In 1991, in order to satisfy Resident Review Committee requirements for teaching housestaff an understanding of research, journal reading skills, and critical thinking skills, we developed a program to address all of these issues. The curriculum includes a journal club component and a series of didactic presentations focusing on reading the literature, project design, epidemiology, and statistics. In addition, each resident is required to plan, conduct, and present the results of a small, focused research project during their three year training experience. The projects are conducted with a faculty mentor and are overseen by a small faculty committee, which is also responsible for implementing the entire program. Since the inception of the program, 71 residents have completed the curriculum. In a rough categorization, six of these project could be called laboratory based, 34 were clinical subspecialty based (primarily neonatology, infectious disease, and nephrology), and 31 addressed issues in general and community pediatrics. Many of the subspecialty based projects dealt with issues of importance to the general physician. The results of the projects have been presented at an annual research forum in the format of presentations at a national meeting (15 minute presentations plus questions). Prizes for the first and second best projects are awarded by an impartial jury. Evaluations of the process by the participating housestaff have consistently been positive (78% learned a lot, 69% felt it helped them to critically read the literature). An evaluation of the learning needs of the housestaff in various areas related to research(e.g., statistics, journal reading) showed improvement during their three years of training. The major expressed concerns were the time required to conduct the projects and the stress of giving presentunities). Problems that the program had to overcome included initial resistance to a new curriculum, motivation of the trainees, coordination with mentors, and evaluation of the program. Thus, a curriculum to develop critical thinking skills in a diverse group of residents, the majority of whom will become primary care physicians, can be implemented successfully. The major driving force of the program has been accomplishment of individual projects which stimulate learning with mentors, other experienced research faculty, and peers.
