care