Student Performance and Stress in Histology and Cell Biology in a Redesigned Preclinical Undergraduate Medical Curriculum

Abstract

In the legacy curriculum at TTUHSC School of Medicine, histology and cell biology were taught in dedicated units in Block 2: Biology of Cells & Tissues (BCT). In Fall 2021 (Class of 2025), a new compressed organ-based integrated curriculum with restructured delivery of histology and cell biology and permanent change to pass/fail grading was implemented. Therein, basic histology was integrated into Unit 1 of Block 1: Anatomy, Histology & Embryology (AHE). Cell biology was divided into AHE and the second unit of Block 2: General Principles (GPX). Our objective was to evaluate performance in histology and cell biology and influential factors, such as student stress and academic and personal concerns in the new organ-based integrated curriculum. For AHE and GPX students completed pre- and post-block surveys regarding stress and academic and personal concerns. Deidentified scores for performance on the 10 most diffcult histology questions on the fall 2021 AHE Exam 1 were compared to the same exam questions in BCT in fall 2020. Scores for the 10 most diffcult cell biology questions on the fall 2021 GPX Exam 2 were compared to those for same exam questions in BCT in fall 2020. Biochemistry performance also was evaluated, as its instruction remained similar to that in the legacy curriculum. Fall 2021 histology scores were markedly lower than scores in fall 2020 (p = 0.002); however, end of block NBME exam scores for histology were comparable to scores in fall 2020 (p = 0.445). Cell biology scores in fall 2021 were moderately lower than in fall 2020 (p = 0.0035). Surprisingly, scores for the 13 most diffcult biochemistry topics in fall 2021 were lower than in fall 2020 (p = 0.0051). AHE pre- and post-block surveys indicated students anticipated dedicating 12% of their time studying histology, but actually allocated 10% of their time. At the start of AHE, the top concern was the amount of material in the block; by the end, it was learning histology. GPX post-surveys indicated student stress was comparable or even less than anticipated. Top concerns were curriculum design, biochemistry, and amount of material. Over 50% of students felt overwhelmed by the amount of material in GPX. In the new curriculum, student performance in histology on the unit exam was attenuated, but NBME exam scores were on par with the legacy curriculum. Student acclimation to the rigors of school and honing of time management skills may explain improved performance at the end of AHE. Lower performance in cell biology and biochemistry might be due in part to inclusion of medical genetics and pharmacology that were not taught in the analogous legacy block. Whether such trends in student performance in these foundational blocks persist in subsequent iterations of the curriculum and potential influence of student perception on performance are being evaluated. Funded through TTUHSC-SOM. This is the full abstract presented at the American Physiology Summit 2024 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.