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If You Build It, Will They Come? A Hard Lesson for Enthusiastic Medical Educators Developing a New Curriculum.

ABSTRACT: Background:Primary care forms a critical part of pediatricians' practices, yet the most effective ways to teach primary care during residency are not known. Objective:We established a new primary care curriculum based on Malcolm Knowles' theory of andragogy, with brief clinical content that is easily accessible and available in different formats. Methods:We used Kern's model to create a curriculum. In 2013, we implemented weekly e-mails with links to materials on our learning management system, including moderators' curricular content, resident-developed quizzes, and podcasts. After 3 years, we evaluated the curriculum with resident focus groups, retrospective pre-/post-resident surveys, faculty feedback, a review of materials accessed, and resident attendance. Results:From content analysis of focus groups we learned that residents found the curriculum beneficial, but it was not always possible to do the pre-work. The resident survey, with a response rate of 87% (71 of 82), showed that residents perceived improvement in 37 primary care clinical skills, with differences from 0.64 to 1.46 for scales 1-5 (P < .001 for all). Faculty feedback was positive regarding curriculum organization and structure, but patient care often precluded devoting time to discussing the curriculum. In other ways, our results were disappointing: 51% of residents did not access the curriculum materials, 51% did not open their e-mails, only 37% completed any of the quizzes, and they attended a weekly conference 46% of the time. Conclusions:Although residents accessed the curriculum less than expected, their self-assessments reflect perceptions of improvement in their clinical skills after implementation.

SUBMITTER: Nicklas D

PROVIDER: S-EPMC6919177 | biostudies-literature | 2019 Dec

REPOSITORIES: biostudies-literature

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If You Build It, Will They Come? A Hard Lesson for Enthusiastic Medical Educators Developing a New Curriculum.

Nicklas Daniel D Lane J Lindsey JL Hanson Janice L JL

Journal of graduate medical education 20191201 6

<h4>Background</h4>Primary care forms a critical part of pediatricians' practices, yet the most effective ways to teach primary care during residency are not known.<h4>Objective</h4>We established a new primary care curriculum based on Malcolm Knowles' theory of andragogy, with brief clinical content that is easily accessible and available in different formats.<h4>Methods</h4>We used Kern's model to create a curriculum. In 2013, we implemented weekly e-mails with links to materials on our learni ...[more]

PMID: 31871570

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Project description:BackgroundAquatic ecosystems are greatly altered by urban development, including the complete loss of natural habitat due to water diversions or channel burial. However, novel freshwater habitats also are created in cities, such as effluent-dependent streams that rely on treated wastewater for flow. It is unclear how diverse these novel ecosystems are, or how quickly aquatic species are able to colonize them. In this study, we (1) quantify odonate (Insecta, Odonata) colonization of a novel effluent-dependent river reach, (2) examine how drying events affect odonates in these novel habitats, and (3) explore whether effluent-dependent streams can support diverse odonate assemblages.MethodsWe conducted monthly odonate surveys at three sites along the Santa Cruz River (Tucson, AZ, USA) between June 2019 and May 2020. One site was in a long-established effluent-dependent reach (flowing since the 1970s) that served as a reference site and two sites were in a newly-established reach that began flowing on June 24, 2019 (it was previously dry). We compared odonate species richness, assemblage composition, and colonization patterns across these reaches, and examined how these factors responded to flow cessation events in the new reach.ResultsSeven odonate species were observed at the study sites in the new reach within hours of flow initiation, and species rapidly continued to arrive thereafter. Within 3 months, species richness and assemblage composition of adult odonates were indistinguishable in the new and reference reaches. However, drying events resulted in short-term and chronic reductions in species richness at one of the sites. Across all three sites, we found over 50 odonate species, which represent nearly 40% of species known from the state of Arizona.DiscussionOdonates were surprisingly diverse in the effluent-dependent Santa Cruz River and rapidly colonized a newly established reach. Richness levels remained high at study sites that did not experience drying events. These results suggest that consistent discharge of high-quality effluent into dry streambeds can be an important tool for promoting urban biodiversity. However, it remains to be seen how quickly and effectively less vagile taxa (e.g., mayflies, caddisflies) can colonize novel reaches. Effluent-dependent urban streams will always be highly managed systems, but collaboration between ecologists and urban planners could help to maximize aquatic biodiversity while still achieving goals of public safety and urban development.

Project description:BackgroundHigh infant and maternal mortality rates are one of the biggest health issues in Pakistan. Although these rates are given high priority at the national level (Millennium Development Goals 4 and 5, respectively), there has been no significant decrease in them so far. We hypothesize that this lack of success is because the undergraduate curriculum in Pakistan does not match local needs. Currently, the Pakistani medical curriculum deals with issues in maternal and child morbidity and mortality according to Western textbooks. Moreover, these are taught disjointedly through various departments. We undertook curriculum revision to sensitize medical students to maternal and infant mortality issues important in the Pakistani context and educate them about ways to reduce the same through an integrated teaching approach.MethodsThe major determinants of infant mortality in underdeveloped countries were identified through a literature review covering international research produced over the last 10 years and the Pakistan Demographic Health Survey 2006-07. An interdisciplinary maternal and child health module team was created by the Medical Education Department at Shifa College of Medicine. The curriculum was developed based on the role of identified determinants in infant and maternal mortality. It was delivered by an integrated team without any subject boundaries. Students' knowledge, skills, and attitudes were assessed by multiple modalities and the module itself by student feedback using questionnaires and focus group discussions.ResultsAssessment and feedback demonstrated that the students had developed a thorough understanding of the complexity of factors that contribute to infant mortality. Students also demonstrated knowledge and skill in counseling, antenatal care, and care of newborns and infants.ConclusionsA carefully designed integrated curriculum can help sensitize undergraduate medical students and equip them to identify and address complex issues related to maternal and infant mortality in underdeveloped countries.

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.

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If You Build It, Will They Come? A Hard Lesson for Enthusiastic Medical Educators Developing a New Curriculum.

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If You Build It, Will They Come? A Hard Lesson for Enthusiastic Medical Educators Developing a New Curriculum.

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