MSE Articles

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Curriculum integration can also be accomplished in smaller steps.

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What do you do when faced with a student accusing another of cheating on a test?

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The growing interest in Complementary and Alternative Medicine (CAM) and the increasing incorporation of its modalities in the United States’ healthcare system have exposed a number of problems in the field. These include a shortage of qualified CAM providers, scarcity of evidence-based research, lack of trained scientists in the field, and the ubiquitous marketing of frequently uncontrolled CAM products. Thus, the development of a comprehensive and scientifically sound educational infrastructure has become a crucial initial step in redirecting these adverse trends.

With support from the NIH-sponsored curricular CAM initiative, faculty from the department of physiology and biophysics at Georgetown University developed a M.S. program in CAM in 2003. This unique, first of its kind, science-based graduate program offers a master’s degree (MS) in physiology with an emphasis on CAM. The CAM-MS degree in physiology is designed to enable students to critically assess various CAM modalities, apply scientific rigor, and carry out evidence-based CAM research. The curriculum includes core science courses and CAM-related classes. Additionally, in order to emphasize the application of academic knowledge and further strengthen problem-solving skills, the students complete an eight-week summer practicum in a professional CAM-related environment.

Here, we report on our innovative and interdisciplinary CAM graduate program where creative teaching is implemented by basic scientists and enhanced by the application of their disciplines in tandem with the clinical expertise of CAM practitioners in the community. Thus, the faculty in the Department of Physiology & Biophysics is developing emerging cross disciplinary areas of study and interest in order to prepare new generations of future physicians, health professionals, educators, and researchers capable of objectively assessing the safety and efficacy of various CAM modalities, and introducing scientific rigor to much needed research into the various aspects of CAM therapies.

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There is increasing recognition that experiences to help students integrate the basic sciences and clinical reasoning should be incorporated into the medical school curriculum. Many schools have adopted case study methods for this purpose in the pre-clinical years but the attempt at integration is often incomplete with failure to return to basic science after clerkships. The Medical Literature Curriculum was developed to integrate the curriculum throughout medical school by study of the medical literature as formal coursework. In the pre-clinical years, students read published case reports, while after clerkships, students read reports of clinical and translational research to return attention to the scientific basis of medicine. The program features guided independent study and large-group discussion with expert clinicians and basic scientists with the goal of modeling, from the first day of medical school, high-level clinical reasoning and the use of basic science knowledge in the discussion of clinical problems. The program has progressively grown as a feature of the required curriculum at our school. It has involved participation by faculty from nearly every clinical and basic science department and provides students with a strong message that reading the medical literature is an integral activity of the profession.

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Academic health centers that utilize a mission-based management system often employ metrics of faculty contributions to inform revenue distribution. These relative value unit (RVU) metrics generally omit the concept of value added to the education interaction by the faculty member’s preparation and redaction. These RVU-based systems tend to incentivize functions that are part of the revenue stream at the expense of critical functions such as service to the institution on committees. Such functions go under-supported handicapping the academic environment and educational enterprise at large. Unless carefully designed, RVU systems can undervalue and inhibit collaborative interdisciplinary teaching. A larger view of duty to teaching and to the institution is advocated.

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This study explores medical student attitudes on the effectiveness of Team-Based Learning (TBL) after completing their first year in a TBL curriculum. While individual attitudes toward many aspects of TBL varied, our data suggest that TBL is seen as an effective tool for use in supplementing medical education.

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In recent years, there has been an increased emphasis on interprofessional education (IPE) in universities that offer health professions programs. The body of knowledge about the importance of student participation in IPE is well developed. This descriptive narrative from a multidisciplinary college in the Midwest region of the United States explores the development of an IPE experience that includes medical, nursing and social work students. Benefits and barriers to implementation, as well as strategies for incorporating IPE experiences into curricula are described. The development of an IPE experience for health professional students may provide a unique solution to improving patient safety in the health care setting.

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Surgical skills training plays an important role in residency training. The training and development of technical skills have largely been confined to the operating room. Although most institutions in the West have implemented surgical skills training programs for surgical residents, few such programs exist in India. A basic surgical skills course was conducted for surgical residents in liaison with ETHICON Institute of Surgical Education. Sixteen students were enrolled in the course. The course consisted of a short lecture followed by hands on instruction and practice. The students were allowed to spend additional time practicing and refining the skills that were taught. The course was divided into six sessions: 1) overview of suture material, 2) handling of surgical instruments, 3) sutures and needles, 4) basic suturing techniques and 5) opening and closing of abdomen. The students were provided with the surgical instruments, suture material, knot tying board and a suturing pad to practice knot tying. A pre course versus post course survey of the students’ perceived self assessment score for all the skills combined rose from 2.97+0.6 to 3.96+0.3 (p value < 0.0001).The students thought the course was highly relevant to their current level of training (mean rating 4.8+0.5) and comfort levels performing the skills taught compared with before the course was markedly improved (4.5+0.6).

Since knowledge of surgical skills is becoming increasingly important, these results are presented to the curriculum committee to consider integrating the surgical skills course into the first year of postgraduate curriculum. The earlier in one’s career that proper suturing and knot tying technique is learned, the more opportunity there will be for practice and development of the speed, efficiency and precision that is characteristic of expert performers.

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At a time of financial austerity in training programmes in many parts of the world, it is important ensure that the training offered efficiently meets the needs, and where possible, the preferences of both trainees and the healthcare systems they are training within. The time available for educational activities in postgraduate medical education is limited, and it would be useful to those providing training programmes to know which educational activities are considered most important by the trainees and trainers, and to know if there is discordance between the two groups on this issue.

This paper reflects on the findings of a recent survey of the relative importance placed by cellular pathology trainees and trainers in Great Britain.

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Institutional Goals and Objectives define and inform the curriculum of medical schools. However, an understanding of the curriculum is not complete without understanding what specific educational experiences contribute to the learning and behaviors that the goals and objectives define. The University of Illinois College of Medicine has developed Curriculum Maps to determine the vertical and horizontal threads of learning that build knowledge for students beginning in the basic sciences, as foundational materials, and then build into the clinical curriculum, defining learning from matriculation to graduation. These foundations of knowledge are linked to the Graduation Competencies of the University of Illinois’ Institutional Goals and Objectives and are defined by the educational methods used to present the content and the evaluation methods employed to assess student learning. The process of developing Curriculum Maps, for a complex four-campus medical school, is described along with examples of each step.

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Problem-based learning (PBL) curricula for medical education present unique challenges for longitudinal disciplines such as pharmacology. The time and attention that is required to introduce students to fundamental principles of pharmacology may be overlooked in deference to other content learning goals that are taught in a more concentrated fashion. The solution chosen for the Western Reserve2 Curriculum was to create an online pharmacology supplement to the existing curriculum, in order to introduce pharmacology early in the curriculum and increase student pharmacology knowledge, engagement with the material, and self-efficacy in learning pharmacology topics. The process of choosing a method of delivery and obtaining buy-in from stakeholders, as well as details about the creation, integration, and implementation of this supplemental curriculum is described. Student participation was higher than expected, with positive initial feedback and significant learning gains for regular users. Important lessons in managing timelines and obtaining institutional approval for initiating a new supplemental curriculum are also discussed.

Welcome to the first issue of volume 20 of JIAMSE. As always, we have a variety of manuscripts to present to the reading public. I am sure everyone will find something to learn or apply in this issue. We, more than any other published journal, have papers which describe utilizable information that can be integrated into your curricula and courses. There is rarely an issue where there aren’t a couple of papers that I forward to people in my educational circle and often find emails thanking me for the information. I am sure many of you reading this issue are either doing or have in mind educational advances for your courses and curricula. These would be useful to everyone at IAMSE and beyond and we would be happy to consider them for publication. Send them to me and our review process is extremely user-friendly. I look forward to many submissions!

All best,

Uldis N. Streips, Ph.D.
Editor-in-Chief, JIAMSE