Utility of the AAMCʼs Graduation Questionnaire to Study Behavioral and Social Sciences Domains in Undergraduate Medical Education

Abstract

The Institute of Medicine (IOM) report on social and behavioral sciences (SBS) indicated that 50% of morbidity and mortality in the United States is associated with SBS factors, which the report also found were inadequately taught in medical school. A multischool collaborative explored whether the Association of American Medical Colleges Graduation Questionnaire (GQ) could be used to study changes in the six SBS domains identified in the IOM report. A content analysis conducted with the GQ identified 30 SBS variables, which were narrowed to 24 using a modified Delphi approach. Summary data were pooled from nine medical schools for 2006 and 2007, representing 1,126 students. Data were generated on students' perceptions of curricular experiences, attitudes related to SBS curricula, and confidence with relevant clinical knowledge and skills. The authors determined the sample sizes required for various effect sizes to assess the utility of the GQ. The 24 variables were classified into five of six IOM domains representing a total of nine analytic categories with cumulative scale means ranging from 60.8 to 93.4. Taking into account the correlations among measures over time, and assuming a two-sided test, 80% power, alpha at .05, and standard deviation of 4.1, the authors found that 34 medical schools would be required for inclusion to attain an estimated effect size of 0.50 (50%). With a sample size of nine schools, the ability to detect changes would require a very high effect size of 107%. Detecting SBS changes associated with curricular innovations would require a large collaborative of medical schools. Using a national measure (the GQ) to assess curricular innovations in most areas of SBS is possible if enough medical schools were involved in such an effort.