Medical Science Educator Volume 15: No. 2

In this era of tight travel budgets, basic scientists have to consider carefully how they spend those precious dollars. I am pleased to tell you there is one meeting on medical education guaranteed to give you top value, the annual meeting of the International Association of Medical Science Educators (IAMSE). What does the IAMSE meeting… Read more »

Ask Google (a search engine) for a definition of a search engine and you will be rewarded with a list of twenty-seven definitions. One of the shortest defines a search engine as “a computer program that retrieves documents or files or data from a database or from a computer network” such as the Internet (http://wordnet.princeton.edu… Read more »

ABSTRACT

The College of Medicine at the University of Arkansas for Medical Sciences (UAMS) has developed an easy and practical method of evaluating medical student professionalism. The evaluation instrument is a single page document listing parameters of professionalism. Next to each parameter are the options of designating a student as either “Inadequate” or “Outstanding” i.e. is the student unable to meet or has he/she exceeded the College’s expectations of professional behavior. The form also provides space for comments from the evaluator. A comment is required for all “Inadequate” ratings; “Outstanding” ratings do not require comments but are strongly encouraged. The process allows for faculty, nurses, residents, clerical staff, and even other medical students to submit a form. Generally, however, faculty is the major source of these reports. The use of this form greatly facilitates the evaluation of medical student professionalism and importantly saves faculty time.

ABSTRACT

Given that the physician’s role today, in comprehensive health care management, is expanding to include managerial, collaborative, and teaching components in their regular practices, and given our increased knowledge about the relationship between conscious and unconscious learning and memory, it is time to question whether the “one size fits all” didactic lecture that merely transmits information as the primary instructional strategy is the best approach for preclinical medical education. Gardner’s Multiple Intelligences Theory offers a framework for actively learning complex medical concepts. We can construct instructional processes for the multiplicity of learners, with identical content, by applying the various multiple intelligences.

ABSTRACT

At UMDNJ-New Jersey Medical School, we took a new approach in teaching histology to first year medical students. In keeping with the new trend in curricular change, we focused primarily on two objectives: 1) to make histology as clinically relevant as possible and 2) to reduce the lecture time. The core strategy of our approach was to make the laboratory sessions more efficient and effective in both teaching and learning. We implemented two changes to accomplish our goals. First, we equipped histology laboratories with an “Audiovisual Switching and Projection System”. The technology enabled us to project images from: a) glass slides, b) 2’x2″ slides, c) textbook figures and photomicrographs, or d) videotape. Second, we switched from a traditional Lecture-Laboratory-Review sequence to a Laboratory-Lecture-Conference sequence. Each topic starts with a live pre-lab presentation by a topic expert who guides the students in observing the basic histological features to be studied in that laboratory session. Afterward, the students complete the laboratory exercise. Lecture time is used primarily to emphasize the structure-function relationships. The Conference uses structure-function relationships as the basis for a meaningful discussion of clinically relevant topics. With the new approach, we have reduced lecture time from 43 hrs to 34 hrs and moved away from the histological detail previously presented in lecture. We believe that this approach prepares students for subsequent medical training by enabling them to remember the useful and clinically relevant aspects of histology.

ABSTRACT

Started in 1997, the new medical program of the National University of Cuyo, requires that students pass a Global Clinical Exam before graduation, in order to determine if they are able to approach and solve health problems in each of the major medical specialties. This report describes the first experience with this type of exam held at the Medical School by the Global Clinical Exam Committee.

The exam consists of two parts: a written test, including multiple choice questions (MCQ) and case-based open-ended questions, and an oral exam to assess clinical skills using simulated patients. Students must pass both parts of the exam. This examination was first administered in the year 2003 to 59 students, all of who passed the written test, while only two failed the oral exam.

In the written exam, the minimum passing grade was 60 %, using a traditional approach for setting this standard. The scores on the written exam ranged from 68 to 87, with a mean value of 79.1 %. There was significant variation among means when the scores at each specialty were considered separately. The procedure for setting the standard used for the OSCE was the Modified Angoff method. Students were clustered in two groups for the oral exam that was held on two consecutive days. The average score was 54 % for the first group and 61 % for the second. The overall scores ranged from 44 % to 69 %. The correlation was high when considering the score for each station.

This experience demonstrated that this medical school is able to implement a global clinical exam, despite the complexity implied. Most of the students showed that they had achieved the knowledge, skills and attitudes required for graduation. The statistical analysis of the results oriented the Committee regarding how to increase validity and reliability of the assessment tools.

ABSTRACT

Learning environments, given the limited time and available resources, may play a crucial role in teaching undergraduate clinical urology. Purposes of the present study were: 1) to determine in which environment students best acquire knowledge and skills on certain topics, 2) to investigate whether they consider exposure in urology as sufficient for future patient management, and 3) to assess whether the above are influenced by different institutional environments and possible specialty choices. Students were asked anonymously to fill in a survey in order to check out the environment in which they believed their acquisition of knowledge and skills (15 items) was best, and whether they felt confident in managing certain urological problems (11 items). Data were analyzed using the chi-square test in relation to gender, future specialization plans, and school of origin. All educational environments except from the operating room provided at least moderate benefit. Differences exist between institutions in learning environments preferences. For certain subjects more than 5% of the students stated they did not acquire the corresponding knowledge or skills. For the majority of the problems addressed, more than 50% of respondents felt confident in managing them. Gender, possible career choice and educational environment preference had marginal or negligible effect on self-confidence development. Based on the results of this study seeing patients and student-oriented conferences represent the most suitable setting for acquiring basic clinical urology knowledge and skills. Moreover, given the plans for an integrated European medical curriculum and despite the differences in health care systems throughout Europe, a standardized core undergraduate curriculum in urology is of outmost importance.

ABSTRACT

Latino and African American standardized patients bring diversity and authenticity to the instructional and assessment mission of standardized patient programs. However, minority standardized patients are often difficult to recruit and retain and may require different training strategies to maximize their performance and recall potential. The purpose of this study is to identify important factors that affect the recruitment, retention, and training of African American, and Latino Standardized Patients (SPs) in two medical schools.

Latino and African American standardized patients from the University of Colorado Health Sciences Center and University of Southern California Keck School of Medicine SP Programs participated in a telephone interview. Trained African American interviewers interviewed the African American SPs and trained Latina interviewers conducted the Latino/a interviews. They asked structured questions, using open-ended and probing techniques to elicit information from the participants. The phone calls were audio taped, transcribed and later analyzed using qualitative methods by the team. Sixty-eight potential participants were sent a letter inviting them to participate. Forty-six standardized patients responded and participated in the telephone interviews (27 African American, 19 Latino; 32 female and 14 male). The interview transcripts were analyzed using an ??bf?editing??bf? approach, a technique derived from grounded theory which encourages interpretation of the data using a team approach. Transcripts were compared across team members to identify common elements or themes. Common themes, patterns, and representative quotations were analyzed and confirmed.

Common themes identified included reasons participants became SPs, motivation for continued involvement as SPs, preferred training methods and preferred recruitment, retention, and training strategies. This study revealed potential barriers and suggested strategies that could improve recruitment, training, and retention of minority-standardized patients in medical education.

ABSTRACT

Concern over the number of medical students choosing pathology and the “graying” of pathology as a profession have been expressed over many years. In Canada, changes in the structure of training, as well as a reduction in the number of foreign medical graduates able to train in pathology, have meant that the profession has had to rely much more heavily than in the past on competitive recruitment directly from undergraduate medical students. The second-year undergraduate course in pathology is often the sole exposure of medical students to this profession. The purpose of this study is to explore the impression of pathology as a career formed during the second year course and relate it to other factors leading to a career choice in pathology. We used the qualitative techniques of focus group interviews and grounded theory analysis to retrospectively explore this question. Both undergraduates who had just completed their second-year course as well as residents and practicing pathologists participated. It was found that the course was considered important for students in forming impressions of pathology, but related more often to the quality of the teaching and the personality of the teachers rather than the actual content of the course. The influence of rumor and other poorly grounded information was noted to play a role in the students??bf? impressions and actions regarding careers. The course was less prominent than lifestyle reasons for the residents and the intellectual attractions of the career for pathologists. All three groups described the stigma of choosing pathology as a career and their reactions to it.

ABSTRACT

This manuscript describes assessment processes that can be used during the normal conduct of Problem-based learning. The recent focus on assessment causes educators to consider different types of assessment methods designed for the purposes of improving students’ performance. Scoring rubrics and Likert scale assessment forms can be used in both formative and summative assessments. Formative assessment can be an on-going and integral part of the learning and improvement cycle. Summative assessment can be based upon patterns of performance toward the end of the course. Students’ written reports on their research on learning issues and integrative in-class discussions that follow after their research offer especially rich opportunities to assess students on many types of learning. Repeated observations of individuals working together throughout the in-class steps of the PBL process provide further opportunities for assessment. Appropriate assessors include faculty members, student peers and the students can assess themselves.