Medical Science Educator Volume 18: No. 1

Message from the President

Edward P. Finnerty, Ph.D.

As we approach our 12th annual meeting this July, I am delighted by the vitality of IAMSE. This is because of the membership and their energy and involvement in the association. The meeting this year in Salt Lake City will mark a new milestone in our development. This year we will incorporate the former ā€˜Slice of Lifeā€™ group into our fold. This group, in which many IAMSE members were also involved, will bring a strong technology perspective to our family. In addition, the Team Based Learning group will be a part of our IAMSE meeting. The TBL group represents another instructional strategy that fits well within our mission of ā€œā€¦sharing current and innovative means to teach the sciences fundamental to medicine and healthā€. These new additions to our meeting program are built upon the successful relationship we have had for some years with the Pathology educators, GRIPE. The 2008 Program committee has worked diligently to meld all of these into an engaging and productive gathering. We certainly hope all of you will be with this July. Check out the meeting program for details (

Also occurring at the Salt Lake meeting will be the installation of our new board members following the Spring election. We are excited to introduce the new members to the Board: Peter de Jong, Kathryn McMahon, Mathew Gwee, Ferhan Girgin Sagin and William Jeffries. They will join the re-elected members: Veronica Michaelsen, Jack Strandhoy, Peter Anderson, and Bruce Newton as well as the current members: Mark A.W. Andrews, Deborah Barr, Floyd Knoop, Susan Pasquale, Frazier Stevenson and John Szarek, Ph.D. They along with the rest of the Board will provide our leadership for the coming years. The new officers will be elected from the Board at the meeting in July. Deserving special thanks go to the ā€˜retiringā€™ Board members Sheila W. Chauvin, Jerome Rotgans and Giulia A. Bonaminio, our Past president.

In addition to the changes in the Board and officer selection process, the meeting this July will bring my term as President to an end. As I look at where IAMSE is today, I am filled with pride. We have seen an energy and enthusiasm in our membership through activities and projects of the committees that bodes very well for our future. We have been invited to participate and contribute with a number of other medical education groups, including: AMEE, AAMC, AACOM, CGEA and The Generalists in Medical Education. These collaborations have fostered interactions with other groups as well, such as the Alliance of Clinical Educators. Our project, Flexner Revisited, examining the role and value of the basic sciences in medical education, has increased our credibility and visibility tremendously. We have developed a long relationship with our sister organization, AMEE, and through that have established a presence in Europe. The Essential Skills for Medical Educators (ESME) program, which we offer as part of our annual meeting, is testimony to this collaboration. Building on this international theme, we are well on our way to what looks to be a very exciting IAMSE meeting in Leiden, The Netherlands, in 2009. I addition to a European perspective, we have developed relationships and a presence, again through our active members, in the Middle East and Asia.

Our committee structure has served us well as a vehicle for member involvement. Through their activities, we have developed a collaboration to promote and develop new features for the HEAL resources, which will be showcased at the July meeting in Salt Lake City. Our Webcast audio seminar series has continued to be a success. The Membership and Development committees have initiated some important projects that will be of benefit and enjoyable for all. Note that we are going to once again have the ā€˜silentā€™ auction at the Annual meeting with the proceeds to be used for travel support for junior faculty. We will have several award recipients to be recognized for their contributions and excellence as medical educators. Our Journal, JIAMSE, has initiated several changes with the publication of supplemental theme issues. Further, the Editorial and Publication committee are continuing their quest for indexing of the Journal.

As you can see, we have accomplished much and are more than meeting our mission of advancing ā€œmedical education through faculty development and to ensure that the teaching and learning of medicine continues to be firmly grounded in scienceā€. Most importantly, none of this could occur without the commitment, efforts and energy of all of those who are IAMSE. We have much to be proud of and even more to do.

Thank you for the opportunity to serve as your President for the past two years- it has been a pleasure and an honor. I am looking forward to seeing all of you at the 12th Annual IAMSE meeting in Salt Lake City this July.

Message from Editor-in-Chief

Uldis N. Streips, Ph.D.

It is a great pleasure for me to welcome you to volume 18-1 of the Journal of the International Association of Medical Science Educators. This is another robust volume featuring 2 short communications, and 4 articles, which all advance the knowledge in the broad field of medical education. They also illustrate how you can easily interact with this journal for publication of your unique findings in medical education and pedagogy. I am also very pleased that this issue initiates the Case Studies in Medical Education. We will present typical case scenarios which illustrate common problems in medical education. This will be an interactive part of the Journal. Once you have read the case, and if you have a solution or an opinion, please submit it to me as a Letter to the Editor. It will be peer-reviewed and, if accepted, will be published in the next supplement to the journal and will be part of your educational publication portfolio.

Also, if you have interest in becoming an active participant in our journal author collegium, come to the IAMSE meeting in Salt Lake City in July and take part in the workshop on publishing or the session on publication at this meeting. If you choose to take advantage of these opportunities, make sure you bring a laptop as well as any ideas you wish to turn into publication or papers you have already initiated and want our editorial board to examine at the meeting. See you in Salt Lake.

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

SHORT COMMUNICATION: An Innovative Course to Introduce Human Spirituality and End-of-Life Care

Kathryn N. Huggett, Ph.D.1, Marcia Shadle-Cusic, M.A., M.S.2, Marilyn Crane, M.S.1, Amanda S. Lofgreen, M.S.1, William B. Jeffries, Ph.D. 1


Growing attention to end-of-life care has fostered innovation in medical education. We describe an effective model to introduce third-year medical students to principles of end-of-life care, and spirituality and faith traditions in the care of the dying. Many aspects of the curriculum are adaptable for use at other medical schools.

SHORT COMMUNICATION: The Efficacy of Three Anatomy Instructional Tools: 2D Images, 3D Images, and Models/Prosected Specimens

Donna Newhouse, H.B.P.E., M.Sc., Ph.D. Candidate


This study determined efficacy (bellringer exam scores) of three anatomy instructional tools: 2D images, 3D images, and hands on models & prosected specimens (HO). Eighteen undergraduate students participated in this prospective, cross-over controlled, single-blind study. After analysis there was no strong pedagogical evidence to support one instructional tool over another.

MEDICAL EDUCATION CASE STUDY: The case of the “Missing Feedback”

Kathryn K. McMahon, Ph.D.

At Northern U School of Medicine the faculty has been “asked” to write a higher percentage of exam questions that follow the National Board style where a short clinical vignette is followed by a question with 5 to 10 optional independent answers to chose from. Each question is to have a single correct answer. The… Read more »

Learner-Centered Strategies for the Lecture Hall: an IAMSE Webcast Audio Seminar Series

Niamh Kelly Ph.D.1, Tom Angelo, Ph.D.2, Ronald Harden, M.D.3, Jeanne Schlesinger, M.ED.4, Stephen C. Ehrmann, Ph.D.5, Carol Nichols, Ph.D.6

The delivery of higher education is going through a paradigm shift whereby the straightforward transmission of information, such as occurs in a lecture, is being reconsidered in favor of learner-centered approaches. A previous IAMSE Webcast Audio Seminar series explored the theory behind such Learner Centered Education (JIAMSE 16(2):48-54. 2006). The importance of a University education… Read more »

Medical Studentsā€™ Reactions to a Competency-Based Curriculum: One Schoolā€™s Experience

Mary Alice Bell, M.S.1, Wilma J. Griffin, M.S.2, James Y. Greene, Ph.D.3, James J. Brokaw, Ph.D., M.P.H.1


In 1999, the Indiana University School of Medicine implemented a competency-based curriculum structured around nine core competencies. The students responded to this new curriculum with minimal enthusiasm. We sought to better understand the student perspective in an effort to improve and refine the competency requirements. Accordingly, early in the 2003-2004 academic year, we established four focus groups (6-10 students per group) to systematically analyze student experiences with the competency requirements across four years of medical school. Each of the groups met once to respond to a series of scripted questions about the competencies. Sessions were transcribed and analyzed by three readers using standard protocols for qualitative analysis. Analysis of 525 student comments revealed two major areas of dissatisfaction, as reflected by the frequency: Inconsistent knowledge and use of the competencies by the faculty (39%) and lack of clarity and uniformity in communication about the competencies (26%). Despite these perceived deficiencies, the students generally embraced the important concepts inherent in the nine competencies and recognized their application to the physician role (33%). Sixteen percent of the comments were specific recommendations for improvement, which included competency-specific training for all teachers, clear and consistent communication throughout all four years of the curriculum, and improved methods of feedback and assessment. Many of these recommendations were incorporated into refinements and additions to the competency-based curriculum, which probably contributed to the notable improvement in student acceptance of the competencies measured by end-of-course evaluations. This study has shown that focus groups can provide a rich source of information about student perceptions and attitudes regarding curricular change, and can reveal problems and shortcomings not otherwise apparent. By soliciting student feedback early in the new curriculum, we were able to gather constructive criticisms that led to actionable reforms.

The Pedagogic Impact of Exploring Philosophical Concepts in The Basic Health Sciences: The Studentsā€™ Perspective

James R. Brawer, Ph.D.1,2, Colin Chalk, M.D., CM, FRCP 1,3, Peter McLeod, M.D., FRCPC, FACP 1, 4, 5


We have developed a pedagogic strategy for exposing students to philosophical concepts embedded in the basic medical sciences. The intent of this approach is to stimulate reflection and to cultivate intellectual depth and broadness of outlook. The purpose of the present study was to determine the extent to which these goals are realized.

We asked 202 occupational and physical therapy students and science undergraduates enrolled in a neuroanatomy course to describe, in writing, the impact of addressing philosophical issues on the quality of their educational experience. Thematic content analysis was used to identify specific themes in the 93 responses received.

Fifty nine student responses (63%) were uniformly positive, comprising one or more of the following themes. The inclusion of philosophical material: 1) evoked a nonspecific positive feeling, 2) stimulated reflection, 3) engendered an appreciation of the complexity of reality, and 4) enhanced understanding of the rest of the course material. Twenty six percent of the responses contained one or more of the positive themes, as well as concerns, largely regarding the increase in material to be learned. Eleven percent of the responses were exclusively negative. Our results indicate that periodic exposure to philosophical topics appears to stimulate reflection and provides valuable insight for a significant segment of the class.

Fourth-year Medical Students as PBL Tutors

Laurie C. Clark, D.O., M.S., W. Stephen Eddy, D.O., M.P.H., Joan E. Stewart, D.O., M.P.H., Sherril M. Stone, Ph.D., Christopher C. Thurman, D.O.


Problem-based learning (PBL) is a popular teaching method in medical schools, but is resource intensive due to the large number of faculty required to serve as small group tutors. This study 1) compares the effectiveness and student satisfaction of PBL small groups tutored by physicians with groups tutored by 4th year medical students (MSIVs) and 2) examines the effect of tutoring on learning by MSIVs. Sixteen MSIV students were recruited to tutor MSII groups. Seven MSIVs participated in a separate study to analyze the amount of learning that occurred as a result of teaching. The MSII students were given a quiz after each module to measure the amount of information learned, and a satisfaction survey regarding their tutor. Additionally, the tutors completed a pre-test and a post-test of the material they taught. All data was input into SPSS, a statistical analysis package, and analyzed using an Independent Samples t-test. Results indicated that there was no statistically significant difference in mean quiz scores of the MSII students between groups (those tutored by physicians and those tutored by MSIVs). There was also no statistically significant difference between groups on any of the questions on the satisfaction survey. Furthermore, the MSIV student tutor pre- and post-test scores showed no statistically significant difference although the post-test scores were all higher than the pre-test scores. These findings support the use of MSIV students as PBL tutors. The results also indicated that MSIV students may benefit from teaching MSII students. Additionally, the results suggest that MSIV students may be better prepared and more knowledgeable as physicians when they have been in a position to teach medical students.

A Computer-Based Examination for Laboratory Programs in Histology

John R. Cotter, Ph.D.1, Jason S. Crosby, B .S.2


An independently-developed, interactive, Web-based examination is used to assess learning in histology. The examination assesses factual information, concepts and whether the examinees recognize the organs of the body and the cells, tissues and structures that are associated with them and the other parts of the body. The method of assessment streamlines the administration and scoring of an examination and overcomes some of the inadequacies of examinations that use a microscope, video, projection slides or projected digital images. The strengths of the examination flow from the delivery of the examination to a computer workstation, the duel display of the questions and the images of the specimens on a computer monitor, and the use of an interactive computer interface. The interface allows the examinees to perform operations that improve the process of test-taking by conventional means. As a result, the examination is less cumbersome than a synchronous laboratory examination. The examinees advance by opening individual question windows. The examinees tag questions for review, view the images of specimens at more than one level of magnification, add notes to a textbox and strikethrough the options of multiple-choice questions that are judged to be erroneous. The evaluation of the computer application by the examinees shows the interactive features of the application are useful. The security of the examination during and following an examination is handled by the computer application and the actions taken by the course director. The security measures make the recycling of the images and questions on future examinations feasible.

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