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PubMed2002

Assessment of an integrated curriculum in radiology.

OBJECTIVE: To describe an interdisciplinary team's experience using a six-stage curriculum-development model to assess an integrated curriculum in radiology. DESCRIPTION: In 1996 the University of Maryland School of Medicine implemented reforms of its undergraduate curriculum. A third-year required clerkship in radiology was eliminated, but an integrated curriculum was developed for first- and second-year students and for third-year students during their core clinical clerkships. A fourth-year elective was retained. In 2000 the school's Curriculum Coordinating Committee found that it lacked data regarding program performance or learner competencies in radiology since the reforms were implemented. The Committee designated an interdisciplinary team including a radiologist, an anatomist, and an internist with medical education expertise to conduct a rapid review of the adequacy of the curriculum as it is currently integrated. The team mapped the curriculum, identifying where radiology was taught, and analyzed each sub-curriculum according to a six-stage curriculum-development model. This method permitted nearly concurrent assessment of the national literature, local needs assessment, presence and adequacy of educational objectives and methods, adequacy of resources to support curriculum implementation, and the availability and adequacy of learner and program outcome measures. The team identified changes in the clinical classrooms that have been unanticipated four years earlier, including implementation of PACS systems for digital film storage and retrieval, rapid advances in clinical imaging capabilities, and diminished faculty teaching time due to increased clinical volumes. The team concluded its work in four months and issued a report recommending revisions to third-year curricula. The Curriculum Committee, the Dean's Office, and the Department of Radiology accepted the analysis and have dedicated personnel, technical, and financial resources to effect the recommended revisions, which include (1) revision of clinical clerkship objectives for competencies in radiology, (2) development of Web-based modules for self-directed learning, (3) faculty development to enhance teaching skills, and (4) competency-based assessment measures based on learning objectives. DISCUSSION: Schools and faculty are often faced with the need to develop and implement innovative curricula rapidly. Periodic assessments by oversight groups such as curriculum committees identify where additional information is required to assess the performances of learners and curricula in rapidly-changing clinical contexts. In this study a three-member team with focused expertise in radiology, anatomy, and medicine/medical education conducted a rapid in-depth review of an integrated radiology curriculum "hosted" by several departments. A curriculum-development model provided a template for analysis of needs, objectives, methods, resources, and assessment measures for all curricula, and guided the team's recommendations for targeted revision. Each team member brought expertise in some element of the integrated curriculum or in curriculum design. The team identified what integrated curricular elements had not been designed adequately, what could no longer be supported with current resources, and how curricular revisions could be assessed for adequacy.

Curriculum↗

PubMed2001

AMEE Guide No. 21: Curriculum mapping: a tool for transparent and authentic teaching and learning.

The curriculum is a sophisticated blend of educational strategies, course content, learning outcomes, educational experiences, assessment, the educational environment and the individual students' learning style, personal timetable and programme of work. Curriculum mapping can help both staff and students by displaying these key elements of the curriculum, and the relationships between them. Students can identify what, when, where and how they can learn. Staff can be clear about their role in the big picture. The scope and sequence of student learning is made explicit, links with assessment are clarified and curriculum planning becomes more effective and efficient. In this way the curriculum is more transparent to all the stakeholders including the teachers, the students, the curriculum developer, the manager, the public and the researcher. The windows through which the curriculum map can be explored may include: (1) the expected learning outcomes; (2) curriculum content or areas of expertise covered; (3) student assessment; (4) learning opportunities; (5) learning location; (6) learning resources; (7) timetable; (8) staff; (9) curriculum management; (10) students. Nine steps are described in the development of a curriculum map and practical suggestions are made as to how curriculum maps can be introduced in practice to the benefit of all concerned. The key to a really effective integrated curriculum is to get teachers to exchange information about what is being taught and to coordinate this so that it reflects the overall goals of the school. This can be achieved through curriculum mapping, which has become an essential tool for the implementation and development of a curriculum. Faced with curricula which are becoming more centralized and less departmentally based, and with curricula including both core and optional elements, the teacher may find that the curriculum map is the glue which holds the curriculum together.

Journal Article↗

PubMed2006

Curriculum development in anesthesia: basic theoretical principles.

PURPOSE: Educational theories provide a guiding basis for coherent medical curriculum development and instruction in a similar way that evidence-based medicine provides a rational basis for medical treatment. The purpose of this review is to provide general organizational, theoretical and educational principles for developing or modifying an anesthesia curriculum. SOURCE: This paper draws from the general educational and cognitive psychology literature, the medical educational literature from the period 1996-2006, as well as our experience in renewing the anesthesia clerkship curriculum at McMaster University. PRINCIPAL FINDINGS: Successful curriculum development includes the consideration of stakeholder needs, organizational issues, funding and sustainability, curriculum design, implementation and evaluation. Curriculum design includes the development of curricular goals and objectives, determination of the content and its organization, instructional methods and strategies, and assessment of the learners. Curriculum evaluation is used to judge the curriculum's merit and worth. The findings and recommendations from these evaluations feed back into the curriculum development cycle for further curricular improvements or modifications. CONCLUSION: The current medical environment requires a responsive and efficacious curriculum that is able to keep up with its rapid pace of change. By providing a discussion of the educational and theoretical principles which underpin coherent curriculum development, this paper advocates a rational, theory-based approach to curriculum development.

Anesthesiology↗

PubMed2000

Development and assessment of a radiology core curriculum in health care policy and practice.

RATIONALE AND OBJECTIVES: The purpose of this study was to evaluate the feasibility of implementing a core curriculum in health policy and practice for radiology residents and fellows, to determine whether such a curriculum would be considered professionally valuable by participants, and to determine if the curriculum would influence participants' careers. MATERIALS AND METHODS: A core curriculum in health policy and practice was developed, involving 19 seminars presented over 5 weeks. Twelve faculty members presented comprehensive and integrated information relevant to current and future radiology practice. Topic clusters included health care structure and payment, technology and health services, radiology practice management, and career issues. Classroom teaching was supplemented by a course syllabus and resource library. Participants were surveyed following each seminar and at the conclusion of the curriculum. RESULTS: Participants described their baseline knowledge of each topic as weak. As a result of the curriculum, self-described knowledge ratings increased considerably. Interest in curriculum topics and perception of their importance and relevance to radiology practice increased. Of respondents, 84% (26 of 31) described the curriculum as having very good or excellent educational value. All respondents indicated that the curriculum should be repeated in the future, 42% (13 of 31) indicated that the curriculum motivated them to pursue further related education, and 61% (19 of 31) developed interest in personal involvement in administrative issues and radiology organizations. CONCLUSION: A core curriculum in health policy and practice was successfully integrated into radiology training. The curriculum resulted in increased knowledge, interest, and perceived importance of medical management issues by residents and fellows and stimulated their interest in pursuing further management education and involvement in radiology administration and organizations.

Attitude of Health Personnel↗

PubMed2001

A program to teach curriculum development to junior faculty.

BACKGROUND AND OBJECTIVES: Even though curriculum skills are widely acknowledged to be an important part of faculty development in family medicine, reports of outcomes of programs that teach those skills are rarely found in the medical education literature. The Curriculum Workshop Series, one part of a 1-year faculty development fellowship for recent residency graduates, was designed to teach curriculum skills to junior faculty. THE PROGRAM: Developed as part of the Harbor-UCLA Family Medicine Faculty Development Fellowship, the Curriculum Workshop Series consisted of monthly or twice-monthly group sessions, readings, discussion, and individual projects with feedback from colleagues and the instructor. Objectives included developing an understanding of six fundamental steps of curriculum development, completion of an individual project, and giving and receiving feedback regarding projects. Outcome measures included number of projects implemented, the quality of projects, and participant satisfaction. OUTCOMES: Eight fellows participated in the Curriculum Workshop Series and completed projects. Six of eight were implemented, providing three new curricular opportunities and three enhancements to existing curricula for three family practice residency programs. Review of projects by outside experts showed that a majority of the six steps were addressed by most fellows but that more emphasis needed to be placed on the clarity of the written curriculum, the link between teaching strategies and specific learning objectives, and evaluation of learners and projects. Participants endorsed the relevance of curriculum skills, the practical step-by-step approach to curriculum development, and the opportunity to produce and implement an individual project. CONCLUSIONS: The Curriculum Workshop Series provides a straightforward format for teaching curriculum skills to junior faculty and demonstrates that recent graduates have the ability to make a contribution in the area of curriculum development. The format presented here could readily be adapted to other faculty development settings. Long-term outcomes of this type of faculty development remain to be studied.

Curriculum↗

PubMed2004

The dental curriculum at North American dental institutions in 2002-03: a survey of current structure, recent innovations, and planned changes.

This study examined the current format of curricula at North American dental schools, determined curriculum evaluation strategies, and identified recently implemented changes as well as planned future innovations. The academic affairs deans of sixty-four North American dental schools received an email survey in August 2002; a second, follow-up survey was sent to nonresponders in February 2003. Online responses were collected and analyzed using SurveyTracker software. The final response rate was 87 percent, with forty-eight U.S. schools and eight Canadian schools responding. Respondents were asked to select descriptive statements about the general organization of their curricula and the degree to which problem-based learning (PBL), case-reinforced learning (CRL), curricular integration, and community-based clinical treatment experiences were incorporated. They were also requested to identify strategies employed to evaluate the curriculum and to report recently completed and desired future curriculum modifications. In regard to desired future curriculum innovations, respondents identified why they were considering curriculum changes and identified resources needed to implement the planned changes. Sixty-six percent of those who responded defined their current curriculum organization as primarily discipline-based with a few interdisciplinary courses. Nearly 60 percent of schools reported that they used PBL and CRL in specific courses or for components of certain courses, but only 5 percent of the respondents indicated that all of their courses used PBL. Regarding integration of major sections of the curriculum, only 7 percent reported that their entire curriculum was organized around themes of interrelated topics. Sixty-four percent reported that their curriculum had required community-based clinical treatment experiences for students. The most frequent innovations in the past three years were increased use of computer and web-based learning (86 percent), creation of patient care experiences early in the curriculum (84 percent), enhancement of competency evaluation methods (84 percent), and curriculum decompression (79 percent). These items plus increased community-based care were the most frequently identified future curricular innovations. There were virtually no differences between the responses of Canadian and U.S. dental schools. The results of this study help to broadly characterize dental curricula at North American dental institutions and identify curriculum modifications anticipated by the academic dean respondents.

Canada↗

PubMed2006

Implementation of curriculum by family medicine fellows: what factors help and what factors hinder?

BACKGROUND AND OBJECTIVES: The need for change in medical curricula is increasing, due partially to tougher curriculum and evaluation standards. Participants in our academic medicine fellowship learn to develop curricula, but not all are successful at fully implementing them. This study looked for facilitators of and barriers to curriculum implementation by individual fellows. A literature review uncovered studies identifying institutional variables relating to successful curriculum innovation but little that identified variables pertaining to the individual curriculum developer. METHODS: We interviewed alumni of the curriculum development track of the Primary Care Faculty Development Fellowship at Michigan State University, asking what promoted or hindered their curriculum implementation. We analyzed interview notes to identify themes according to a theoretical framework. RESULTS: Common facilitators were (1) having a strong advocate, (2) perception of need for the curriculum by both fellow and institution, and (3) having a curriculum plan. Common barriers were (1) no time slot for curriculum, (2) fellow had left job, and (3) curriculum was too large or complex. CONCLUSION: Successful curriculum developers have powerful advocates of well-designed curriculum plans that address recognized institutional needs.

Curriculum↗

PubMed1998

Patient choice in diabetes education curriculum. Nutritional versus standard content for type 2 diabetes.

OBJECTIVE: To examine the effects of patient choice between two education curriculums that emphasized either the standard or nutritional management of type 2 diabetes on class attendance and other outcomes among a mostly Hispanic patient population. RESEARCH DESIGN AND METHODS: A total of 596 patients with type 2 diabetes were randomly assigned to either a choice or no choice condition. Patients in the choice condition were allowed to choose their curriculum, while patients in the no choice condition were randomly assigned to one of the two curriculums. Outcomes were assessed at baseline and at a 6-month follow-up. RESULTS: When given a choice, patients chose the nutrition curriculum almost four times more frequently than the standard curriculum. Contrary to our hypothesis, however, patients who had a choice did not significantly increase their attendance rates or demonstrate improvements in other diabetes outcomes compared with patients who were randomly assigned to the two curriculums. Patients in the nutrition curriculum had significantly lower serum cholesterol at a 6-month follow-up, whereas patients in the standard curriculum had significant improvements in glycemic control. Of the randomized patients, 30% never attended any classes; the most frequently cited reasons for nonattendance were socioeconomic. Hispanic patients, however, were just as likely as non-Hispanic patients to attend classes and participate at the follow-up. Patients who attended all five classes of either curriculum significantly increased their diabetes knowledge, gained less weight, and reported improved physical functioning compared with patients who did not attend any classes. CONCLUSIONS: Although providing patients with a choice in curriculums at the introductory level did not improve outcomes, differential improvements were noted between patients who attended curriculums with different content emphasis. We suggest that diabetes education programs should provide the opportunity for long-term, repetitive contacts to expand on the modest gains achieved at the introductory level, as well as provide more options to match individual needs and interests and to address socioeconomic barriers to participation.

Adult↗

PubMed2000

A national general pediatric clerkship curriculum: the process of development and implementation.

OBJECTIVE: To describe a new national general pediatrics clerkship curriculum, the development process that built national support for its use, and current progress in implementing the curriculum in pediatric clerkships at US allopathic medical schools. CURRICULUM DEVELOPMENT: A curriculum project team of pediatric clerkship directors and an advisory committee representing professional organizations invested in pediatric student education developed the format and content in collaboration with pediatric educators from the Council on Medical Student Education in Pediatrics (COMSEP) and the Ambulatory Pediatric Association (APA). An iterative process or review by clerkship directors, pediatric departmental chairs, and students finalized the content and built support for the final product. The national dissemination process resulted in consensus among pediatric educators that this curriculum should be used as the national curricular guideline for clerkships. MONITORING IMPLEMENTATION: Surveys were mailed to all pediatric clerkship directors before dissemination (November 1994), and in the first and third academic years after national dissemination (March 1996 and September 1997). The 3 surveys assessed schools' implementation of specific components of the curriculum. The final survey also assessed ways the curriculum was used and barriers to implementation. OUTCOMES: The final curriculum provided objectives and competencies for attitudes, skills, and 18 knowledge areas of general pediatrics. A total of 216 short clinical cases were also provided as an alternative learning method. An accompanying resource manual provided suggested strategies for implementation, teaching, and evaluation. A total of 103 schools responded to survey 1; 84 schools to survey 2; and 85 schools responded to survey 3 from the 125 medical schools surveyed. Before dissemination, 16% of schools were already using the clinical cases. In the 1995-1996 academic year, 70% of schools were using some or all of the curricular objectives/competencies, and 45% were using the clinical cases. Two years later, 90% of schools surveyed were using the curricular objectives, 88% were using the competencies, 66% were using the clinical cases. The extent of curriculum use also increased. Schools using 11 or more of the 18 curriculum's knowledge areas increased from 50% (1995-1996) to 73% (1996-1997). CONCLUSION: This new national general pediatric clerkship curriculum developed broad support during its development and has been implemented very rapidly nationwide. During this period the COMSEP and the APA have strongly supported its implementation with a variety of activities. This development and implementation process can be a model for other national curricula.

Clinical Clerkship↗

PubMed1995

Multi-national, multi-lingual, multi-professional CATs: (Curriculum Analysis Tools).

A consortium of dental schools and allied dental programs was established in 1991 with the expressed purpose of creating a curriculum database program that was end-user modifiable [1]. In April of 1994, a beta version (Beta 2.5 written in FoxPro(TM) 2.5) of the software CATs, an acronym for Curriculum Analysis Tools, was released for use by over 30 of the consortium's 60 member institutions, while the remainder either waited for the Macintosh (TM) or Windows (TM) versions of the program or were simply not ready to begin an institutional curriculum analysis project. Shortly after this release, the design specifications were rewritten based on a thorough critique of the Beta 2.5 design and coding structures and user feedback. The result was Beta 3.0 which has been designed to accommodate any health professions curriculum, in any country that uses English or French as one of its languages. Given the program's extensive use of screen generation tools, it was quite easy to offer screen displays in a second language. As more languages become available as part of the Unified Medical Language System, used to document curriculum content, the program's design will allow their incorporation. When the software arrives at a new institution, the choice of language and health profession will have been preselected, leaving the Curriculum Database Manager to identify the country where the member institution is located. With these 'macro' end-user decisions completed, the database manager can turn to a more specific set of end-user questions including: 1) will the curriculum view selected for analysis be created by the course directors (provider entry of structured course outlines) or by the students (consumer entry of class session summaries)?; 2) which elements within the provided course outline or class session modules will be used?; 3) which, if any, internal curriculum validation measures will be included?; and 4) which, if any, external validation measures will be included. External measures can include accreditation standards, entry-level practitioner competencies, an index of learning behaviors, an index of discipline integration, or others defined by the institution. When data entry, which is secure to the course level, is complete users may choose to browse a variety of graphic representations of their curriculum, or either preview or print a variety of reports that offer more detail about the content and adequacy of their curriculum. The progress of all data entry can be monitored by the database manager over the course of an academic year, and all reports contain extensive missing data reports to ensure that the user knows whether they are studying complete or partial data. Institutions using the beta version of the program have reported considerable satisfaction with its functionality and have also offered a variety of design and interface enhancements. The anticipated release date for Curriculum Analysis Tools (CATs) is the first quarter of 1995.

Curriculum↗

PubMed2001

Curriculum assessment for prevention topics and the population perspective.

BACKGROUND: According to the Association of American Medical College's (AAMC) Senior Questionnaire, medical students spend an inadequate amount of time learning about health promotion, disease prevention, and the population health perspective. OBJECTIVE: Determine the health promotion/disease prevention (HPDP) content of the medical school curriculum at the University of Kansas School of Medicine, using an inventory of knowledge and skills in HPDP and using physician education objectives from Healthy People 2000. METHODS: A 121-item survey to evaluate curriculum content was developed. All course directors evaluated their course by using this instrument. An average of three medical students used this instrument to assess each curriculum lecture and every clinical clerkship day in the required medical school curriculum. A teaching session was defined as spending a minimum of 3-5 minutes teaching an HPDP topic. RESULTS: Of 21 required courses in the medical school curriculum, 11 accounted for the 393 teaching sessions in HPDP. Seventy-five percent (293 sessions) of these dealt with clinical prevention. Quantitative methods received 40 sessions, whereas the health services organization and delivery and the community dimensions of medical practice received 37 and 23 sessions, respectively. Course directors and students disagreed significantly in which HPDP topics were taught in the curriculum. CONCLUSIONS: Clinical prevention was fairly well covered in the medical school curriculum. Quantitative methods, health services organization and delivery, and community dimensions of medical practice were poorly covered. This assessment was used to substantially improve the curriculum. To track and improve curriculum content in all courses, course directors need to know more precise details about the content of their courses, so this detail can be used to better evaluate the overall curriculum.

Curriculum↗

PubMed2001

Evaluation of a problem-based curriculum in midwifery.

OBJECTIVE: to evaluate the implementation of a 'problem-based' learning (PBL) curriculum within midwifery. DESIGN: a 'realistic evaluation' model based on cost-effectiveness models of economics, and incorporating both qualitative and quantitative methodology. The design used historical comparison, comparing students following the new curriculum with a baseline of previous student cohorts and exploring staff and student experiences. SETTING: a 'new' university, providing a degree-level 18 month pre-registration midwifery programme for an intake of about 40 students per cohort. PARTICIPANTS: all students in the cohort qualifying immediately before the implementation and all those in the first cohort following the new curriculum were invited to participate fully. Assessment outcomes for three cohorts of students qualifying before and the first three cohorts qualifying following the change were analysed. All clinical staff directly involved in mentoring the relevant student groups, all academic staff involved in delivering the new curriculum and the course external examiner were invited to participate. INTERVENTION: the evaluation studied a major change in the way the overall midwifery curriculum was delivered, widely described as PBL. MEASUREMENTS: students' experiences and perspectives were sought through review of routine evaluation documents, nominal group technique exercises and focus group discussions at about six months following qualification. Clinical staff experiences and perspectives were sought through written structured questionnaires. Academic staff views were sought through personal semi-structured interviews. Participant observation of the process, review of course documents and of staff reflective commentaries were also conducted. Data on student completion rates and final grade were analysed. FINDINGS: although students' views of the curriculum were generally positive, they experienced some discomfort and difficulty in adjustment to a new style of learning. Small group learning, independence and skills in using and conveying information and research evidence were valued aspects of the new approach. Quality of clinical placement experience and university-practice links were an important area of positive experience or concern. Clinical staff views of the curriculum showed considerable stability, with major concerns being the balance of theory and practice time and skills which were not influenced by the curriculum change. At both points, ability to critically evaluate and use evidence in practice was regarded highly. Student outcomes showed some evidence of possible divergence of grades in the new curriculum. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: the manner and context of implementation of educational change may have important implications for student experiences and outcomes and the experiences of educators. Adequate preparation at all levels for a different, more independent style of learning is important and students are likely to need clear guidance and feedback on their progress in the early stages of the curriculum, to monitor progress and to provide reassurance. Longer-term research is needed to assess the impact of PBL on theory-practice links and on the midwives as practitioners.

Attitude↗

PubMed2001

Effect of an integrated nutrition curriculum on medical education, student clinical performance, and student perception of medical-nutrition training.

BACKGROUND: Ninety-eight percent of medical schools report nutrition as a component of medical education. However, most schools do not have an identifiable nutrition curriculum. Medical schools that do include nutrition have not evaluated its effect on clinical skills. OBJECTIVE: The objective was to determine the efficacy of an integrated undergraduate medical curriculum to increase the quantity of nutrition instruction and to advance nutrition clinical skills demonstrated by medical students. DESIGN: A quasiexperimental design was constructed to determine whether an integrated nutrition curriculum increased the performance on nutrition-oriented clinical examinations of medical school classes that received 1, 2, or 3 y of the curriculum. The evaluation of the curriculum focused on 3 areas: 1) hours of nutrition instruction, 2) the application of nutrition within a clinical setting, and 3) perceptions about the nutrition curriculum. The Objective Structured Clinical Examination (OSCE) nutrition score was compared between graduating classes by use of analysis of variance. Data from the American Association of Medical Colleges were analyzed to determine the change in the proportion of students who reported that the amount of time devoted to nutrition was adequate. RESULTS: The implementation of the integrated nutrition curriculum resulted in a doubling of the total hours of required instruction in the medical curriculum (35 compared with 75 h). The mean (+/-1 SEM) OSCE nutrition score significantly improved after the implementation of the curriculum (41.7 +/- 0.9% compared with 50.6 +/- 1.1%) and the percentage of students who reported that the amount of nutrition taught during medical school was inadequate decreased (68.4% compared with 11.5%). CONCLUSION: Medical students improved their clinical nutrition practice skills through participation in an integrated nutrition curriculum.

Adult↗

PubMed2001

Meeting the needs of future physicians: a core curriculum initiative for postgraduate medical education at a Canadian university.

UNLABELLED: In addition to possessing medical expertise, contemporary physicians are expected to be skilled communicators, critical consumers and users of medical research, teachers, collaborators, health care advocates, and managers. A core curriculum is a common set of learning experiences designed to help prepare physicians for these complex roles. PURPOSE: This article describes the design and implementation of one core curriculum, summarizes the feedback received from residents, and shares some of the lessons we are learning as we use feedback to develop our programme. METHOD: The core curriculum described was implemented at a Canadian university which offers 56 residency programmes with a total enrollment of approximately 360 students. The curriculum consisted of 30 sessions organized around four themes: biostatistics and epidemiology; communications and teaching skills; healthcare management, and ethical, medicolegal and lifestyle issues. Each session in the Core Curriculum was evaluated by residents with respect to the timing, quality, and value of the learning experience. In addition, residents participated in focus group discussions of their Core Curriculum experiences. RESULTS: Key findings related to the characteristics of effective core curriculum learning experiences and to the barriers to implementing a core curriculum across programmes. Of particular salience were findings related to explicit issues of attendance and the diverse needs of learners and programmes, and to more implicit issues of communication and managing change. The specific content and format of the Core Curriculum and the results of the evaluation process will be of interest to others considering a core curriculum for postgraduate medical programmes.

Clinical Competence↗

PubMed2004

Electronic curriculum implementation at North American dental schools.

Electronic curriculum, or E-curriculum, refers to computer-based learning including educational materials available on CD or DVD, online courses, electronic mechanisms to search the literature, email, and various applications of instructional technology including providing laptops to students, multimedia projection systems, and Internet-compatible classrooms. In spite of enthusiasm about the potential for E-curriculum to enhance dental education, there is minimal guidance in the literature to assist schools with implementation. The study objectives were: 1) identify U.S. and Canadian dental schools that have initiated mandatory laptop programs and assess cost, faculty development issues, extent of curricular use, problems, and qualitative perceptions; 2) determine the extent to which twenty-two other E-curriculum resources were available and used at North American dental schools; and 3) identify factors that influenced E-curriculum implementation. A twenty-six item questionnaire, known as the Electronic Curriculum Implementation Survey (ECIS), was mailed to all sixty-six North American dental schools (ten Canadian and fifty-six U.S. schools) during 2002-03 with a response rate of 100 percent. Twenty-five of the twenty-six ECIS questions employed a menu-driven, forced choice format, but respondents could provide amplifying comments. Fifty-three questionnaires were completed by associate deans for academic affairs, three by deans, and ten by instructional technology (IT) managers, IT committee chairs, or directors of dental informatics departments. The survey found that E-curriculum implementation among North American dental schools is following the classic innovation pattern in which a few early adopting institutions proceed rapidly while the majority of potential adopters make modifications slowly. Fourteen U.S. dental schools have established mandatory laptop programs for students. Ten of these laptop programs were created in the past two years; respondents reported numerous growing pains but were generally pleased with their progress. Other E-curriculum capabilities were incorporated into courses more frequently at laptop schools than the fifty-two non-laptop schools including websites, online course evaluations, and instructor use of email to communicate with students. Few dental schools use online courses, and at most schools, few faculty have received training in online instructional techniques. Virtually all North American dental schools have provided substantial instructional technology resources to their faculty, but use of twenty-two components and capabilities of E-curriculum was limited, especially at schools without laptop programs. Various faculty-related issues were reported as implementation barriers including lack of time, skill, and incentive to develop educational software. We conclude that many North American dental schools, especially those with laptop programs, are functioning at the "learn by doing" phase of initial implementation in a four-stage innovation adoption model. E-curriculum planners should pay close attention to implementation problems that occur at this stage where many innovation efforts break down.

Canada↗

PubMed1997

An ethics curriculum for the pediatric residency program. Confronting barriers to implementation.

BACKGROUND: The 1997 Residency Review Committee requirements in pediatrics mandate a structured curriculum in medical ethics for all accredited pediatric residency programs. To our knowledge, there are no published models for the development of an ethics curriculum for pediatric residents. Several obstacles may confront those attempting to begin an ethics teaching program. OBJECTIVE: To describe the successful implementation of a structured ethics curriculum for pediatric residents. METHODS: Our program was designed to overcome the following obstacles: (1) time constraints of faculty and residents, (2) scheduling difficulties and lack of continuity, (3) attitudes of residents toward the material, and (4) inadequate ethics training among faculty. In addition to traditional topics in medical ethics, the curriculum focuses on issues that confront residents primarily during their training, issues that may shape their professional values in important ways. RESULTS: This ethics curriculum has been successfully implemented in our own program and offers solutions to common barriers faced by those seeking to implement an ethics curriculum for pediatric residents. CONCLUSION: We present the ethics curriculum currently in use at our institution as a tool that may be adopted as it stands or as altered by others as they develop their own program's ethics curriculum. We believe the proposed curriculum directly confronts many of the barriers to successful ethics education of pediatric residents.

Curriculum↗

PubMed2005

Smoking prevention for ethnically diverse adolescents: 2-year outcomes of a multicultural, school-based smoking prevention curriculum in Southern California.

BACKGROUND: Effective school-based curricula are needed to prevent smoking among ethnically diverse adolescents. This study evaluated a multicultural smoking prevention curriculum in ethnically diverse Southern California middle schools. METHODS: Students in 24 middle schools (N = 3157 sixth graders) received the multicultural curriculum, a similar curriculum without references to cultural issues, or a control condition. Odds ratios for experimentation with smoking over a 2-year period were calculated. RESULTS: The multicultural program was associated with a lower risk of smoking between sixth and eighth grade, relative to the control group. Program effects varied according to the ethnic composition of the schools. In schools with predominantly Hispanic populations, the multicultural curriculum was more effective than the control, but the standard curriculum was not. In schools with predominantly Asian or multicultural populations, the standard curriculum was more effective than the control, but the multicultural curriculum was not. Analyses stratified by ethnicity within the schools revealed that the multicultural curriculum was effective among Hispanic students within predominantly Hispanic schools, but not among Hispanic students within predominantly Asian/multicultural schools. CONCLUSIONS: Smoking prevention for adolescents in culturally diverse school contexts is a challenge. In this study, a multicultural curriculum was most effective among Hispanic students in predominantly Hispanic schools. Further research is needed to determine the best ways to prevent smoking in predominantly Asian and multicultural schools.

Adolescent↗

PubMed1998

Practicing what we preach? An analysis of the curriculum of values in medical education.

PURPOSE: Although medical students are expected to adopt and practice the ideals stated in the Hippocratic Oath, little is known about whether these values are actually taught during clinical training. The purpose of this study was to examine the "recommended curriculum" of medical values and compare it with values that are actually taught. SUBJECTS AND METHODS: The recommended curriculum was identified through content analysis of curriculum documents and interviews with individuals responsible for teaching. The taught curriculum of values was identified through naturalistic observations and audio taping of inpatient internal medicine teams at an academic medical center. RESULTS: The values most consistently recommended in the medical curriculum are honesty, accountability, compassion, the importance of public health, and self-policing. While accountability and caring were found frequently in the taught curriculum, self-policing and the importance of public health were emphasized less. Interprofessional respect and the importance of service were present in the recommended curriculum, but were taught as interprofessional disrespect and as the burden of service. The importance of industry (working hard) was not found in the recommended curriculum, but frequently identified in the taught curriculum. CONCLUSION: This study indicates that one reason medical students are not learning the intended norms of the profession may be that the teachers are not consistently teaching the recommended values of the profession. Future research should concentrate on confirming these findings in other settings and on understanding why these values are not consistently taught.

Curriculum↗