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PubMed2001

A continuous curriculum for general practice? Proposals for undergraduate-postgraduate collaboration.

The development of a seamless general practice 'spiral' curriculum, in which topics may be revisited at different levels of intensity and complexity during the learning process, has been discussed in the context of undergraduate-postgraduate co-operation. Although the lifelong curriculum for all doctors contains a number of core competencies that aim to produce a 'stem' doctor, concerns remain about the effects of excessive reductionism. It is therefore essential that the content and delivery of the spiral curriculum ensure that intellectual interest is nurtured, by containing both taught theory and training in a hospital context. The opportunity for generalists to teach core competencies such that general practice is at the centre of the undergraduate curriculum--emphasising working within primary health care teams in teaching and training practices--is an ideal area for undergraduate-postgraduate co-operation. The use of the directly observed measures of performance would bring the undergraduate approach to assessment closer to that used in postgraduate general practice. However, supporting the tutors' network is crucial in undergraduate departments where much can be gained by joint working with postgraduate colleagues.

Curriculum↗

PubMed2000

Need for bringing in a change in biochemistry curriculum to make it clinically oriented?

OBJECTIVES: This study was conducted to (a) assess the views of medical students and doctors regarding relevance of biochemistry training, (b) explore if they have any suggestion to bring in any improvement in contents of biochemistry curriculum and mode of teaching. METHODS: In 1997-98, a structured questionnaire was filled up by 114 medical students and 118 doctors. RESULTS: As many as 62/114 (55%) medical students and 40/118 (34%) doctors believed that it is not important to remember minute details of biochemical reactions (p value < 0.0001). Among medical students, 108/110 (98.2%) agree that a clinician should be invited to seminars for developing skills of interpretation of laboratory investigations; whilst 110/118 (93.2%) doctors expressed similar view, p value ns. Approximately 92% responders favored that departments biochemistry and physiology should co-ordinate on the topics of common interest in order to save time and effort. What is the most informative and effective way of teaching biochemistry?' in response to this question only 0.9% responders opted lecture as the best option. Seminars with active participation of medical students was preferred by 93.2% responders. About 6.9% responders reckoned that symposium prepared by a more than one teacher. In response to the question whether it is possible to cover pre-clinical subjects in 12 months so as to allow spiral mode of curriculum, 73% of all the responders agreed that it would be good idea, there was no difference of opinion among the doctors and medical students. On the other hand, 27% were strongly opposed to this suggestion. CONCLUSIONS: We suggest that there is a need to modify the contents, methods of teaching, and curriculum organization of training in clinical biochemistry. How best the curriculum can be made problem oriented needs to be debated among medical educationists.

Biochemistry↗

PubMed2001

Women's health and oral health implications of the curriculum study.

This article discusses the effect of medical school and dental school curriculum surveys, which allowed interdisciplinary analysis of the status of women's issues in the health profession. With this documentation of the status of women's health and oral issues, changes in the curriculum can now occur to close the gaps in education and training exposed in the surveys. Changes in the curriculum are aimed at improving clinical practice by practitioners and lowering barriers to care experienced by women. These changes must be incorporated into not only the medical school and dental school curriculums, but also into the practices of the current health care practitioners to be effective.

Curriculum↗

PubMed2002

Curriculum emphasis and resident preparation in postgraduate general dentistry programs.

In 1999 HRSA contracted with the UCLA School of Dentistry to evaluate the impact of federal funding on postgraduate general dentistry programs. Part of that evaluation analyzed curriculum emphasis and preparation of incoming residents in advanced general dentistry programs over a five-year period. Directors of 208 civilian AEGD and GPR programs were surveyed about the curriculum content of their programs, increased or decreased emphasis in thirty subject areas, and resident preparation and quality (GPA and National Board scores). Results indicate that curriculum changes in AEGD and GPR programs over the time period have been responsive to the changing nature of general practice. At least half of all program directors reported that their residents were less than adequately prepared in fourteen curriculum areas. Sub-analyses were conducted for AEGD/GPR programs and HRSA-funded versus nonfunded programs. Multivariate regression identified lower student quality as the most important program variable in predicting a perceived need for resident remediation. Logistic regression showed that programs with higher resident GPA and National Board Part I scores had less difficulty filling resident positions.

Adolescent↗

PubMed1977

A curriculum for primary care dentistry.

This paper is a discussion of curricular planning with respect to primary care dentistry. It is meant to be anticipatory, although the proposals contained are transitional and evolutionary rather than abrupt. It is intended to be suggestive rather than authoritarian and exemplary rather than definitive. Many of the recommendations and suggestions are already operative in dental education, albeit in limited or experimental form. An overview of both the content and the process of a primary care dental curriculum is presented, and several specific recommendations for curricular change are submitted. Among the more salient recommendations are (1) changing the admissions process to attract to dentistry those most qualified for primary care; (2) moving the basic sciences into the predental curriculum during the initial phase in the development of primary care dentistry; (3) substantially increasing the amount of behavioral science in the dental curriculum; (4) placing curricular emphasis initially on diagnosis and expanding the competence of the primary care dentist in endodontics, periodontics, pedodontics, orthodontics, and prevention; (5) initiating student group practice as the vehicle for patient care; (6) including intradisciplinary and interdisciplinary training as integral components of primary care curricula; (7) extending the curriculum; (8) establishing general practice or primary care residencies either as an intracurricular experience or as a postdoctoral requirement; (9) reorganizing dental school clinics and clinical training to reflect primary care curricular goals; (10) making more rational use of existing auxiliaries, the eventual goal being auxiliaries who perform most of the routine functions; and (11) ultimately integrating dentistry into medicine so that the future primary care practitioner receives both medical and dental training. It is obvious that the extent to which any of these recommendations will be implemented depends on a great deal more than what happens within a dental school. There are many putative countervailing forces which can make implementation difficult; on the other side of the ledger, these same forces might be propitious. As an illustration, the staggering financial constraints imposed on the dental schools can cause us to throw up our hands in despair or can impel us to look carefully at what we are doing, ask why we are doing it, and by building on what is sound and discarding the antiquated and irrelevant, reassemble our curricula to meet public need better than we have been doing...

Career Mobility↗

PubMed2003

The new rural health curriculum at Dunedin School of Medicine: how has it influenced the attitudes of medical students to a career in rural general practice?

AIM: To evaluate the effect of the new fifth-year rural health curriculum developed at Dunedin School of Medicine on the attitudes of students to a career in rural general practice. METHODS: A structured questionnaire was administered to all fifth-year medical students immediately before and after participation in the rural health curriculum at DSM during 2000 and 2001. RESULTS: There were statistically significant positive changes in the students' responses to each question regarding their attitudes towards rural general practice. Students identifying as being of rural origin were more likely to give positive answers both before and after the course. The numbers indicating that they will or probably will enter rural general practice increased from 1.1% (0% (n = 0) of urban and 6% (n = 1) of rural students) to 13% (10% (n = 6) of urban and 22% (n = 4) of rural), pre- to post-course. CONCLUSIONS: Students who identify their origins as rural are more likely to have a positive attitude towards rural general practice as a career choice. However, a rural curriculum can produce attitude changes in students, irrespective of origin. If medical schools wish to assist in addressing the needs of their rural communities they should consider selection of students from rural origin and ensure that rural health plays a significant part in the school curriculum.

Career Choice↗

PubMed2003

Predoctoral clinical curriculum models at U.S. and Canadian dental schools.

In fall 2002, the ADEA Section on Comprehensive Care and General Dentistry conducted a survey of the predoctoral clinical curriculum models at sixty-four North American dental schools. Fifty-eight percent of the schools reported that most patient care is provided in a comprehensive care clinic setting, 22 percent reported that most patient care is provided in discipline-specific settings, and 20 percent reported a hybrid of comprehensive care and discipline-specific settings. While ten Primarily Discipline-Based (PD) schools have instituted new Primarily Comprehensive Care (PCC) or Hybrid clinical curricula since 1997, one PCC school has converted to a Hybrid model, and one PCC school has converted to a PD model. PCC curriculum models were frequently associated with the following institutional factors: more densely populated metropolitan areas; private institutional sponsorship; location within a university medical center; larger class size; and more students enrolled in advanced training at the school. Curriculum factors frequently associated with PCC models included the following: increased use of simulation technology: higher proportion of clinical/teaching track faculty; higher proportion of part-time faculty; higher proportion of generalist faculty; same faculty supervising both treatment planning and patient treatment; and use of competency exams as the main requirement for completion of the curriculum.

Canada↗

PubMed2004

[A national curriculum in neurology for medical education].

The knowledge within medicine is growing rapidly. It has become more and more difficult to decide what knowledge that has to be taught to medical students during their University Medical Degree (MD) education and what has to be omitted from their study plans. As help for teachers and students, a core curriculum of the education defines what is of importance for all students. However, there is a risk of "curriculum overload" with too much information being put into a short time interval. To avoid this and to define what is really the "core" of a course, a national consensus decision may be useful. As an example of this approach, we here report a new joint Swedish core curriculum in neurology for medical students. Teachers responsible for neurological education at all six universities giving University MD education in Sweden have in January 2003 agreed upon the core curriculum that we present. It is our hope that this method can be useful also for other clinical specialities.

Clinical Competence↗

PubMed2004

Incorporating bioterrorism training into dental education: report of ADA-ADEA terrorism and mass casualty curriculum development workshop.

Numerous areas have been identified in which the dental profession may be called upon to assist in the event of a major terrorism attack. In order to successfully fulfill these roles, dentists and dental students must be adequately prepared. Dental schools play a vital role in this preparation. Participants in an ADA-ADEA workshop reached consensus that all dental students should be trained in a core set of competencies enabling them to respond to a significant bioterrorism attack, help contain the spread of the attack, and participate in surveillance activities as appropriate upon direction of proper authorities. Further emergency response training should be available to individuals interested in gaining additional knowledge and skills to assist in response to an attack. Participants also concluded that, where possible, training should be seamlessly implemented into the current curriculum without the addition of new courses; however, the group also recognized the possible need for alternative models at some dental schools. Challenges to implementing bioterrorism training into the dental school curriculum include regional variation, management of the basic science curriculum, and financial considerations. The development of an exportable training package will be considered and funding sources explored in moving forward with the development of a curriculum.

American Dental Association↗

PubMed2004

[Innovation of the curriculum system of otorhinolaryngology and its impact on education of capable medical students].

OBJECTIVE: The impact of the curriculum system innovation of otorhinolaryngology in the education of capable medical student was investigated. METHOD: The curriculum system of otorhinolaryngology in our college was innovated. The innovated curriculum of otorhinolaryngology was put in practice in 3 grades of undergraduate students and 2 grades of seven-year education system students. RESULT: The clinical practice ability and the mast of the knowledge of otorhinolaryngology were improved significantly. CONCLUSION: The principle of the curriculum system innovation of otorhinolaryngology in our college is effective and, therefore, valuable in education of potential and capable medical students for other subjects of clinical medicine.

Curriculum↗

PubMed2005

[Changes in the medical curriculum in Mongolia].

Since 1996, general practitioners from the universities in Amsterdam, Groningen and Leeds (England) have been involved in restructuring the medical curriculum in Mongolia. The Mongolians desired a problem-based and integrated new curriculum that would be suitable for training generalists. We started by training Mongolian teachers in modern pedagogic developments and in multidisciplinary consultation. The new curriculum started in 1999 and after a cumbersome start, integration was achieved, the library was completely renewed and equipped for self-study and rural opportunities were created so that medical students could acquire practical experience outside of the university hospital. The new curriculum is a step in the direction of training doctors who will be able to function independently in the new Mongolian health-care system.

Adult↗

PubMed2006

An interactive web-based curriculum on evidence-based medicine: design and effectiveness.

BACKGROUND AND OBJECTIVES: Medical education experts have called for improved training in evidence-based medicine (EBM) and the increased use of e-learning technologies in medical education. In response, we developed an interactive, Web-based curriculum on key aspects of EBM in family medicine. METHODS: Students participating in a 6-week family medicine clerkship (n=238) were randomly assigned to intervention (n=134) or control (n=104) groups. Both groups participated in the traditional clerkship experience, but intervention group students received additional training via an on-line curriculum that included learning modules in MEDLINE searching skills, EBM skills, and the calculation of the number needed to treat (NNT) statistic. The on-line curriculum was evaluated using a case-control design with a test case at the clerkship's end. RESULTS: Results suggested that the on-line curriculum was effective, with experimental group students outperforming control group participants on a variety of measures, including the number of MEDLINE searches conducted during the clerkship (13 searches versus 3 searches) and the quality of literature search strategies on an evaluation patient case study (2.9 versus 2.1 on a 1=poor to 4=excellent scale). Intervention group students reported greater confidence and enjoyment in searching the biomedical journal literature via MEDLINE and were more likely to identify the best articles (randomized controlled trials or meta-analyses) for the evaluation case from among those retrieved (60% versus 34%). In addition, intervention group students' abilities to correctly calculate the NNT were significantly higher than those of control group participants (73% versus 27%). Intervention group students were more likely than control subjects to report learning from other students during the clerkship. CONCLUSIONS: This study demonstrates that an e-learning approach to educating medical students to effectively search MEDLINE for articles meeting the criteria for evidence-based practice can result in higher-quality literature search strategies, identification of higher-quality evidence, and improved confidence in information retrieval and analysis skills.

Clinical Clerkship↗

PubMed2006

Obesity prevention in pediatrics: A pilot pediatric resident curriculum intervention on nutrition and obesity education and counseling.

INTRODUCTION: Obesity is a highly burdensome public health issue associated with premature death, multiple comorbid disabilities and staggering healthcare costs. Between 1980-2000, the prevalence of obesity among children and adolescents nearly tripled. Obesity subjects youth to social stigmatization and discrimination. These economic and personal burdens mandate targeted prevention and detection educational programs for all individuals at risk. The most cost-effective method of approaching this obesity epidemic is through education of health professionals. METHODS: As part of an "Obesity Prevention in Pediatrics" curriculum, postgraduate-year (PGY)-2 residents first observed and then participated in the dietary evaluation and counseling of pediatric patients and their families. Attitudinal questionnaires, multiple-choice knowledge examinations and a pre-established checklist of desired skills and behaviors provided evaluation of the curriculum's effect on the participants' ability and willingness to manage actually obese or at-risk pediatric patients and their families. RESULTS: Attitudinal survey and knowledge test scores from control PGY-3 residents generally confirmed that their knowledge and counseling skills on obesity prevention and management were well below expectation. Following participation in the curriculum, study residents' knowledge tended to improve, as did their level of comfort in counseling obese and at-risk children, adolescents and their parents. CONCLUSION: Implementation of an "Obesity Prevention in Pediatrics" curriculum appears to improve participants' knowledge base as well as their skills and level of personal comfort in the recognition, evaluation and management, including counseling, of both obese and at-risk pediatric patients and their families.

Counseling↗

PubMedDate not supplied

Emotional competence as a positive youth development construct: conceptual bases and implications for curriculum development.

This paper outlines the conceptual bases of 'emotional competence' as a positive youth development construct and the implications for curriculum development in junior secondary schools. In essence, 'emotional competence' includes (i) identifying personal feelings and those of others; (ii) managing emotional reactions and communication; and (iii) building self-managing strategies to cope with negative emotions and adversities. By considering adolescents' developmental progression, gender and cultural issues, eight units of positive youth development are designed in the P.A.T.H.S. Project, supported by the Hong Kong Jockey Club Charities Trust, to promote 'emotional competence' in Secondary 1 to 3 students in Hong Kong. In the Secondary I curriculum, the goals of the units are to develop student's awareness of their emotions and proper expression of them. In the Secondary 2 curriculum, the goals of the units are to enhance students' understanding of others' emotions and the importance of communicating emotions in relationships. In the Secondary 3 curriculum, the goal is to enhance students' adaptive coping strategies in the face of adversities.

Adaptation, Psychological↗

PubMedDate not supplied

Spirituality as a positive youth development construct: conceptual bases and implications for curriculum development.

This paper outlines the conceptual bases of 'spirituality' as a positive youth development construct and the implications for curriculum development in junior secondary schools. In essence, spirituality embraces (i) connectedness with others that includes other people and a higher being, (ii) establishing personal beliefs and values, and (iii) the search of answers to the meaning of life. By considering adolescents' cognitive development and other developmental needs, gender and cultural issues, ten units of positive youth development programmes are designed to foster spirituality in Secondary 1 to 3 students in Hong Kong. These programme units constitute part of the P.A.T.H.S. Project supported by the Hong Kong Jockey Club Charities Trust. In the Secondary 1 curriculum, the goal of the units is to facilitate students to connect with other people and a higher being. In the Secondary 2 curriculum, the goals of the units are to help students reflect on their possessions in life and reevaluate the meaning of their life from people who experience great agony. In the Secondary 3 curriculum, the goals are to help students search for the meaning of life.

Adolescent↗

PubMedDate not supplied

Cognitive competence as a positive youth development construct: conceptual bases and implications for curriculum development.

This paper outlines the conceptual bases of "cognitive competence" as a positive youth development construct and the implications for curriculum development. Cognitive competence refers to the cognitive processes that comprise (i) creative thinking, which includes various creative thinking styles, such as legislative, global, and local thinking styles; and (ii) critical thinking, which includes reasoning, making inferences, self-reflection, and coordination of multiple views. Based on the adolescent development progression on cognitive competence, and with reference to Hong Kong Chinese context, six units are designed to promote creative and critical thinking for Secondary 1-3 students in the Project P.A.T.H.S., supported by the Hong Kong Jockey Club Charities Trust. In the Secondary 1 curriculum, the goals of the units are to enable students to recognize different but inter-related thinking styles and to apply these thinking skills to deal with daily life issues. The goal in the Secondary 2 curriculum is to enhance students' creative thinking skills to solve problems, whereas the goal in the Secondary 3 curriculum is to enhance students' critical thinking skills to accept beliefs and make decisions.

Adolescent↗

PubMed1991

Preparing faculty to teach in a problem-based learning curriculum: the Sherbrooke experience.

Over the last 6 years Sherbrooke Medical School has undertaken a major reform of its undergraduate curriculum. A new student-centred, community-oriented curriculum was implemented in September 1987. Problem-based learning (PBL) is now the main educational method. To adequately prepare teachers for the curriculum a series of faculty development programs in pedagogy were offered: first, a 2-day introductory workshop to initiate teachers into educational principles and their application in the new program; second, a 1-year basic training program in medical pedagogy; third, a 1-day workshop on PBL; and fourth, a comprehensive 3-day training program in PBL tutoring. Over 60% of all full-time teachers attended the introductory program and 80% the tutor training program. The 1-year basic training program was completed by 33% of the faculty members. The implementation of these programs, coupled with a high participation rate, resulted in a more student-centred educational philosophy and a greater interest in medical education. This had a significant impact when the new curriculum was instituted. Lessons learned from the experience are discussed.

Curriculum↗

PubMedDate not supplied

A family practice residency curriculum in critical appraisal of the medical literature.

This paper reports a five-year experience with a comprehensive curriculum for teaching critical appraisal and practical research skills to family practice residents. The curriculum includes a seminar series in research and medical practice and simulated research projects. Rationale, methods, format, and evaluations of the curriculum are presented. The curriculum prepared graduates to critically review research studies in the professional literature and translate valid conclusions into medical practice. Residents were able to identify potential areas of research interest and acquired additional skills that encouraged continuing education and professional growth.

Curriculum↗