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PubMedDate not supplied

A curriculum for multicultural education in family medicine.

BACKGROUND AND OBJECTIVES: To deliver effective medical care to patients from all cultural backgrounds, family physicians need to be culturally sensitive and culturally competent. Our department implemented and evaluated a 3-year curriculum to increase residents' knowledge, skills, and attitudes in multicultural medicine. Our three curricular goals were to increase self-awareness about cultural influences on physicians, increase awareness about cultural influences on patients, and improve multicultural communication in clinical settings. Curricular objectives were arranged into five levels of cultural competence. Content was presented in didactic sessions, clinical settings, and community medicine projects. METHODS AND RESULTS: Residents did self-assessments at the beginning of the second year and at the end of the third year of the curriculum about their achievement and their level of cultural competence. Faculty's evaluations of residents' levels of cultural competence correlated significantly with the residents' final self-evaluations. Residents and faculty rated the overall curriculum as 4.26 on a 5-point scale (with 5 as the highest rating). CONCLUSIONS: Family practice residents' cultural knowledge, cross-cultural communication skills, and level of cultural competence increased significantly after participating in a multicultural curriculum.

Curriculum↗

PubMed1998

Survey of curriculum on homosexuality/bisexuality in departments of family medicine.

BACKGROUND AND OBJECTIVES: This study assesses what US departments of family medicine are doing to teach undergraduate medical students about homosexuality/bisexuality and the care of gay, lesbian, and bisexual patients. METHODS: A two-page, 14-item, self-administered questionnaire was sent to predoctoral directors at all US medical schools with departments of family medicine (n = 116). The questionnaire asked about teaching methods and curriculum hours, whether other departments address the topic, and if there is a gay/lesbian/bisexual student group at the medical school. RESULTS: Of the 116 predoctoral directors surveyed, 95 (82%) responded. The mean number of departmental curriculum hours devoted to this topic was 2.5 hours for all 4 years of undergraduate medical school. About half (50.6%) of respondents reported that their department spent zero hours teaching about homosexuality/bisexuality. There were no differences in time spent by geographic region, size of school, or between public and private institutions. The most frequently cited teaching method was lectures in medical ethics, followed closely by lectures in human sexuality. CONCLUSIONS: About half of the responding family medicine departments did not include this topic in their curricula. Homosexuality/bisexuality should be included in family medicine's curriculum to ensure that future primary care physicians can properly care for all of their patients. Recommendations for curriculum modifications are provided.

Bisexuality↗

PubMed2002

Evaluation of a cancer prevention and detection curriculum for medical students.

BACKGROUND: Undergraduate medical education needs revision to ensure that medical students graduate with the skills necessary to assist their patients in cancer prevention and detection. We sought to implement and incorporate a cancer education curriculum into the students' core curriculum and to assess their skill levels prior to (1996), during (1997), and at the peak (1998-1999) of the incorporation of new hours. METHODS: We conducted pretest and posttest surveys of students at Boston University School of Medicine (medical student years 1-4) enrolled in each of the four study years (1996-1999). A total of 1,956 surveys (response rate, 82%) were completed. The primary outcome measure was the student's self-reported skill level (with responses ranging from 1 (very unskilled) to 5 (very skilled)) for counseling for tobacco cessation, tobacco prevention, and sun protection and for the early detection of breast, skin, and cervical cancer. Mean scores were computed for each chronological year of the study and medical school year. Differences and trends over time in mean scores of students in each medical school year were evaluated using multiple regression analysis. RESULTS: The number of hours of cancer education increased from 6 in 1996 to 15 in 1999. Strong improvements in self-rated skill levels were recorded for four of the six measures. In particular, tobacco cessation counseling skill rose from 2.16 (1996) to 3.13 (1999) for second year students (P < 0.001) and from 3.27 (1996) to 4.17 (1999) for fourth year students (P < 0.001). Among fourth year students, the percentage reporting that cancer prevention was given too little emphasis declined from 62% (1996) to 26% (1999) (P < 0.001), suggesting that the expanded curriculum reflected the students' preferences. CONCLUSIONS: Cancer education can be interwoven into the existing medical school curriculum and produce improvements in students' skill levels for counseling and examinations. Strategies to enhance prevention teaching can use this model.

Adult↗

PubMed1994

Development of a clinical forensic medicine curriculum for emergency physicians in the USA.

To address the forensic needs of living patients, the Department of Emergency Medicine at the University of Louisville School of Medicine in Louisville, Kentucky, USA initiated the first clinical forensic medicine training programme in the USA. In July 1991, formal training in clinical forensic medicine was incorporated into the core curriculum of the USA's second oldest academic emergency medicine training programme. The University of Louisville, in cooperation with the Kentucky Medical Examiner's Office, developed the curriculum to provide the emergency physician with the knowledge base and technical skills to perform forensic evaluations of living patients. Forensic lectures are given monthly by local and regional forensic experts including: forensic pathologists, prosecuting attorneys, firearm and ballistics examiners, law enforcement officers, forensic chemists and forensic odontologists. Topics which are presented include: forensic pathology, forensic photography, ballistics and firearms analysis, paediatric physical and sexual assault, crime scene investigation, forensic odontology, courtroom and expert testimony and the forensic evaluation of penetrating trauma. As a result of the introduction of clinical forensic medicine into the core curriculum of an emergency medicine training programme the residents are now actively addressing the forensic issues encountered in the Emergency department. Key, often short-lived forensic evidence, which was frequently overlooked or discarded while delivering patient care is now recognized, documented and preserved. The development and introduction of a clinical forensic medicine curriculum into emergency medicine training has greatly enhanced the emergency physician's ability to recognize, document and address the forensic needs of their patients who are victims of violent and non-fatal trauma.

Journal Article↗

PubMed2001

AMEE Medical Education Guide No. 23 (Part 2): Curriculum, environment, climate, quality and change in medical education - a unifying perspective.

This paper looks at five focal terms in education - curriculum, environment, climate, quality and change - and the interrelationships and dynamics bemeen and among them. It emphasizes the power and utility of the concept of climate as an operationalization or manifetation of the curriculum and the other three concepts. Ideas pertaining w the theory of climate and its measurement can provide a greater understanding of the medical cumadurn. The environment is an impoltant detemzinant of behaviour. Environment is perceived by students and it is perceptions of environment that are related w behaviour. The environment, as perceived, may be designated as climate. It is argued that the climate is the soul and spirit of the medical school environment and curriculum. Students' experiences of the climate of their medical education environment are related w their achievements, sangaction and success. Measures of educational climate are reviewed and the possibilities of new climate measures for medical education are discussed. These should take account of current trends in medical education and curricula. Measures of the climate may subdivide it inw dzfferent components giving, for example, separate assessment of so-called Faculty Press, Student Press, Administration Press and Physical or Material Environmental Press. Climate measures can be used in different modes with the same stakeholders. For example, students may be asked to report, first, their perceptions of the actual environment they have experienced and, second, w report on their ideal or preferred environment. The same climate index can be used with different stakeholders giving, for example, staff and student comparisons. The climate is important for staff as well as for students. The organizational climate that teaching staff experience in the work environment that they inhabit is important for their well-being, and that of their students. The medical school is a learning organization evolving and changing in the illuminative evaluation it makes of its environment and its curriculum through the action research studies of its climate. Consderations of climate in the medical school along the lines of continuous quality improvement and innovation are likely to further the medical school as a learning organization with the attendant benefits. Unless medical schools become such learning organizations their quality of health and their longevity may be threatened.

Journal Article↗

PubMed2001

A systematic process for content review in a problem-based learning curriculum.

The integrative nature of a problem-based curriculum provides unique challenges to the task of maintaining a current curriculum. This paper describes a systematic process for content review in a problem-based curriculum, which utilizes consultation among students, faculty and the clinical community, use of external reviewers and a faculty consensus process. Advantages of the process include increased communication and cooperation among faculty and development of a curriculum that balances the need for preparing students for new evidence-based practice with preparing them for clinical reality.

Journal Article↗

PubMed2006

Clinical role models are important in the early years of a problem-based learning curriculum.

Following a comprehensive study of the role models identified by the first five years of students in a traditional medical programme, it was hypothesized that with curriculum reform clinical role models would assume greater importance earlier in the undergraduate medical programme. Indeed, when compared with their first- and second-year traditional curriculum colleagues, more problem-based learning students identified role models. Almost four times as many identified faculty role models (largely medically qualified) in comparison with their traditional curriculum counterparts. Concomitant with this increase was a decline in the selection by the PBL students of family members, friends and other students as role models. For all cohorts, however, the mother was the most important role model. Since students in integrated curricula have earlier clinical experience and patient contact, they interact with clinicians in hospitals and clinics as well as in the academic environment of the small-group tutorial and lecture theatres. Academic faculty members, particularly clinicians, need to be aware that students take note of their attitudes and behaviour as members of the medical profession, a profession that students had chosen as a career. Retraining of senior doctors from the traditional curriculum might be necessary to ensure that all clinicians have an equivalent understanding of patient care.

Adolescent↗

PubMed2001

Endocrine physiology in a patient-centered learning curriculum.

The medical curriculum at the University of North Dakota School of Medicine and Health Sciences has recently been redesigned into a problem-based/traditional hybrid model that utilizes an integrated organ systems-based approach to teach basic and clinical sciences. The number of lecture hours in general has been greatly reduced, and, in particular, lecture hours in physiology have been reduced by 65%. Students learn basic science in small groups led by a faculty facilitator, and students are responsible for a great deal of their own teaching and learning. The curriculum is centered around patient cases and is called patient-centered learning (PCL). The curriculum includes traditional lectures and laboratories supporting faculty-generated learning objectives. Endocrine physiology is taught in year one, utilizing four weeks of patient cases that emphasize normal structure and function of endocrine systems. Endocrine physiology is revisited in year two, which is primarily focused on pathobiology. The PCL curriculum, with emphasis on the endocrine component, is described in detail along with key portions of an endocrine case.

Education, Medical↗

PubMed2002

Philosophy and psychiatry: a new curriculum for child and adolescent psychiatry.

Residents in psychiatry and child and adolescent psychiatry often seem to their preceptors to have difficulty with critical thinking. The author designed a curriculum for first-year (PGY-4) child and adolescent psychiatry residents with this perceived deficit in mind. The curriculum consisted of a blend of traditional first-year child and adolescent psychiatry didactic curriculum with a curriculum in philosophy. On the Cornell Critical Thinking Test, residents who took this course outscored residents who did not at a statistically significant level. The advantages of such a course are discussed.

Journal Article↗

PubMed2002

Medical informatics in an undergraduate curriculum: a qualitative study.

BACKGROUND: There is strong support for educating physicians in medical informatics, and the benefits of such education have been clearly identified. Despite this, North American medical schools do not routinely provide education in medical informatics. METHODS: We conducted a qualitative study to identify issues facing the introduction of medical informatics into an undergraduate medical curriculum. Nine key informants at the University of Toronto medical school were interviewed, and their responses were transcribed and analyzed to identify consistent themes. RESULTS: The field of medical informatics was not clearly understood by participants. There was, however, strong support for medical informatics education, and the benefits of such education were consistently identified. In the curriculum we examined, medical informatics education was delivered informally and inconsistently through mainly optional activities. Issues facing the introduction of medical informatics education included: an unclear understanding of the discipline; faculty and administrative detractors and, the dense nature of the existing undergraduate medical curriculum. CONCLUSIONS: The identified issues may present serious obstacles to the introduction of medical informatics education into an undergraduate medicine curriculum, and we present some possible strategies for addressing these issues.

Academic Medical Centers↗

PubMed2003

[The ideal curriculum for undergraduate clinical practice training in clinical laboratory medical education].

A model core curriculum for medical education is proposed to serve as an essential basis of material to be mastered. The fundamental laboratory techniques specified by this curriculum are the following five items. 1. Ability to appropriately record a 12-lead EKG. 2. Ability to perform urinalysis. 3. Ability to prepare and examine blood smear samples. 4. Ability to select and preserve microbiological samples for analysis, and to perform Gram staining analysis. 5. Ability to perform and evaluate pregnancy test. However, many other laboratory skill items are permitted in the model curriculum, as emphasized by the individual university. Therefore, reforms require appropriate changes in the educational programs for laboratory practice on the undergraduate level. In the Toyama Medical and Pharmaceutical University, all students must study compulsory fundamental laboratory technique in the first semester of the 5th year and, in addition, 6th graders in the last two months may choose an advanced clinical training course including genetic examinations. An important feature of our clinical training program is to introduce problem-based learning(PBL) tutorial education, which utilizes reversed CPC(R-CPC). An additional elective curriculum in clinical laboratory practice will be required, providing unique training programs based on student needs, the educational principles of each university and the specialties of the instructors.

Clinical Laboratory Techniques↗

PubMed2006

Report of the Task Force on National Fourth Year Medical Student Emergency Medicine Curriculum Guide.

This manuscript reports recommendations of the National Fourth Year Medical Student Emergency Medicine Curriculum Guide Task Force. This task force was convened by 6 major emergency medicine organizations to develop a standardized curriculum for fourth year medical students. The structure of the curriculum is based on clerkship curricula from other specialties such as internal medicine and pediatrics. The report contains a historical context, global and targeted needs assessment, goals and objectives, recommended educational strategies, implementation guidelines, and suggestions on feedback and evaluation.

Advisory Committees↗

PubMed1986

A specific curriculum in facial plastic surgery. Effect on residency training.

There has been a dramatic change in the degree of exposure to facial plastic surgery by the otolaryngology resident in the past decade. The amount of this exposure and the method of presentation of aesthetic concepts and procedures varies. We favor a specific curriculum in facial plastic surgery for the residency training program. The effect of this curriculum is measured by statistical analysis of resident-generated aesthetic surgery cases in one year following the introduction of this curriculum into the teaching program. These data are compared with the same period one year prior to the initiation of the program. Tympanoplasty, mastoidectomy, and tonsillectomy case numbers served as controls for statistical comparison over the same time period. These data serve as a guide to residency programs in determining the most effective means of providing optimum facial plastic surgery exposure to their trainees.

Curriculum↗

PubMed1992

Preliminary assessment of a scientific curriculum in a surgical residency program.

A structured, basic science curriculum was instituted for surgical residents of the University of Connecticut (Farmington) Integrated Residency Program during the 1990-1991 academic year in concordance with American Board of Surgery guidelines. The impact of the new program was measured by comparing performance on monthly basic science examinations, the in-training examination, and "mock" oral examinations for the 1990-1991 academic year with that of the preceding academic year. While monthly examination scores improved for the entire group of residents (67.7 vs 64.6), in-training and oral examination scores did not change significantly. Categorical residents generally demonstrated superior performance and greater improvement than did preliminary residents. Data analysis suggested that the new curriculum was an effective educational device and that university-designed monthly examinations were valid testing instruments, but there was an apparent incongruity between the goals of the curriculum and the American Board of Surgery In-Training Examination.

Attitude↗

PubMed1998

Anatomy education in a changing medical curriculum.

How we educate students in the first two years of medical school is changing at many institutions. Effective medical education should be viewed as a continuum, integration of the basic sciences and clinical medicine should occur throughout the curriculum, and self-directed, life-long learning should be emphasized. Curricular revision may be appropriate if these fundamental concepts are absent. The principles of three curricular models are discussed: traditional, problem-based, and systems-oriented. The ideal curriculum may draw from each of these: A truly integrated curriculum. However, the curricular model chosen must meet the needs of the institution and its students. As anatomists we should not shy away from this process of change. With progressive educational approaches, we can be leaders in this climate of curricular reform. Anatomy courses are laboratory based and the laboratory is an outstanding small group, faculty/student interactive opportunity. However, we must show flexibility and innovation in our educational approaches whatever the curricular design being proposed.

Anatomy↗

PubMed1996

Core curriculum for the training of pediatric invasive/interventional cardiologists: report of the Society for Cardiac Angiography and Interventions Committee on Pediatric Cardiology Training Standards.

Within the field of pediatric cardiology, a number of subspecialty fields are generally recognized. Some of these overlap. For example, most electrophysiologists also would consider themselves to be clinical cardiologists. Some fields, however, are relatively mutually exclusive. For example, most clinical pediatric cardiologists would not consider themselves to be electrophysiologists and would admit that there is a different knowledge, skill, and experience base that separates an electrophysiologist from other specialists within the broader field of pediatric cardiology. Likewise, it is our opinion that a separate knowledge, skill, and experience base exists among pediatric Invasive/Interventional cardiologists. The purpose of this report is to define the unique knowledge and skill base required for the training of an invasive pediatric cardiologist. The scope of this report is limited to the training of Invasive/Interventional cardiologists dealing with the treatment of pediatric patients and the cardiac diseases most often encountered in these patients. This report describes in detail the core curriculum suggested for the training of an invasive pediatric cardiologist. For these purposes, invasive pediatric cardiology encompasses all aspects of pediatric diagnostic cardiac catheterization, whether congenital or acquired. Additional curriculum regarding training for therapeutic or interventional procedures is also addressed because of today's needs: most pediatric cardiac catheterizations are performed to acquire specific data that cannot be obtained otherwise by non-invasive technologies and are required for the best medical or surgical management. However, more and more frequently the need for a cardiac catheterization entertains the possibility of having to proceed with an interventional procedure, and therefore, to conserve the vessels of pediatric patients as well as to consider costs, any invasive pediatric cardiologist should be well trained in most of the accepted interventional pediatric cardiology procedures. The curricula is divided here into five major sections followed by a bibliography keyed to those sections. Also included is a suggested format for the objective evaluation and documentation of the progress of invasive pediatric cardiology fellows. It is intended to complement the core curriculum and provide a means for standardizing the evaluation of invasive pediatric cardiology fellows.

Angiography↗

PubMed2005

Undergraduate coursework in anatomy as a predictor of performance: comparison between students taking a medical gross anatomy course of average length and a course shortened by curriculum reform.

The performance of students taking medical gross anatomy at the University of California at Davis during a 4-year period (1999-2002) was correlated with prior undergraduate anatomy coursework. Significant correlations were observed between class rank in medical anatomy and taking any undergraduate anatomy as well as the total number of undergraduate anatomy units (P<0.01). Taking human gross anatomy and an anatomy laboratory course were significantly correlated with medical anatomy class rank (P<0.01) as were grades in human anatomy, comparative vertebrate anatomy and anatomy laboratory courses (P<0.05). The medical anatomy course offered in 1999-2000 was 172 hr long, and the course offered in 2001-2002 was 135 hr long, with most of the difference made by decreasing lecture time while sparing the dissection laboratory. The reduction in course length was the consequence of a curriculum-wide cap in weekly contact hours. In the 172-hr medical anatomy course there were significant correlations between the students who took undergraduate anatomy and both class rank and the score on the final examination (P<0.01). These correlations did not exist for the 135-hr course. This may be explained by previous anatomy experiences helping students learn from lecture more than from dissection laboratory, as well as the extra study time available to students in the reformed medical curriculum. Pre-medical students and health science advisors need to consider that the benefits of taking anatomy as an undergraduate may be dependent on the configuration of a medical school's curriculum.

Adult↗

PubMed2004

Development of a global curriculum for professional psychology: implications of the Combined-Integrated model of doctoral training.

This article considers the development of a global training curriculum and qualification in professional psychology, with particular emphasis on the Combined-Integrated (C-I) model. The C-I model exposes professional psychology trainees to two or more of the practice areas (i.e., clinical, counseling, school/educational). The authors argue that the C-I approach is one that is well suited to the development of a global training curriculum due to its emphasis on broadly training psychologists as well as its respect for diversity and integration of various theoretical and professional orientations. A survey of training programs in 16 countries/regions on six continents found significant variation in training, minimal qualifications, and roles of the professional psychologist. The authors recommend that an international group of psychologists develop a regionally flexible, but common, training curriculum and qualification that would include a five- to six-year competency-based qualification. Ways in which the C-I training model may serve to integrate and globalize professional psychology are discussed.

Curriculum↗