Student performance and satisfaction in the first iteration of an integrated renal and respiratory systems course in a redesigned one-pass preclinical curriculum

Abstract

Texas Tech University Health Sciences Center School of Medicine converted its legacy two-pass preclinical curriculum to a one-pass organ system-based format and changed the grading system from categorical to pass/fail (>70%). Our objective was to assess first-year medical student (MS1) performance and satisfaction in the first iteration of Organ Systems-2:Renal and Respiratory ( RNR), an 8-week block taught at the end of Year I. RNR integrates the physiology, pathophysiology, infectious diseases, and pharmacology of the renal system (Weeks 1-4) and respiratory system (Weeks 5-8), using reorganized and updated material from legacy Year-I blocks ( General Principles & Infectious Diseases and Structure & Function of Major Organ Systems) and Year-II blocks ( Immunity & Multisystem Disorders and Systems Disorders). Instruction was delivered via didactic lectures, team-based activities, case-based reviews, dry labs, cognitive integration of clinical reasoning (CICR) sessions, and simulations. Formative weekly quizzes and practice exams were assigned before each exam. Learning in the renal physiology, renal pathophysiology, and respiratory physiology units was assessed by instructor-generated exams at the end of Weeks 2, 4 and 6, respectively, and a final customized, comprehensive NBME exam at the end of Week 8. Aggregate performance on instructor-generated renal and respiratory exam questions was compared to that on similar questions from legacy curriculum exams. Aggregate performance on the NBME exam was compared to USMLE Step 1 exam difficulty, as the legacy curriculum did not include a dedicated renal/respiratory NBME exam. Aggregate performance on instructor-generated renal physiology and pathophysiology and respiratory physiology questions was comparable to that in the legacy curriculum. Average performance on the renal portion of the NBME exam was 0.76 vs. Step 1 exam difficulty of 0.78; average performance on the respiratory portion of the exam was 0.77 vs. Step 1 exam difficulty of 0.78. Per end of block survey and student focus group feedback, overall student satisfaction with RNR was 73%. Thus, the first iteration of the integrated organ systems-based renal and respiratory systems course in Year I yielded a MS1 performance on the NBME that was comparable to USMLE Step 1 source difficulty, and student satisfaction was positive overall. More detailed analysis of exam performance is needed. Further modifications of RNR will include additional simulations and flipped-classroom sessions. This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.