Curriculum restructuring at Texas Tech Health Science Center Medical School: Evaluation and lessons learned

Abstract

Texas Tech Health Sciences Center Medical School (TTUHSC, SOM) recently changed from a 2 years pre‐clerkship curriculum to a 1.6 year organ system‐based curriculum. This change was implemented to develop an integrated curriculum specifically comprising of horizontal integration across disciplines. In order to provide students with a “cutting‐edge” curricula, TTUHSC medical educators involved in pre‐clerkship curriculum thoroughly reviewed the “traditional” curriculum content and strategically aligned the content to avoid redundancies and enhance student learning. As a result of the restructuring, a block entitled General Principles was created. This is a foundational block that covers basic principles of biochemistry, cell biology, medical genetics, pharmacology, and microbiology. Historically, pharmacology and medical genetics are two content areas that occurred later in our “traditional” pre‐clerkship curriculum. Previously, principles of pharmacology (pharmacokinetics/dynamics) were introduced in the Infectious Diseases block, prior to lectures over antibiotics, and medical genetics was part of the second year Multi‐System Disorders block. Now, both of these content areas are incorporated into the second unit of the General Principles block and follow biochemistry, cell biology, and cellular transport lectures. The objective of this study was to evaluate the performance of this block, specifically the student performance on pharmacology and medical genetics topics. We hypothesized that incorporating pharmacology and medical genetics in a block that covers basic biochemistry and cell biology will enhance student performance. To achieve this goal and as part of our efforts to ascertain the potential effects of curricular restructuring on topic mastery, we compared the past and present performance of pharmacology (n=11) and medical genetics (n=7) based questions. For questions related to medical genetics, the overall performance was not significantly affected, 88% (“traditional” curriculum) versus 89% (p=0.54). In contrast, overall performance on pharmacology based questions saw a significant drop, 85% former curriculum and 80% new curriculum (p=0.02). Interestingly, performance on questions related to pKa values and drug excretion improved within the new curriculum, a potential benefit to presenting pharmacology topics following basic principles of biochemistry. In conclusion, the student performance on medical genetics questions, topic that was traditionally taught in year 2 of medical school, was not negatively impacted even though this topic is introduced earlier. At the moment, it is unclear if the overall drop in pharmacology performance is due to the content being placed earlier within the pre‐clerkship curriculum or simply content overload. As a new program is implemented, a period of decline in performance often occurs. Thus, we will continue monitoring student performance and lessons learned from this block will help us in making fine adjustments to this newly implemented curriculum.