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PubMed2004

Plastic surgery in the undergraduate curriculum: the importance of considering students' perceptions.

As the undergraduate medical curriculum becomes increasingly crowded the competition for time inevitably increases and surgical specialties have decreasing representation. Plastic surgery is regarded with some confusion in terms of its relevance to the generic doctor. Plastic surgeons have no doubt about the relevance of the specialty to undergraduates. Others see this as a very technical specialty dealing with complex reconstructions and surgical interventions or, as a rather indulgent specialty focusing mainly on glamour and cosmesis. This study focuses on students' perceptions of an undergraduate teaching program in plastic surgery. The reality is that highly pressured undergraduates do not have the luxury of time to consider the finer details of the specialties to which they are exposed. Their priority is to pass their examinations and, having addressed that concern, further information becomes an acceptable bonus. The conclusion is that if plastic surgeons are going to gain greater involvement in the undergraduate curriculum they must start with involvement in examinations and assessments. The students will then ensure that adequate and appropriate teaching time is allocated.

Attitude of Health Personnel↗

PubMed2006

Integrating sexual and reproductive rights into the medical curriculum.

All individuals and couples are entitled to enjoy reproductive rights, which are guaranteed through human rights that are already recognized in national laws, international human rights documents and other consensus documents. Indeed, they are essential for the attainment of the goal of the International Conference on Population and Development Goal of universal access to reproductive health through the primary healthcare system by 2015. However, reproductive rights are usually absent from the undergraduate curriculum in medical schools. This chapter examines the components that should be included in the curriculum, and ways in which reproductive rights can be integrated into medical education.

Curriculum↗

PubMed2007

Developing a psychopathology curriculum during child and adolescent psychiatry residency training: general principles and a problem-based approach.

Psychopathology is one of the core elements in a curriculum on child and adolescent psychiatry. Because there is no best-evidence model described for teaching this topic, an approach must be developed in each program that meets the standards set out by the Residency Review Committee and fully prepares its graduates to be competent child and adolescent psychiatrists. Methods used for teaching psychopathology may vary widely among programs and should be based on a sound educational rationale and adult learning principles that emphasize life-long, self-directed learning. This article describes an overall approach to curriculum design and expands on the use of problem-based learning as an educational method for teaching psychopathology in a child and adolescent psychiatry residency program.

Accreditation↗

PubMed2003

Curriculum content and evaluation of resident competency in anatomic pathology: a proposal.

In response to new requirements laid down by the Accreditation Council for Graduate Medical Education (ACGME), the Association of Directors of Anatomic and Surgical Pathology (ADASP) has developed a detailed curriculum, as well as guidelines for assessing competence, for resident training in anatomic pathology, focused principally on the core competencies in patient care and medical knowledge. The proposed curriculum described herein is offered as a template for potential use (with or without any necessary local modifications) by pathology training programs. Other areas of competency (eg, practice-based learning, interpersonal/communication skills, professionalism, and systems-based practice) are covered elsewhere on the Program Directors in Pathology and ACGME websites.

Clinical Competence↗

PubMed2004

Medical informatics at Heidelberg/Heilbronn: status-evaluation-new challenges in a specialised curriculum for medical informatics after thirty years of evolution.

After reporting on characteristics, structure and contents of the specialised informatics-based curriculum for medical informatics (MI) at the University of Heidelberg/University of Applied Sciences Heilbronn, the paper describes the development during the last 5 years, and in particular a complementary health care oriented postgraduate program in 'Health Information Management' (IM). Furthermore, it outlines results of a study among the MI graduates, which aims to assess their job situation and to evaluate the curriculum from their viewpoint and so establishes a summary of 30 years of experience with the program. Finally, the paper discusses new challenges of the program, considering the results of the study, perspectives of health care provision in the next decade, content changes to be focused on and the growing competition in the field of programs for medical informatics.

Computer-Assisted Instruction↗

PubMed2005

Effect of an informatics for evidence-based practice curriculum on nursing informatics competencies.

Effective and appropriate use of information and communication technologies is an essential competency for all health care professionals. The purpose of this paper is to describe the effect of an evolving informatics for evidence-based practice (IEBP) curriculum on nursing informatics competencies in three student cohorts in the combined BS/MS program for non-nurses at the Columbia University School of Nursing. A repeated-measures, non-equivalent comparison group design was used to determine differences in self-rated informatics competencies pre- and post-IEBP and between cohorts at the end of the BS year of the combined BS/MS program. The types of Computer Skill competencies on which the students rated themselves as competent (> or =3) on admission were generic in nature and reflective of basic computer literacy. Informatics competencies increased significantly from admission to BS graduation in all areas for the class of 2002 and in all, but three areas, for the class of 2003. None of the three cohorts achieved competence in Computer Skills: Education despite curricular revisions. There were no significant differences between classes at the end of the BS year. Innovative educational approaches, such as the one described in this paper demonstrate promise as a method to achieve informatics competence. It is essential to integrate routine measurement of informatics competency into the curriculum so that approaches can be refined as needed to ensure informatics competent graduates.

Clinical Competence↗

PubMed2004

The development and pilot-testing of a training curriculum in adolescent medicine and health.

PURPOSE: To select and propose a set of knowledge, attitudes, and skills essential for the care of adolescents; to encourage the development of adolescent health multidisciplinary networks; and to set up training programs in as many European countries as possible. METHODS: The curriculum was developed by 16 physicians from 11 European countries with various professional specializations. In line with modern guidelines in medical education, it is a modular, flexible instrument which covers the main teaching areas in the field, such as basic skills (i.e. setting, rights and confidentiality, gender and cultural issues) as well as specific themes (i.e. sexual and reproductive health, eating disorders, chronic conditions). It consists of 17 thematic modules, each containing detailed objectives, learning approaches, examples, and evaluation methods. RESULT: Two international one-week summer schools were used to assess the feasibility and appropriateness of the curriculum. The overall evaluation was good, with most of the items surpassing three on a four-point Likert scale. However, it pointed to several aspects (process and content) which will need to be refined in the future, such as an increase in interactive sessions (role playing), and a better mix of clinical and public health issues.

Adolescent Medicine↗

PubMed2005

Changing of an anesthesiology clinical base year to create an integrated 48-month curriculum: experience of one program.

To allow for growth in our anesthesiology residency, we assumed control of the clinical base year (postgraduate year 1[PGY-1]) and adjusted the curriculum to accommodate the expanded size. With this opportunity to change the curriculum, we created a clinical base year to prepare PGY-1 for clinical anesthesia training in PGY-2 to PGY-4 using, for this purpose, the best resources of our clinical site. We describe the process and preliminary results of the change.

Anesthesiology↗

PubMedDate not supplied

Integrating nursing history into the curriculum.

Understanding nursing history helps us to comprehend current issues in nursing and anticipate future trends in the profession. Faculty need strategies that will assist them in making history meaningful in the crammed, packed undergraduate and graduate curricula. This article examines how nursing history has been taught in the curriculum since the National League of Nursing Education first introduced a standardized curriculum in 1917 until the present. It explores the teaching strategies used in the past and expands on some of these methods and strategies in order to include them in nursing curricula today.

Curriculum↗

PubMed2005

Should there be a change in the teaching of airway management in the medical school curriculum?

OBJECTIVE: To evaluate the use of the Laryngeal Mask Airway (LMA), the oesophageal-tracheal combitube (ETC) and the tracheal tube (TT) by medical students, with a view to recommend changes to the medical school curriculum. METHODS: A prospective cohort study of 93 third-year medical students were taught the use of LMA, ETC and TT on manikins and had their skills tested at 0 and 6 months. RESULTS: Overall, LMA insertion was the fastest technique with a mean time taken for successful insertion of 32.2 s, compared to that for ETC (55.0 s, P = 0.000) and TT (71.5s, P = 0.000). There was a significant delay in the time taken for insertion at 6 months for all three devices: 13.5 s for the LMA (P = 0.000), 29.6 s for the ETC (P = 0.000) and 31.8 s for the TT (P = 0.001). Both the ETC and the TT had a significantly lower first-attempt success rate at 6 months (ETC: 91% versus 63%, P = 0.000 and TT: 80% versus 55%, P = 0.003) but not the LMA (96% versus 92%, P = 0.549). At 6 months, the overall success rate was 99% for the LMA, 100% for the ETC and 93% for the TT. Complication rate was higher for the ETC (9% versus 46%, P = 0.000) and the TT (38% versus 78%, P = 0.005) but not for the LMA (3% versus 10%, P = 0.688). CONCLUSIONS: The use of the TT is difficult and the skills acquired by the medical students deteriorate significantly over time. The LMA and the ETC seem to have an advantage over the TT in that they are more easily learnt and the skills better retained. It is recommended that these alternative devices be included in the medical school curriculum for airway management.

Attitude of Health Personnel↗

PubMed2003

Pathways curriculum and family interventions to promote healthful eating and physical activity in American Indian schoolchildren.

BACKGROUND: Pathways, a multisite school-based study aimed at promoting healthful eating and increasing physical activity, was a randomized field trial including 1704 American Indian third to fifth grade students from 41 schools (21 intervention, 20 controls) in seven American Indian communities. METHODS: The intervention schools received four integrated components: a classroom curriculum, food service, physical activity, and family modules. The curriculum and family components were based on Social Learning Theory, American Indian concepts, and results from formative research. Process evaluation data were collected from teachers (n=235), students (n=585), and families. Knowledge, Attitudes, and Behavior Questionnaire data were collected from 1150 students including both intervention and controls. RESULTS: There were significant increases in knowledge and cultural identity in children in intervention compared to control schools with a significant retention of knowledge over the 3 years, based on the results of repeating the third and fourth grade test items in the fifth grade. Family members participated in Family Events and take-home activities, with fewer participating each year. CONCLUSION: A culturally appropriate school intervention can promote positive changes in knowledge, cultural identity, and self-reported healthful eating and physical activity in American Indian children and environmental change in school food service.

Child↗

PubMed1999

University and practice-based physicians' input on the content of a surgical curriculum.

BACKGROUND: The specific knowledge and skills students learn during surgical rotations are reconsidered in light of recent changes in medical school curricula. The purpose of this study was to determine the priorities of a surgical curriculum based on input from three groups; surgical faculty (SF), primary care faculty (PCF), and community-based , practicing primary care physicians (PCP). METHODS: A questionnaire was developed in which SF (n=54), PCF (n=85), and PCP (n=876) were asked to rank the importance of 145 areas of knowledge and 48 areas of clinical skills on a 5-point Likert-type scale. Responses were rank ordered by the mean of importance ratings for each group. Differences among groups were evaluated using ANOVA. RESULTS: Response rates were best for faculty (100%) SF, 88% PCF, 61% PCP). All three groups were best considered general surgery related topics and general skills very important. Primary care physicians and PCF consistently ranked otolaryngology, ophthalmology, and orthopedic topics and skills higher than did SF. Surgery faculty ranked invasive surgical procedures higher than did PCP while PCP ranked orthopedic procedural skills more highly. CONCLUSIONS: There is significant overlap among physicians about what medical students should learn during surgical rotation. Differences between groups centered on surgical subspecialty knowledge and clinical skills. These results provide a broad perspective about required subjects for a core surgical clerkship curriculum, which should include surgical subspecialty training.

Curriculum↗

PubMed1995

Problems with the fourth-year curriculum of students entering surgical residencies.

BACKGROUND: Because of concerns about the relevance of the fourth-year curriculum of students entering surgical residencies, this study was undertaken to analyze the curriculum, electives, and grades and to compare the students' elective choices with previously documented preferences of surgical educators. METHODS: Computer profiles of all fourth-year students at New York Medical College who entered surgical residencies during a 3-year period were reviewed. The records of 115 students (92 male, 23 female), who were placed in 68 categorical and 47 preliminary positions, comprised the study. Four-week rotations in internal medicine, neurology, and ambulatory medicine were mandatory. An average of 5.1 electives per student, along with time for vacation and interviews, filled the remainder of the year. RESULTS: Students were statistically significantly more likely to receive honors grades in electives. Students, especially those in preliminary positions, frequently selected electives in their eventual specialty choice. CONCLUSIONS: Program directors interviewing prospective candidates for residency should view elective grades with care. Students often take electives that duplicate or do not enhance their career choices. Elective grades are inflated and may be based on subjective evaluations. This issue should be investigated further, and the major surgical education organizations should propose meaningful changes.

Adult↗

PubMed2006

Medical knowledge: the importance of faculty involvement and curriculum in graduate medical education.

PURPOSE: The Accreditation Council for Graduate Medical Education requires that each residency program must demonstrate and document actual accomplishments through objective measures. At University of Washington we identified deficiencies in resident medical knowledge and designed interventions that would assist in improving resident AUA IS scores, using this as a metric to document the outcomes. MATERIALS AND METHODS: In 2001 the University of Washington syllabus and faculty precepted chapter review sessions were formally established. The national AUA IS was used as an objective standardized examination to determine an annual group percentile score. RESULTS: We noted a gradual and consistent increase in the average percentile group score on the national annual AUA IS examinations of our residents. A generalized estimating equation model demonstrated a significant difference between pre-intervention and post-intervention average percentile resident AUA IS scores (p <0.001). Average resident percentile rankings in 2001 to 2004 were 25.6 points higher than the average rankings of residents tested in 1997 to 2000. CONCLUSIONS: We developed and evaluated a cohesive core curriculum designed to improve resident knowledge in urology, as measured by the AUA IS metric. With the active participation of faculty the curriculum enhanced resident education.

Curriculum↗

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↗

PubMed1990

An ethics curriculum for teaching emergency medicine residents.

Instruction in medical ethics has become standard in undergraduate medical education within the past decade; more recently, several specialty boards have formally endorsed ethics teaching and evaluation for residents as well. However, the current emergency medicine Core Content, representing emergency medicine's central body of knowledge, makes no specific mention of ethics. An ethics curriculum is proposed to remedy this gap in the emergency medicine residency curriculum. Issues frequently encountered in the emergency department are emphasized, and topics include moral foundations of clinical medicine, the unique ethical concerns of emergency medicine, patient competence, informed consent and refusal of treatment, truthfulness, confidentiality, foregoing life-sustaining treatment, duty to provide care, moral issues in disaster medicine, allocation of health care, and research and teaching involving human subjects. Educational objectives and readings for each of these topics are presented along with sample case scenarios to be used in a small group discussion format.

Curriculum↗

PubMed1981

Adaptation of the emergency medicine core content to a three-year residency core curriculum.

An outline of a didactic curriculum from the Core Content in Emergency Medicine is presented. The 430 hours of lecture are distributed over three years. Three new categories have been added to the Core Content as previously defined by the Graduate/Undergraduate Education Committee of the American College of Emergency Physicians: drugs of emergency medicine, laboratory/radiology use in emergency medicine, and resident evaluation series. The benefits of this core curriculum are improved organization in educational format, better defined curricular guidelines for developing residencies, and standardized guidelines for individual topic assessment and review.

Curriculum↗

PubMed1986

A pediatric curriculum for emergency medicine training programs.

Surveys of current training show that many areas of pediatric emergency medicine are not taught in emergency medicine residencies. Furthermore, published recommendations for minimum pediatric core content in emergency medicine are scant and conflicting. To address this issue we have compiled from a variety of sources a detailed pediatric emergencies curriculum for emergency residency training. This curriculum is complete, and yet may be carried out with currently available resources.

Curriculum↗