Welcome to issue 19-3 of the JIAMSE. As we have done all 2009, this issue again has a variety of contributions from articles to innovative ideas, and also a medical education case. I hope this provides some ideas for you to contribute articles of your own, or to include the ideas into your own curriculum. I strongly encourage you do educational research. There is a lot of satisfaction to be gained and also your work can provide a reason for you to attend the national meeting of IAMSE (New Orleans next year!). I have also found that the educational research I do translates directly into improving the medical course I run at my school and the curriculum of our school. So, the benefits are multitudinous. I look forward to hearing from you.
Uldis N. Streips, Ph.D.
This innovation addresses two major difficulties related to case-based small-group learning: (1) the faculty-intensive nature of small-group learning, and (2) the inconsistencies in experiences between groups. This paper describes a method used at the DeBusk College of Osteopathic Medicine (DCOM) to run 15 small groups simultaneously using PowerPoint and the TurningPoint audience response system.1 Technology… Read more »
Professional responsibility in medicine has been increasingly recognized as a key target for raising the quality of health care provided around the world. The Professional Responsibility in Medical Error and Transparency (PRMET) course, funded through the Center for Professionalism in Business and Society, was developed to facilitate the creation of safe and effective health care… Read more »
Clinical skills assessment exams using Standardized patients (SPs) are an established component of medical school education, including the current USLME Step 2 CS exam™. The authors have developed a novel method for conducting SP encounters using web-based chat technology (e.g. Google® chat). “Remote Live Standardized Patient” (RLSP) interviews are conducted entirely online. The interview requires… Read more »
Students have variable and sometimes multimodal learning preferences that include kinesthetic (i.e. hands-on or tactile) learning. Yet the pre-clerkship medical school curriculum does not emphasize kinesthetic learning of basic science, particularly content in modern genetics, cell biology, immunology, pharmacology and nutrition. A new instructional strategy to enhance kinesthetic learning of basic science is the Basic Science Learning Station. At the Learning Station, students experience weekly self-guided activities which include the physical manipulation of games, puzzles and conceptual models. The Learning Station modules provide opportunities for students to integrate basic science information, reinforce concepts presented in other formats (i.e. lecture or case-based), and provide motivation and enthusiasm for basic science learning. Furthermore, the Learning Station kinesthetic strategy provides a new curricular structure in which basic science faculty can design ways to help students integrate clinical and basic science content domains. Our students report they enjoyed the hands-on approach to learning.
The personal lives of medical students routinely continue in parallel with their academic endeavors, but at times they intersect with one another. Presented is the case of a medical student whose mother was diagnosed with metastatic breast cancer during his first clinical rotation. The student subsequently experienced both personal and academic difficulties. The case raises questions about when and how faculty and course directors should proceed when these situations arise.
Critics of the lecture methodology see it as an outmoded device for passive transfer of factual information. Defenders view it as critical, thought-provoking discourse. There is little data clearly supporting either view. Most significantly, the health professional student viewpoint is under-represented in the literature. We have, therefore, investigated the factors that motivate medical and dental students to attend non-compulsory lectures in the basic medical sciences. First year medical and dental students were asked to explain in writing why they attended lectures in a course in which the examinations are based entirely on a set of published notes. Thematic content analysis of the student responses was performed. Ten advantages to attending lectures emerged as dominant themes. These were reformatted as statements and arranged in a questionnaire asking students to indicate on a Likert scale the extent to which they agreed with each statement. The questionnaire was distributed to the new class of the following year. Most of the advantages were highly rated by the second class of students. Those that facilitate learning, e.g. providing focus or breadth, ranked higher than those that merely support learning (anxiety reduction). The advantage that ranked the lowest was time-efficiency, suggesting that students do not view the lecture as a particularly effective way to acquire factual information. We conclude that a substantial number of medical and dental students at McGill view lectures as a valuable multifaceted aid to learning.
This study was designed to assess whether a human patient simulator (SimMan®) improves long-term retention of autonomic pharmacology facts and principles. Twenty-six second year medical students were randomly assigned to either a facilitator-guided simulator (S)-aided or a traditional facilitator-guided paper (P)-aided small group clinical case discussion session. Scores on a pre-session quiz and on small group topic-related course examination questions were compared between the S and P groups. There were no statistically significant differences between the groups with respect to their performance on the pre-session quiz and course examination test items. The results obtained in this pilot study do not support our hypothesis that the use of a human patient simulator in case-based contexts enhances long-term retention of concepts and facts related to the pharmacology of the autonomic nervous system in comparison to traditional paper-based problem solving of the same case-based contexts.
An Autopsy Review Lab was introduced into a first-year medical student General Pathology course with the intention of providing an effective learning experience for the integration of General Pathology concepts in a clinicopathologic context by utilizing “real patient”-based cases. Four autopsy cases were selected to provide integration of basic principles of General Pathology (Neoplasia, Immunopathology, Cell Injury, Hemodynamic Disorders, Inflammation, Nutritional Pathology). Fixed organs for each case were displayed at separate stations; under faculty supervision, Pathology residents discussed the pathologic findings and their clinical relevance with small groups of students that rotated among the stations. Students critiqued the Autopsy Review Laboratory in required anonymous post-course evaluations. Scores on identical pre- and post-lab tests were compared by paired t-test analysis. Class performance on Autopsy Review Laboratory-related final examination questions was also analyzed.
The average score on the post-laboratory test was significantly higher than the pre-test (p<0001). On the final examination, the entire class (p=0.08) and the lowest quartile (p=0.05) of the class answered more Autopsy Review Laboratory-related questions correctly than unrelated questions. Students also favorably rated the Autopsy Review Laboratory for reinforcing concepts of General Pathology by application to real patients (4.18 out of a 5-point Likert score); for illustrating the value of an autopsy (4.12/5); and for encouraging autopsy requests when they care for patients in the future (3.93/5). Pathology faculty and residents observed that the exercise provided a valuable supervised teaching experience for resident training.
The Autopsy Review Laboratory provides medical students with an effective and enjoyable learning experience for clinicopathological correlation and integration of General Pathology concepts. In addition, the Autopsy Review Laboratory enhances student appreciation of the value of an autopsy and allows Pathology residents to cultivate their teaching skills in a supervised environment.
Academic curriculum subcommittees of the Association of Medical School Microbiology and Immunology Chairs (AMSMIC) have developed a series of core knowledge objectives for courses in medical microbiology and immunology. Detailed and specific objectives were created by separate subcommittees on Fundamental Microbiology, Host Defenses and Pathogenesis. The academic subcommittees consisted of meeting conferees and distinguished faculty that met at biennial meetings. In 2006 the faculty developed a practical wiki site for membership guidance and revision of the objective documents, allowing changes, contributions and corrections to the core objectives. The wiki afforded the identification of problematic areas and provided a process for ranking objectives, using a numerical rating scale, which provided quantifiable information. The wiki site greatly facilitated the evaluation of core knowledge objectives and was formulated into a condensed set of parameters listing specific academic areas of importance. The final documents contain core competency objectives and provide a format for academic medical microbiology and immunology departments on a national and international level.