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PubMed2004

Teaching pharmacology to medical students in an integrated problem-based learning curriculum: an Australian perspective.

The world-wide move away from the didactic teaching of single disciples to integrated Problem-based Learning (PBL) curricula in medical education has posed challenges for the basic sciences. In this paper we identify two major challenges. The first challenge is the need to describe a core disciplinary curriculum that can be articulated and mapped onto the new structure. We illustrate how the British Pharmacological Society (BPS) Guidelines are used to evaluate the curriculum coverage in the medical course at The University of Melbourne. The second challenge is to ensure that foundational concepts are given adequate emphasis within the new structure, and in particular, that students have the opportunity to pursue these concepts in their self-directed learning. We illustrate one approach to teaching important pharmacological concepts in an integrated curriculum with a case study from the first year curriculum at The University of Melbourne. Finally, we propose the features of an integrated curriculum that facilitates the learning of basic pharmacology in a situation where PBL and integration sets the curriculum framework.

Australia↗

PubMed2005

Public health challenges in Kyrgyzstan: developing a new curriculum.

INTRODUCTION: The public health challenges facing the Central Asian Republic of Kyrgyzstan are rooted in the social, economic and political conditions that emerged after the collapse of the Soviet Union in 1991. Geographically remote and with a substantial part of it's population living in mountainous rural villages, economic recovery and the maintenance of basic standards of public health is now a major problem for the Kyrgyz people. This project report sets out the case for restructuring public health education in Kyrgyzstan. It also explains how a new public health curriculum will equip Kyrgyz students with the knowledge and skills to work effectively with urban and rural communities in this geographically remote region of Central Asia. METHODS: With financial support from the European Union's Tempus program St Martin's College, the Kyrgyz State Medical Academy (KSMA) and Pirkanmaa Polytechnic (Finland) worked together to develop a new public health curriculum for Kyrgyzstan. Project activities took place in Kyrgyzstan and Europe throughout 2002-2004 and included English language training, fact finding visits to partner institutions and health services. Seminars and workshops were used to develop curriculum content and to support the design of new programs. A core curriculum team from KSMA, supported by European project staff, devised the new curriculum now on offer in Kyrgyzstan. RESULTS: The project achieved its three main goals: (1) development of a new public health curriculum; (2) establishment of an international forum for public health in Kyrgyzstan; and (3) dissemination of the project's findings via an international conference and the provision of web based support services. CONCLUSIONS: New courses in Preventive Medicine and Public Health Nursing at KSMA represent a significant cultural shift within public health in Central Asia, complementing the structural reforms of health care introduced in the 1990s. Emphasis on community engagement, health promotion and preventive action enhances knowledge, develops new skills and refocuses work practices for public health staff serving Kyrgyzstan's remote rural communities.

Advertising↗

PubMedDate not supplied

Reducing the risk: impact of a new curriculum on sexual risk-taking.

Reducing the Risk is a new sexuality education curriculum, based on social learning theory, social inoculation theory and cognitive-behavioral theory and employing explicit norms against unprotected sexual intercourse. In a quasi-experimental evaluation, this curriculum was implemented at 13 California high schools; 758 high school students assigned to treatment and control groups were surveyed before their exposure to the curriculum, immediately afterwards, six months later, and 18 months later. Among all participants, the program significantly increased participants' knowledge and parent-child communication about abstinence and contraception. Among students who had not initiated intercourse prior to the pretest, the curriculum significantly reduced the likelihood that they would have had intercourse by 18 months later. Reducing the Risk did not significantly affect frequency of sexual intercourse or use of birth control among sexually experienced students. Among all lower risk youths and among all students who had not initiated intercourse prior to their exposure to the curriculum, the curriculum appears to have significantly reduced unprotected intercourse, either by delaying the onset of intercourse, either by delaying the onset of intercourse or by increasing the use of contraceptives. Among the students not sexually active before participation in the program, effects seem to have extended across a variety of subgroups, including both whites and Latinos and lower risk and higher risk youths, but were particularly strong among lower risk youths and females.

Adolescent↗

PubMed1984

Teaching developmental pediatrics to pediatric residents: effectiveness of a structured curriculum.

A national Task Force on Developmental Pediatrics was convened in 1979 to produce a curriculum for pediatric residents pertaining to the detection, assessment, and management of children with atypical development. During a 2-year period, the task force developed a structured curriculum composed of specific goals, educational objectives, and matched learning activities that identified and described the basic knowledge, skills, and attitudes of developmental pediatrics to be acquired during a pediatric residency. Subsequently, the curriculum was implemented and evaluated in 11 pediatric programs with a developmental pediatrics rotation. On a seven-point subjective scale, the mean resident (n = 64) rating of the curriculum's usefulness was 6.0 and of their perceived competence in the skills of developmental pediatrics was 5.2; the mean percent of this competence attributed to the curriculum-based rotation was 56.6. On an objective case management test, residents who used the curriculum scored significantly (P less than .005) higher than those who did not. These results suggest the efficacy of structured curricula in pediatric resident education.

Child↗

PubMed1995

A model curriculum of health care informatics for Dutch higher professional education.

This paper describes the results of a two year project to design a model curriculum of health care informatics for Dutch higher professional education. The core of the curriculum are sixteen modules which cover the broad range of medical informatics and which are closely related to the profiles of the professions involved (nursing, physiotherapy, speech therapy, occupational therapy and dietetics). The curriculum emphasizes the need of using structured data and information to perform tasks in health care delivery and management, for which modern information technology is indispensable. The model curriculum will enable faculty to redesign existing undergraduate programs and to select the contents they see appropriate. In this way we hope that the model curriculum will contribute to an innovative attitude of future graduating health care professionals. A new three year project just has started to develop learning materials using professional health care software based on the sixteen modules of the curriculum.

Curriculum↗

PubMed1996

[The practicability of preceptorship in the curriculum of medical education].

Physicians who have graduated from traditional medical education curriculum focus on technological and organ system training, and are deficient in modern community health care concepts and skills. A preceptorship course integrates at various medical educational periods is one of the important goals at education reform in America. In this study, we attempt to ascertain the opinions of family physicians about the current family medicine curriculum and the practicability of preceptorship in Taiwan. The result can be a reference for future medical curriculum design. Two hundreds and thirty-five (40.8%) questionnaires were collected and analyzed. They showed most respondents were dissatisfied with the current curriculum of family medicine, and most agree that primary care physicians involvement would be helpful in producing efficient and well-qualified physicians. They suggested that preceptorship should best be first integrated in a basic knowledge course. We suggest that faculties who are responsible for curriculum design should evaluate the current curriculum and the appropriateness of preceptorship in Taiwan. Prior to the reform, faculty development and evaluation are the essential and crucial tasks.

Adult↗

PubMed1996

A curriculum for teaching family practice residents how to manage skin lesions.

BACKGROUND AND OBJECTIVES: A curriculum was developed to teach family practice residents how to manage skin lesions as part of an outpatient rotation during which family practice residents are taught procedures by family medicine faculty. The curriculum can be used as a template for teaching and assessing competency for any family practice outpatient procedure. METHODS: The curriculum was pilot tested by eight second-year family practice residents and evaluated by experts in curriculum design and the methods for teaching outpatient procedural skills. Procedure checklists were used to evaluate competency. RESULTS: The residents scored higher on their posttests than on their pretests. The residents, implementing faculty, and outside reviewers rated the curriculum design highly. Performance of procedures did not require longer times when accomplished through this educational experience. CONCLUSIONS: This curriculum can be used to teach family practice residents how to manage skin lesions. Residents were deemed competent to perform a procedure if they successfully followed all of the steps on the procedure checklist. A specific minimum number of procedures was not required to establish competency.

Clinical Competence↗

PubMed1996

Using concept maps on the World-Wide Web to access a curriculum database for problem-based learning.

Development of medical school curriculum databases continues to be challenging. Representation of the instructional unit is becoming increasingly difficult due to characteristics of the problem-based learning (PBL) curricula. Curriculum databases may be used to store materials for the PBL curricula, and also to provide a delivery mechanism for those materials. However, in order to take advantage of the curriculum database as a tool for PBL, methods for accessing the curriculum database that are better suited to the information needs of students, faculty, and administrators must be developed. Concept maps are directed graph representations of conceptual relationships, and may be used to represent the content of a curriculum database. In this paper, we describe a Web application that uses Java-based concept maps was the user interface to a curriculum database.

Computer Communication Networks↗

PubMed1997

Effectiveness of a violence prevention curriculum among children in elementary school. A randomized controlled trial.

OBJECTIVE: To determine if a commonly used violence prevention curriculum, Second Step: A Violence Prevention Curriculum, leads to a reduction in aggressive behavior and an increase in prosocial behavior among elementary school students. DESIGN: Randomized controlled trial. SETTING: Urban and suburban elementary schools in the state of Washington. PARTICIPANTS: Six matched pairs of schools with 790 second-grade and third-grade students. The students were 53% male and 79% white. INTERVENTION: The curriculum uses 30 specific lessons to teach social skills related to anger management, impulse control, and empathy. MAIN OUTCOME MEASURES: Aggressive and prosocial behavior changes were measured 2 weeks and 6 months after participation in the curriculum by parent and teacher reports (Achenbach Child Behavior Checklist and Teacher Report Form, the School Social Behavior Scale, and the Parent-Child Rating Scale) and by observation of a random subsample of 588 students in the classroom and playground/cafeteria settings. RESULTS: After adjusting for sex, age, socioeconomic status, race, academic performance, household size, and class size, change scores did not differ significantly between the intervention and control schools for any of the parent-reported or teacher-reported behavior scales. However, the behavior observations did reveal an overall decrease 2 weeks after the curriculum in physical aggression (P=.03) and an increase in neutral/prosocial behavior (P=.04) in the intervention group compared with the control group. Most effects persisted 6 months later. CONCLUSIONS: The Second Step violence prevention curriculum appears to lead to a moderate observed decrease in physically aggressive behavior and an increase in neutral and prosocial behavior in school.

Aggression↗

PubMed2006

Caring for the underserved: blending service learning and a web-based curriculum.

BACKGROUND: Recognition of health disparities among underserved individuals, whose demographic, geographic, or economic characteristics impede access to health-related services, has led to calls for the development of medical school curricula that address care for the underserved, but reports of the development and evaluation of such curricula are limited. METHODS: Two formats of a curriculum addressing care for the underserved were developed and implemented during the 6-week pediatric clerkship for third-year medical students during the 2003-2004 academic year. One format was faculty-led; the other was web-based. Skills for providing care to underserved families were taught through didactic, experiential, and service-learning curriculum components. Novel core curriculum elements included a screening tool for recognizing underserved patients and an independent clinical project through which students linked underserved families with community health resources. Analyses from 2004-2005 compared pre- and post-curriculum knowledge and attitudes of web-based students (n = 29) to those receiving either the faculty-led (n = 36) or the established "readings-only" curriculum (n = 35). Qualitative data from service learning projects were analyzed to assess clinical skills. RESULTS: Compared to students in the established curriculum, both web-based and faculty-led students demonstrated improved knowledge (p < 0.001) and attitudes (p < 0.05) about caring for the underserved. Both web-based and faculty-led students were successful in recognizing and addressing underserved health issues in the clinical setting. CONCLUSIONS: Faculty-led and web-based curricula can equally improve student knowledge, attitudes, and skills about caring for the underserved.

Adult↗

PubMed2001

The EONS core curriculum revision project.

This paper provides an overview of the EONS (European Oncology Nursing Study) core curriculum revision project. The aim of this project was to revise the EONS core curriculum for a Post-Basic Course in Cancer Nursing, first published in 1989, so that it would better reflect patient and family need and contemporary cancer nursing practice. A further aim of the project was to address the educational needs of both adult and paediatric oncology nurses. To achieve these aims a core curriculum revision meeting was organized and attended by representatives from most of the EU Member States. A rough draft of the core curriculum was developed, circulated and subjected to further scrutiny and modification. Following approval of the final draft, the core curriculum was translated from English into the 10 other official EU languages and made available in both paper and electronic form. The updated core curriculum was launched during the ECCO-10 conference and has now been disseminated widely amongst European cancer nurses and the wider nursing and medical community.

Journal Article↗

PubMed2006

Does a new integrated PBL curriculum with specific communication skills classes produce Pre Registration House Officers (PRHOs) with improved communication skills?

Over recent years communication skills training has played an increasingly important role in UK medical curricula. When The University of Liverpool reformed its medical curriculum in 1996 from a traditional lecture-based curriculum to an integrated problem-based learning curriculum formal communication skills training was introduced into the course. The paper deals with a comparison between PRHOs' ideas about communication competencies for PRHOs who did receive communication skills training and those involved in a traditional curriculum without formal communication training. This has involved distributing questionnaires to PRHOs and their educational supervisors, holding focus groups with PRHOs and interviewing educational supervisors. Data have been collected on the last cohort of the traditional curriculum and first cohort of the new curriculum to allow comparisons between cohorts. The PRHO questionnaires show that both cohorts feel they are good communicators but the focus groups show different reasons for this. The traditional graduates feel it is because doctors are 'natural communicators' and those skills can't be taught. The PBL graduates relate their communication skills to their undergraduate tuition and found they used these techniques when communicating as PRHOs. Both the questionnaires and interviews with the consultants demonstrate they feel the communication of PRHOs has significantly improved.

Cohort Studies↗

PubMed2006

A collaborative approach to developing a validated competence-based curriculum for health professions students.

PROBLEM: Curricula are developed to educate health professions students to provide efficient and effective health services. In addition to learning their disciplinary perspective, today's students must master the concepts of multidisciplinary team care. Traditionally, curriculum was developed based primarily on the perspectives of the discipline faculty, administration and accrediting agencies. However, now there are multiple groups (other academic educators, consumers and employers of health care providers) who may hold differing perspectives about outcomes expected from these programs. PURPOSE: The purpose of this investigation was to use an innovative methodology to generate and validate a curriculum for health professions students from multiple disciplines. METHOD: A multi-phased method using focus groups, surveys, dissemination and affirmation was presented to identify the concepts and best practices that should be included. RESULTS: Several performance-based themes evolved during the interviews and a questionnaire was generated. Academic educators, consumers and employers of health care providers indicated agreement that the components on the survey were realistic and important for health professions students to achieve. Thus, outcomes for a curriculum were validated. The faculty rated several components of the curriculum as less realistic for students to achieve than did the consumers and employers. This investigation suggests it may be necessary for faculty to assist providers and parents in developing more realistic expectations about what students can achieve during their educational program. The approach used in this current project moves the field of the health professions curriculum development to a different level when compared with the traditional curriculum development approaches and should be used by others concerned with multi-professional education to assure the validity of the curricula.

Cooperative Behavior↗

PubMed1997

Preparing residents for managed care practice using an experience-based curriculum.

Many U.S. residency graduates will practice in various types of managed care organizations, where they will be expected to arrive skilled in managed care activities such as prescribing with formularies and adhering to preauthorization processes for procedures, referrals, and hospital admissions. Residency programs must prepare their trainees to negotiate for their patients' needs within such systems. This article describes a University of California, Los Angeles, UCLA School of Medicine curriculum that teaches managed care skills to residents in two internal medicine residency training programs. The residents in one program participate in a commercial health maintenance organization plan via a group-model faculty practice. Managed care activities for residents in this program were gradually introduced beginning in 1990. This reflected previous years' gradual yet enforced introduction of managed care activities that occurred for this program's faculty and most group practice physicians in California. Residents in the other program train at a public hospital where managed care practice is simulated. Managed care activities were not required by this program's institution but were voluntarily introduced for their educational value beginning in 1994. Responding to this program's trainee and faculty requests, these activities were rapidly implemented over two years with the goal of preparing residents for joining practices in a market with high managed care penetration. Since 1994, the centerpiece of the curriculum has been residents' participation in ambulatory utilization review and related activities. Residents learn managed care principles through problem-based learning, experiential exercises, and feedback on resource utilization. The curriculum has affected residents' attitudes toward managed care and changed their patterns of referrals and resource use. Residents trained with this curriculum perceive managed care practices as familiar and less intrusive. They submit fewer requests for referrals, perhaps with review in mind. However, precautions may be required to avoid undercare. The authors found that the reduction of referrals requested was greater than what they had expected. Residents may find scrutiny by colleagues intimidating. Also, this curriculum requires a substantial time commitment from residency training, with its already busy teaching agenda. The authors feel that initiating a managed care curriculum is an important investment in time for U.S. residency programs. Given that most graduates of residency programs will have their health care management decisions scrutinized while in practice, the authors feel it is important that residents' first exposure to managed care be while they are still in the supportive residency environment. They believe that early exposure will not only give residents the confidence to overcome the intimidation of colleague scrutiny, but may also give graduates the tools for involvement with the development of future managed care health policy.

Ambulatory Care↗

PubMed2005

An oral health curriculum for medical students at the University of Washington.

Oral health disparities are a major public health problem, according to the U.S. Surgeon General. Physicians could help prevent oral disease, but lack the knowledge to do so. To create an oral health curriculum for medical students at the University of Washington School of Medicine, the authors (beginning in 2003) (1) reviewed current evidence of medical education and physician training in oral health, (2) developed oral health learning objectives and competencies appropriate for medical students, and (3) identified current oral health content in the undergraduate curriculum and opportunities for including additional material. The authors identified very few Medline articles on medical student education and training in oral health. The United States Medical Licensing Examination Steps 2 and 3 require specific clinical knowledge and skills in oral and dental disorders, but other national curriculum databases and the Web site of the Liaison Committee on Medical Education devote no significant attention to oral health. To develop learning objectives, the authors reviewed major oral health reports, online oral health educational resources, and consulted with dental faculty. The curriculum was assessed by interviewing key medical school faculty and analyzing course descriptions, and was found to be deficient in oral health content. The authors developed five learning themes: dental public health, caries, periodontal disease, oral cancer, and oral-systemic interactions, and recommend the inclusion of corresponding competencies in targeted courses through a spiral curriculum. Current progress, the timeline for curriculum changes at the University of Washington, and the ethical values and attitudinal shifts needed to support this effort are discussed.

Competency-Based Education↗

PubMed1997

Retrospective evaluation of undergraduate medical education by doctors at the end of their residency time in hospitals: consequences for the anatomical curriculum.

Reform of the undergraduate medical curriculum, including the debate on which of its parts or subjects are superfluous, is a topic of interest in many countries. On being examined at the end of their specialization period, doctors were asked to grade the relevance of all subjects in the undergraduate curriculum for training to become a medical doctor. The subjects that gained the highest grades were internal medicine, gross anatomy, physical examination course, physiology, and pharmacology. The five subjects graded least relevant were biomathematics, terminology, social medicine, medical physics, and medical chemistry. More than 80% of the doctors expressed interest in special lectures and courses, e.g., in topographic anatomy at the beginning of their postgraduate training. Retrospective evaluations at the end of residency time are helpful "evidence" to be considered in reforming the medical curriculum, and in particular in defining "core" and "optional" parts of the curriculum. The data show that anatomy is graded as highly relevant in the undergraduate medical curriculum by doctors at the end of their postgraduate training.

Adult↗

PubMed1984

Assessing curriculum implementation: a process for identifying salient variables.

The focus of this study was a process for selecting variables for assessing curriculum implementation. Three sets of variables, program characteristics, curriculum content, and curriculum emphasis, were measured to determine the degree to which program goals were implemented in 18 continuing education pediatric nurse practitioner programs. Program directors (19) responded to a questionnaire on the three sets of variables. Results from one-way analysis of variance (alpha = .05) and omega squared (omega 2) were used to identify variables from each of the three sets most likely to account for differences in curriculum implementation among the programs. Three of 11 program characteristics, 5 of 14 content domains, and 3 of 6 emphasis parameters were identified as salient variables for assessing student achievement and long-term curriculum outcomes.

Achievement↗

PubMed2002

Developing an action plan for integrating sleep topics into the medical school curriculum.

Sleep disorders are prevalent although they go unrecognized by clinicians, partially because of limited exposure to sleep medicine topics during medical school. Sleep topics can be integrated during both the preclinical and clinical years of the medical school curriculum by developing an integration strategy and action plan. Components of the action plan include examining the current medical school curriculum and the teaching infrastructure. Understanding curricular governance issues and how curriculum time is allocated will allow development of an effective integrative strategy. Sleep topics can be integrated into neuroscience, neuroanatomy, physiology, and behavioral science courses during the preclinical years. The sleep history and physical can be integrated into the physical diagnosis course. Sleep disorders can be introduced in clinical correlation courses. Integration strategies during the clinical years may include computer-based simulations. Careful assessment of the existing curriculum, curricular governance processes, and available educational resources will optimize the probability of successfully integrating sleep topics into the medical school curriculum.

Curriculum↗