Evaluation of a longitudinal medical school evidence-based medicine curriculum: a pilot study.
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ABSTRACT:
SUBMITTER: West CP
PROVIDER: S-EPMC2517920 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundEvidence-based medicine (EBM) is an important element of medical education. However, limited information is available on effective curricula.ObjectiveTo evaluate a longitudinal medical school EBM curriculum using validated instruments.Design, participants, measurementsWe evaluated EBM attitudes and knowledge of medical students as they progressed through an EBM curriculum. The first component of the curriculum was an EBM "short course" with didactic and small-group sessions occurring at the end of the second year. The second component integrated EBM assignments with third-year clinical rotations. The 15-point Berlin Questionnaire was administered before the course in 2006 and 2007, after the short course, and at the end of the third year. The 212-point Fresno Test was administered before the course in 2007 and 2008, after the short course, and at the end of the third year. Self-reported knowledge and attitudes were also assessed in all three classes of medical students.ResultsEBM knowledge scores on the 15-point Berlin Questionnaire increased from baseline by 3.0 points (20.0%) at the end of the second year portion of the course (p < 001) and by 3.4 points (22.7%) at the end of the third year (p < 001). EBM knowledge scores on the 212-point Fresno Test increased from baseline by 39.7 points (18.7%) at the end of the second year portion of the course (p < 001) and by 54.6 points (25.8%) at the end of the third year (p < 001). On a 5-point scale, self-rated EBM knowledge increased from baseline by 1.0 and 1.4 points, respectively (both p < 001). EBM was felt to be of high importance for medical education and clinical practice at all time points, with increases noted after both components of the curriculum.ConclusionsA longitudinal medical school EBM was associated with markedly increased EBM knowledge on two validated instruments. Both components of the curriculum were associated with gains in knowledge. The curriculum was also associated with increased perceptions of the importance of EBM for medical education and clinical practice.
| S-EPMC3101983 | biostudies-literature
Project description:IntroductionMedical students often do not value attending in-person large group sessions. It is also not clear from prior research whether attendance at large group sessions impact on performance in medical school. The goal of this study was to assess the relationship between voluntary attendance in large group sessions organized as a "flipped classroom" in a new innovative curriculum and students' mastery of clinical applications of basic science knowledge.MethodologyOur students' ability to apply basic science knowledge to clinical problems is assessed via progress testing using three methodologies: a locally developed multiple-choice examination, written examination developed through the National Board of Medical Examiners (NBME) Customized Assessment Services Program and post encounter questions included in a clinical skills examination. We analyzed the relationship between voluntary attendance at weekly large group "flipped classroom" sessions and the students' performance on examinations given at four intervals over the initial 24-week module of the medical school curriculum.ResultsComplete data were available for 167 students. A total of 82 students (49.1%) attended all large group sessions, 65 students (38.9%) missed one or two sessions and 20 students (12.0%) missed three or more sessions. There were no difference between the students in the groups on their medical admission (MCAT) examination scores. The growth in performance from each time point until the next was statistically significant. There was no statistically significant difference in growth between the students who had no absences and those who had one or two absences. Students who missed three or more sessions performed significantly lower than their peers over the 24 week module and were more likely to score one or more standard deviations below the class mean on the assessments.ConclusionsWe found no relationship between attendance and MCAT scores suggesting the differences in performance on the progress tests was not due to initial differences in knowledge or reasoning skills. While the study was not experimental, it suggests large group sessions using a "flipped classroom" approach to provide reinforcement, feedback and practice may be effective for increasing learning and retention in the application of basic science knowledge among first year medical students.
| S-EPMC6071618 | biostudies-literature
Project description:Introduction:While evidence-based medicine (EBM) is an Accreditation Council for Graduate Medical Education core competency, EBM teaching in pediatric subspecialties is rarely reported. Therefore, we designed, implemented, and evaluated this focused EBM curriculum for trainees in neonatal-perinatal medicine. Methods:This EBM curriculum consists of seven weekly 1-hour sessions. Specific EBM skills taught in the sessions include formulating a structured clinical question, conducting an efficient literature search, critically appraising published literature in both intervention and diagnostic studies, and incorporating evidence into clinical decision-making. The course was evaluated by a neonatology-adapted Fresno test (NAFT) and neonatology case vignettes, which were administered to learners before and after the curriculum. This publication includes the needs assessment survey, PowerPoint slides for the seven sessions, the NAFT, and the scoring rubric for the test. Results:The NAFT was internally reliable, with a Cronbach's alpha of .74. The intraclass correlation coefficient of the three raters' variability in assessment of learners was excellent at .98. Mean test scores increased significantly (54 points, p < .001) in 14 learners after the EBM curriculum, indicating an increase in EBM-related knowledge and skills. Discussion:This focused EBM curriculum enhances trainees' knowledge and skills and fosters evidence-based practice. The curriculum can be easily adapted for learners in pediatrics, as well as family medicine, in order to enhance trainees' EBM skills and knowledge.
| S-EPMC6338140 | biostudies-other
Project description:OBJECTIVE: The present questionnaire survey investigated student reception of problem-based learning (PBL) in the orthodontic curriculum with regard to acceptance, sense of purpose and motivation, knowledge and understanding, as well as tutorial support. METHODS: Over a period of two terms, we compared two different didactic methods (PBL and short presentations) by randomizing the participants of a course on orthodontic diagnostics into two different groups, who inversed methods after the first term. RESULTS: The two student groups did not show any significant differences with regard to assessments or examination performance. Therefore, acceptance of the PBL concept seems to be mainly associated with the motivation of individuals to use this method. The higher the motivation, the more positive is the attitude towards the PBL concept. Students seem to work more constructively and efficiently with PBL if they can judge the concept meaningful for themselves. CONCLUSION: In consideration of the relevant literature and the present results, PBL can be principally integrated into the dental curriculum as a method of learning. However, student motivation is vital to learning success.
| S-EPMC3778530 | biostudies-other
Project description:A strong competency and milestone framework is imperative for medical schools adopting competency-based education and assessment. Milestones can be used to align what is taught and what students are asked to demonstrate from matriculation to graduation. We describe the creation and implementation of our milestone framework as an exemplar.Supplementary informationThe online version contains supplementary material available at 10.1007/s40670-022-01558-1.
| S-EPMC9055212 | biostudies-literature
Project description:Background and Purpose. Gastroenterology is a diverse subspecialty that covers a wide array of topics. The preclinical gastroenterology curriculum is often the only formal training that medical students receive prior to becoming residents. There is no Canadian consensus on learning objectives or instructional methods and a general lack of awareness of curriculum at other institutions. This results in variable background knowledge for residents and lack of guidance for course development. Objectives. (1) Elucidate gastroenterology topics being taught at the preclinical level. (2) Determine instructional methods employed to teach gastroenterology content. Results. A curriculum map of gastroenterology topics was constructed from 10 of the medical schools that responded. Topics often not taught included pediatric GI diseases, surgery and trauma, food allergies/intolerances, and obesity. Gastroenterology was taught primarily by gastroenterologists and surgeons. Didactic and small group teaching was the most employed teaching method. Conclusion. This study is the first step in examining the Canadian gastroenterology curriculum at a preclinical level. The data can be used to inform curriculum development so that topics generally lacking are better incorporated in the curriculum. The study can also be used as a guide for further curriculum design and alignment across the country.
| S-EPMC5397633 | biostudies-literature
Project description:Disaster medicine education in medical curricula is scarce and frequently nonexistent. It is reasonable to initiate educational approaches for physicians in this field at the medical school level. An understanding of disaster medicine and the health care system during massive casualty incidents has been recommended as an integral part of the medical curriculum in the United States and Germany.The goal of the reformed curriculum was to develop a longitudinal integrated disaster and military medicine education program extending from the first year to the sixth year based on previously separated clinical and military medicine topics. Emergency medicine physicians, military emergency medical technicians, and Tactical Combat Casualty Care instructors formed an interprofessional faculty group and designed a learning curriculum.A total of 230 medical students participated in the revised disaster preparedness curriculum. Satisfaction survey response rates were high (201/230, 87.4%). Most of the free-text comments on the program were highly appreciative. The students considered the number of teaching hours for the whole program to be adequate. The students showed significant improvements in knowledge and judgment regarding disaster medicine after the program.We found that medical students were highly interested, were appreciative of, and actively participated in this longitudinal integrated disaster and military medicine education program, but gaps existed between the students' scores and the educators' expectations. The educators believed that the students needed more disaster preparedness knowledge and skills.
| S-EPMC7461121 | biostudies-literature
Project description:BackgroundVaccination is the most cost-effective medical intervention known to prevent morbidity and mortality. However, data are limited on the effectiveness of residency programs in delivering immunization knowledge and skills to trainees. The authors sought to describe the immunization competency needs of medical residents at the University of Toronto (UT), and to develop and evaluate a pilot immunization curriculum.MethodsResidents at the University of Toronto across nine specialties were recruited to attend a pilot immunization workshop in November 2018. Participants completed a questionnaire before and after the workshop to assess immunization knowledge and compare baseline change. Feedback was also surveyed on the workshop content and process. Descriptive statistics were performed on the knowledge questionnaire and feedback survey. A paired sample T-test compared questionnaire answers before and after the workshop. Descriptive coding was used to identify themes from the feedback survey.ResultsTwenty residents from at least six residencies completed the pre-workshop knowledge questionnaire, seventeen attended the workshop, and thirteen completed the post-workshop questionnaire. Ninety-five percent (19/20) strongly agreed that vaccine knowledge was important to their career, and they preferred case-based teaching. The proportion of the thirty-four knowledge questions answered correctly increased from 49% before the workshop to 67% afterwards, with a mean of 2.24 (CI: 1.43, 3.04) more correct answers (P < 0.001). Sixteen residents completed the post-workshop feedback survey. Three themes emerged: first, they found the content specific and practical; second, they wanted more case-based learning and for the workshop to be longer; and third, they felt the content and presenters were of high quality.ConclusionsFindings from this study suggest current immunization training of UT residents does not meet their training competency requirements. The study's workshop improved participants' immunization knowledge. The information from this study could be used to develop residency immunization curriculum at UT and beyond.
| S-EPMC7671185 | biostudies-literature
Project description:IntroductionCase-based learning (CBL) is a pedagogical method using clinical case studies to reinforce learning topics. A pilot elective course incorporating CBL was offered for first-year medical students. The purpose of this study is to (1) describe the logistics of implementing the course and (2) evaluate its reception among medical students on its efficacy in learning basic science class material.MethodAn 8-week elective course was offered to medical students from 2012 to 2017. Specialists facilitated case discussions synthesizing material from didactic lectures with clinical scenarios. End-of-term surveys with multiple choice and free response questions were distributed to students and described using summary statistics.ResultsThere were 13 cohorts of enrollees, and the average number of students enrolled per cohort was 45.6, out of an average class size of 186 (24.5%, range 36-60). One hundred ninety-eight (64.2%) students reported that the course considerably changed or greatly expanded knowledge. Three hundred two (89.1%) students felt it met a majority of or exceeded expectations. Two hundred eighty-seven (80.2%) responses indicated interest in taking the course again or recommending it to others. One hundred six responses (27.1%) indicated preference for CBL over traditional lectures, and 177 (45.3%) were interested to see CBL integrated into the curriculum.ConclusionsOverall, this CBL elective course was well-received and perceived as effective for better learning class material by students. Additionally, students were receptive to case-based learning and integrating this style of learning into a preclinical curriculum without entirely replacing didactic-based learning. These findings may encourage more medical schools to explore incorporating CBL in the curriculum.
| S-EPMC8368533 | biostudies-literature
Project description:IntroductionOver 20% of U.S. medical students express interest in global health (GH) and are searching for opportunities within the field. In addition, domestic practice increasingly requires an understanding of the social factors affecting patients' health. Unfortunately, only 39% of medical schools offer formal GH education, and there is a need to incorporate more GH into medical school curricula.MethodsWe designed a longitudinal case-based curriculum for the core clerkships. We conducted an institution-wide survey to determine baseline GH interest and developed three case-based sessions to incorporate into medicine, surgery, and pediatrics clerkships. The cases included clinical learning while exploring fundamental GH concepts. Cases were developed with GH faculty, and the pilot was implemented from October to December 2019 with 55 students. We used pre- and postdidactic surveys to assess interest in GH and elicit qualitative feedback. A follow-up survey assessed students' identification of barriers faced by their patients domestically.ResultsStudents felt that clinical management, physical exam skills, epidemiology, and social determinants of health were strengths of the sessions and that they were able to apply more critical thinking skills and cultural humility to their patients afterwards. Students felt that simulation would be a great addition to the curriculum and wanted both more time per session and more sessions overall.DiscussionIntegrating GH didactics into the core clerkships has potential to address gaps in GH education and to help students make connections between clinical learning and GH, enhancing their care of patients both domestically and in future GH work.
| S-EPMC7732136 | biostudies-literature