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Biomedical subjects

Daniel D Federman

Publications and source records attributed to Daniel D Federman.

10 recordsLinked to original sources
PubMed2007

Spaced education improves the retention of clinical knowledge by medical students: a randomised controlled trial.

PURPOSE: Medical knowledge learned by trainees is often quickly forgotten. How can the educational process be tailored to shift learning into longer-term memory? We investigated whether 'spaced education', consisting of weekly e-mailed case scenarios and clinical questions, could improve the retention of students' learning. METHODS: During the 2004-5 surgery clerkships, 3rd-year students completed a mandatory 1-week clinical rotation in urology and validated web-based teaching programme on 4 core urology topics. Spaced educational e-mails were constructed on all 4 topics based on a validated urology curriculum. Each consisted of a short clinically relevant question or clinical case scenario in multiple-choice question format, followed by the answer, teaching point summary and explanations of the answers. Students were randomised to receive weekly e-mailed case scenarios in only 2 of the 4 urology topics upon completion of their urology rotation. Students completed a validated 28-item test (Cronbach's alpha = 0.76) on all 4 topics prior to and after the rotation and at the end of the academic year. RESULTS: A total of 95 of 133 students (71%) completed the end-of-year test. There were no significant differences in baseline characteristics between randomised cohorts. Spaced education significantly improved composite end-of-year test scores (P < 0.001, paired t-test). The impact of the spaced educational e-mails was largest for those students who completed their urology education 6-8 and 9-11 months previously (Cohen's effect sizes of 1.01 and 0.73, respectively). CONCLUSION: Spaced education consisting of clinical scenarios and questions distributed weekly via e-mail can significantly improve students' retention of medical knowledge.

Boston↗
PubMed2006

A multi-institutional randomized controlled trial of adjuvant Web-based teaching to medical students.

PURPOSE: To investigate the impact of an adjuvant Web-based teaching program on medical students' learning during clinical rotations. METHOD: From April 2003 to May 2004, 351 students completing clinical rotations in surgery-urology at four U.S. medical schools were invited to volunteer for the study. Web-based teaching cases were developed covering four core urologic topics. Students were block randomized to receive Web-based teaching on two of the four topics. Before and after a designated duration at each institution (ranging one to three weeks), students completed a validated 28-item Web-based test (Cronbach's alpha = .76) covering all four topics. The test was also administered to a subset of students at one school at the conclusion of their third-year to measure long-term learning. RESULTS: Eighty-one percent of all eligible students (286/351) volunteered to participate in the study, 73% of whom (210/286) completed the Web-based program. Compared to controls, Web-based teaching significantly increased test scores in the four topics at each medical school (p < .001, mixed analysis of variance), corresponding to a Cohen's d effect size of 1.52 (95% confidence interval [CI], 1.23-1.80). Learning efficiency was increased three-fold by Web-based teaching (Cohen's d effect size 1.16; 95% CI 1.13-1.19). Students who were tested a median of 4.8 months later demonstrated significantly higher scores for Web-based teaching compared to non-Web-based teaching (p = .007, paired t-test). Limited learning was noted in the absence of Web-based teaching. CONCLUSIONS: This randomized controlled trial provides Class I evidence that Web-based teaching as an adjunct to clinical experiences can significantly and durably improve medical students' learning.

Education, Medical↗
PubMed2004

A survey of medical ethics education at U.S. and Canadian medical schools.

PURPOSE: To assess the format, content, method, and placement of medical ethics education in medical schools; the faculty and curricular resources and institutional structure and support of medical ethics; and the perceptions of ethics education among deans of medical education and medical ethics course directors at U.S. and Canadian medical schools. METHOD: Two questionnaires were mailed to 125 U.S. medical schools and 16 Canadian schools: one to be completed by the deans of medical education and one to be completed by the medical ethics course director. Descriptive statistics were used to compare responses. RESULTS: In all, 123 (87%) deans and 91 (64%) course directors responded, providing information about 91 schools (six Canadian). All responding institutions offered some formal instruction in medical ethics, and among these, 71 (78%) incorporated ethics into required preclinical courses. The primary pedagogic course structure was small-group discussion and the primary pedagogic method was case discussions. One-fifth of schools provided no funding for ethics teaching, and 47 (52%) did not fund curricular development in ethics. Institutions with a dedicated ethics faculty member were twice as likely to have a mandatory introductory ethics course (64% versus 32%, p <.05). The primary obstacles to ethics education were thought to be a lack of time in the curriculum, a lack of qualified teachers, and a lack of time in faculty schedules. CONCLUSIONS: Within a few decades the number of U.S. and Canadian medical schools requiring medical ethics has increased. Nevertheless, significant variation in the content, method, and timing of ethics education suggests consensus about curricular content and pedagogic methods remains lacking. Further progress in ethics education may depend on institutions' willingness to devote more curricular time and funding to medical ethics.

Canada↗
PubMed2004

Development of validated instrument to measure medical student learning in clinical urology: a step toward evidence based education.

PURPOSE: To date published efforts to assess and improve medical student learning in urology have been limited due to the lack of an assessment tool with which to measure student learning. We report the development of a validated measure of medical student learning in urology. MATERIALS AND METHODS: Four core topics in clinical urology were selected as the focus of the test development, namely prostate cancer, screening with prostate specific antigen, benign prostatic hyperplasia and erectile dysfunction. Detailed curricula and multiple choice questions were created for each topic. Content validity of the curriculum and 28 item examination was established by a panel of 2 urologists and 2 medical physicians. Instrument reliability was determined by administering the test on line to third-year surgery students. Test construct validity was established through its administration to 19 urology residents and attending physicians. RESULTS: Reliability of the 28-item test instrument was measured by Cronbach's alpha at 0.76 and its 1-week test-retest reliability was 0.72. All urology experts performed well on the test. Mean urological expert scores were significantly higher than mean student post-test scores (24.9 +/- 2.1 vs 17.8 +/- 3.8, 2-tailed t test p <0.001). Urological experts with greater urological training had higher scores than those with less residency training. CONCLUSIONS: This study documents the development of a validated measure of medical student learning in urology. This validated instrument has the potential to improve educational quality control at medical schools and facilitate the development of effective, evidence based teaching methods.

Adult↗
PubMed2004

Development and initial evaluation of a novel urology curriculum for medical students.

PURPOSE: After the development and implementation of a novel urology curriculum for medical students we evaluated urological learning by medical students using a validated measure of learning in the 4 clinical areas of benign prostatic hyperplasia, erectile dysfunction, prostate cancer and prostate specific antigen screening. MATERIALS AND METHODS: Third year medical students completed an online validated pre-test and post-test immediately before and after the mandatory 1-week clinical rotation in urology. Online pre-surveys and post-surveys were also administered. Overall student participation was 90% (37 of 41) with 63% of students (26 of 41) completing all 4 tests and surveys. RESULTS: Student overall test scores improved significantly upon completion of the 1-week clinical rotation in urology (p <0.001). A trend toward increased learning by male students was identified (p = 0.07). Significant variation in exposure to outpatient clinics and in the performance of physical examination skills was observed among the different teaching sites. CONCLUSIONS: This study demonstrates significant learning by medical students during their 1-week clinical rotation in urology. Further data are needed to confirm the trend toward increased learning by males and elucidate its etiology. Scheduling changes have been implemented to address the inconsistencies across clinical sites.

Adult↗
PubMed2002

Should medical school faculty see assessments of students made by previous teachers?

Whether medical school faculty should be provided with assessments of students made by previous teachers remains controversial. To document which schools have implemented policies that address this issue and to characterize the specific features of these policies, in 1998 the authors conducted a direct mail survey of deans of student affairs and medical education at 144 medical schools in the United States, Canada, and Puerto Rico. Replies were received from 129 (90%) of the 144 medical schools. Of those schools, 72 (56%) reported having policies that address this issue. The policies permit the sharing of information in 38 (53%) of the 72 schools that had policies; therefore, at the time of this study, 29% of the 129 medical schools that responded to the survey had a policy that permits the sharing of assessment information. The policies permit the sharing of information related to problems with academic performance (35%), professional conduct (35%), physical health (25%), and miscellaneous circumstances, such as learning disability (5%). Information may be shared with clerkship coordinators (44%), course directors (35%), faculty mentors (11%), clinical faculty supervisors (8%), and resident supervisors (3%). The findings show that there is considerable diversity in the format and content of policies that address the issue of whether medical school faculty should be provided with information about students' assessments made by previous teachers. The authors explain why policies that require the provision of such information are helpful to medical school faculty, and offer recommendations based on the survey findings.

Confidentiality↗