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PubMed1995

A model alcohol and other drug use curriculum for pediatric residents.

While alcohol and other drug (AOD) use is a major health risk for adolescents in the United States, there is a paucity of AOD training for pediatric residents. In 1991-92, the University of Wisconsin Medical School developed an experiential, community-based AOD curriculum for pediatrics residents. The curriculum included resident participation in a community-based AOD adolescent assessment and intervention program, interactive didactic sessions, role-playing practice, and interviewing skills sessions. The residents who participated in the curriculum (n = 25) were compared with a control group (n = 19). Evaluation included pre- and post-curriculum written tests, objective structured clinical examinations, and residents' ratings of the curriculum components. The residents who participated showed significant gains in AOD knowledge, utilization of screening techniques, and clinical management skills as compared with the controls. The residents gave positive ratings to all curriculum components. This well-received curriculum can serve as a national model both for AOD education in pediatrics and for curriculum development in other areas of adolescent health-risk-taking.

Adolescent↗

PubMed1991

Conceptual frameworks and patterns of nursing curriculum.

Common concepts of conceptual frameworks and curriculum patterns are identified by studying all 18 English-speaking, generic baccalaureate nursing programmes in Canada. Four identified curriculum patterns use client systems, health-illness, growth and development, and nursing roles as the primary curriculum organizer to sequence programme courses. The nursing programmes commonly use nursing process, followed by growth and development, human needs, and family as secondary organizers to structure contents of programme course. Identifying a curriculum by its organizers is useful to curriculum practice and research. Nursing faculty can use the identified organizers as primary or secondary organizers in designing, changing or evaluating their curriculum. It is also possible to use a nursing model with the identified organizers for an effective curriculum structure. Research studies on conceptual frameworks could use primary and secondary organizers to compare strength and weakness among different nursing curriculum structures.

Canada↗

PubMed1999

[The curriculum plan for the Split University Medical School--a modern concept for a new school].

The transformation of the Zagreb University Medical School into an independent medical school, i.e., Split University Medical School prompted us to develop a new curriculum which had to adapt Zagreb curriculum to the new circumstances and to overcome its weaknesses. Additional reasons for new curriculum were the need for implementation of the current trends in medical education and adaptation to the Split Faculty. Principles according which the curriculum was developed took into account the current international recommendations on medical education, equal treatment of all teaching subjects, flexible curriculum and vertical integration of the elective subjects. New curriculum requires substantial changes in the organization of the undergraduate teaching. Because of the differences between Croatian medical schools, it is impossible and unnecessary to have a unique curriculum. Joint effort of medical schools has to be directed to the development of a common curriculum core and corresponding computer base of questions for examinations, enhancing state examination development, standard for the evaluation of the medical schools' quality.

Croatia↗

PubMed1999

Developing a competency-based curriculum for a dental hygiene program.

A three-step process was used that involved developing a competency document, an evaluation plan, and a curriculum inventory. The competency document, Competencies for the Dental Hygienist, included three domains, nine major competencies, and fifty-four supporting competencies. These became the department's educational goals. The evaluation plan included multiple methods for assessing each of the nine major competencies. The faculty initially identified evaluation methods that were currently in place and then added strategies for the various gaps in the plan. The curriculum inventory defined the entire curriculum in terms of the competencies. For each supporting competency, there was a list of major and foundation topics, each linked to specific courses. The strategy used to identify both the evaluation methods and curriculum topics was to survey the faculty. Information from assessments and the curriculum inventory directed the modification of the curriculum for alignment with the competencies. This process has resulted in improvements in teaching, evaluation, and student learning. The strengths and weaknesses of this competency-based curriculum development are presented, with specific recommendations for other-programs undergoing similar curriculum development.

Competency-Based Education↗

PubMed1995

Issues and challenges in the design of curriculum information systems.

Medical schools are increasingly using curriculum information systems to better manage their curricula, to incorporate alternative learning environments, to expand subject-specific instruction, or to adapt the curricula to the changing health care environment. A curriculum information system contains key features, selected by the system's designers, that describe the objectives, the specific content, and/or the educational activities that compose the curriculum. The underlying purpose of such a system is to document and describe the knowledge, behaviors, skills, attitudes, or activities students will be expected to develop or learn. While it might be ideal to have one system that would meet the needs of all possible users, the programming and maintenance requirements of such a single system would exceed most medical schools' resources. Thus, designers of curriculum information systems must first identify the primary intended-user group: students, faculty, or administrators. The system designed for one group will typically differ from the systems for other groups in the emphasis on and level of content detail and curriculum structure information. The general structure and purposes of curriculum information systems are expressed in three distinct system designs: a curriculum database (most helpful for administrators), a curriculum textbase (for faculty), and an electronic syllabus (for students). The authors describe these different designs, and they discuss challenges faced by system designers.

Curriculum↗

PubMed2001

Ethical issues in the managed care setting: a new curriculum for primary care physicians.

Several challenging ethical issues have been associated with the shift to managed healthcare in the United States. Our objective was to develop, implement, and evaluate a curriculum designed to help physicians identify and examine ethical issues encountered in the managed care setting. The curriculum was developed during a year-long workshop at Johns Hopkins Bayview Medical Center. The content of the curriculum was established through literature review, focus group discussions with physicians, and a needs assessment of targeted learners (primary care physicians practicing in managed care settings). Some of the key issues addressed in the curriculum include: changing professional responsibilities of physicians; fair use of resources; and threats to the doctor-patient relationship as a consequence of the new healthcare delivery system. The 7.5-h curriculum was taught over five sessions using varied teaching methods. Evaluations demonstrated that the curriculum was successful in increasing learner awareness of ethical issues confronted in the managed care environment and improved learner knowledge in these areas. The physician-learners reported that this educational experience would change their teaching of medical students and residents. After completing the curriculum, learners felt that they were at least somewhat better able to cope with ethical challenges encountered in the managed care setting. Future research might examine whether such a curriculum could positively affect physician behavior or enhance physician satisfaction with the managed care setting.

Journal Article↗

PubMed1994

Development and evaluation of a sexual history-taking curriculum for first- and second-year family practice residents.

BACKGROUND: Primary care physicians need to assess their patients' sexual behaviors to help prevent, diagnose, and treat sexually transmitted diseases. However, few physicians take sexual histories. We developed an educational curriculum aimed at increasing the frequency with which our residents take sexual histories from patients. METHODS: Residents were observed for 5 months through video monitoring of patient encounters to document the precurriculum rate of taking sexual histories. Residents also completed a sexuality questionnaire about the likelihood of encountering certain patient problems and the residents' degree of comfort and competence with these problems. They then completed the educational curriculum and were monitored for 3 months for any change in taking sexual histories. We added follow-up telephone interviews with the residents to determine the effect of the curriculum and the extent of taking sexual histories. RESULTS: Due to insufficient data collected with video monitoring in the postcurriculum phase, we used telephone interviews to evaluate the curriculum. Prior to the curriculum, only 7% of the residents reported routinely asking patients about their sexual history, compared to 36% of residents 6 months after implementation of the curriculum. CONCLUSION: The sexual history-taking curriculum improved the frequency with which residents collected information from patients on sexual activity. In addition, this article addresses the development of the curriculum based on a needs assessment, and the difficulties in and possible solutions to evaluating curricular changes within family practice residency programs.

Adult↗

PubMed1995

Ideal residency curriculum in reproductive endocrinology and infertility.

OBJECTIVE: Knowledge in reproductive endocrinology and infertility is fundamental to the delivery of quality women's health care. In 1991, the American Fertility Society formed a resident education committee to gather data on the current status of reproductive endocrinology and infertility training and develop an ideal curriculum. METHODS: Program directors and reproductive endocrinology and infertility faculty from 288 residencies in obstetrics and gynecology were surveyed about training in reproductive endocrinology and infertility; 257 (89%) of the program directors (survey I) and 203 (82%) of the reproductive endocrinology and infertility faculty (survey II) responded. An ideal curriculum has been developed from consensus discussions, review of survey data, and polling of experienced educators. The curriculum was reviewed and approved by the board of directors of both the Society for Reproductive Endocrinologists and the American Fertility Society. RESULTS: The curriculum is divided into subject matter and therapeutics, which are prioritized into three levels of knowledge: critical core curriculum, less critical material, and material with which residents should have familiarity and general knowledge. In addition, other recommendations and suggestions are made regarding the number of rotations, duration of rotations, and teaching methods. CONCLUSION: The ideal curriculum may serve as a guide to assist program directors in the formulation of the most effective residency training in reproductive endocrinology and infertility. The curriculum can help prioritize what should be taught and where an emphasis can be placed. There is not enough time or resources to teach residents all aspects of reproductive endocrinology and infertility.

Curriculum↗

PubMed2004

Clinical prevention and population health: curriculum framework for health professions.

The Clinical Prevention and Population Health Curriculum Framework is the initial product of the Healthy People Curriculum Task Force convened by the Association of Teachers of Preventive Medicine and the Association of Academic Health Centers. The Task Force includes representatives of allopathic and osteopathic medicine, nursing and nurse practitioners, dentistry, pharmacy, and physician assistants. The Task Force aims to accomplish the Healthy People 2010 goal of increasing the prevention content of clinical health professional education. The Curriculum Framework provides a structure for organizing curriculum, monitoring curriculum, and communicating within and among professions. The Framework contains four components: evidence base for practice, clinical preventive services-health promotion, health systems and health policy, and community aspects of practice. The full Framework includes 19 domains. The title "Clinical Prevention and Population Health" has been carefully chosen to include both individual- and population-oriented prevention efforts. It is recommended that all participating clinical health professions use this title when referring to this area of curriculum. The Task Force recommends that each profession systematically determine whether appropriate items in the Curriculum Framework are included in its standardized examinations for licensure and certification and for program accreditation.

Advisory Committees↗

PubMed2004

Curriculum changes and moral issues in nursing education.

Through history nursing education has strongly advocated the importance of educating students towards moral and ethical responsibility. In today's society however, it has become increasingly difficult to honour this concern. One peephole to capture the ongoing struggle is to look into the curriculum where different stakeholders voice different opinions. Following a social constructive perspective the curriculum texts represent specific interest among stakeholders related to nursing education in a certain historical periods. By analysing the two last versions of the curriculum we get an insight into moral and ethical issues at stake and different ways of addressing these questions. While moral and ethical issues in the curriculum of 1987 follow a disciplinary discourse emphasising the importance of learning ethical concepts and modes of arguments, the curriculum of 2000 places ethical and moral issues within an employability discourse. In this curriculum moral issues are seen as an obligation linked to students practical and technical skills. The 2000 curriculum represents a shift from emphasising the independent and reflective professional to underline the skillful and morally obliged practitioner.

Curriculum↗

PubMed2006

Tales of sociology and the nursing curriculum: revisiting the debates.

The relationship between nursing and sociology has been extensively debated for more than two decades [Cox, C.A., 1979. Who cares? Nursing and sociology: the development of a symbiotic relationship. Journal of Advanced Nursing 4, 237-252; Cooke, H., 1993. Why teach sociology? Nurse Education Today 13, (3) 210-216; Sharpe, K., 1994. Sociology and the nursing curriculum: a note of caution. Journal of Advanced Nursing 20, (2) 391-395; Sharpe, K., 1995. Why indeed should we teach sociology? A response to Hannah Cooke. Nurse Education Today 15, (1) 52-55; Sharpe, K., 1996. Feedback - sociology and the nursing curriculum: a reply to Sam Porter. Journal of Advanced Nursing 23, (7) 1275-1278; Balsamo, D., Martin, S.I., 1995a. Developing the sociology of health in nurse education: towards a more critical curriculum. Part 1. Andragogy and sociology in Project 2000. Nurse Education Today 15, 427-432; Balsamo, D., Martin, S.I., 1995b. Developing the sociology of health in nurse education: towards a more critical curriculum. Part 2. Linking methodology and epistemology. Nurse Education Today 15, 427-432; Porter, S., 1995. Sociology and the nursing curriculum: a defence. Journal of Advanced Nursing 21, (6) 1130-1135; Porter, S., 1996. Why teach sociology? A contribution to the debate. Nurse Education Today, 16, 170-174; Porter, S., 1997. Sociology and the nursing curriculum: a further comment. Journal of Advanced Nursing 26, (1) 214-218; Porter, S., 1998. Social Theory and Nursing Practice. Macmillan, Basingstoke; Corlett, J., 2000. The perceptions of nurse teacher, student nurses and preceptors of the theory-practice gap in nurse education. Nurse Education Today 20, 499-505; Allen, D., 2001. Review article: nursing and sociology: an uneasy marriage?. Sociology of Health and Illness 23, (3) 386-396; Pinikahana, J., 2003. Role of sociology within the nursing enterprise: some reflections on the unfinished debate. Nursing and health Sciences 5, (2) 175-180; Holland, K., 2004. Sociology and the nursing curriculum; editorial. Nurse Education in Practice 4, 81-82; Mowforth, G., Harrison, J., Morris, M., 2005. An investigation into adult nursing students' experience of the relevance and application of behavioural sciences (biology, psychology and sociology) across two different curricula. Nurse Education Today 25, 41-48]. Much attention has been given to the role, utility and value of sociology mostly within pre-registration but also post-registration nursing curricula. Through an initial analysis of a series of letters appearing in The Nursing Times over a 12 week period in 2004, and using an analytical framework of four tales (realist, critical, deconstructive and reflexive) we revisit this relationship. Unlike previous debates our argument is that this relationship is more usefully viewed as emblematic of the legitimation crisis inherent in all modern projects. We argue that in order to move beyond the 'utility' discussion, an interrogation of the knowledge claims of both nursing and sociology is required.

Attitude of Health Personnel↗

PubMedDate not supplied

Clinical Prevention and Population Health Curriculum Framework: the nursing perspective.

The Clinical Prevention and Population Health Curriculum Framework (Curriculum Framework) was developed by the Healthy People Curriculum Task Force comprised of representatives from allopathic and osteopathic medicine, dentistry, nursing and nurse practitioners, pharmacy and physicians assistants. This multidiscipline Task Force was covened to address the Healthy People 2010 objective of increasing the health promotion/prevention content in health professional education. A focus on clinical prevention and population health activities is central to the goal of improving the health status of the nation and offers the greatest potential to reduce many leading causes of death and improve quality of life across diverse populations. The Curriculum Framework provides a set of 4 components (evidence base for practice, clinical preventive services, health systems/health policy and community aspects of practice) and 19 domains for organizing and implementing the curriculum. The title "Clinical Prevention and Population Health" includes both individual and population focused health promotion and prevention efforts. The role of nursing in developing the Curriculum Framework, and the tailoring and implementation of the Curriculum Framework for undergraduate and graduate programs in nursing is discussed.

Clinical Competence↗

PubMed2002

Interdisciplinary development of a preconception health curriculum for four medical specialties.

A group of obstetricians and gynecologists, along with physicians from three other medical specialties, nurses, and midwives, developed a curriculum on preconception health care for women. This curriculum was specifically aimed at residents in obstetrics and gynecology, internal medicine, pediatrics, and family medicine. The curriculum was designed to convince these physicians that they needed to participate in promotion of preconception health for many reasons, such as the need to teach women to take folic acid daily because it significantly decreases the incidence of neural tube defects. Because over 50% of all pregnancies are unplanned, it is imperative that all physicians think of themselves as preconception health providers. Our group then taught the curriculum to medical students, residents, fellows, and attending physicians in all specialties at four hospitals affiliated with the medical college. Evaluation of the curriculum in 171 physicians who participated revealed that only a small percentage of physicians took folic acid daily themselves. Almost 36% of the obstetricians did not currently provide preconception care for their patients. Most physicians in all specialties believed that the curriculum provided them with useful information for their practice. The March of Dimes is currently distributing this curriculum on its Web site.

Curriculum↗

PubMed2000

Curriculum in radiology for residents: what, why, how, when, and where.

Developing a curriculum in chest radiology should follow the same general principles that are used when developing a curriculum in any subspecialty area of radiology. A curriculum is more than a "list of topics" with which a resident should be familiar after 4 years of training. It includes objectives and goals, content, faculty, methods, and evaluation. Numerous resources are available for those who are charged with developing a curriculum in chest radiology. In addition to faculty members in the department, whose input during development can ensure successful implementation of the curriculum, organizations (i.e., ACR, APDR, STR) already have begun to develop "model" curricula. Attending the annual meeting of the Association of American Medical Colleges is a way to meet and hear from professionals who develop and oversee curriculum development at their medical schools, and another important resource available at some medical schools is the Office of Medical Education. The faculty within such offices are uniquely qualified to assist with curriculum and faculty development, especially for those areas in which radiology faculty traditionally are less experienced, such as development of valid and reliable assessment forms and construction of behaviorally based objectives.

Curriculum↗

PubMed2002

Medical students' attitudes towards and perception of the basic sciences: a comparison between students in the old and the new curriculum at the University Medical Center Utrecht, The Netherlands.

OBJECTIVES: The attitudes towards the basic sciences of medical students enrolled in either of 2 different curricula at the University of Utrecht Medical School in The Netherlands were investigated. The purpose of this study was threefold: first, to compare students (beginning clerks) in a conventional and an innovative curriculum; second, to compare beginning clerks with advanced clerks; and third to compare the present results with those of 2 previous American and Canadian studies in which the same questionnaire was used. SETTING: Beginning clerks in the old and in the innovative curriculum, and advanced clerks in the old curriculum, rated 9 statements on a 5-point (disagree - agree) Likert scale. The statements assessed students' attitudes toward the basic sciences. RESULTS: The results showed that beginning clerks in our innovative curriculum, unlike those in a conventional curriculum, consider the basic sciences as somewhat less important for medical practice and do not think that as many biomedical facts as possible should be learned before entering clinical practice. On the other hand, students in the innovative curriculum are more excited by the faculty's teaching of the basic sciences. This latter result confirms the findings in a previous Canadian study. No significant differences were found between beginning and advanced clerks in the conventional curriculum. CONCLUSION: Students experience teaching of the basic sciences as more exciting when they are integrated in organ system blocks with clinical bearings, though they are somewhat less positive about the actual importance of these sciences.

Attitude↗

PubMed2002

Attitudes among students and teachers on vertical integration between clinical medicine and basic science within a problem-based undergraduate medical curriculum.

Important elements in the curriculum at the Faculty of Health Sciences in Linköping are vertical integration, i.e. integration between the clinical and basic science sections of the curriculum, and horizontal integration between different subject areas. Integration throughout the whole curriculum is time-consuming for both teachers and students and hard work is required for planning, organization and execution. The aim was to assess the importance of vertical and horizontal integration in an undergraduate medical curriculum, according to opinions among students and teachers. In a questionnaire 102 faculty teachers and 106 students were asked about the importance of 14 different components of the undergraduate medical curriculum including vertical and horizontal integration. They were asked to assign between one and six points to each component (6 points = extremely important for the quality of the curriculum; 1 point = unimportant). Students as well as teachers appreciated highly both forms of integration. Students scored horizontal integration slightly but significantly higher than the teachers (median 6 vs 5 points; p=0.009, Mann-Whitney U-test), whereas teachers scored vertical integration higher than students (6 vs 5; p=0.019, Mann-Whitney U-test). Both students and teachers considered horizontal and vertical integration to be highly important components of the undergraduate medical programme. We believe both kinds of integration support problem-based learning and stimulate deep and lifelong learning and suggest that integration should always be considered deeply when a new curriculum is planned for undergraduate medical education.

Attitude of Health Personnel↗

PubMed2006

Improving medical student performance in smoking health promotion: effect of a vertically integrated curriculum.

The majority of medical schools have curricula that address the health effects of smoking. However, there are many gaps in smoking education, especially in relationship to vertical integration. The authors aimed to determine whether medical students would better address adolescent smoking within a vertically integrated curriculum in comparison with the previous traditional curriculum. They studied two groups of fifth-year students; one group received a specific smoking intervention. Each group consisted of the entire cohort of students within the Child and Adolescent Health rotation of a newly designed medical curriculum. Two groups of students from the previous traditional undergraduate curriculum were available for direct comparison, one of which had received the same teaching on adolescent smoking. An objective structured clinical examination station was used to measure adolescent smoking enquiry. Intervention students in the new curriculum were more likely to enquire about smoking in the objective structured clinical examination than students who did not receive the intervention (p < 0.005). New curriculum students performed better than students from the previous curriculum, whether or not they had received the smoking intervention (p < 0.001). This study suggests that integrated undergraduate teaching can improve student clinical behaviours with regard to opportunistic smoking enquiry in adolescents.

Adolescent↗

PubMed2006

A web-based smoking cessation and prevention curriculum for medical students: why, how, what, and what next.

This paper summarises some major developments in medical education relating to the health risks of tobacco and to training in tobacco cessation and prevention strategies, and discusses some of the barriers to training. We also describe a project whose purpose was to design, implement and evaluate a web-based self-study tobacco curriculum for medical students to teach medical students to assist smokers to quit and to counsel non-smoking adolescents not to start smoking. This curriculum addresses some of the barriers, namely lack of curriculum time, lack of access to materials and experts, and relevance of the materials. The project was designed and evaluated at two medical schools in Georgia: Morehouse School of Medicine and Mercer University School of Medicine. A curriculum on tobacco control strategies and techniques designed for use in clinical settings was made available to first-year medical students as interactive computer-based tutorials. The curriculum, based on the US Public Health Service Clinical Guideline for Treating Tobacco Use and Dependence, was divided into two parts: the tutorial and practicum sections. Pre- and post-exposure measures were collected for the evaluation. The mean differences for correctly answered knowledge items in the two schools were similar: mean for Morehouse was +2.07 and for Mercer +1.67, indicating improvements in knowledge for both schools. There were statistically significant improvements in all categories of self-rated ability to perform six counselling skills, except for Mercer students for the 'Ask' skill category (p=0.069). The amount of exposure (measured only at Morehouse) was not related to overall change in scores but was associated with self-reported improvement in skill in assisting patients to quit smoking, confidence in counselling patients not interested in quitting, and confidence in counselling teens. The web-based curriculum successfully improved the students' self-rated counselling skills. Given the need and desire on the part of practitioners for training, the curriculum may be found useful by practising physicians and other health-care professionals who wish to improve their skills in smoking prevention and cessation.

Adult↗