Medical Science Educator Volume 16: No. 1

Message from the Editor

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

I will be assuming the daunting position of Editor-in-Chief starting with the December issue of JIAMSE. Our current Editor-in-Chief, Douglas Gould has already done the yeoman work of putting our journal on strong footing with International recognition and a steady stream of high quality peer-reviewed papers on subjects most important to the International medical education community. He and our superb Editorial Board deserve all praise for what JIAMSE is today.

My first IAMSE meeting was in Chicago and I have been a steady contributor to the Basic Science Educator (predecessor of JIAMSE) and to JIAMSE over the years. Currently, I am a Professor of Microbiology and Immunology at the University of Louisville, School of Medicine, and I felt I was at a time in my career where I could take on this important job and devote the time and energy necessary to accomplish what I hope to achieve. When the call came out that Doug was stepping down from his position and IAMSE was looking for a successor, I never thought that I would get the job; I was shocked but pleased when it was offered. I accepted the offer with great enthusiasm, excitement, and strong intentions of building on what has been so ably started.

It is my goal to shepherd JIAMSE to the very top of available medical education journals. It is important to increase the paper submission totals and maintain a high level of quality, so I ask each of you to consider submitting articles to JIAMSE for review on the exciting things you do at your schools to foster better medical education. It is also critical to be indexed in Index Medicus, an initiative that has already been started. Then, we need to increase the exposure radius for this journal in the educational community.

I have requested the Editorial Board and staff to remain and I have happily heard from most of them that they will. I have increased the number of Associate Editors to expand the expertise and also to provide a wider opportunity for targeted editing. I intend to maintain the methodology and quality for review started by Doug. I am looking forward to Doug??bf?s assistance in putting together the December issue.

I will be happy to talk to any of you in Puerto Rico about JIAMSE and also about publishing your work in the journal of our association. If you have posters and oral talks, you should definitely consider submitting your work.

In closing, I am very proud and excited to be the next Editor-in-Chief of JIAMSE, and I hope all of you share my pride and the pride of our great organization in this journal which so brightly represents our association.

The Medical Educators Resource Guide

John R. Cotter, Ph.D.

The five reviews in this issue of the Guide were written by medical and osteopathic students and a graduate student in anatomy. All of the reviews deal with three of the four major sub-disciplines of anatomy: histology, neuroanatomy, and gross anatomy. This may not be a coincidence. Anatomy is one of the cornerstones of medical… Read more »

Integration of Basic Sciences and Clinical Sciences in a Clerkship:
A Pilot Study

John C. Sakles, M.D.1, Renee J. Maldonado2 and Vijaya G. Kumari, M.B.B.S., Ph.D.3

Limited formal mechanisms exist for exploring basic sciences during the clinical clerkships in many medical schools. This study was designed to create a model for integrating basic and clinical sciences in a fourth year clerkship. Fifty-eight fourth year students enrolled in the Emergency Medicine clerkship participated in the study, undertaken by the clinical director of the clerkship and a basic scientist. Expert basic scientists were invited as discussants. Clinical presentations commonly encountered in the Emergency Department were selected for a case-based approach. Students researched and discussed both basic science and clinical questions that arose from the case discussion. They completed a questionnaire at the end of the session. More than 50% of the participants reported that the sessions enabled them to achieve a deeper understanding of the basic science principles relevant to clinical problems and improved their ability to evaluate and manage another comparable patient. They noted that this approach would motivate them to explore the basic sciences in the future and agreed that understanding basic science principles would contribute to better patient care. They reported that the availability of a basic science expert facilitated the integration and that they would recommend the model for other fourth year clerkships. Our results suggest that the incorporation of a structured basic science inquiry related to a patient problem in a fourth year clerkship could be an effective approach to encourage the exploration of the relevant basic science principles. Presence of a basic science expert, along with a clinician, enhanced the reported effectiveness of the integration.

Analysis on the Effects of Block Testing in the Medical Preclinical Curriculum

Uldis N. Streips1*, Gabriel Virella3, Ruth B. Greenberg2, Amy Blue4


Using a whole day, comprehensive test three times a semester, rather than many individual course examinations in the same time span is the hallmark of Block Examinations. This manuscript examines the effect such a curriculum change has made at two medical schools of similar size (University of Louisville with 144 students and Medical University of South Carolina with 146). The implementation of Block testing at both medical schools has been associated with a sustainable increase in pass rates as well as absolute scores in Part 1 USMLE at both schools. This testing process is well accepted by faculty and students and appears to provide time for students acquire and retain preclinical material.

Using Metaphors, Analogies and Similes as Aids in Teaching Pathology to Medical Students

Rani Kanthan, M.D. and Sheryl Mills, M.Ed.

Metaphors, analogies, and similes bridge the known to the unknown, and alter the conceptual system of existing knowledge by modifying and strengthening its associations. Although the use of metaphors, analogies, and similes is pervasive in our language, not much has been written about its use as a potential active teaching strategy in medical education to explain complex or abstract concepts. Metaphors, analogies, and similes were used intentionally in two consecutive years of an undergraduate pathology course for medical and dental students for two purposes: a) to communicate and understand complex concepts such as those related to acute and chronic inflammation, thrombosis, embolism and infarction; and b) to provide practice for students to become better communicators of complex medical concepts using these strategies. Students found that working with metaphors, analogies and similes enhanced and aided their learning, and challenged their communication skills. The unexpected impact of creating visual metaphors had a unique potential for improving recall of information. The discussion and negotiation of metaphors can be used in medical education as an effective teaching strategy to augment communication skills towards a better understanding of complex medical concepts. This, in turn, may aid students in becoming effective communicators with their prospective patients.

Effects of Lecture Absenteeism on Pharmacology Course Performance in Medical Students

Anwar Hamdi, M.D., Ph.D.


Few studies have investigated the effects of absenteeism on medical student test results. The purpose of this study was to determine the effects of lecture absenteeism on performance in a medical pharmacology course as measured by test scores. Data on lecture absenteeism in pharmacology and the end-of-semester test scores were analyzed for two classes of medical students during four semesters. Based on the percentage of absenteeism in each semester, students were divided into two groups, group-I and group-II, with less than and more than 15% absenteeism, respectively. The percentage score attained and the frequency of failure in the two groups were compared. In addition, two groups of students were categorized; the uppermost 15% and the lowest 15% are based on test scores. The percentage absenteeism was compared between the groups and correlated with test scores. The percentage of high grades and percentage of failure in group-II (more than 15% absenteeism) were significantly lower and higher, respectively, when compared to group -I. The percentage of absenteeism was significantly higher in the group of students who scored in the lowest 15% of the class. Finally, a significant negative correlation was found between percentage of absenteeism and test score. The above results were similar for the four semesters of the study. The results obtained in this study confirm that absenteeism had a significant effect on the level of achievement in medical pharmacology, and suggest the importance of regular attendance as an effective way of increasing test’s scores.

Health Science Faculty Members’ Perceptions of Curricular Integration: Insights and Obstacles

Jennifer K. Brueckner, Ph.D. and Douglas J. Gould, Ph.D.


The objective of this pilot study was to analyze the results of a survey of basic science and clinical faculty regarding the integration of their institution’s health sciences curriculum. Forty-four basic and clinical scientists responded to our survey, providing information regarding their level of interest in a more integrated curriculum and the level of integration that they currently enjoy at their institutions and opinions on obstacles to integration. Results indicate that interest in integration of the curriculum is high, that individual faculty members are interested in increased integration, but that the current level of integration is not adequate. Clinicians are less positive about curricular integration than were their basic science counterparts. The main obstacles cited by survey participants include the lack of a reward system for faculty to put effort into integration and lack of time. In sum, although faculty members recognize that integrating the basic and clinical sciences into a more cohesive experience for students is of interest to them and of benefit to their students, there is currently not sufficient support in the form of faculty time or reward to move forward towards a more vertically integrated curriculum.

The Satisfaction Levels of Students on Academic Support and Facilities, Educational Activities and Tutor Performance in a PBL Program

Berna Musal, M.D., MHPE,1 Yucel Gursel, M.D.,1 Sema Ozan, M.D.,1 H. Cahit Taskiran, M.D.1 and Henk van Berkel, Ph.D.2


Dokuz Eylul University School of Medicine changed its curriculum from a traditional one to a Problem-based Learning (PBL) curriculum in 1997. The objectives of this study were to investigate students’ satisfaction levels regarding academic support, facilities of the School, educational activities and tutor performance and to compare the satisfaction levels in different years. At the end of each of the academic years 1999, 2001 and 2003 satisfaction levels, opinions, and expectations of the students were determined with a questionnaire. On a five point scale (1:min, 5:max), the satisfaction scores for academic support and facilities of the School varied between 1.9?1.1 and 4.2?0.9 and the scores on educational activities varied between 2.8?1.4 and 4.1?0.9. The points attributed to PBL sessions, our professional skills program, basic science practical exams, and self-study activities were higher than the overall assessment point of educational activities. The performance scores of the tutors given by the students varied between 3.5?1.0 and 4.4?0.9. The highest satisfaction scores were observed in 1999, followed by a moderate decrease in 2001, and a moderate increase in 2003. As part of the program evaluation studies, the findings of the present study were evaluated and necessary revisions were made. The present study may constitute an example of using student feedback in evaluation and revision of PBL programs.

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