Abstracts on General Education

The following abstracts have been accepted for presentation at this meeting in Poster format in the category of General Education.  Those selected for Oral Poster Presentations are so designated in the far right column.
 
 

G1	A COCHRANE-MODEL COLLABORATION: EDUCATION, PRACTICE, AND BEST EVIDENCE FOR THE COLLEGE OF VETERINARY MEDICINE, WESTERN UNIVERSITY, AND BANFIELD THE PET HOSPITAL James F. Amend, DVM, Ph.D.*, Hugh B. Lewis, BVMS, MRCVS, DACVP, Billy E. Hooper, DVM, Ph.D., DACVP, Robert V. Mason, DVM, and Shirley D. Johnston, DVM, Ph.D., DACVT, College of Veterinary Medicine, Western University of Health Sciences, Pomona, California 91766, and Banfield the Pet Hospital, Portland, OR 97220 U.S.A. The College of Veterinary Medicine (CVM), Western University of Health Sciences, the first new American veterinary college to be founded in over twenty years, opened in August, 2003. The CVM bases its clinical teaching program upon strategic alliances with public and private practice partners. Banfield the Pet Hospital (Banfield) is now the largest private veterinary practice in the United States, with more than 360 hospitals, and recently opened its first international hospitals in England. The CVM and Banfield are both committed to best-evidence veterinary medicine in education and practice (Cockcroft and Holmes, 2003). Activities of the two groups intersect with an agreement in which Banfield will support a ‘wellness’ clinical teaching facility at the CVM, and several remote private hospital teaching sites. Both groups approach the assembly and integration of this joint program using principles of review promoted by the Cochrane Collaboration, a methodology now widely used in best-evidence human medicine. Together, the partners will develop a Web-accessible database of evidence-base diagnostic and treatment protocols, for teaching and practice. The extensive network of Banfield hospitals will support collaborative, clinically-based research to determine and refine such best-evidence protocols. The program will support student education and experience, and promote faculty development as CVM faculty participate in protocol evaluation and application. This presentation traces the plan and design for program development that integrates best-evidence educational practices of the CVM with best-evidence veterinary medical practices as defined by Banfield. The authors hope that discussion of concepts and details of the best-evidence program design will be informative in the IAMSE forum.
G2	EFFECT OF GROUP SIZE ON PBL QUIZ SCORES Gregory K. Asimakis* and Jeffrey P. Rabek, The University of Texas Medical Branch, Galveston, TX 77555 U.S.A. Freshmen medical students participate in an 8-week multidisciplinary, multimodality course "Molecules, Cells, and Tissues". The course includes three, 2-hour PBL sessions per week in 24 groups consisting of 8 or 9 students and one faculty facilitator. Students are assigned randomly to the groups. The PBL cases introduce clinical scenarios, from which the students discuss relevant basic science issues while developing mental models that aid understanding and retention of knowledge. In 2000, we piloted a PBL group, team learning exercise, which consisted of an open-resource, open-discussion quiz (usually 4 multiple choice questions) administered in the last hour of each PBL week. Quiz questions were designed to be difficult and somewhat ambiguous in order to stimulate in depth discussions and teamwork, as well as to test the students’ ability to seek, apply and integrate basic science and clinical information. Faculty facilitators had no prior knowledge of the quiz content and were instructed not to interact during the quiz. Quizzes were graded on an individual basis, so each student was not bound to a group consensus. The average of all quizzes contributed 10% to the student’s grade. Because the faculty and students perceived the PBL quiz to be a highly effective learning tool, the exercise has been included in the PBL portion of the course in each subsequent year. We observed, however, a progressive decline in the average PBL quiz grades (mean + std) from 2000 (91.1 + 4.2) to 2002 (85.7+ 4.2). This decline in PBL quiz grades was most likely due to increasing difficulty of the quizzes as the faculty became more comfortable with writing these types of questions. We emphasize to the students that due to a limited amount of time (one hour) and virtually unlimited resources, the probability of answering the quiz questions correctly is increased when ALL students in the group contribute to the process. Consequently, we were curious if PBL groups with 9 students perform better on the quizzes than groups with 8 students. In 2000, the PBL quiz averages (+ std) for students in 9-member and 8-member groups were 91.3 + 4.3 (n=117) and 90.8 + 4.0 (n=87), respectively (p<ns). In 2001, the PBL quiz averages for students in 9-member and 8-member groups were 90.1 + 4.9 (n=142) and 87.9 + 5.2 (n=64), respectively (p<0.05). In 2002, the PBL quiz averages (+ std) for students in 9-member and 8-member groups were 87.4 + 7.0 (n=108) and 83.7 + 6.3 (n=96), respectively (p<0.001). Collectively, for 2000; 2001; and 2002, the PBL quiz averages (+ std) for students in 9-member and 8-member groups were 89.7 + 5.7 (n=367) and 87.3 + 6.1 (n=247), respectively (p<0.001). We conclude that an additional member in the PBL group improves the likelihood that the students will identify the correct answers on the PBL quiz.
G3	ADAPTATION OF A MEDICAL IMMUNOLOGY COURSE FROM A TRADITIONAL TO A CLINICAL PRESENTATIONS CURRICULUM: SUCCESSES AND CHALLENGES Bonnie Buxton, Ph.D., Department of Microbiology, University of Health Sciences, Kansas City, MO 64106 U.S.A. Curriculum change has become the norm rather than the exception in American medical schools. Many schools are moving away from discipline-based education and adopting a more integrated curriculum model. In these models, basic science is taught as it relates directly to clinical medicine. This adaptation can be difficult for faculty who fear losing continuity of their discipline and/or are uncomfortable with the perception of having to mold basic material into a clinically relevant format. The University of Health Sciences adopted a Clinical Presentations Model for curriculum delivery in 2000. In this model, all material is delivered as it relates to the way patients present with illnesses. Finding a way to teach basic medical immunology in this context was and continues to be a challenging task. The immunology curriculum, taught over a two-year period, will be presented for the purpose of illustration and to initiate discussion with others involved in medical education.	ORAL
G4	CREATING A COMMUNICATION SKILLS PROGRAM FOR FIRST YEAR MEDICAL STUDENTS George P. Kolo, D.O, Cheryl Benge, Gautam J. Desai, D.O*, Depts of Family Medicine/Academic Affairs, The University of Health Sciences, Kansas City, MO 64106 U.S.A. Physician-patient communication training at the University of Health Sciences (UHS) College of Osteopathic Medicine had not been taught prior to 1997. The majority of patient concerns about their physicians relate not to their medical management, but the inability of the physician to communicate well with their patient. Better communication skills have been shown to improve the ability of physicians to diagnose their patients’ ailments, thereby improving patient care, which decreases the chances of a lawsuit against the physician, and improves the doctor-patient relationship. Prior to the creation of this program, our students’ performance in this realm was historically poor, based on feedback of preceptors. Realizing the need to incorporate medical communication skills into our curriculum, we obtained, a grant in order to initiate the program as a pilot study in 1997 for first year medical students. Our goal was to improve the ability of medical students to achieve rapport with patients and to become comfortable with the patient encounter, and ultimately to become better practicing physicians. Improved performance on communication skills training will likely improve performance on clerkships as well as the recently implemented clinical skills portion of the national board examination. A new course, Introduction to Core Communication Skills, was created in 1997 to achieve an enhanced level of medical communication skills performance and to begin to prepare for the national boards performance examination, which we had begun hearing about at that time. Below are some challenges and solutions we realized during this process. Challenge/solution Large class size/repeat learning activities in small groups  - Few full time faculty/use of community faculty/residents Objective evaluation/enhanced faculty training, checklists  - Training of Standardized patients/obtaining local thespians Case creation/adapting cases from actual patients  - Faculty involvement/staff realization of course’s importance The Introduction to Core Communication Skills course was successfully implemented as part of the curriculum. Feedback from learners, faculty and preceptors has been positive, and has served to increase interest in the Standardized Patient Program as well. Although the assessment tool for clerkships has changed, overall performance for the communication skills of our students has improved. Ongoing assessment of this program’s success includes evaluation of preceptor feedback following clerkships, and UHS student success on the first performance evaluation component of national boards this fall.
G5	OLD HABITS DIE HARD: IMPACT OF PRIOR LEARNING EXPERIENCES IN SCHOOL ON STUDENT-CENTERED LEARNING IN AN UNDERGRADUATE MEDICAL COURSE Matthew Gwee, Ph.D.*, Tan Chay Hoon, Khoo Hoon Eng, Zubair Amin and Koh Dow Rhoon, Medical Education Unit, Faculty of Medicine, 10 Medical Drive, National University of Singapore SINGAPORE 117597 In 1999, our medical school implemented a hybrid problem-based learning (PBL) curriculum for our year I and II students as part of our overall undergraduate curriculum reform strategy. A primary aim is to enhance student-centered learning (SCL) for the development and acquisition of self-directed learning (SDL) skills as a foundation for lifelong continuing self-education. At the beginning of each academic year, PBL workshops are conducted for each new cohort of students to explain the PBL process and to provide the opportunity for hands-on practice sessions. Implementing PBL required a corresponding reduction (withdrawal) in the number of lectures, especially in the areas where PBL cases are deemed to provide adequate learning for the intended curriculum outcomes. At informal feedback sessions students showed symptoms of agitation and discomfort: they expressed concern over their perception that they are ‘not learning and knowing enough details’ although, in our PBL practice, the case writer (usually a senior clinician) reviews the case with all students in a third session. A recent student-initiated survey confirmed the concerns of students: 82% of students (n = 387) responded that PBL should not be the core mode of teaching, and 78% further indicated that PBL should not replace lectures no matter how well PBL tutorials are conducted. Although our medical students generally represent the academic cream of the university student population in Singapore, they still appear to display a high dependency state on and, therefore, an apparent addiction to lectures delivered by individual teachers for their learning needs. The apparent mismatch in the acceptance of the problem-first self-directed learning approach used in PBL and the content-first teacher-directed learning in schools can be attributed to the conditioned student mindsets and attitudes to learning developed over 12 years of prior learning experiences in school. The same phenomenon has also been implicated in explaining the mismatch between the expected outcomes from and actual outcome measures of PBL. Thus, when designing SCL strategies, undergraduate medical schools which admit school leavers directly into their medical course should be fully cognizant of and make appropriate adjustments for the pervading influence and impact of the prior learning experiences of their students when in school.	ORAL
G6	RESULTS OF LASSI IN STUDENTS WITH A POOR ACADEMIC PERFORMANCE OR RISK OF ABANDON MEDICAL STUDIES. Hernández M., Castañeda A., Farfan A., Gómez-Acevedo C., Montemayor G., Pinzón-Estrada E., López-Cabrera M*, Unit of educational programs for enforcement of the medical studies, Faculty of Medicine, National Autonomous University of Mexico, 04510, Mexico City MEXICO The School of Medicine of National Autonomous University of Mexico, as a response to the increase in the number of students with a poor academic performance or at risk of abandoning medical studies, created the Program for the Strengthening Medical Studies in 2002. As part of this program, the School of Medicine established the Program of Attention to Regularized Students (PAAR). The objective of this Program is to increase the terminal efficiency at the School by means of the control and evaluation of students with poor academic performance. The Program supports the students academically, vocationally, and emotionally, so that they can successfully pass their courses, as well as acquire the necessary skills to satisfactorily graduate from medical studies. In order to know the deficiencies of the students we applied the Learning and Studies Strategies Inventory (LASSI). It consists on 77 statements graded on a 5 component Likert scale, which are grouped in 10 different categories, as follows: attitude, motivation, use of time, anxiety, concentration, processing of information, selection of main ideas, learning strategies, self regulation and exam preparation. Each category is defined as strength if more than 75% of the highest value is achieved, as regular if the percentage is between 55 and 75%, and as weakness if the value lies below 50%. 227 of the students (70.72%) that had poor academic performance, determined by the failure one of the courses that conform the first year of their studies (Anatomy, Embryology, Histology, Biochemical and Molecular Biology, Public Health and Medical Psychology). The results show weakness in attitude, exam preparation and concentration categories. The categories valued as strength were selection of main ideas and learning strategies. Also in a brief questionnaire students assign as a possible cause of their failure they did not know how to study and the schedule of courses assigned.	ORAL
G7	FACULTY FOLLOW UP IN A HIGH ACADEMIC DEMAND PROGRAM AT THE SCHOOL OF MEDICINE IN THE NATIONAL UNIVERSITY OF MEXICO. Castañeda A., Mújica M.L., Hernández-Quiroz M., Pinzón-Estrada E. and López-Cabrera M*, Unit of educational programs for enforcement of the medical studies, Faculty of Medicine, National Autonomous University of Mexico (UNAM) 04510, Mexico City MEXICO The Educational Quality Nuclei Program (NUCE), which began during 1992 at the School of Medicine, UNAM, as a response to the High Academic Demand Program (PAEA), is a program oriented to create special working conditions that achieve the highest quality of medical education by means of the community’s commitment and effort. To accomplish the objectives and goals of the program it is necessary to maintain a close follow up of the faculty. This improves the performance of the teaching-learning process considerably, allowing a high sense of responsibility in everyone involved. It is procured that the NUCE faculty has the following profile: be a professor of biomedical sciences, preferably in the medical area, have a postgraduate degree in the subject imparted, be a full time teacher, have a minimum teaching experience of three years, participate actively in research, have given proof of irreproachable professional conduct and ethics, show interest, availability and commitment to the program. Currently, the faculty for first and second grades is appointed by the chief of each Department, based on previously established criteria. We made a follow up of our faculty permanency in the program in the first and second grades through 12 years, showing that 77.9 % had 1-4, 12.2 % had 5-8 and 9.88 had more than 9 years teaching. Also obtain a = 81.94 in the evaluation of the academic skills in their classroom made by the Medical Education Secretary of the Medical School. The results showed that professors that have spent more time within the program (more than 8 years) have better results in their academic skills than ones with less than 7 years.
G8	PREPARING A MANUSCRIPT FOR SUBMISSION TO THE JOURNAL OF THE INTERNATIONAL ASSOCIATION OF MEDICAL SCIENCE EDUCATORS (JIAMSE) David L. McWhorter Ph.D.*, Jean-François Bertholon, M.D., Ph.D., David L. Bolender, Ph.D., Jennifer Brueckner, Ph.D., John R. Cotter, Ph.D., Carlos A. Feldstein, Ph.D., E. Pat Finnerty, Ph.D., and Douglas J. Gould, Ph.D., JIAMSE Editorial Board The objective of this presentation is to address one of the primary reasons that manuscripts are rejected for publication in the Journal of the International Association of Medical Science Educators (JIAMSE), poor manuscript writing. One of the primary goals of the International Association of Medical Science Educators (IAMSE) annual meeting is to improve the way we teach medical science students. The information that IAMSE members share in their poster presentations represents cutting-edge medical education research. The impact of these presentations is limited if the results are not disseminated beyond the annual IAMSE meeting to a larger audience. It remains a goal of the JIAMSE Editorial Board to encourage IAMSE members to share their medical education research with the community of medical educators by publishing the results of their work in JIAMSE. The journal is the peer-reviewed, biannual (June and December) electronic journal of IAMSE that is published in three languages (i.e., English, French, and Spanish). JIAMSE publishes multiple types of medical education related contributions, including: original research manuscripts, reviews, editorials, opinion papers, and announcements. Submissions address a wide range of topics that are of interest to IAMSE members, such as the introduction, application, and success of new teaching methods.  In this presentation, conference participants will receive practical information on how to strengthen their medical education reports for publication in JIAMSE. Guidelines for each section of a medical education research manuscript will be addressed as well as key elements that JIAMSE editors use when reviewing a paper for publication. Miniature copies of the poster presentation will be distributed to interested meeting attendees at the poster site. Additionally, JIAMSE Editorial Board members will be available throughout the annual IAMSE meeting to answer individual questions.
G9	Pre-Medical Internship: Preparing for the Medical School Experience Dennis W. Mullins, Ph.D*, Jocelyne O.J. David, M.D., Katherine Meyer-Siegler, Ph.D, John H. Hull, M.D., Luana Mahone, Timothy J. Westmorland, Veterans Affairs Medical Center, Bay Pines, Florida 33744 U.S.A., Maria A. Nijenhuis, Universiteit Medisch Centrum Utrecht NETHERLANDS Pre-Medical Internship Year One: is designed for first year undergraduate college students pursing a career in medicine. Students applying for this program undergo a rigorous screening process, first by the college academic coordinator, then with the Medical Center Academic Coordinator and finally with the medical center mentor. Students are assigned to the Hospice Unit and are required to participate for two academic semesters, for a minimum of 12 hours per week. A daily journal and a scientific paper are required at the completion of the program. The purpose of this program is to introduce students into the end of life issues such as psychosocial, as well as palliative care. It provides the first opportunity for student exposure to appropriate bedside manner. Students are integrated into the daily operations of the clinical area to which they are assigned. Students meet with the coordinator monthly to review the journal, discuss their experience and provide guidance. Pre-Medical Internship Year Two: is designed for second year undergraduate college students pursing a career in medicine. Students accepted and successfully completing year one are considered for year two, however there is no guaranteed matriculation. The research scientist to whom the student will be assigned conducts a second screening process for the final concurrence. Again the students are required to participate for two academic semesters, for a minimum of 12 hours per week. A daily journal and a scientific paper are required at the completion of the program. Students meet with the coordinator monthly to review the journal, discuss their experience and provide guidance. Students are required to present their papers to the research staff. Several papers published in scientific journals have been co-authored by students participating in this program. Because of the unique design of the program, Universiteit Utrecht, The Netherlands, contacted the VAMC to include its medical students in this education program. To date, twenty Dutch medical students have completed this program as part of their first year medical school training. Pre-Medical Internship Year Three: is designed for the third year undergraduate college student that includes a prerequisite of anatomy and physiology and focuses on preparing the student for the entrance exam into medical school. Students accepted and successfully completing year two are considered for year three, again, there is no guaranteed matriculation. A final screening process is conducted with the final concurrence by the physician mentor, which the student will be assigned. Students are required to participate for two academic semesters, for a minimum of 12 hours per week. A daily journal and a scientific paper are required at the completion of the program. Students are assigned to Internal Medicine and rotate to various sub-specialties throughout the academic year along with residents and medical students. They participate in a full spectrum of inpatient clinical experience including teaching rounds and case presentations. Students meet with the coordinator monthly to review the journal, discuss their experience and provide Students are required to present their papers to the clinical staff.
G10	VISIONS, VALUES, AIMS AND GOALS: WAYS WITH WORDS? Matti Nikkola*, Klara Bolander, and Birgitta Gelius, (1)Department of Cell and Molecular Biology, 171 77, Karolinska Institutet, SWEDEN, (2)Dept of Learning, Informatics, Management and Ethics (LIME), 171 77, Karolinska Institutet, SWEDEN, (3) Current address: Astra-Zeneca Biotech Laboratory, 151 85 Södertälje SWEDEN Aims and goals are key concepts in education, defining context and content. Many successful teaching organizations even formulate visions, missions or value statements. In the beginning of a three-year departmental project, the teaching staff (PhD students and professors) at the department of Cell and Molecular Biology (CMB) were asked to state the educational vision and values of the Karolinska Institutet. Moreover, they were asked to give the operative definitions for aims and goals as used in our course plans. In this study, we wanted to see how teachers interpret the word "aims" in relation to the word "goals" in the context of education. As for the educational vision of the university, almost half of the 41 PhD students and 21 professors answered the question, all formulating different visions without any clear consensus. The answers ranged from "educating more and better physicians", to "critical thinking", often emphasizing the importance of a scientific basis. Approximately one third of the PhD students and professors answered the question on values, the spectrum of answers spanning from "ethical", "excellence", "scientific" and "professional" to "helping mankind". Surprisingly, one fourth of the professors reported that values are the same as visions. Approximately one fifth of the PhD students and professors defined "aims" as giving context, intention, direction or meaning. Two thirds of both PhD students and professors gave other, conceptually different definitions. The biggest difference between the two groups was in the definition of "goals", defined by 32% of PhD students and 19% of professors as specific contents, measurable knowledge, abilities or milestones in learning. 32% of PhD students and 24% of professors gave other, conceptually different definitions. 24% of PhD students and 33% of professors stated that aims and goals are indistinguishable. The results indicate that there is some confusion among teachers as to the definition and application of these key concepts, most likely impacting on the quality of our educational activities.
G11	EXAMINATION STRESS AND SALVARY CORTISOL James N. Pasley, Ph.D.,* and Judy E. Garrett, Ph.D., Department of Physiology & Biophysics, University of Arkansas for Medical Sciences, College of Medicine, Little Rock, AK 72205 U.S.A. Psychologic factors produce the same neuroendocrine response as other stressor agents (e.g., exercise or forced immobilization) consisting of elevated plasma ACTH and glucocorticoids. Glucocorticoids increase blood glucose level and increased blood glucose has been shown to improve cognitive function in humans. In this study, we examined the influence of examination stress on salivary cortisol levels in first year medical students enrolled in medical physiology. Non-invasive saliva samples were obtained from 15 volunteer classmates using salivettes (Sarstedt Inc., N.C.). Each salivette contains a cotton swab which is placed in the mouth between cheek and gum for 50 seconds. The cotton swabs are then removed and centrifuged to obtain the sample. Saliva samples were obtained (1) during a period when no exams were scheduled and (2) just prior to a major exam and (3) upon return from Spring Break. Salivary cortisol levels were measured by specific radioimmunoassay. Pre-examination salivary cortisol levels were greater (P<0.01) than when no examinations were scheduled. The data suggest that the stress of an imminent examination in a basic science course in medical school significantly elevates free cortisol levels. Students with above average scores on a previous exam tended to exhibit higher cortisol levels prior to the examination. No gender differences were noted. In conclusion, salivary cortisol levels are an excellent tool for investigating the effects of stress on examination performance.
G12	DEVELOPING QUALITY CRITERIA FOR DIGITAL HEALTH SCIENCES EDUCATIONAL RESOURCES Sebastian Uijtdehaage, PhD1, Sheila W. Chauvin, Ph.D2, Kevin Souza, M.S.3, Kathy Lovell, Ph.D.4, and Sara Kim, Ph.D.5 1UCLA School of Medicine, 2Louisiana State University Health Sciences Center, 3UCSF School of Medicine, 4Michigan State University College of Human Medicine, 5University of Washington School of Medicine U.S.A. Digital educational materials developed by health sciences faculty are rarely recognized in the promotion and tenure process. No broadly accepted peer review criteria exist for digital materials such as virtual cases, digital videos and image libraries. In 2003, a national Special Interest Group (SIG) was formed to (1) develop a set of draft peer review criteria for assessing the quality of digital teaching resources in medical education; and (2) help academic institutions adopt reliable and valid procedures to document educational scholarship involving digital teaching resources. The main peer review criteria include: (1) Accuracy of Content; (2) Significance; (3) Effectiveness; and (4) Ease of Use. This SIG has conducted a series of workshops across the country at the AAMC’s Regional Meetings of the Group on Educational Affairs to obtain input and consensus from medical educators on these criteria. Furthermore, the Health Education Assets Library (HEAL) is planning training workshops for peer reviewers to pilot these review criteria. This presentation will provide a progress report by the SIG on the development of peer review criteria. Furthermore, we will demonstrate how these criteria are operationalized in selected institutions.
G13	BASIC SCIENCES COURSES THAT FOSTER ACHIEVEMENT OF THE DEVELOPMENTAL TASKS OF YOUNGER ADULTS ALSO LIKELY HELP TO ACHIEVE ALL MEDICAL TRAINING OBJECTIVES Lon J. Van Winkle, Ph.D.* Department of Biochemistry, Midwestern University, Downers Grove, IL 60515 U.S.A. Medical schools formulate educational goals and objectives meant to be achieved by students after four years of training. One view is that successful completion of courses in the basic sciences contributes to accomplishment of some but not all of these goals. When, however, the educational activities in courses are designed to foster the personal and professional development of younger adult medical students, progress can be made towards each and every goal and objective of medical training. Using Erickson’s terminology (Van Winkle, 1989, Biochem. Ed. 17, 29-31), three conspicuous developmental tasks of younger adults are gaining or maintaining (1) their identity, (2) their capacity for intimacy, and (3) their ability for sustained generativity (here mainly productivity and creativity). To foster such development we designed several educational activities in our regular biochemistry course series that together contribute about 35% to medical students’ final course grades. For example, students work in groups to generate case studies pertinent to didactic information presented in lectures. These cases are then used to demonstrate clinical relevance during lectures. In addition, each exam unit ends with a clinical correlation lecture in which faculty members integrate lecture information pertinent to cases developed by student groups. This group work, as well as group work to solve other case problems, also fosters development of the capacity to work together intimately. Students further develop their identities by working independently to solve clinical problems. Like the group case studies, these problems require students to read the pertinent medical literature. After developing consensus answers to the problems in their groups, students submit a self assessment grade of their previously submitted answers. Since their self assessment both contributes to their final grade and is itself assessed by the faculty, most students gain confidence in their ability to evaluate themselves and make adjustments if necessary. Finally, by role playing patients in case studies, students also develop in each of the above three ways. When viewed as fostering the personal and professional growth of younger adults, the activities described above likely contribute to accomplishing all goals and objectives of medical training. For example, to accomplish the goal that our graduates will understand their place in the world of health care delivery teams and participate in/lead those teams, students need to advance in each of the above developmental tasks. In our view, exercises that foster such development in our biochemistry courses contribute to accomplishment of any goal requiring the development.	ORAL
G14	Problem-Based Learning Facilitation by Fourth-Year Medical Students Carol F. Whitfield, Ph.D.*, Department of Cellular and Molecular Physiology & Office of Medical Education, Penn State College of Medicine, Hershey, PA 17033 U.S.A. Problem-based learning (PBL) has become a widespread and accepted instructional method in medical education. In our first two years, it requires approximately 260 facilitators for the 16 small groups in each year. Due to these needs, we use residents and fellows as well as faculty. To prepare students for this teaching role in their residency training, I designed a one-month elective course. The purpose is to teach fourth-year students facilitation skills and the educational theories that underlie this type of active learning. Students who register for the course must be in good academic standing, have had good performance in PBL in their first two years, and get formal recommendation from a faculty member who can assess their skills. Course requirements include a training session, reading assignments in the areas of cognition, constructivism and PBL processes, and a 10-page paper describing how educational theories for learning are applied in PBL. Once accepted into the course, the students independently facilitate PBL groups in MSI and MSII courses. They meet once a week with the rotation director to discuss their experiences and receive feedback, to discuss performance of students in their PBL group and discuss the reading assignments. The final course grade is based on the written paper (80%) and student evaluations (20%). Student facilitators are evaluated by the eight students in their PBL group using the same instrument used for faculty facilitators. Their skills were assessed in each of 10 categories, on a five-point Likert scale. Papers are graded by two faculty members, using a predetermined scoring rubric. Fourteen students enrolled in the elective. Results from student evaluations are extremely positive. The average score for student facilitators so far, for all categories is 4.69; for faculty facilitators it is 4.43. Written comments by the PBL students are also very positive. Student facilitators seem to do best in guiding the group without excessive questioning or lecturing. The mean exam score for groups facilitated by MSIV students did not differ from that of groups facilitated by faculty. Evaluation of the elective by the student facilitators is also very positive. They uniformly enjoy the experience and feel it was valuable to them. They also thought it helped them review for USMLE II, and was a positive factor in their interviews for residency.