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Genetics and molecular diagnostics in the clinical laboratory science curriculum.

OBJECTIVE: To determine the nature and extent of education in human genetics and molecular diagnostics in clinical laboratory science (CLS) programs throughout the U.S. DESIGN: A written survey was mailed to 263 CLS programs. Data were expressed as raw numbers and percentages of responses. SETTING: State University of New York, Upstate Medical University. PARTICIPANTS: There were 162 responses and 151 usable surveys. Most respondents (86.8%) were department chairs/CLS program directors; 13.2% were CLS faculty or educational coordinators. MAIN OUTCOME MEASURES: Questions were designed to determine frequency of CLS programs providing education in genetics, specific molecular methods and clinical applications, format of instruction, satisfaction levels with education provided, and perceptions on importance of teaching genetics, molecular diagnostics, and related hands-on experiences. RESULTS: Over 92% of CLS programs teach human genetics and molecular diagnostics in varied formats. Polymerase chain reaction was the most frequently taught molecular method; microorganism detection, the most commonly taught clinical application. More programs teach theory than provide hands-on experience in molecular diagnostics. Only 59 (39.1%) teach related ethical issues. Sixty-seven respondents (44.4%) were dissatisfied with the education they provide, due to lack of time to teach the material (n = 49; 73.1%), lack of knowledgeable faculty (n = 43; 64.2%), and expense of methods (n = 37; 55.2%). Most respondents felt it was important to include human genetics (n = 145; 96%) and molecular diagnostics (n = 149; 98.7%) in their curriculum, and related hands-on experiences in the student laboratory (n = 106; 70.2%) or clinical rotation (n = 135; 89.4%). Over 82% (n = 124) expected instruction of molecular diagnostics to increase in the next five years. CONCLUSION: Most CLS programs include human genetics and molecular diagnostics in their curriculum, and expect the education they provide to increase in the next 5 years. In order to meet this expectation, CLS programs may need to provide opportunities for faculty training, seek funding to cover the cost of methods, and consider innovative curriculum changes.

Curriculum↗

Neuroimaging curriculum for neurology trainees: report from the Neuroimaging Section of the AAN.

Neuroimaging plays a major role in the evaluation of patients with neurological disorders. Surveys of neurologists have revealed that most rely on their own readings of images for patient management, and a majority believe that neurologists should be allowed to officially interpret and bill for scan reviews. The importance of neuroimaging training for neurology residents has been stressed by the Association of University Professors of Neurology. Although there is a desire to promote the neuroimaging education of neurologists, no curricula have existed previously. The Neuroimaging Section of the American Academy of Neurology (AAN) developed a task force of practicing neuroimagers to provide a neuroimaging curriculum for neurological trainees and training directors. The resulting curriculum is available on the Web sites of the AAN (http://www.aan.com) and the American Society of Neuroimaging (http://www.asnweb.org/education/curriculum.shtml) and will be updated as the need arises through evolving technology or breadth of applications. This curriculum should help in the design of neurology residency and fellowship programs and subspecialty pathways in which adequate neuroimaging education and training are desired for various reasons, including certification and the demonstration of competency and proficiency.

Curriculum↗

[Pedagogic reflexions on the evidence-based medicine curriculum of the German Central Agency for Quality in Medicine and the German Network for Evidence-Based Medicine].

The German Agency for Quality in Medicine (AQuMed) and the Network for Evidence-based Medicine (EbM) have recently published the draft of an EbM Curriculum for continuing medical education. This standardised concept might lead to an improvement of the quality of EbM courses for physicians. Critical appraisal of the curriculum from a didactic point of view reveals both a substantial lack of teaching methods and teaching aids, and a lack of appropriate tools for the evaluation of the actual increase in professional competence. This includes specialised subject knowledge, methodological considerations as well as highly developed communication and social skills. We recommend incorporation of these components into the curriculum design to facilitate its successful implementation.

Communication↗

An experience with a systems approach to curriculum design.

Learning system design, based on general systems theory, is a powerful facilitator for planning and implementing programs of curriculum and instruction. Curriculum planners are directed to a practical consideration of all systems components, and an awareness of their interrelatedness. Specifically they must deal with: Problem areas or barriers to success; the need to define and choose explicit outcomes; ways to make the curriculum operational; and a specific plan for program assessment. The systems process is value free and content free. Values are generated as content is selected and fitted into the system components. Therefore the system input is a crucial factor in the quality of the system. I have attempted to share some aspects of systems methodology which were very useful in the experience of designing a program for the education of gerontological nurse practitioners.

Curriculum↗

Development methodology for a "next generation" medical informatics curriculum for clinicians.

We describe a new methodology for development of a medical informatics curriculum for practicing clinicians. The curriculum is based on a biaxial framework in which information is categorized by type of application and role of the learner in relation to the application. The curriculum development process incorporates feedback from practicing clinicians on an ongoing basis.

Curriculum↗

Developing a group practice comprehensive care education curriculum.

In fall 2002 the University of Illinois at Chicago College of Dentistry implemented a Group Practice Comprehensive Care Clinical Education Curriculum. The primary responsibility for patient care has shifted in this comprehensive care curriculum from the students to the faculty and staff. Students have a primary responsibility for learning. This competency-based education curriculum utilizes a variety of student evaluation methods including self-evaluation, OSCE, and portfolio to verify competence. Formative evaluation methods are utilized in daily assessment of student performance. On-time graduation rates have increased from 60-70 percent to 96 percent, and regional board first-time pass rates have been maintained at 90+ percent. Overall predoctoral clinical productivity in the first full year of the program has increased by over 300,000 dollars.

Chicago↗

Preserving the pipeline: a model dental curriculum for research non-intensive institutions.

Current advanced degree and research training programs no longer attract adequate numbers of students. The present system of dental education severely limits the appeal of these programs due to overcrowded curricula and clinical components that operate in an environment segregated from the academic/research enterprise. To make research-oriented education/training programs more accessible and increase the number of interested students, the culture of dental schools and dental education must change. Programs for future dental researchers and academicians must be supported by curricula that foster an appreciation of research/discovery, an interest in academic/research careers, and the application of biomedical/clinical advances to practice. The Marquette University School of Dentistry has designed a comprehensive new curriculum that supports student research and scholarly activity throughout all four years of dental education. The curriculum minimizes discipline-based courses and is structured into interdisciplinary content tracks that integrate biomedical, behavioral, and clinical sciences while emphasizing the application of science to patient care. A specific research/scholarly track represents dedicated didactic time that exposes all dental students to material not traditionally included in dental curricula. This track includes mentored research/scholarly experiences at local and national sites that are individually structured for each student. Customized student schedules facilitate participation in these experiences without hardship or penalty. This curriculum structure may serve as a model for research non-intensive institutions seeking to increase student interest in academic and research careers.

Curriculum↗

Supporting collaboration through a nursing informatics curriculum stage II.

Collaboration is at the center of the process used to design, implement and evaluate an integrated informatics curriculum in a baccalaureate nursing program. This paper describes the second stage of a process to design the informatics nursing courses. The challenges to foster faculty collaborative relationships as well as to enhance the course content of all nursing informatics curriculum. A number of strategies were used to develop the collaborative efforts between the faculty and nursing staff in the clinical agencies. Information technology was incorporated into the didactic and clinical portions of courses through the use of creative teaching strategies. Therefore, the faculty have ensured a blend of information, technology, and the clinical care process throughout the curriculum.

Curriculum↗

A curriculum database with boolean natural-language searching in HyperCard.

A curriculum database including both natural-language and keyword searching was developed to assist faculty in curriculum research and reform. HyperCard (with extensions) on the Apple Macintosh provides a flexible single-user or networked environment for entering, indexing, searching and retrieving content in detailed faculty notes for the instructional activities in a four-year predoctoral curriculum.

Curriculum↗

Collaborating to integrate curriculum in primary care medical education: successes and challenges from three US medical schools.

BACKGROUND AND OBJECTIVES: Traditional medical school department-based clerkship structures can lead to redundancy and/or gaps in curriculum, inefficient administrative systems, and academic isolation for clerkship directors. This paper describes the approaches, successes, and challenges three institutions experienced when implementing an interdepartmental collaboration to create an integrated primary care clerkship experience. METHODS: Each school combined family medicine, ambulatory pediatrics, and ambulatory medicine into contiguous clerkship blocks. In all institutions, each clerkship maintained certain distinct features while the integrated aspects contained longitudinal curriculum of certain primary care topics. RESULTS: Evaluations by students demonstrated favorable responses to the new content and integrated methods of teaching, as did results of the Association of American Medical Colleges graduation survey. Faculty at each institution reported that their multidisciplinary approach has stimulated important educational collaborations, many of which require an economy of scale not often achievable within a single clerkship. These included innovative evaluation/documentation efforts; centralization of administrative tasks; enhanced recruitment, retention, and development of community-based faculty; an increase in the active core group of local and national primary care leaders; and an increase in scholarly activities. The collaborations have not occurred without challenges, primarily in the need for identifying sustainable resources for these and future collaborative educational endeavors. CONCLUSIONS: The benefits involved in developing an integrated primary care experience include expansion of curriculum content and methods, as well as enhancement of collegial support and resources to community-based and academic faculty. These integrations do, however, bring added challenges, time, and costs to traditional independent clerkships.

Ambulatory Care↗

Curriculum evaluation. Who, when, why, how?

The faculty of a large, Midwestern, public university implemented a community-based baccalaureate curriculum to prepare students for the changing health care environment. Evaluation was planned as the curriculum was developed. The constituents of the School of Nursing were determined to be the students, alumni, employers, clinical agencies, and faculty. Surveys, focus groups, questionnaires, and meetings with agency representatives were some of the methods used to gather data from the constituents. Information gathered during a three-year period resulted in further curriculum revision, increased community partnerships, and more positive feedback from students.

Adult↗

Predoctoral dental school curriculum for catastrophe preparedness.

Preparing for catastrophic events, both human-made and natural, is in the national interest and has become a priority since catastrophic events in Oklahoma City, Washington, DC, and New York City. Dentists are a large source of non-physician health manpower that could contribute to the public welfare during catastrophic events that require additional public health human resources. Dentists, by virtue of their education, understand biomedical concepts and have patient care skills that can be directly applied during a catastrophic event. Dentists also can provide training for other types of health care workers and can supervise these individuals. In this article, we propose that dentistry can make a significant contribution as part of a national response before, during, and after a catastrophic event or at the time of a public health emergency. We describe the potential collaboration among a dental school, city and state health departments, law enforcement, the military, and others to develop a curriculum in catastrophe preparedness. Then we describe one dental school's effort to build a catastrophe preparedness curriculum for our students. The competencies, goals and objectives, and sources of content for this catastrophe preparedness curriculum are described as well as suggestions for sequencing instruction.

Civil Defense↗

What is the appropriate health policy content in a program curriculum?

Faculties of graduate health administration programs have considerable flexibility in applying curriculum guidelines established by the Accrediting Commission on Education for Health Services Administration (ACEHSA) to help achieve their self-determined missions. When a program's mission includes preparing graduates for eventual careers at the strategic levels of healthcare organizations, specific health policy content is appropriate. In determining this curriculum content, faculties can be guided by the need to prepare graduates to accomplish three policy-related activities that are vital to successful strategic management: 1. comprehend and understand relevant governmental health policy aspects of a healthcare organization's external environment, including assessing the impact of these aspects of the environment on the organization; 2. lead strategic responses to the challenges and opportunities emanating from the governmentalhealth policy aspects of an organization's external environment; and 3. participate in shaping, to the organization's benefit, the governmental health policy aspects of its external environment. Curriculum design options for providing this content are discussed.

Accreditation↗

Using focus groups to develop a bone health curriculum for after-school programs.

INTRODUCTION: Childhood behaviors influence peak bone mass and osteoporosis risk in later life. The after-school environment provides an opportunity to enrich a child's learning and experience. Our objective was to gain a better understanding of the knowledge of, attitudes and beliefs about, and barriers to achieving bone health among children, parents, and after-school program leaders from low-income, ethnically diverse communities. Findings led to the development, implementation, and evaluation of a bone health curriculum in the after-school setting. METHODS: Eight focus groups were conducted in three representative communities. Focus group participants included children aged six to eight years, parents of children aged six to eight, and after-school program staff. Transcripts and written notes from each session were reviewed and common themes were identified within each group. RESULTS: Most adults had some understanding of osteoporosis, but did not recognize that childhood behaviors had a role in developing the disease. Program leaders raised concerns about their ability to implement a health program and recommended a flexible format. Parents and program leaders recognized the importance of maintaining a fun atmosphere. CONCLUSION: It is feasible to create a curriculum for a bone health program that meets the unique needs and interests of children and program leaders in the after-school setting. Addressing the needs, interests, and common barriers of the target population is an essential first step in curriculum development.

Bone and Bones↗

The impact of a curriculum change on student attitude and ultimate professional behavior.

The longitudinal effects of curriculum changes on student attitude and the relationship between attitudes as students and behavior as a professionals in practice are explored in this paper. A curriculum change (treatment of handicapped patients) was planned, introduced, and its effects on student attitude and professional behavior monitored. Findings indicate that: (1) exposure to handicapping conditions significantly lowered student humanitarian attitudes about the treatment of handicapped patients, (2) involvement with handicapped, regardless of the type of involvement (i.e. clinical or supervising oral hygiene care), appears to adversely affect humanitarian attitudes of students regarding handicapped patients. (3) student estimation of their future behavior is not a reliable indication of their future behavior, and (4) changes in curriculum should not be evaluated from student attitudes alone.

Attitude↗

[The process of curriculum redesign for the nursing baccalaureate program: an analysis of teacher actions].

The purpose of this study is to define the teacher's actions in the process of developing a new curriculum for the Faculty of Nursing, in National Yang-Ming University. The authors defined three tasks of teachers developing the curriculum: Relocating, strategizing, and reflective practice. Relocating implied reflecting on the dilemmas of nursing education, world trends in nursing education, the experience of medical schools with problem-based learning, and the philosophy of the university. Strategizing meant developing guidelines that included humanistic education, faculty development, and course content of the new curriculum. Reflective practice included intersubject integration, dialogue teaching, and shifting the focus from hospital care to community and family care.

Curriculum↗

[Incorporation of implant overdentures into the dental curriculum].

This article is focusing on incorporation of implant overdentures into the dental curriculum. For mandibular edentulism, an implant-retained overdenture should nowadays be considered a first choice for prosthodontic care, if not the standard of care. Yet, it is not incorporated in practical teaching today. Curriculum change is always difficult. The needs of our patients specifically, and those of society generally, should be primarily drivers of innovation of the curriculum. Therefore, Dutch dental schools should make sure that graduated students are experts in analyzing edentulous patients' problems, in considering possible treatments, and in carrying out the standard of care.

Curriculum↗

A longitudinal curriculum to improve resident teaching skills.

Residents are essential teachers of students and interns, yet few opportunities exist for them to improve their teaching skills. The authors designed and implemented a longitudinal teaching skills curriculum for second-year categorical medicine residents on ambulatory block. This curriculum involves residents giving talks to one another, with close observation and personalized guidance by faculty in one-on-one and group feedback sessions. Evaluation by self-assessment surveys administered at the beginning and end of the curriculum showed significant improvement in nearly all of the domains assessed, including overall teaching skills. Intensive interventions can improve resident teaching proficiency and thereby improve the education provided to trainees.

Curriculum↗