MSE Articles

This issue of the Medical Educator’s Resource Guide introduces us to websites concerned with embryology, the inner ear, radiology and eponyms.

Besides providing mini lessons on several aspects of embryological development, the developer of Human Embryology Animations, Dr. Valerie O’Loughlin, uses pre- and posts-tests to measure learning and a survey to evaluate the effectiveness of the instructional content and the animations used in the lessons. Participation in the practice tests, the post-tests and the survey is entirely anonymous and not required by the author.

It should be noted that the use of Lieberman’s eRadiology is strictly limited by the terms and conditions set forth by the author. The restrictions serve as a reminder that a website cannot always be used freely even when the user only wishes to use the site or some aspect of the site for educational purposes.

The intent of Who Named It? is to provide background information on the men and women in science and medicine for which diseases, anatomical structures, tests and so on are named. Thus far, the website reports having over eight thousand eponyms, and with time, the number of entries is expected to nearly double.

The Association of Medical Schools Microbiology and Immunology Chairs (AMSMIC) sponsor the Microbiology & Immunology Educational Strategies Workshop on a biennial schedule. At the 7^th meeting held in 1998, a session was devoted to core learning objectives for teaching medical microbiology (separate objectives for fundamental/basic microbiology and pathogenesis/infectious diseases) and immunology/host defenses. These were interactive sessions lead by medical microbiology and immunology course directors. As a starting point, learning objectives discussed were an amalgam of objectives that were currently in use at several medical schools. Attendees at each of the three sessions could suggest additional objectives. No objectives were deleted. To prioritize the objectives, a show of hands was used to rank the objectives with respect to trivial (no need to include in curriculum), important (include if there is time), or essential knowledge. Although not widely disseminated, these served as guidelines for course directors until the 2006 biennial meeting. At that meeting, there were formal sessions to revisit core objective development, using the same format as utilized at the 1998 meeting. During the panel discussion following the breakout sessions, it was quickly realized that the “show of hands” method for prioritizing was slow and inaccurate. It was therefore proposed to develop a collaborative web site based upon the wiki¹ format. The web site was developed by the Division of Information Technology at Creighton University. At the 12^th biennial meeting held in May, 2008, additional formal sessions were held to finalize the procedures for ranking the core objectives. Attendees of the 11^th & 12^th workshops have been provided passwords to allow them to edit and/or rank the posted objectives. At this writing, on-line ranking and editing of the objectives is in progress. The consensus of the attendees was that these core objectives should be used as a resource for course content and not an attempt to develop a national curriculum. Our intent is to review and update the learning objectives every two years. The learning objectives are available for viewing at http://mmi.creighton.edu/CoreObjectives/

REFERENCES

1.Wikipedia, http://en.wikipedia.org/wiki/Wiki Accessed 05/20/2008

ABSTRACT

Marshall University, JCESOM’s second-year medical students worked in teams to debate the validity and interpretation of clinical-pathologic findings in a “mock-medical malpractice trial” setting. This teaching format is based on the principles of teamwork and critical thinking. Student feedback on this approach to clinical case-based teaching was overwhelmingly positive.

ABSTRACT

Small group learning involves pre-clinical students solving problems that potentially integrate basic medical science and clinically related correlates. However, a disruptive learner detracts and undermines the effective learning group process, necessitating the content or non-content expert facilitator to guide, challenge, offer feedback, and intervene when the process falters.

ABSTRACT

A medical school course on biostatistics and epidemiology can be effective and popular, as long as the concepts and applications needed by medical students are carefully addressed – and illustrated by vivid, clinically-relevant examples and demonstrations. The authors present their approach to teaching, and some specific techniques and teaching tips, based on more than two decades worth of experience during which they have developed a course praised by the students for clinical relevance.

ABSTRACT

At the Leiden University Medical Center in the Netherlands, laptop computers were introduced in medical education starting September 2000. This introduction was performed bottom-up (at student level) at a time when the educational program and individual faculty members were not prepared for this innovation. In this article the authors studied the changes in student use and perceptions of laptop computers in the period 2001-2005. They found that faculty had to adapt their teaching styles and educational programs before the laptops could be used most efficiently. Also students needed some time to discover the benefits of the laptop. Currently, the use of laptop computers is well integrated into teaching and learning.

ABSTRACT

Technology is increasingly used in medical education. This study describes student and faculty attitudes toward and use of tablet PCs, electronic textbooks, and video podcasts in a technology-enhanced integrated curriculum.

A survey concerning the use of technology was collected at the end of each semester for the graduating class of 2010. Faculty completed a technology survey at the middle and end of the second year. Analyses consisted of descriptive statistics and proportional analyses were used to determine significant differences.

Most students took lecture notes directly on the table PC with less than 3% using paper and pencil. The use of specialized note taking software dropped over time from 73% to 51%, while the use of Microsoft Word increased from 5% to 16%. Students that wrote notes directly on the tablet PC remained relatively constant, while those that typed increased from 38% to 60%. Podcasting of lectures was popular, but lecture attendance dropped over time. While student preference for electronic textbooks increased over time, most students would buy print or a combination of print and electronic textbooks. Most faculty reported that having computers in learning activities enhanced the learning process and indicated that the electronic textbooks were easy to integrate into their learning activities.

Students and faculty were generally satisfied with the technologies and the student use of the technologies changed over time. If technology can enhance the learning environment, then we should embrace it because our students have.

Welcome to JIAMSE Volume 19-1

Hello everyone! This is the first issue of a four issue year. At the 12th annual meeting in Salt Lake City, it was decided to expand the Journal to four issues per year and include all types of publications in the volume, rather than separating according to Supplement material and regular volume publications. This will facilitate the documentation of your publications for your educator portfolios.

Volume 19-1 has a Letter to the Editor with a possible solution to the two Medical Education Cases Studies we have published earlier, two new innovations, four research articles, and a new Medical Education Case Study that will interest you. Let me remind you that “solutions” or your opinions on the Medical Education Case Studies can be sent to us, as Letters to the Editor, and will be peer reviewed. They count as a documentable publication. Let me also remind you to look toward your own teaching program and determine whether there is something innovative, successful, and perhaps unique to what you do and that might be of value to someone else who is teaching or even starting out in the education field. Such material can be written up and submitted to JIAMSE in one of our many possible formats for publication (see the website: www.iamse.org). With four volumes per year, the turnaround times will be relatively short and also, as always, our editorial policy is very user-friendly. I look forward to receiving your contributions.

All best,

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

I have read two of the medical cases in recent issues of JIAMSE which deal with examination question “security”. Our experience at the University of Louisville, School of Medicine bears on this case.

For years our course in Medical Microbiology and Immunology released the examinations to the medical students. After many years, it became difficult to come up with new, relevant questions. Even in a dynamic field such as ours, it becomes hard to ask a question in new, valid ways. We would keep stems and change answers, or change stems for same answers. Anyway, this all became moot, when our school went to Block Testing. We run classes for five semester weeks, give the students four days free, and test them all day Friday of the sixth week on all the subjects presented in the five weeks (Streips, et al. JIAMSE, 2006, 16:10-18). The questions are scrambled and presented in 6 sections of 50 questions each. The test is carefully assembled, proofread, validated, integrated, and made as close to NBME type question sets, as possible. The test is also sequestered. Once they take it, the section is removed and the students don’t see the test again until review. The test is only revealed with answers in a review session, where they can’t take notes but can challenge questions. This allows them to discuss questions with peers and learn in that way, as well. However, with 300 questions it is impossible for them to pass on this test to next year students, aside from a question or two. We have a bank of questions which obviates this method as well. We have had no changes in success rates for questions in question analysis as long as we have done the examination process this way.

I feel we have the best of both worlds and the best answer for the cases proposed in the Journal. The students “see” the questions after taking the test, can discuss and learn, challenge answers, but cannot pass the question on to later classes. That way there is no copy of the exam floating around, which would be accessible to some people but not others. Also, students cannot study from our question set for the exams, but must study the material as they would for the USMLE Step 1.

ABSTRACT

This innovation is related to the integration of radiology sessions into a first-year basic science anatomy course. The authors used a Picture Archiving and Communication System (PACS) to provide computerized tomography (CT) radiology images that enhanced visual learning in anatomy and provided an interactive exchange among faculties and students.

Student achievement in first year basic science courses is commonly measured with multiple choice examinations to assess knowledge acquisition. Measuring growth/achievement in “doctoring courses” is more challenging. The goals of our Patient Centered Medicine (PCM I) course include developing effective patient-doctor communication skills, learning to work as members of multi-disciplinary health care teams, and demonstrating knowledge of ethics, cultural competency, and medical economics. Course instruction includes large group activities (lectures, films, patient interviews), faculty facilitated small group activities (discussions and standardized patient encounters), and individual self-directed learning (readings, journal writing.) Faculty facilitators evaluate students weekly in small groups; an end-of-year OSCE evaluates communication skills. To assess the broader array of course competencies, we implemented a creative final course evaluation that is enjoyable for both students and faculty.

Each spring toward the end of PCM I, students collaborate in their small groups (10 -11 students) to select a health care system problem and potential solution, and to develop a 10 minute creative presentation (skit, song, poem, dance), to present to the whole class. Over the past two years, topics/themes have included improving the quality and safety of health care, complementary/alternative/integrative medicine, culturally competent care, ethical challenges in health care, and interfacing spirituality, religion, faith, and medicine. Faculty rate the presentations (2 = Excellent, 1 = Good, 0 = Fair/Poor) on the extent that acquisition of the course competencies is demonstrated, on evidence of working collaboratively, and on overall creativity.

Student evaluations of the final exercise have been overwhelmingly positive. Students enjoy the change of pace, collaborating with classmates, engaging in the project, and the satisfaction of having produced a good quality final presentation. Negative comments related to the project taking more time than expected, and to the difficulty in getting the group together for planning. Although there was some resistance in year one, the exercise now appears to be part of school “culture,” an expectation for the end of PCM I and the M1 year. Faculty report that watching the performances is enjoyable, and an effective way for students to demonstrate growth and achievement in the Patient Centered Medicine course.

ABSTRACT

This case highlights the challenges both faculty and entering medical students face when faith-based practices collide with schedules. Specifically in this case, the faculty member ponders the balance between accommodation and avocation for an entering Muslim student attempting to maintain all religious holidays, fasts and prayer five times/day.