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PubMed2001

Learning in the field: curriculum issues in a diploma in public health nursing.

Illuminative evaluation of a public health nursing curriculum shows that there was a gap between theory and practice, originating in the ways in which public health nursing was understood in the field, and therefore during students' placements, and in the university. The difference was chiefly in how the community staff and the lecturers understood primary health care. The former had a 'medical/professional' understanding of primary health care, implying that the professional knows best and that the client is an individual, a family or a group. The lecturers held a philosophy of primary health care with special emphasis on partnership with clients at all levels: individual, family, group and community; the partnership approach was intended to permeate the entire curriculum. Besides philosophical differences, there were other features of the theory practice gap demonstrated elsewhere. Fieldwork practice is integral to learning public health nursing so these contrasts created a serious disjunction within the curriculum. Actual and potential ways of improving curriculum integration are discussed.

Community Health Nursing↗

PubMed2001

Evaluation of the medical curriculum: why, when, by whom and for whom should questionnaires be used.

The undergraduate medical curriculum has been modified or even totally reorganized in many countries in recent years, and there are plans to make departmental budgets and the salaries of university professors partially dependent on the outcome of teaching. Questionnaires are often used in such situations as a means of curriculum evaluation. Based on our own experience such evaluations should be done not only during and immediately after a course in the curriculum, but also at later time points, e.g., at the end of the undergraduate and also the postgraduate phase. The clinical relevance of lectures and courses can only be graded adequately after some years of clinical experience. Gross anatomy was graded top at all time points evaluated and reached higher levels of 'clinical relevance' than other typical preclinical and even clinical subjects. Efforts should be made to obtain a high response rate for representative results. After modifying parts of a course detailed questionnaires should also include space for students' suggestions. The results of such evaluations are not only relevant to the head of department as feedback on the individual lecturers but also important for the curriculum committee and the dean. Anatomists should utilize these evaluations to improve teaching.

Anatomy↗

PubMed2002

The undergraduate curriculum of Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak in terms of Harden's 10 questions.

The curriculum of the Faculty of Medicine and Health Sciences (FMHS) is designed particularly to cater for the health needs of the State of Sarawak, Malaysia. The framework of the curriculum is built on four strands: biological knowledge, clinical skills, behavioural and population aspects. The training is community based and a graduate of FMHS is expected to possess the ability to deal with many ethnic groups with different cultures and beliefs; expertise in tropical infectious diseases; skills to deal with emergencies such as snakebite and near drowning; qualities of an administrator, problem-solver and community leader; and proficiency in information and communication technology. The content of the curriculum strives for commitment to lifelong learning and professional values. The FMHS has adopted a 'mixed economy' of education strategies and a 'mixed menu approach' to test a wide range of curriculum outcomes. The FMHS fosters intellectual and academic pursuits, encourages friendliness and a sense of social responsibility and businesslike efficiency.

Cultural Diversity↗

PubMed2003

The application of a core curriculum and options to an undergraduate paediatric course: a personal view.

The time allocated to the undergraduate paediatrics curriculum has been reduced in recent years. It is therefore increasingly important to organize a structured curriculum that provides students with the necessary competences to care for sick children in the early years after graduation. In this paper, the educational strategy of a core curriculum and options is discussed and its application to an undergraduate paediatrics course is described. A core curriculum with options can be readily adapted to undergraduate paediatrics but it requires careful planning to provide the student with the necessary competences and a rewarding and enjoyable educational experience.

Curriculum↗

PubMed1993

Effects of a curriculum and inservice program on the quantity and quality of elementary physical education classes.

The primary responsibility for engaging children in opportunities to be physically active and learn physical skills rests with school physical education. This study evaluated the effects of a combined health-related curriculum and inservice program on the quantity and quality of elementary school physical education lessons. Seven schools (N = 28 fourth-grade classes) in one district were randomly assigned to one of three conditions: 10 classes were taught in their usual manner by classroom teachers (Control [CO]); 10 classes were taught by trained classroom teachers (TT) who received inservice training and follow-up consultations; and 8 classes were taught by physical education specialists (PES) hired by the research project. Student activity level, curriculum context, and teacher behavior were directly observed and coded during a sample of 112 lessons over an 8-month period. Results indicated significant differences in both the frequency and mean length of classes (PES, 26.7 min; TT, 23.4 min; CO, 18.9 min). Additionally, the curriculum and inservice program equipped trained classroom teachers to provide significantly better classes than were provided by controls in terms of student activity engagement, lesson context, and active instructional behavior, though their classes did not match the quality of those taught by the physical education specialists. This study is unique in its use of direct observation of lessons to assess a curriculum and inservice intervention.

Curriculum↗

PubMed2000

Changes in nutrition knowledge among first- and second-year medical students following implementation of an integrated nutrition curriculum.

Existing studies suggest that many of the objectives called for by the National Academy of Sciences in its 1985 report are not being addressed in medical student education. Members of the Nutrition Curriculum Working Group at the UCLA School of Medicine prepared a list of proficiencies in nutrition and developed a coordinated, vertically integrated, two-year nutrition education curriculum to address those objectives. To assess the impact of the curriculum on students' knowledge, the authors tested a cohort of students at repeated intervals over a two-year period using a Nutrition Progress Survey drawn from the Nutrition Test-Item Bank developed at the University of Alabama. There was a significant increase in knowledge over the three administrations of the Progress Survey as measured by total score. This was largely accounted for by an increase in the number of correct responses, which rose from 39% at pre-test to 62% at delayed follow-up. In spite of a significant increase in nutrition knowledge, the low percentage correct indicates that nutritional content should be threaded throughout the core clerkship curriculum as well.

Curriculum↗

PubMed1993

The Canadian Palliative Care Undergraduate Curriculum.

In 1988 the deans of 12 (out of 16) Canadian medical schools appointed representatives to a Canadian Palliative Care Curriculum Committee. The Committee has subsequently published the Canadian Palliative Care Curriculum which outlines specific goals and objectives for palliative care instruction in undergraduate medical teaching. The Curriculum covers 22 different topics, including 13 symptoms and 9 psychosocial issues. The Canadian Curriculum Committee continues to meet and is now considering other national educational initiatives in palliative care.

Canada↗

PubMed1994

"Sunshine and skin health": a curriculum for skin cancer prevention education.

Skin cancer rates are increasing. Instilling preventive behavior in youngsters is essential to prevent overexposure during childhood. The effectiveness of a curriculum for increasing knowledge and skills, creating supportive attitudes, and engendering a supportive environment to enhance skin cancer prevention was tested on 139 fourth-, fifth-, and sixth-graders. One class in each grade was assigned to treatment (curriculum) and another to control. The curriculum increased knowledge of the effects of exposure to sunlight, skin cancer, and prevention immediately and eight weeks later, across all grades. It also cultivated less favorable attitudes toward tanning and, among fourth-graders, reduced unfavorable attitudes toward sunscreen. Behavioral changes were less consistently evident, with students reporting less suntanning, fourth-graders more frequently using sunscreen, and fifth- and sixth-graders more frequently wearing protective clothing compared with controls. The curriculum was more effective at influencing knowledge and attitudes than changing behavior, highlighting the need for student- and parent-oriented cues to action.

Child↗

PubMed1989

Priorities for nutrition content in a medical school curriculum: a national consensus of medical educators.

The ASCN Committee on Medical/Dental School and Residency Nutrition Education conducted a series of activities to establish guidelines for nutrition core content in a medical school curriculum. These activities included mail surveys of medical-nutrition educators and a representative group of medical school curriculum administrators and a national consensus workshop of nutrition educators. Results indicated close agreement between the nutrition educators and curriculum administrators (r = 0.89, p less than 0.0001) on the importance ratings of 41 nutrition topics and on the number of hours of nutrition course work that medical schools should provide (44 vs 37 h, respectively, p = 0.14). There was consensus among the nutrition educators that 26 topics should be given priority ratings as essential for inclusion in medical course work. Further prioritization of these topics resulted in a listing of core content topics and subtopics to serve as a guide to administrators and educators for planning nutrition course work in a medical school curriculum.

Curriculum↗

PubMed2000

The history of the undergraduate curriculum in music therapy.

The undergraduate curriculum determines the quality of student preparation and serves to ensure consistency in clinical practice, thus promoting acceptance of music therapy by the medical community. As members of the newly-formed American Music Therapy Association strive to integrate diverse viewpoints, a historical review of the curriculum may provide direction for future revisions. Columbia University offered the first music therapy course in 1919, yet the profession did not establish an official undergraduate curriculum until 1952. This paper chronicles the events occurring prior to 1952 which contributed to curriculum development. Preceding university degree offerings, hospitals provided music therapy training. Hospital music directors established detailed guidelines for both lecture courses and clinical work. Authorities also outlined specific qualifications for potential students, including musical ability and suitable personality traits, and discouraged students who did not meet these criteria. As university programs grew in number, notable figures such as Roy Underwood and E. Thayer Gaston influenced curricular decisions through their personal beliefs and professional activities. Exploring this chain of events may assist contemporary authorities in understanding and strengthening the educational foundation for music therapists.

Curriculum↗

PubMed1976

Designing a curriculum in a clinical setting: an iterative process.

A curriculum for the training of medical students was designed and implemented in a functioning clinical setting. The multidisciplinary, multiprofessional staff of a primary care center participated with professional educators in an iterative process for curriculum development. A three-stage plan was conceived: behaviorally oriented educational objectives were constructed, instructional methodologies to satisfy these objectives were created, and evaluation instruments were designed. Throughout each stage the educators facilitated the process by teaching the staff the necessary techniques for the design and implementation of the curriculum. The curriculum that resulted from this process is focused on those issues that are important to team delivery of primary care. An important outcome of the project is the increased enthusiasm and competence of the professional staff in the teaching of students in the health professions.

Curriculum↗

PubMed1986

Preclinical curriculum characteristics and institutional performance on NBME. Part I.

A study was conducted that analyzed the relationship between various characteristics of the preclinical curriculum and institutional performance on the Part I examination of the National Board of Medical Examiners (NBME) at a sample of 85 U.S. medical schools. Total scheduled hours per week was the single curriculum characteristic having a positive and significant relationship with institutional NBME examination performance. However, when the data were controlled by medical school selectivity in admissions and institutional policy on the taking of the examination, total scheduled hours per week failed to make a significant contribution to the prediction of performance. The results were viewed as failing to provide support and justification for intense preclinical curriculum loads on the basis that this would enhance NBME examination performance. The authors conclude that simple comparisons of schools on the basis of mean NBME examination performance are meaningless unless the entering abilities of students and school policies on the examination are taken into account. The authors also suggest that those schools that prescribe heavy and intense preclinical curriculum loads should reexamine those policies in light of recommendations of the Project Panel on the General Professional Education of the Physician and College Preparation for Medicine.

Certification↗

PubMed1989

A first-year problem-based curriculum in health promotion and disease prevention.

This paper describes Harvard Medical School's integration of a curriculum on health promotion and disease prevention into the first year of its New Pathway to General Medical Education. The goals of the curriculum were to develop in each student (1) the knowledge and skills necessary to evaluate critically the major issues in prevention and (2) an attitude that acknowledges the pertinence of prevention in virtually every clinical encounter. The case method was used for all teaching in the curriculum, as it is throughout the New Pathway. Students worked together in small groups, addressing the issues raised by each case under the direction of faculty preceptors. The component was taught by clinicians as part of a two-year course in which students learned clinical skills and addressed topics from the social sciences and medical humanities. In addition, issues in health promotion and disease prevention were integrated into the cases used to teach the other components of the New Pathway curriculum.

Boston↗

PubMed1991

Assessing the first eight years of an optional five-year medical curriculum.

Experience with the initial eight years (1980-1987) of a voluntary five-year medical degree program at the Boston University School of Medicine is examined. The program, called the Alternative Curriculum, permits medical students to "decompress" the first year of their medical school curriculum. The program was designed to be a parallel curricular pathway and not a remedial program. Some students in academic difficulty, however, have been enrolled in this program. The students' records and their responses to a questionnaire form the basis for this report. The students who entered the Alternative Curriculum before the start of classes or who, upon entering, were in good academic standing generally did well academically and were uniformly pleased with the time that was available to pursue other interests. Several of these students were subsequently permitted to decompress other curricular years, with uniform success. Of the students for whom the Alternative Curriculum was used as a remedial program, nearly half had left or been dismissed from school at the time of this report.

Boston↗

PubMed1991

Implementing the Association of Teachers of Preventive Medicine's recommendations into the undergraduate medical school curriculum.

In 1989, an expert panel appointed by the Association of Teachers of Preventive Medicine proposed minimum curricular content requirements for health promotion-disease prevention, including recommendations for timing, duration, and course sequencing during medical school. Making clinical preventive medicine an integral part of a primary care rotation is a central feature of the proposal. The panel presents recommendations for using the Guide to Clinical Preventive Services, which assesses the effectiveness of 169 types of prevention interventions, in both undergraduate and postgraduate medical education. Recommendations for incorporating the guide into the undergraduate medical school curriculum are outlined. The recommendations include options for using the guide as part of a curriculum in quantitative skills, in clinical preventive medicine, in a primary care rotation, as a health services and community dimension curriculum, and as part of continuing self-education. Recognizing that teaching methods and curriculum structures are varied in preventive medicine, the panel designed the recommendations to be adaptable to all medical schools' programs. The recommendations are aimed at achieving the goal of making preventive medicine an integral part of the education, training, and practice of physicians.

Clinical Competence↗

PubMed1993

The medical school curriculum committee revisited.

Numerous study commissions have contended that departmental territoriality and lack of coordinated planning are stagnating contemporary medical education. As a cure, these commissions have recommended the creation of centralized academic management units empowered to oversee revitalization of the curriculum through a series of reforms, including better definition of graduation competencies, community-based training, interdisciplinary courses, problem-based learning, and modernization of evaluation strategies. To determine the extent to which these recommendations were being adopted, in 1990 the authors sent a questionnaire on curriculum committee functions, current innovation efforts, and future priorities to academic administrators and members of medical school curriculum committees at 143 North American medical schools. Responses were received from administrators (primarily associate deans for academic affairs) at 118 schools and committee members (primarily faculty) at 111 schools. Recommendations for enhancing curriculum committee effectiveness were also elicited. The authors conclude that centralization of curricular management has occurred at very few institutions, and that the commonly mentioned reforms are being adopted at a modest pace. The results are analyzed in light of theories of the institutional change process and strategies for introducing educational innovations into established institutions.

Administrative Personnel↗

PubMed1995

Using electronic mail for a small-group curriculum in ethical and social issues.

PURPOSE: To initiate an electronic mail (e-mail) program as a supplement to a medical humanities curriculum focusing on ethical and social issues. METHOD: In 1991-92 an e-mail track (called NET) was established for second-year students participating in Medicine in Contemporary Society, a four-year curriculum in medical humanities at the State University of New York at Stony Brook School of Medicine. In 1991-92 ten students volunteered to form a NET group; in 1992-93 22 students, forming two groups, were randomly selected from a volunteer pool of 76 students (from a class of 100). In both study years, the NET students analyzed and discussed electronically a series of cases posted sequentially through the academic year. Faculty tutors reviewed the students' responses, interacting with the groups and with individual students by e-mail. NET was evaluated in two ways: at the end of the course, the students completed e-mail questionnaires that included quantitative and qualitative assessments; and throughout the course, the tutors assessed the students' participation, quality of case analysis and discussion, and quality of writing. RESULTS: The students' assessments indicated that they considered NET to be more educational than the lectures, "live" group discussions, problem-based learning exercises, and formal papers in the medical humanities curriculum; that they made gains in computer literacy; and that NET enhanced their abilities to think about ethical and social issues. The tutors judged that the students had improved their written self-expression as the course progressed. CONCLUSION: NET adequately accomplished the goals set for it as an adjunct to the small-group sessions and other components of the medical humanities curriculum.

Attitude↗

PubMed1995

The undergraduate medical curriculum: centralized versus departmentalized.

The authors describe the advantages and disadvantages of central governance of the undergraduate medical curriculum as contrasted with traditional departmental approaches, based upon their school's experience with a new centrally governed curriculum during the preceding four years. Central governance has more advantages, but also more costs, compared with traditional departmental approaches. Central governance does what it was intended to do: it provides rational and integrative mechanisms for ensuring a broad general education in medicine focusing on the doctor-patient relationship. It also provides an effective mechanism for dealing with "turf" and time issues in the curriculum while allowing for and encouraging changes and providing mechanisms for evaluating those changes. However, as the allocation of resources and rewards remains more departmentally than centrally based, a major challenge of central governance has been to help faculty resolve a "conflict of loyalty" (the sense of serving two masters) between school and department, particularly in the evaluation and reward of teaching. On balance, central governance provides a powerful means of introducing broad-based reforms into all elements of the undergraduate medical curriculum, but it requires ongoing collaboration with faculty and chairs to assist them in negotiating competing pressures and priorities as they strive to become excellent teachers.

Administrative Personnel↗