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Neuroimmune pharmacology as a sub-discipline of medical neuroscience in the medical school curriculum.

ABSTRACT: The emerging field of neuroimmune pharmacology (NIP) is the confluence of three distinct disciplines: neuroscience, immunology, and pharmacology (Gendelman and Ikezu 2008). NIP was born from the realization that inflammation within the central nervous system (CNS) plays a crucial role in many neurological pathologies and as such offers a rich array of novel pharmacological targets as potential therapeutics. As this field is likely to have a major impact in medical science, educating future physicians on this area will help increase awareness and may potentially inspire them to pursue careers in the field of NIP. However, a key challenge for medical educators, is how best to incorporate new material on emerging fields, such as NIP, into the medical school curriculum, specifically in the context of a medical neuroscience course. We propose the addition of two 50-min lectures plus an additional optional 2-h lab module to the standard first year medical neuroscience class curriculum. Lecture 1 will focus on how the CNS and the immune system inter-communicate with one another with emphasis on neuroanatomical features and chemical signal transduction between the two systems. Lecture 2 provides an introduction to inflammation in the CNS and provides a series of clinical correlates to describe how CNS inflammation contributes to the disease process. The lab module provides detailed visual examples of how CNS inflammation influences disease processes and provides two examples of how application of an immunomodulatory pharmacological agent can modify disease processes.

SUBMITTER: Freilich RW

PROVIDER: S-EPMC3101078 | biostudies-literature | 2011 Mar

REPOSITORIES: biostudies-literature

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Neuroimmune pharmacology as a sub-discipline of medical neuroscience in the medical school curriculum.

Freilich Robert W RW Ikezu Tsuneya T

Journal of neuroimmune pharmacology : the official journal of the Society on NeuroImmune Pharmacology 20101120 1

The emerging field of neuroimmune pharmacology (NIP) is the confluence of three distinct disciplines: neuroscience, immunology, and pharmacology (Gendelman and Ikezu 2008). NIP was born from the realization that inflammation within the central nervous system (CNS) plays a crucial role in many neurological pathologies and as such offers a rich array of novel pharmacological targets as potential therapeutics. As this field is likely to have a major impact in medical science, educating future physi ...[more]

PMID: 21103946

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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.

Project description:BACKGROUND:Vaccination rates against Human Papillomavirus (HPV) in the US remain alarmingly low. Physicians can significantly influence a parent's decision to vaccinate their children. However, medical education often lacks training on specific strategies for communicating with vaccine hesitant parents. METHODS:We created an innovative curriculum designed to teach medical students how to address HPV vaccine hesitancy. The curriculum consisted of (1) a presentation on the epidemiology, biology, and disease morbidity associated with HPV, (2) a video that teaches specific communication strategies and (3) role-playing simulations. This curriculum was delivered to medical students at two separate sites. Medical students were surveyed before and after completing the educational curriculum. The surveys assessed student comfort talking to HPV vaccine hesitant parents and their likelihood to recommend the HPV vaccine. RESULTS:Pre- and post-intervention surveys were completed by 101 of the 132 participants (77% response rate). After the intervention, student awareness of the benefits of the HPV vaccine increased by a mean of 0.82 points (Likert scale 1-5, p?<?0.01) and student comfort talking to vaccine hesitant parents increased by a mean of 1.37 points (p?<?0.01). Prior to the intervention, students more strongly recommended the HPV vaccine to females compared to males, but this gender disparity was eliminated after the intervention (p?<?0.01). Personal vaccination status was independately associated with a higher likelihood of recommending the HPV vaccine both before and after the intervention. CONCLUSION:Our innovative curriculum improved medical student comfort level discussing HPV vaccination with hesitant parents and increased the perceived likelihood of recommending HPV vaccination. The intervention is easy to implement, scalable, and requires minimal resources. Educating future providers on this important topic has the potential to improve vaccination rates nationwide and thus should be considered for all medical students.

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.

Project description:Effective healthcare disparities curricula seek to train physicians who are well equipped to address the health needs of an increasingly diverse society. Current literature on healthcare disparities curricula and implementation focuses on courses created independent of existing educational materials. Our aim was to develop and implement a novel resource-conserving healthcare disparities curriculum to enhance existing medical school lectures without the need for additional lectures. This non-randomized intervention was conducted at the University of California Los Angeles. The curriculum was offered to all first-year medical students in the class of 2021 (n=188). With institutional approval, a new healthcare disparities curriculum was created based on the Society of General Internal Medicine's core learning objectives for effective healthcare disparities curricula (J General Internal Med 25:S160-163, 2010). Implementation of the curriculum made use of "teachable moments" within existing medical school lectures. Teachable moments were broad lecture topics identified by the research team as suitable for introducing relevant healthcare disparities content. The new lecture-enhancing healthcare disparities curriculum was delivered with the related lecture via integrated PDF documents uploaded to an online learning management system. Students were encouraged to complete pre- and post- course assessments to examine changes in disparities knowledge and self-rated confidence in addressing disparities. Matched χ2 tests were used for statistical analysis. Participating students (n=92) completed both pre- and post-course assessments and were retrospectively stratified, based on self-reported use of the new lecture enhancing curriculum, into the "high utilizer" group (use of materials "sometimes" or "very often," n=52) and the comparison "low utilizer" group (use of the materials "rarely" or "very rarely," n=40). Students who self-identified as underrepresented racial and ethnic minorities in medicine were more likely to utilize the material (41% of the high utilizers vs. 17% of the low utilizer group, p<.01). Post-course knowledge assessment scores and self-reported confidence in addressing healthcare disparities improved only in the high utilizer group. Integrating new guideline based curricula content simultaneously into pre-existing lectures by identifying and harnessing teachable moments may be an effective and resource-conserving strategy for enhancing healthcare disparities education among first year medical students.

Dataset Information

Neuroimmune pharmacology as a sub-discipline of medical neuroscience in the medical school curriculum.

Publications

Neuroimmune pharmacology as a sub-discipline of medical neuroscience in the medical school curriculum.

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