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PubMed2003

Flexible teaching for inflexible schedules: an online resident curriculum in acute ambulatory care.

The authors report on a work in progress: a web-based curriculum for residents working shifts, addressing management of common acute outpatient problems. All components of the curriculum are available online, and residents may complete modules and submit tests at a time and from any location. There are few reports of web-based curricula in postgraduate training. Our interactive model avoids scheduling conflicts, is easily updated, encourages self-directed earning and facilitates resident assessment.

Acute Disease↗

PubMed2004

Identifying the perceived weaknesses of a new curriculum by means of the Dundee Ready Education Environment Measure (DREEM) Inventory.

The Canadian Memorial Chiropractic College is in the fourth year of implementing a new four-year Integrative Curriculum. In order to determine how the students experienced the educational environment generated by the new curriculum, the Dundee Ready Education Environment (DREEM) Inventory was administered on the same day to 148 (96%) first-year, 131 (87%) second-year, and 128 (84%) third-year students (n = 407). Resultant scores indicated many areas of concern. However, bimodal and large numbers of 'uncertain' responses also occurred. In order to establish and compare areas of most concern between the three year groups, responses were calculated as percentages indicating for each item those who agree, disagree or are uncertain. This result clearly indicated areas of joint concern for each of the five domains addressed by the DREEM Inventory. Analysis of these concerns formed the basis of strategic planning in order to institute remedial action, and on which to focus institutional resources.

Canada↗

PubMed2006

Medical ethics and tomorrow's physicians: an aspect of coverage in the formal curriculum.

Medical ethics has created contentious issues and requires reforms in medical education such as renewed emphasis on formal instruction. The aim here was to review the current status of bioethics teaching in medical schools, determine Saudi students' perception of its coverage in the formal curriculum and make recommendations. Using a self-administered questionnaire in a cross-sectional study, undergraduate students' opinion about medical ethics coverage was obtained. Fourteen clinical departments and 201 students were studied. Only 46% of respondents were satisfied with the current coverage of ethical issues in the formal curriculum; 23% were unaware of the value of the subject. Students' approval rate was highest in Neurology and Psychiatry (70%). The study confirmed inadequate formal instruction on medical ethics in a developing country. Five recommendations are made. At admission, students' integrity and character should be assessed. Bioethics should be taught in clinical settings. In the Islamic world, medical curricula should include the Islamic code of medical ethics. Peers, nurses and patients should evaluate graduates' performance in ethics at the bedside. Evidence-based assessment and continuous quality improvement are required to maintain the requisite standard.

Consumer Behavior↗

PubMed2005

Student-selected components in the undergraduate medical curriculum: a multi-institutional consensus on assessable key tasks.

This paper describes further progress by the Northern Universities SSC Consortium in achieving consensus on the contribution of the Student Selected Components (SSCs) to undergraduate medical courses. Following the identification of common purposes and outcomes, the group has matched these to assessable key tasks which students may undertake in order to demonstrate competence on a range of attributes not normally fully assessed in the core curriculum. In some schools, SSCs may be the predominant route through which students gain exposure to research methods and reflective practice. In addition to opportunities to acquire knowledge and skills outside the core curriculum, SSCs can contribute towards enhancement of core skills. SSCs may also contribute to the overall longitudinal assessment of personal and professional development. The potential role of portfolios in maximizing student learning from SSCs is discussed, and future areas for development identified.

Choice Behavior↗

PubMed2006

Not just another multi-professional course! Part 2: nuts and bolts of designing a transformed curriculum for multi-professional learning.

Multi-professional education has traditionally aimed to develop health professionals who are able to collaborate effectively in comprehensive healthcare delivery. The respective professions learn about their differences in order to work together, rather than developing unity in their commitment to a shared vision of professionalism and service. In this, the second of two papers, the 'nuts and bolts' or practicalities of designing a transformed curriculum for a multi-professional course with a difference is described. Guidelines for the curriculum design process, which seeks to be innovative, grounded in theory and relevant to the learning of the students and the ultimately the health of the patients, include: valuing education; gaining buy-in; securing buy-out; defining of roles; seeking consensus; negotiating difference and expediting decisions. The phases of the design process are described, as well as the educational outcomes envisaged during the process. Reflections of the designers, in particular on what it means to be a multi-professional team, and a reconceptualization of multi-professional education are presented as challenges for educators of health professionals.

Cooperative Behavior↗

PubMed2006

Students' evaluation on a two-stage anatomy curriculum.

This study evaluated students' perspectives of the two-stage anatomy course, which is designed to retain the time-honored tradition of cadaver dissection and to include innovative components into anatomy education. A total of 94 sixth-year medical students completed a questionnaire survey at the end of the second stage anatomy course. The results showed that more than half of the students were satisfied with the two-stage anatomy course. Students found that cadaver dissection was most helpful in learning anatomy. The two-stage anatomy course can enhance understanding and memory of anatomical knowledge. However, students disagreed on whether or not the two-stage course can reduce the burden of learning or that the parallel study of anatomy and the 'Life and Death' course could change their attitude toward death more effectively. National Licensing Examination revealed no obvious change after the implementation of the new anatomy course. Traditional and innovative components in anatomy curriculum could coexist in harmony. We provided an alternative for those who wanted to retain cadaver dissection in a reformed curriculum. Further study is needed to evaluate the adequacy of anatomy knowledge and student performance in the long run.

Anatomy↗

PubMed2006

Developing a competence-based core curriculum in biomedical laboratory science: a Delphi study.

In this study the Delphi technique has been used to develop a core curriculum for education of the biomedical scientist. The rapid development in biomedicine and the corresponding changes in methodology in biomedical laboratories demand careful planning of the education of biomedical scientists. The Delphi technique uses an anonymous panel of experts for suggestions and assessments aiming at consensus. Twenty-six experts from different kinds of hospital and university laboratories took part in the investigation. They suggested and assessed necessary competences for a recently graduated biomedical scientist, and if 75% or more of the participants agreed on a competence, it was included in the core curriculum. The final list consisted of 66 competences of varying depth, in three categories. This list contained several generic competences, concerning for example basic laboratory methods, handling of samples, dealing with apparatus and applying relevant rules and laws; basic knowledge in chemistry, preclinical medicine and laboratory methods; and finally attitudes that the panel expected in the recently graduated person. The core was sufficiently restricted to be used in a three-year programme and still leave space for about one year of electives/special study modules. It became rather traditional, e.g. it did not include competences that many recent reports consider important for the future professional.

Biomedical Research↗

PubMed2006

A model for communication skills assessment across the undergraduate curriculum.

Physicians' interpersonal and communication skills have a significant impact on patient care and correlate with improved healthcare outcomes. Some studies suggest, however, that communication skills decline during the four years of medical school. Regulatory and other medical organizations, recognizing the importance of interpersonal and communication skills in the practice of medicine, now require competence in communication skills. Two challenges exist: to select a framework of interpersonal and communication skills to teach across undergraduate medical education, and to develop and implement a uniform model for the assessment of these skills. The authors describe a process and model for developing and institutionalizing the assessment of communication skills across the undergraduate curriculum. Consensus was built regarding communication skill competencies by working with course leaders and examination directors, a uniform framework of competencies was selected to both teach and assess communication skills, and the framework was implemented across the Harvard Medical School undergraduate curriculum. The authors adapted an assessment framework based on the Bayer-Fetzer Kalamazoo Consensus Statement adapted a patient and added and satisfaction tool to bring patients' perspectives into the assessment of the learners. The core communication competencies and evaluation instruments were implemented in school-wide courses and assessment exercises including the first-year Patient-Doctor I Clinical Assessment, second-year Objective Structured Clinical Exam (OSCE), third-year Patient-Doctor III Clinical Assessment, fourth-year Comprehensive Clinical Practice Examination and the Core Medicine Clerkships. Faculty were offered workshops and interactive web-based teaching to become familiar with the framework, and students used the framework with repeated opportunities for faculty feedback on these skills. A model is offered for educational leaders and others who are involved in designing assessment in communication skills. By presenting an approach for implementation, the authors hope to provide guidance for the successful integration of communication skills assessment in undergraduate medical education.

Communication↗

PubMed1996

Student interest in activities in a secondary physical education curriculum: an analysis of student subjectivity.

Situational interest is defined as a student's perception of interest inherent in an activity. Holding interest is conceptualized as a specific situational interest perceived by a student based on his or her subjective understanding of the activity's meaningfulness. It motivates the student to continuously participate in that activity. This research was designed to examine the patterns of holding interest for physical activities in a state physical education curriculum for secondary schools. A group of college students (N = 35) who completed their entire secondary education in the state was invited to construct their perceptions of interest in the activities selected from their secondary physical education curriculum. Q methodology was used to determine and analyze patterns of the interest. Four patterns of holding interest were determined: fitness, socialization, activity variation, and self-expression. Specific activities associated with each pattern were identified, and relationships among the four patterns were described. Findings (a) support the notion that holding interest is based on students' subjective understanding and valuing of the unique meanings in physical activities and (b) suggest that holding interest is person- and activity-specific, implying that physical educators should focus on student-activity matching when making curricular decisions.

Adult↗

PubMed1999

Creating a sense of family in urban schools using the "sport for peace" curriculum.

Urban students often have difficulty engaging in the learning process and affiliating with others. A three-phase research design was used to examine the effectiveness of a high school physical education curriculum reform initiative entitled "Sport for Peace" to enhance student engagement and willingness to interact positively with others. Ten physical educators in six urban schools taught a traditional soccer unit (Phase I) followed by instruction and mentoring in the Sport for Peace curriculum (Phase II). In the third phase of the research, teachers developed and taught a Sport for Peace unit to their students. Data were collected using observation and interview methods and analyzed with constant comparison. Results suggested that the Sport for Peace curricular structures fostered shared responsibility for learning, trust, respect, and a sense of family. Both high- and low-skilled girls and boys felt successful and responded positively, creating a class community more conducive to engagement and participation.

Adolescent↗

PubMed2000

Community-based education in nutrition and cancer: the Por La Vida Cuidándome curriculum.

The Por La Vida (PLV) intervention model relies on community lay health advisors trained to conduct education sessions among members of their existing social networks. PLV Cuidándome was funded by the NCI to develop, implement, and evaluate the PLV model with respect to nutrition and cancer prevention, as well as early detection of breast and cervical cancers. The target population is the Latino community, for which substantial barriers to health care access exist. This article presents the curriculum that guides the sessions and describes its development, which was based on semi-structured interviews with Latina lay-health community workers to explore relevant attitudes and behaviors. Also key to the process was the work of the educational materials committee, whose members offered community representation as well as expertise in nutritional sciences, educational technologies, and community-based health promotion interventions and research. The 12-session curriculum's goal was to increase both the variety and the quality of fruits and/or vegetables consumed. It included information about consumption of fiber and fat in the importance of balance between energy intake and physical activity. The program has been well received. An ongoing study examines how it enhances nutrition and cancer prevention.

Community Health Services↗

PubMed1991

Strategies for maintaining oncology curriculum time amid pressures to cut classroom hours.

A decade of experience with the oncology course offered within the second year pathophysiology curriculum at the Washington University School of Medicine is reviewed. The number of classroom hours allotted to this course has steadily decreased from 28 to 6 hours. Causes of this downward trend include the introduction of new subject matter into the curriculum and the desire for more independent study time. Strategies for maintaining or increasing the number of lecture hours are discussed. Videotaping the principles of surgical, medical, and radiation oncology enables the coursemaster to return the classroom emphasis to the patient as illustration.

Curriculum↗

PubMed1991

A strategy to teach medical decision making within a medical school curriculum.

One of the goals of our medical school is to teach our students how to learn. In theory, this is a noble goal, but, in practice, our style is often to "impart" our knowledge to the students without allowing them to question it, to practice with it, and to really understand it. To address this problem, we are developing a vertically integrated four-year program in medical decision making funded by the Culpeper Foundation. The curriculum begins with classic epidemiology in year one. In year-two courses, principles of clinical epidemiology (diagnosis, variability, etc) and the elements of quantitative decision making are woven into our organ system courses. In year three, these skills are practiced in clerkships, and critical thinking sessions occur in several clerkships. The curriculum culminates in year four with sessions on expected value decision analysis in one of our required courses. Built into this experience are computer interactive programs, faculty and housestaff development sessions, and availability of consultation from a medical decision making team. We are developing competency-based exams in which students will have to demonstrate skills in medical decision making, critical thinking, and problem solving. We hope this will help teach our students "how to" make decisions and understand such things as critical thinking, probability, uncertainty, and variability. Through this, we hope the decisions they will help their patients make will lead to the "best" outcomes for these patients.

Clinical Clerkship↗

PubMed1991

A process for developing a curriculum in ethics and human values.

This article describes the process and results of the deliberations of the group of authors at the 1989 spring meeting of the Northeast Group for Educational Affairs. The participants worked under the premise that someone had given an unlimited amount of money to fund a new medical school. They had to select and define what the educational goals would be and produce a plan to help students reach these goals. There had to be an evaluation process that documented progress toward the stated goals. This paper describes the ethics and human values curriculum, which should be of interest to cancer educators. The knowledge, skills, values, and attitudes are defined and the four-year process of implementing the teaching is described. This curriculum-planning process is applicable to any aspect of cancer education--first defining the outcome, then the evaluation process, and finally, how to get to that outcome.

Curriculum↗

PubMed1994

Cancer education curriculum at the Louisiana State University School of Dentistry.

The cancer education curriculum at Louisiana State University School of Dentistry provides students didactic and experiential learning throughout their dental training. Freshman are presented concepts of early detection of cancer in an oral diagnosis course. Later courses in oral diagnosis, medicine, and pathology include diagnostic and treatment decision making and rehabilitative information. Junior students attend a head-and-neck-tumor board composed of dentists and physicians that decides cancer treatment and rehabilitation. Juniors also participate in a biopsy service that includes observing or performing the biopsy, examining the tissue microscopically, and reporting their findings. Additionally, a required, medical and dental, multidisciplinary course in oral oncology provides instruction in diagnosis, treatment, and rehabilitation of cancer patients. Seniors participate in an oral cancer screening service as part of their community dentistry rotation. The postgraduate dental programs and the dental hygiene programs also participate in this curriculum.

Biopsy↗

PubMed2005

Psychomotor skills for the undergraduate medical curriculum in a developing country--Pakistan.

OBJECTIVE: To identify essential psychomotor skills for all the medical graduates of an undergraduate programme in Pakistan. MATERIALS AND METHODS: Twenty-five physicians practising in a tertiary care centre and ninety primary care physicians used a Likert's scale, ranging from "very essential" to"not required at all", to mark 99 psychomotor skills in the undergraduate medical curriculum in Pakistan. RESULTS: Overall the opinions of both the groups about the essential skills matched except for a few areas. CONCLUSION: This study provides baseline data about psychomotor skills that a medical graduate in developing countries should be able to perform. Further studies will be undertaken by involving other stakeholders to identify and incorporate these skills in the undergraduate medical curriculum, thereby enabling graduates to practice in all the settings in Pakistan.

Adult↗

PubMed2004

Walking the tightrope: developing an attachment-based/relational curriculum for trainee psychotherapists.

I describe how the Centre for Attachment-based Psychoanalytic Psychotherapy (CAPP) in London has gone about developing an attachment-based/relational curriculum for training psychotherapists. A key problem the training is meant to address is how to maintain a balance between enabling students to absorb research and clinical knowledge of psychological processes at the same time as they learn to maintain the flexibility necessary to address the uniqueness of each individual encounter in the consulting room. I describe the task of the training in terms of a linguistic metaphor: the training needs to ensure that students are theoretically multi-lingual while developing higher levels of fluency in the language of attachment-based/relational psychotherapy. In the pursuit of this approach, my colleagues and I developed a set of ten key propositions - the spine of the relational world - which we felt encapsulated the main theoretical assumptions of attachment-based practice that students need to understand and explore. This has been used to evolve a spiral curriculum, designed to help students engage constructively with the often confusing emotional aspects of clinical work, and with the multiplicity of clinical viewpoints that characterises contemporary psychoanalytic psychotherapy.

Curriculum↗

PubMed2004

Basic ultrasound curriculum for medical students: validation of content and phantom.

Effective use of ultrasound requires an understanding of the physics, combined with the ability to interpret the sonographic images. The aim of our study was to evaluate the impact of a basic ultrasound curriculum using a phantom to train medical students. Twenty-eight first- to fourth-year medical students were randomized to two groups: a control group that received no formal training and a trained group that received basic ultrasound training. Both groups took an initial multiple-choice written test and an ultrasound hands-on test using an agarose-based tissue mimic containing various objects. The curriculum for the trained group consisted of reading the principles of ultrasound and a hands-on session over the phantom. After training, both groups underwent a second multiple-choice exam and ultrasound practical test. The initial and the post-training test results were analyzed using a two-tailed Student's t-test. Baseline written and practical test scores were similar for both groups. After training, written test scores improved (82% trained vs. 66% control, P < 0.001). Hands-on ultrasound task performance also improved with training (96% trained vs. 60% control, P <0.001). The trained group took a shorter time to obtain a clear image and found on average one more object per scan. Parameters such as time to obtain a useful image and number of objects recognized also improved with training. Basic sonographic physics, imaging, and interpretation can be effectively taught to medical students during a short training session.

Curriculum↗