ArticleBMC health services research2026
Enhancing specialist competence in clinical pathways for left ventricular hypertrophy: design and evaluation of a competency-based curriculum.
Article in BMC health services research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundLeft ventricular hypertrophy (LVH) is a frequent clinical phenotype with diverse etiologies, including hypertensive heart disease, hypertrophic cardiomyopathy, and infiltrative or metabolic disorders. Despite the availability of disease-specific therapies, diagnostic delays and misclassifications remain prevalent. From a health services perspective, these diagnostic gaps are often driven by significant variability in specialist-level diagnostic reasoning and the inconsistent implementation of clinical pathways. To design and evaluate the feasibility of a competency-based curriculum aimed at standardizing specialist-level clinical pathways for LVH-related diseases, and to assess its immediate impact on physician knowledge acquisition, diagnostic reasoning, and clinical confidence.
methodsA structured curriculum was developed following principles of patient-centered care and multidisciplinary collaboration. The program, delivered as a continuing medical education (CME) initiative for 45 cardiologists, incorporated guideline reinforcement, genetics-oriented learning, case-based discussions, and pathway design exercises via a blended learning format. Outcomes were assessed through pre- and post-training knowledge tests, structured case-based evaluations, and self-reported confidence and satisfaction surveys.
resultsForty-five cardiologists from secondary and tertiary centers completed the program. Mean knowledge test scores significantly improved from 62% ± 12% pre-training to 86% ± 8% post-training (p < 0.001). The correct identification of rare LVH etiologies (e.g., Fabry disease, cardiac amyloidosis) in structured cases rose from 35% to 78%. Participants reported significantly higher diagnostic confidence for both common and rare etiologies, and overall course satisfaction was high (92% rating ≥ 4/5).
conclusionThis competency-based curriculum was associated with short-term improvements in specialist-level knowledge and diagnostic reasoning for LVH-related diseases. This program shows potential to assist in reducing variability in specialist practice and establishing standardized clinical pathways, serving as a preliminary health services intervention that may enhance downstream referral consistency and inter-provider care coordination. CLINICAL TRIAL NUMBER: Not applicable.
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