How curricular changes influence medical students' perceptions of basic science: A pilot study.

Yousef Elfanagely,Hanin Rashid,Ricardo Pulido,Liesel Copeland,Joshua Ray Tanzer,Frederick Grinnell

doi:10.1371/journal.pone.0236365

Abstract

The perceived value of study material may have implications on learning and long-term retention. This study compares the perceived value of basic science of medical students from schools with a traditional "2+2" curriculum and the USMLE Step 1 placed before core clerkships to those from medical schools that have undergone curricular revisions, resulting in shortened pre-clerkship curricula and administration of the USMLE Step 1 after core clerkships. We hypothesize that differences in curricula, particularly duration of pre-clerkship curriculum and timing of the USMLE Step 1, affect medical students' perceived value of basic science. A twenty item anonymous questionnaire using a 5-point Likert scale was developed to assess medical students' perceptions of basic science. The questionnaire was distributed to third-year medical students across four medical schools. Generalized linear models and p-values were calculated comparing the perceived value and use of basic science between medical schools with the USMLE Step 1 before clerkships and 2-years of basic science (BC) and medical schools with the USMLE Step 1 after core clerkships and 1.5-years of basic science (AC). The questionnaire was distributed to 695 eligible students and completed by 287 students. Students at BC schools tended to view basic science as more essential for clinical practice than students at AC schools across both outcomes (rating independence of basic science and clinical practice, AC school mean = 2.97, BC school mean = 2.73, p = 0.0017; rating importance of basic science to clinical practice, AC school mean = 3.30, BC schools mean = 3.50, p = 0.0135). Our study suggests that students who have a longer basic science curriculum tend to value basic science greater than students with a shorter basic science curriculum. The timing of the USMLE Step 1 may also influence this relationship. Curricular decisions, such as reductions in pre-clerkship curricula and administration of the USMLE Step 1 after clerkships, may impact medical students' perceptions of the value of basic science to clinical practice. This can have implications on their future engagement with basic science and should be considered when modifying curriculum.

Highlights

The current structure of medical education can be attributed to the reform following early criticisms of medical schools in Flexner’s 1910 report
Our study suggests that students who have a longer basic science curriculum tend to value basic science greater than students with a shorter basic science curriculum
While preclinical basic science is a pillar of medical education, the literature assessing the attitudes medical students have towards basic science is incongruent [11, 12]

Summary

Introduction

The current structure of medical education can be attributed to the reform following early criticisms of medical schools in Flexner’s 1910 report. Flexner criticized the nonscientific approach and lack of emphasis on basic science in medical courses and research [1,2,3]. He argued that basic science played a fundamental role in the practice of medicine and should be reflected in medical training [4]. Since Flexner’s report, many schools have adopted a “2+2” model with medical students spending their first two years taking basic science courses, such as anatomy and biochemistry, and their last two years completing clinical training in a teaching hospital [5]. Further investigation is warranted as to what factors may contribute to medical students’ perceived value of basic science

Methods

Discussion

Conclusion