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PubMed1978

The preceptorship, an integral unit of the curriculum in community and family medicine.

A curriculum in community and family medicine at the University of Massachusetts Medical School, planned to include a primary care preceptorship as an integral unit, is described. The curriculum has been planned to allow for repeated and increasing exposure of medical students during their undergraduate years to a variety of health care settings within the state. An extensive program of courses is required for all students and consists of a three-week field clerkship in the first year, a field-oriented epidemiology course in the second year, and a six-week field clerkship in the third or fourth year. A preceptorship elective is available to all medical students after they have completed their first two years. Field visits by community and family medicine faculty to the preceptorship site provide overall guidance, facilitate the implementation of objectives, and provide opportunities to strengthen bonds between the practicing physicians of the Commonwealth of Massachusetts and the state medical school. The results to date are discussed.

Community Medicine↗

PubMed1992

Impact of a clinical preventive medicine curriculum for primary care faculty: results of a dissemination model.

BACKGROUND: This study was designed to test a dissemination model for providing clinical preventive medicine (CPM) training to general internal medicine faculty across the United States. METHODS: The model incorporated direct instruction of a few faculty as seminar facilitators who, in turn, taught a CPM curriculum to their faculty colleagues, who then could teach it to housestaff and students. The CPM curriculum consisted of six seminars that focused primarily on the risk factors for chronic diseases and on behavior change methods for modifying smoking, diet, and exercise. RESULTS: Faculty who participated in the seminars had significant pre- to post-test increase in knowledge and reported self-efficacy to implement CPM strategies with patients, as well as changes in CPM clinical practices. These faculty, in turn, successfully disseminated CPM information to their housestaff, who also had increases in self-efficacy and changed clinical practices regarding CPM topics. CONCLUSIONS: The successful implementation of the dissemination model attests to its viability as a mechanism for disseminating CPM curricula and increasing the emphasis on CMP issues in both clinical teaching and clinical encounters with patients.

Adult↗

PubMed1992

An integrated approach to curriculum development.

This paper explores some aspects of what is meant by integration in a nursing curriculum, by looking at both integration of course content and subject matter, and a consequent move away from separated academic disciplines towards a thematic approach, and at integration of the student group, so that different groups of nurse learners study and learn together for a certain proportion of the programme. We consider reasons for adopting an integrated approach by discussion: issues related to learners and the learning context (these include theories of how adults learn and our perspective on the part to be played by experiential learning); the potential implications for client/patient care and the need for transferable skills to work as a member of a team; and staff development for the teachers, including moves away from possible isolation towards team-teaching. We then go on to describe a model for curriculum development devised in our own institution and based on these principles, which incorporates the development of learners professionally, educationally and personally. This paper discusses the topic from a mainly theoretical perspective, and many of the issues will be relevant to a wide range of courses.

Clinical Competence↗

PubMed1977

The impact of an elective curriculum in pathology.

Under the revised medical curriculum at Duke University, elective courses were offered in the third and fourth years beginning in 1968-1969. Departmental electives in autopsy, surgical, and systemic pathology were offered as major courses, and the subspecialty courses in cardiovascular, renal, pulmonary, pediatric, and neuropathology were taught by specialists in those areas. Special topics in subcellular and molecular pathology, neoplasia, environmental diseases, and experimental pathology were subscribed by medical and graduate students alike. To determine the impact of elective courses in pathology, these electives were compared to those offered by other basic science disciplines. Tabulation of total courses offered, student enrollment, and total academic credit hours were constructed for each basic science area. The data show that over the six year study period the students elected more courses in pathology than in any other basic science. The most heavily subscribed electives in pathology were those that were clinically oriented, such as cardiovascular or renal pathology. One impact of this elective system may be to enhance recruitment. During the period studied, 29 Duke graduates interned in pathology compared to six under a comparable time period in the traditional curriculum.

Curriculum↗

PubMed1975

Following up the physical therapist assistant graduate; a curriculum evaluation process.

Graduates of the physical therapist assistant program at St. Mary's Junior College in Minneapolis, Minnesota, were studied to ascertain how well prepared they had been for the demands of their jobs and to discover what revisions in the program curriculum might be appropriate. Working graduates and their supervisors were surveyed to obtain information about the frequency and independence of performance of 111 tasks appropriate to physical therapy departments. The response was 90 percent. The St. Mary's curriculum was considered appropriate in most respects. More than 25 percent of the supervisors considered emphasis inadequate only for facilitation, breathing, and mat exercises. Graduates' recommended changes were more extensive, suggesting a desire to expand their knowledge. A manual was designed to guide program faculties through follow-up of their own graduates. The manual includes questionnaires, worksheets, and a guide to analysis. The authors suggest that the process may also be useful for other technical-level allied health occupations.

Clinical Competence↗

PubMed1977

An integrated problem-solving curriculum design for physical therapy education.

Development of and experience with an integrated problem-solving curriculum design for physical therapy education is presented. The basic themes which relate discrete subject areas and a method of organizing the content around the themes are described. Problem-solving learning experiences are sequenced from the simple to the complex around the kind of situations found in clinical practice. Clinical education is integrated throughout the curriculum, and a calendar is developed based on the content of the learning experiences rather than the traditional university calendar.

Curriculum↗

PubMed1975

Issues and methods in curriculum evaluation.

Studies of medical school curricula need not meet the criteria of systematic experimental designs. Instead of compromising aspects of the curriculum to meet such requirements as random sampling, the authors suggest the development of representative curricular research. Such designs require the development of population validity, ecological validity, and referent generality. Examples of these aspects of representative design are derived from the development of a health-maintenance-organization-based primary care curriculum.

Curriculum↗

PubMed1977

An independent study program within a medical curriculum.

The Independent Study Program (ISP) at the University of Rochester School of Medicine and Dentistry is described and its objectives are specified. Experimental (ISP) students and two matched (non-ISP students from the same class) groups were studied in two successive second-year medical school classes. Data were gathered only post-ISP for the first class and both pre- and post-ISP for the second. The data included measures of achievement, personality characteristics, and academic-professional experience. Experimental and control groups were not significantly different on achievement and academic-professional measures but did differ on certain measures of personality and values. The groups also differed on their evaluations of curriculum and reports of study habits. Fache ISP program was considered, and it was found that the ISP is less expensive of faculty time than is the regular curriculum but involves higher nonfaculty costs.

Achievement↗

PubMed1977

Objectives of psychiatric education in a primary care curriculum.

This paper gives the rationale, background, and outline of psychiatric curriculum development in the education of the primary care physician at one medical school. It is important to clarify the educational objectives, to develop specific teaching techniques to meet the objectives, and to have adequate assessment measures to evaluate the objectives and techniques. Additionally, it is necessary for an ongoing committee to continue to monitor and adjust the program as the assessment requires. The value of the program has been educational clarity, the development of a high esprit de corp among the faculty, student acceptance, and integration of psychiatry into the total medical school curriculum.

Curriculum↗

PubMed1977

Student decision-making and performance in a flexible-time curriculum.

Three consecutive classes (213 students) entering the University of Arizona College of Medicine under a flexible-time three-year curriculum were provided the option of extending their program by a year or more. Of the 30 percent who availed themselves of this option, a majority did so because they desired a better personal or academic "life-style" rather than for specific academic reasons. Most continued to pursue medical interests during the free time which became available to them. Through none of the usual admission data was it possible to predict which students would choose to extend their program. At the time of graduation students completing the curriculum in three years achieved scores on the Part II examination of the National Board of Medical Examiners comparable with those earned by students who extended for a four-year program. Nonacademic factors may be of greater importance than academic factors in student acceptance of accelerated curricula.

Arizona↗

PubMed1978

Pediatric residents and young handicapped children: curriculum evaluation.

The systematic evaluation of a curriculum designed to improve the knowledge, skills, attitudes, and clinical judgment of pediatric residents with regard to young handicapped children and their families is described. Residents were assigned to experimental and control groups, and changes were analyzed across several dimensions. The results revealed a number of significant changes due to the implementation of the curriculum. In particular, knowledge of various aspects of handicapping conditions increased as did the tendency to characterize the behavior of handicapped children in a positive manner. In addition, an experimental design is presented that is uniquely compatible with scheduling factors during residency training.

Attitude of Health Personnel↗

PubMed1992

Using a database to analyze core basic science content in a problem-based curriculum.

As medical schools critically reevaluate their methods of instruction and as the number of innovative programs increases, the content delivered across disciplines must be carefully reviewed. However, few methods of content analysis have been applied to problem-based programs. In 1989-90 and 1990-91, the authors analyzed the distribution of basic science content in the 53 cases in the problem-based curriculum of Rush Medical College of Rush University. They developed a content vocabulary and created a database using a widely available computer software program. The content areas specific to each case were identified by faculty using the content vocabulary. To determine whether these content areas were actually identified by the students participating in the problem-solving sessions, the authors surveyed the 36 student participants in the classes of 1993 and 1994 and also interviewed the 15 faculty facilitators of the sessions. The surveys and interviews demonstrated that over 90% of the content areas identified by the faculty were actually covered by the students. The authors conclude that the database assists in their review of the curriculum for omission and redundancy. Other uses and limitations of this method are also discussed.

Biological Science Disciplines↗

PubMed1992

A community health nursing curriculum and Healthy People 2000.

The School of Nursing at the University of Alabama at Birmingham recently revised its graduate level community health nursing curriculum based on the priority areas and health objectives in Healthy People 2000. Health priority areas are presented as class topics and provide direction for the students' fieldwork. This paper provides background on the national strategy used to develop the national health objectives, suggestions on how nursing can be at the forefront of influencing the health of the nation, and specifics involved in implementing a community health nursing curriculum using the year 2000 health objectives.

Community Health Nursing↗

PubMedDate not supplied

One integrated curriculum: an empirical evaluation.

In recognition of accountability to both the community and the student consumer for the process and the product of their educational program, faculty and students of Harris College of Nursing, Texas Christian University, Fort Worth, undertook a three-year study of entering and graduating students. Students exposed to a new integrated curriculum, it was found, tended to possess a higher degree of leadership and empathic ability without sacrifice of knowledge but less critical thinking ability than students graduating from the older "block" curriculum. It is suggested that this might have resulted from too much consistency of approach in the integrated program. Intellective characteristics (IQ, scholastic aptitude test scores, critical thinking ability) plus leadership potential and empathic skill were significant in discriminating between successful and nonsuccessful students.

Achievement↗

PubMed1992

Proposal for an administrative curriculum in pediatric emergency medicine fellowship training.

Administrative tasks make up a significant component of the practice of pediatric emergency medicine (PEM) physicians. Our survey of 10 academic pediatric emergency departments revealed that PEM physicians who are primarily clinical spent an average of 15% of their time on administrative tasks, and PEM physicians whose positions are administrative as well as clinical spent 30 to 60% of their time on administrative tasks. Of the 101 programs responding to our survey of 220 pediatric residency programs, 80% did not address hospital administrative issues, and many that did address these issues allowed these topics only one hour of presentation time per year. It is clear that there is a discrepancy between the demands placed upon PEM physicians to perform administrative tasks and the sparse or nonexistent opportunities for learning about administrative issues during residency training. It is incumbent upon pediatric emergency fellowship programs to provide an inclusive and well-structured administrative curriculum for their trainees. This article suggests a framework for such a curriculum.

Curriculum↗

PubMed1979

The development of a conceptually based nursing curriculum: an international experiment.

Nursing programmes in the United States of America are based on a conceptual framework. Not only do faculty and students ascribe to the necessity of such programmes but the national accreditation agency also provides its accreditation approval for the institution only after all criteria are met, including the requirement of a well-defined, operationalized and implemented framework. Can a nursing programme be developed in other nations utilizing the esoteric, American-based idea of the necessity for a conceptually based curriculum? The author answers this question. The manuscript presents both the process utilized in selecting a conceptual framwork for a new junior college programme in Kuwait and discusses the selected framework. The idea of a conceptual framework to guide the curriculum was as foreign in Kuwait as it was to nursing curricula in the United States 15 years ago. Though initially rejected by the faculty in Kuwait, the idea of a conceptual framework was reintroduced after much faculty discussion and questions related to nursing knowledge vis-a-vis medical knowledge, and what should be included in and excluded from the programme. By the end of the second year, a definite framework had been operationalized into courses and content. The selection of the framework evolved from faculty participation in the operationalization of the framework. This point is quite significant particularly in an international assignment, as it is the faculty who are left with the monumental task of supporting and continuing the work which has been done. Strategies used to develop and implement a conceptual framework included confrontation of faculty of the existing situation, lectures, seminars, workshops, and the identification of a critical review board.

Concept Formation↗

PubMed1976

The organization of an integrated basic medical science curriculum at a new medical school, Nottingham.

The detailed organization of an integrated medical sciences curriculum from its initial planning to the final stage of "automatic" administration are described. Although some reduction in departmental autonomy results, this is outweighed by the advantages of a timetable and curriculum prepared, planned and carried out in a cooperative manner. Flexibility and scope for controlled change and experiment are retained.

Curriculum↗

PubMed1978

Toward a clinical orientation in the basic medical biochemistry curriculum.

A re-evaluation of biochemistry in medical school curricula is presented, with reference to designing more effective courses. Responses to a survey conducted among 103 medical students enrolled in two general biochemistry courses indicated that basic biochemistry would be considered more relevant to the medical curriculum if clinical applications were emphasized over basic principles. A majority of students (91%) expressed interest in applying biochemical principles to pathological conditions. They recommended that the biochemistry curriculum should include lectures on the significance of biochemistry in medical practice and its role in the life processes, laboratory comparisons of normal and pathological specimens, and course titles that reflect a more clinical orientation.

Attitude of Health Personnel↗