Adults with Congenital Heart Disease: Whats Needed

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Adults with Congenital Heart Disease Whats
Needed

• Grace Pei-Wen Chen, MD
• ACC Fellows In Training Committee

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Background

• ACCFIT Committee works closely with Cardiology
  Training Workforce Cmte
• In ACCFIT national survey of fellows, many
  expressed a need for resources in adult
  congenital heart diseases
• Prior ACC product in pediatric cardiology was not
  widely utilized

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Purpose of ACHD Survey

• Desire by the CTWC and ACCFIT to find the KIND of
  resources that fellows and program directors are
  interested in
• Survey sent to all fellows and program directors
  in the US
• Received 387 responses

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Textbooks

• What textbook(s) do you use for ACHD? (361
  responses)
• Overwhelmingly people use Braunwald
• General cardiology texts (Topol, Hurst)
• Specific texts (Gatzoulis, Perloff Child, Moss
  Adams, Webb, Park)
• Echo and cath texts (Otto, Feigenbaum, Ho,
  Grossman, Kern)
• Board review (ACCSAP, Mayo review)
• Misc

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Other Resources

• Do you use any other educational resources? (351
  responses)
• Most answered no
• Up To Date
• Board review CD/DVDs
• Internet
• Lecture notes clinical rotations

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Clinical Training in ACHD

• What is the total length of formal ACHD training
  provided by the general cardiology fellowship at
  your program?
• lt 1 month or minimal 39
• 1 - 2 months 13
• 3 - 4 months 0
• gt 4 months 0
• Episodic exposure over the years 46

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Type of Clinical Training

• What type(s) of experience do they entail?
• Outpatient clinics in ACHD 29
• Outpatient clinics that see variety of pts
  including some ACHD 27
• Mostly inpatient 18
• Rotation through childrens hospitals 23
• Didactic sessions without much bedside 41

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Desire for New Product

• If the ACC puts out a core curriculum to ensure
  basic training in ACHD for every general
  cardiology fellow, do you think you would use it?
• Yes 96
• No 4

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Why Not?

• Apathy
• Zero interest in ACHD
• Several others expressed no interest because will
  not see in future practice
• Cost
• would use if affordable rather than SAP that
  ACC charges for
• Fatigue
• Too encumbered by service/rotations
• Use existing resources
• Better to expand ACCSAP section on ACHD

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What Format

• If the answer is yes what format would you want
  the curriculum to come in?
• Textbook 33
• CD rom for purchase 39
• Web-based for a fee 43
• Other 17
• Make it FREE! At least for fellows
• Combination e.g. textbook CD
• Use Cardiosource
• Lectures on DVD

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How Much to Pay

• How much would you be willing to spend on such a
  resource?
• 25 - 49 43
• 50 - 74 26
• 75 - 99 19
• gt 100 9
• Other 5
• Free?

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Content

• Case-based vs. text-based?
• Case-based 67
• Text-based 38
• Others 33
• Combination of both

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Q A

• Do you want question and answer section?
• Yes 95
• Many prefer board-type questions

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Representative Comments

• This will be a great service to our program and
  many others. Thanks!
• Several mentioned importance of including modern
  surgical management and post-surgery follow-up
  issues in the material
• What is truly lacking is a resource with
  integrated textbook-like review case-based
  illustration.

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Comments Cont.

• Many emphasize the need for very clear
  illustrations with many diagrams
• Many emphasize the need to make it concise, to
  focus on the common ones (ASD, VSD, Eisenmenger,
  Coarc, PS)
• Several again asked to use Cardiosource

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I Didnt Write These

• ACC needs to get out front in all core
  curriculum areas. Program directors need help.
• Too much to learn, too little time
• Keep in mind, fellows generally have a limited
  income, are usually in their 30s-40s, have a
  family, etcIm not interested in another
  expensive educational product.

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What Now

• Theres a need
• Several ACC sub-committees may be able to help
• Open for discussion

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Thanks

• Dr. Carole Warnes
• Moira Davenport
• Kelly Ventura