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PubMed2005

Child advocacy training: curriculum outcomes and resident satisfaction.

BACKGROUND: Many health problems affecting children today are based in the community and cannot be easily addressed in the office setting. Child advocacy is an effective approach for pediatricians to take. OBJECTIVE: To describe pediatric residents' choices of advocacy topics and interventions. DESIGN: Cross-sectional observational study. METHODS: Residents from 3 pediatric training programs participated in the Child Advocacy Curriculum, which featured standardized workshops and the development of individual advocacy projects. To evaluate the curriculum, project descriptions and material products were analyzed to determine individual advocacy topics, topic themes, and targets of project interventions. Differences among programs were assessed. Residents also completed an anonymous questionnaire assessing their experience with the Child Advocacy Curriculum. RESULTS: Residents demonstrated a wide range of interests in selecting advocacy topics: 99 residents chose 38 different topics. The most common topic was obesity (13 residents) followed by health care access (9), teen pregnancy prevention (6), and oral health (5). Themes included health promotion and disease prevention, injury prevention, health care access, children with special health care needs, child development, at-risk populations, and the impact of media on child health. The project interventions targeted the local community most frequently (37%), followed by resident education (27%), hospital systems (21%), and public and health policy (15%). The vast majority of participating residents reported a positive experience with the Child Advocacy Curriculum. CONCLUSIONS: The wide range of topics and settings in which residents developed projects illustrates residents' extensive interests and ingenuity in applying needed advocacy solutions to complex child health issues.

Attitude of Health Personnel↗

PubMed1996

A clinical anatomy curriculum for the medical student of the 21st century: gross anatomy.

Human anatomy forms the foundation for clinical medicine; thus its place in the medical school curriculum deserves careful attention. In an attempt to provide guidance to decision-makers involved in clinical anatomy curriculum development at the medical school level, the Educational Affairs Committee of the American Association of Clinical Anatomists (AACA) developed this document, which defines the contours of a gross anatomy curriculum leading to the M.D. or D.O. degree. The main body of the document sets forth the anatomical concepts as well as the subject matter a student should master prior to graduation from medical school. The AACA seeks to ensure that all medical students receive thorough training in clinical anatomy and that each student, regardless of the institution attended, will be exposed to a curriculum that will provide a fundamental level of competence required for the practice of medicine.

Anatomy↗

PubMed2000

A clinical anatomy curriculum for the medical student of the 21st century: developmental anatomy.

An understanding of human developmental anatomy provides a fundamental framework for the accurate diagnosis and proper treatment of patients with congenital clinical entities, a significant population of any medical practice. Therefore, the regard afforded the study of developmental anatomy in the medical curriculum deserves thoughtful attention. In an effort to provide guidance in designing an undergraduate medical curriculum that properly addresses developmental anatomy, the Educational Affairs Committee of the American Association of Clinical Anatomists (AACA) developed this clinical anatomy curriculum in developmental anatomy. It outlines the subject matter and principles that will not only allow the physician to recognize and treat congenital diseases, but will also provide a solid basis for the incorporation of future discoveries, particularly in the rapidly evolving field of molecular developmental anatomy. The AACA seeks to ensure that all medical students receive thorough training in developmental anatomy and that each student, regardless of the institution attended, will be exposed to a curriculum that will provide the necessary competence and confidence for the effective practice of medicine in the 21st century.

Anatomy↗

PubMed2001

Maximizing the use of a Web-based teaching skills curriculum for community-based volunteer faculty.

BACKGROUND: The University of Kansas School of Medicine in Wichita created an Internet-based faculty development curriculum for community-based faculty. Because relatively few physicians use Internet-based continuing medical education (CME), the most cost-effective methods of encouraging use need to be identified. METHOD: Five interventions intended to increase use of the curriculum were assessed. The number of times the CME curriculum Webpages were accessed was correlated with the interventions. RESULTS: Demonstrating the Website to faculty at a semiannual meeting elicited the most Website "hits." Electronic mail and flyers also appeared to be effective in stimulating interest in the Website. Only four community-based faculty applied for CME credit for completing the curricular modules. FINDINGS: Multiple modalities should be used in advertising and stimulating interest in an Internet-based faculty development curriculum. Demonstrating the Website to faculty at a meeting appeared to achieve the greatest return. Offering CME credit was not helpful in stimulating interest.

Curriculum↗

PubMed2004

Hidden curriculum in continuing medical education.

In developing curricula for undergraduate and graduate medical education, educators have become increasingly aware of an interweaving of the formal, informal, and hidden curricula and their influences on the outcomes of teaching and learning. But, to date, there is little in the literature about the hidden curriculum of medical practice, which takes place after graduation and certification. This article initiates that discussion with influences of the hidden curriculum on the actions physicians take or do not take in caring for patients. Hafferty's framework of institutional policies, evaluation activities, resource-allocation decisions, and institutional slang, along with our knowledge of health services research and the continuing medical education (CME) research literature, suggests that there is a hidden and powerful curriculum that affects physician performance. Determining whether the hidden curriculum conflicts with the messages that we are delivering through formal CME (courses, clinical practice guidelines, peer review journals) may contribute to improving our impact on physician performance.

Curriculum↗

PubMed2002

The impact of the basic skin cancer triage curriculum on providers' skills, confidence, and knowledge in skin cancer control.

BACKGROUND: Primary care providers (PCPs) are in the unique position of being able to deliver preventive health care services to the majority of the general population. Early detection of skin cancer may reduce mortality, but many PCPs do not participate in skin cancer control activities due to lack of training and confidence. We sought to evaluate the effect of a 2-h, Basic Skin Cancer Triage (BSCT) curriculum in overcoming these barriers. METHODS: A convenience sample of 28 primary care providers participated in a 2-h training curriculum. Assessments included skills (evaluated by a 20-item slide quiz), confidence, knowledge, and attitudes measured pre- and post training. RESULTS: Provider ability to accurately diagnose and triage lesions significantly improved (46 to 64%, P < 0.0001, and 61 to 71%, P < 0.0001, respectively). The greatest improvement in triage ability occurred in providers ability to appropriately reassure patients about lesions (49 to 70%, P < 0.0001). There were also significant improvements in both knowledge of skin cancer control practices (68 to 74% correct answers, P = 0.026) and confidence in ability to provide skin cancer preventive services (2.95 to 4.13 on a 1 to 5 scale, P < 0.0001). CONCLUSIONS: Participation in the BSCT curriculum may improve providers' diagnostic and triage accuracy of skin cancer as well as increase their knowledge of skin cancer and confidence in their provision of skin cancer control activities. Defining the full potential impact of this curriculum requires further evaluation.

Adult↗

PubMed1994

The core content of a generalist curriculum for general internal medicine, family practice, and pediatrics.

The authors analyzed the educational content of the curricula developed for teaching in the generalist disciplines of pediatrics, family medicine, and general internal medicine. Fifteen educational components that constitute the core content shared by the three generalist disciplines are identified, described, and referenced. Tailoring the generalist curriculum for students and residents at the different stages of learning is reviewed, along with the refinement of the curriculum to meet the special needs of each generalist discipline. The success of a generalist curriculum will ultimately be measured by generalist career choices, quality of care, and both patient and professional satisfaction. The curricular determinants of success require institutional commitment to an educational philosophy that embraces the generalist disciplines, a core curriculum that provides education and training that are correlated with the demands of clinical practice, and generalist faculty who serve as role models, mentors, and teachers.

Adult↗

PubMed1994

The experiential curriculum: an alternate model for anaesthesia education.

The shift to direct entry into residency training from medical school for all graduates will offer new challenges for anaesthesia training programmes. In this paper we argue that it also offers us an opportunity to re-evaluate our current approach to anaesthesia education. Emphasis in the residency programmes should be to provide trainees with clinical experiences and stimulation that will develop the required traditional competencies. It should also cultivate competency in clinical decision-making, intuition and judgement. Our purpose is to generate discussion by proposing an alternate curriculum model, the experiential curriculum. The basic premise is that learning is a process and outcome is to a large extent related to what the learner does. The process begins with an experience that provides for observation and reflection. Integration of the thoughts provides the basis for executing either existing or new actions. In the experiential curriculum residency training and learning are enhanced by documenting and critically evaluating the experiences to which the resident is exposed. Included within such a structured programme are the methodologies of problem-based and evidence-based learning. Faculty development will be required to help the resident pursue these skills of self-evaluation and efficient learning. We believe that incorporation of an experiential curriculum into the residency training programme will achieve the goals listed above and allow maturation of the process of lifelong learning. It will also allow greater achievement of the application of new information to one's practice.

Anesthesiology↗

PubMed2001

One-year followup on the impact of a sun awareness curriculum on medical students' knowledge, attitudes, and behavior.

BACKGROUND: A one-week sun awareness curriculum was developed at the University of Western Ontario to educate first-year medical students on skin cancer risks and prevention. OBJECTIVE: To assess the retention of knowledge, attitudes, and behavioral practices one year after receiving education in sun awareness. METHOD: Three surveys were administered: before, immediately after the sun awareness teaching, and one year later. Actual practiced behavior in the past year was compared with the intended behavior. RESULTS: Half as many sunburns were reported in the year following the sun awareness curriculum compared with the previous year. Medical students demonstrated a good retention of the knowledge learned a year earlier. However, many students still believed that a tanned appearance looks healthy. While there was intent to adopt more healthy behavior after the curriculum, the actual behavior practiced varied. CONCLUSIONS: An undergraduate medical curriculum on sun awareness can be effective in improving the knowledge, attitudes, and behaviors of future physicians.

Adult↗

PubMed2006

Students' conceptions of constructivist learning: a comparison between a traditional and a problem-based learning curriculum.

This study investigated students' conceptions of constructivist learning activities in a problem-based learning (PBL) and a traditional curriculum. We examined whether students who have chosen for a problem-based curriculum have different conceptions of constructivist assumptions compared to students who have chosen to be enrolled in a traditional, lecture-based curriculum when they enter university. Although constructivism represents an influential view of learning, studies investigating how students conceptualize this perspective have not been conducted before. A structural equation modelling approach was adopted to test the hypothesized model in both student populations and to calculate latent means. Results suggested that students in the PBL environment agree more on constructivist assumptions of cooperative learning and the use of authentic problems, while students in the traditional curriculum acknowledge the importance of motivation to learn more. It is discussed that conceptions of constructivist learning activities can act as an important moderator of PBL effects and should be considered in examining the effects of PBL and probably in all comparative education research.

Adult↗

PubMedDate not supplied

Modifying a childbirth education curriculum for two specific populations. Inner-city adolescents and substance-using women.

An interdisciplinary care provider team conducted a nonexperimental, observational, descriptive study to determine a childbirth education curriculum that would meet the needs of pregnant adolescent and substance-using women who attend prenatal clinics at an urban, municipal hospital center. A childbirth education curriculum, originally taught to a clinic population in 1974, was used with the two special populations in 1993 for a 7-month period. Participants were encouraged to provide feedback about the curriculum for each class by offering suggestions for additions or deletions of content. Provider staff also evaluated the content for applicability today. At the end of the study period, the pregnant adolescent group had been most involved with the class exercises; members of the group provided feedback about content. They were consistently positive in evaluating the entire six-class curriculum and recommended some additional topics. The adolescents demonstrated sustained interest in breast-feeding. The substance-using women, on the other hand, expressed a preference for content that focused on labor and birth; they preferred to ask questions, individually and in the privacy of the examining room, and showed negligible interest in breast-feeding.

Adolescent↗

PubMed1993

Effects of a preventive cardiology curriculum on behavioral cardiovascular risk factors and knowledge of medical students.

We evaluated a Preventive Cardiology Academic Award (PCAA) program designed to integrate preventive cardiology concepts into the medical school curriculum. Diet, preventive cardiology knowledge, preventive cardiology attitudes, exercise behavior, and body mass index were compared at entrance to medical school and during the graduation year. Complete data were available on 94 students (65 men and 29 women). Similar data from students who graduated in 1987, prior to the introduction of the PCAA curriculum, served as a control. Women showed a significant enhancement in attitude towards cardiovascular disease (CVD) prevention, while both men and women significantly increased their knowledge about CVD prevention. The frequency of planned physical activity decreased significantly in both sexes and men showed a significant increase in body mass index. Men significantly reduced total calories, percent of calories from fat and saturated fat and dietary cholesterol and increased fiber intake. In women, the only significant reduction was in total calories. In comparison to the control class that did not have the program, men receiving the PCAA curriculum reduced dietary cholesterol, dietary fat, saturated fat and monounsaturated fat. Changes in these dietary parameters were nonsignificant for women in comparison to the control class women. Additional analyses showed no systematic secular trends in dietary or other variables in classes entering from 1986 to 1990. We conclude that the PCAA curriculum changes have favorably affected the preventive cardiology knowledge, attitudes and diet of medical students.

Adult↗

PubMed2004

Assessing the impact of a comprehensive sexually transmitted disease curriculum on learning outcomes.

OBJECTIVE: Our purpose was to assess the impact of a curriculum designed to improve third-year medical students' knowledge of sexually transmitted diseases, measured by sexually transmitted disease-related items from the National Board of Medical Examiners subject examination and by a locally developed sexually transmitted disease test. STUDY DESIGN: All students (n = 108) were exposed to a new sexually transmitted disease curriculum: a 2-hour laboratory module, lectures, syllabus, and locally developed pretest/posttest with review of the test prior to taking the National Board of Medical Examiners subject examination. Students were randomized to a attend sexually transmitted disease clinic (n = 47) versus no sexually transmitted disease clinic (n = 61). RESULTS: Students performed equal to or better than the national average on 85% of the National Board of Medical Examiners sexually transmitted disease-related items after curriculum institution, compared with 56% of the test items prior ( P < .001). Magnitude of improvement was dependent on clerkship timing, with greater improvement in students taking the obstetrics-gynecology clerkship earlier in the third year. Mean postcurriculum test scores of sexually transmitted disease improved significantly ( P < .001), independent of clinic site and clerkship timing. CONCLUSION: The curriculum for sexually transmitted disease produced significant improvement in third-year medical students' knowledge of sexually transmitted disease. This might have an impact on future prevention and control of sexually transmitted diseases in communities in which these students practice.

Alabama↗

PubMed2005

Implementation and evaluation of a genetics curriculum to improve obstetrician-gynecologist residents' knowledge and skills in genetic diagnosis and counseling.

OBJECTIVE: This study was undertaken to develop, implement, and evaluate a genetics curriculum for obstetrician-gynecologist residents. STUDY DESIGN: We prospectively evaluated the effect of a genetics curriculum on obstetrician-gynecologist residents' knowledge and skills. Residents completed a needs assessment and pretest. Educational intervention included 2 3-hour didactic sessions with 1 hour of lecture followed by case discussion and 1 3-hour session of experiential learning using standardized patients who evaluated residents' knowledge and skills in taking family history, drawing genetic pedigrees, and counseling patients. Posttest scores were compared with pretest scores. RESULTS: Needs assessment was completed by all 40 obstetrics and gynecology residents and identified limited and variable genetics education in medical school. Twenty-eight of 40 residents attended the entire educational intervention and completed the pretest and posttest, and 25 of 28 showed improved test scores. Residents stated that they were more confident in their ability to take a family history, record a 3-generation pedigree, and counsel patients about genetic conditions after completion of the genetics curriculum. CONCLUSION: This multifaceted genetics curriculum improved residents' knowledge of genetics as well as their confidence in applying genetic concepts as assessed by the pretest and posttest and by their comments in the debrief session.

Clinical Competence↗

PubMed2006

Curriculum content and evaluation of resident competency in clinical pathology (laboratory medicine): a proposal.

Ten years have passed since the Graylyn Conference Report on Laboratory Medicine Clinical Pathology training was issued. Over that period, the Accreditation Council for Graduate Medical Education substantially revised the requirements for training programs; the American Board of Pathology amended both the requirements and the periods needed for certification; and the discipline itself, along with the broader discipline of pathology, evolved significantly. Recently, a curriculum proposal in anatomical pathology was published as a potential template to be used by training programs to help meet these new and evolving needs. Toward the same end, the Academy of Clinical Laboratory Physicians and Scientists has now developed a template for a curriculum in clinical pathology (laboratory medicine), taking into account newly designated and revised areas of residency core competency, the alterations in training requirements promulgated by the Accreditation Council for Graduate Medical Education and American Board of Pathology, and the rapidly developing nature of the discipline itself. The proposed clinical pathology curriculum defines goals and objectives for training, provides guidelines for instructional methods, and gives examples of how outcomes can be assessed. This curriculum is presented as a potentially helpful outline for use by pathology residency training programs.

Clinical Competence↗

PubMedDate not supplied

Adapting and implementing a long-term nutrition and physical activity curriculum to a rural, low-income, biethnic community.

This study adapted an urban-based school nutrition program for delivery in a rural community. Specific aims were to adapt the curriculum; expand it to include physical activity; determine effectiveness on students' attitudes, knowledge, and self-efficacy; and assess teachers' impressions. Three cohorts were established: 173 students taught by a resource teacher, 170 students taught by classroom teachers, and 187 students who did not receive the curriculum. Pre- and posttest surveys measured outcomes, and classroom teachers were observed and interviewed. The curriculum was shown to be effective in enhancing student outcomes for both the resource teacher and classroom teacher cohorts. Teachers reported that lessons needed to be simplified and that children enjoyed them. Findings support the transferability of an urban-based nutrition curriculum to a rural community and the need for students to receive health education annually.

Child↗

PubMed2005

The neurosurgical training curriculum in Australia and New Zealand is changing. Why?

The Neurosurgical Advanced Training curriculum of the Royal Australasian College of Surgeons (RACS) is currently undergoing change. Given the high standard of neurosurgery in Australia and New Zealand, it may be questioned why such change is necessary. However, the curriculum has not kept pace with developments in professional practice, educational practice or educational theory, particularly in the assessment of medical competence and performance. The curriculum must also adapt to the changing training environment, particularly the effects of reduced working hours, reducing caseloads due to shorter inpatient hospital stays and restricted access to public hospital beds and operating theatres, and the effects of sub-specialisation. A formal review of the curriculum is timely.

Australia↗

PubMed2006

Nurse teachers' knowledge in curriculum planning and implementation.

BACKGROUND: Nurses are required to base care on research evidence but research findings on nursing practice often suggest that the linkage is poor and ritualistic routines often prevail. AIMS: The study explored the origin and nature of knowledge utilised by nurse teachers when developing and implementing a curriculum. METHODS: In a single, ethnographic case study data were collected from two curriculum development and two curriculum implementation groups, using interviews, participant observation and documents. The study drew directly on Bernstein's theory of the pedagogic device and cultural reproduction. RESULTS: Findings suggested that even though nurse education appears to be dominated by policies and guidelines produced by state agencies, it was teachers operating at institutional and classroom levels who determined what was delivered to student nurses as they relied upon their experience of teaching and clinical practice to plan and implement curriculum. Notwithstanding both national and local aspirations to the contrary, teaching and assessment practices were mostly teacher- rather than student-centred, with heavy reliance on propositional knowledge. CONCLUSION: The practices identified within this study may induce approaches to learning that may be antithetical to delivering research based care within a prevailing climate that advocates evidence-based practice, clinical effectiveness and governance.

Anthropology, Cultural↗