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disparities, and oral presentation skills. The participating students reported that faculty worked effectively with the groups. They reported that instructors cared that students learned, focused on course objectives, and provided useful feedback. The programme was described by participants as well organised and helpful in increasing student understanding of research and health care disparities. Correspondence : Brian Mavis PhD, Office of Medical Education Research and Development, A 202 East Fee Hall, Michigan State University, East Lansing, Michigan 48824, USA. Tel: 00 1 517 353 2037; Fax: 00 1 517 432 1798; E-mail:
[email protected]. doi: 10.1111/j.1365-2929.2004.02003.x
Oversight of medical education research Karen Szauter & Ann Frye
Context and setting Data for research in medical education may be obtained from a variety of sources. Many projects involve active interventions with learners. Information collected for other purposes (performance data, course or colleague evaluations) provides convenient ÔoutcomesÕ data for studies. As interest in medical education research increased at our institution, concerns about how data from the undergraduate medical curriculum were being collected and used began to surface. Why the idea was necessary Gathering information from students or using student data in research studies poses both practical and ethical questions. Is it appropriate to require students to do extra work in a class or clerkship as part of a study? When is it acceptable to use existing educational data for studies? Do course directors maintain ownership or control the use of data collected during their courses? How does the institution ensure that overlapping studies are not underway? A need to develop School of Medicine policies, and a system to manage educational research, became apparent. What was done The Curriculum Research Committee (CRC) was formed in 1995 to co-ordinate the collection of student data for a longitudinal project. In 2001, the responsibilities of the CRC evolved to include the oversight of all research that involved the use of data from educational programmes in the School of Medicine. Guidelines for how School of Medicine information could be used in studies were established by the Curriculum Committee, the faculty group charged with curriculum oversight and served to direct the practices of the CRC. The CRC is a working group of basic science faculty, clinical faculty and medical educators. It
reports directly to the School of Medicine Curriculum Committee. The group works independently from and parallel to the Institutional Review Board. At present, investigators wishing to include medical students or School of Medicine information in a study must submit a research proposal to the CRC. Between 3 and 5 CRC members review the proposal, evaluating both the quality of the study and the potential impact of the intervention or data use on the overall educational programme. If no major concerns are noted, the CRC makes a recommendation to the Curriculum Committee for approval of the project. The CRC also provides supportive feedback to the principal investigator, with suggestions for modifications in the study design or data collection methods if needed. Evaluation of results The CRC has provided feedback and recommendations on over 25 educational studies. Through its active role in the School of Medicine, the Committee has worked to limit the redundancy of studies, to ensure that the educational process is not interrupted unnecessarily for data collection, and to protect the use and anonymity of student data. Through individualised feedback to investigators, the CRC also serves a secondary function as a resource for faculty development in the design and implementation of educational studies. Correspondence : Karen Szauter MD, University of Texas Medical Branch, Standardised Patient Programme, Route 0420, Galveston, Texas 775550420, USA. Tel: 00 1 409 772 6318; Fax: 00 1 409 772 6301; E-mail:
[email protected]. doi: 10.1111/j.1365-2929.2004.02009.x
A rapid clerkship redesign to address new realities Adina Kalet, Mary Ann Hopkins & Thomas Riles
Context and setting To address the educational deficiencies created by the rapidly changing training environment and the impact of a school-wide mandate to reduce the clerkship from 10 to 8 weeks, we implemented a redesigned core surgery clerkship and conducted a pre ⁄ post evaluation after 1 year. Why the idea was needed The traditional clerkship model is no longer relevant to the rapidly changing health care environment. As a result, medical students were confused regarding their goals and roles and frustrated faculty members viewed students as poorly motivated. What was done In 2001, a team of surgery faculty and medical education experts conducted a systematic needs assessment, which served as our pre-test for
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really good stuff evaluating the planned curriculum reform. We identified the following flaws in the core surgery curriculum: 1 unclear structure and expectations; 2 poorly defined core clinical content and poor teaching of the clinical decision making process; 3 uneven quality of teaching, and 4 lack of outpatient exposure. To correct these deficiencies we first clearly defined objectives and expectations for students and teachers. We identified 25 topics as the basis of our core curriculum and designed asynchronous, web-based multimedia learning modules to replace lectures, allowing for increased teaching in the clinical setting and small group teaching time. Four skills lab sessions were designed to allow students to practise basic procedures. We implemented sessions on communication skills and ethics (e.g. informed consent and shared decision making). Criteria for student evaluations were made transparent and assessment of clinical skills and reasoning was instituted through use of an objective structured clinical examination in combination with an oral case discussion and written knowledge test. Systematic clinical teaching evaluations were collected on all surgery faculty and residents, personalised feedback given and faculty development and resident-as-teacher sessions were carried out using interactive experiential techniques. All students now have experience in outpatient surgery practices. Evaluation of results We conducted a pre ⁄ post evaluation of the new curriculum which consisted of student, resident and faculty focus groups and surveys, in-depth interviews with influence leaders, assessment of comprehensive clerkship evaluation data collected by the dean’s office, and student assessments and grades on standardised knowledge tests. There was no decline in standardised knowledge test scores. Students are exposed to a broader mix of cases and procedures, and the web-based modules and surgical skills labs are well received and are improving student preparation and enthusiasm for observing in the operating room. All students are learning in the ambulatory setting. In 1 year, the number of our students applying to a general surgery residency increased from 7 to 17 and preliminary qualitative feedback from students and surgery faculty indicate greater satisfaction with the clerkship. A rapid, multi-pronged effort to revamp the core surgery clerkship resulted in significant short-term
impact on student and faculty satisfaction, increased faculty enthusiasm for teaching, a potential positive impact on educational outcomes and has already increased student interest in surgical careers. Correspondence: Adina Kalet MD, Associate Professor, Department of Medicine, New York University School of Medicine, 550 First Avenue D401, New York, New York 10016, USA. Tel: 00 1 212 263 1137; Fax: 00 1 212 263 8234; E-mail:
[email protected]. doi: 10.1111/j.1365-2929.2004.01994.x
A PBL-based structured genetic curriculum Zohra I Nooruddin & Malila J Jaffery
Context and setting Ziauddin Medical University (ZMU) is an 8-year-old, private medical university. In Pakistan, most medical colleges follow the traditional subject-based curriculum. As a new institution, ZMU decided to introduce an integrated, communitybased curriculum, using problem-based learning (PBL) among its learning strategies, and replacing the traditional didactic lectures. Most of the courses consist of a mixture of lectures and PBL in various proportions. During an endeavour to promote selflearning, the idea to design a course entirely based on PBL was formulated. Why the idea was necessary Our previous experience with a hybrid instructional strategy of lectures plus PBL, combined with the feedback of graduating classes, encouraged us to move towards using PBL as the major learning strategy. The course on genetics was identified as the course with which to start this transition from a hybrid to a fully PBLbased programme because it spans the entire undergraduate curriculum. We would like our graduates to be able to integrate information between patients’ genetic risks for a disease and its environment, along with the ability to effectively consider the many ethical implications that this new medical knowledge presents. These issues could only be dealt with in a forum where the basic concepts are freely discussed and different views are generated. What was done The existing course objectives of genetics were reviewed by a group from Basic Health Sciences and clinical faculty. Based on the objectives, 19 clinical scenarios illustrating various mechanisms leading to genetic disorders were designed. These covered the general principles of genetics, including Mendelian inheritance, cytogenetics, gene mapping, molecular genetics, genetic engineering, quantitative genetics, population genetics and genetic counselling. These scenarios were integrated into the
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