Medical Student Curriculum Research Articles

Patients’ impact on the hidden curriculum of medical students a qualitative study on undergraduate medical students

Aim: To explore and understand professional practice development through medical students’ observation of patient’s responses towards the medical students, illness, and hospital staff.Methodology: Semi-structured focused group discussions were conducted between 3rd September 2019 and 3rd May 2020 using non-probability purposive sampling. Three focused groups were conducted with fourth year medical students (n=19) to discuss about their third-year clinical placement experience. The focused group discussions were audio-recorded and transcribed verbatim. Data were analysed using Interpretative Phenomenological Analysis framework to label the concepts, attached code to the data, and the codes were subsequently grouped into similar themes. Themes that emerged from the interpretation of the coded data were identified. Results: Four main themes emerged from the focus groups: (1) Student’s observation on patient’s responses towards students, illness, and staff; (2) Patient’s perspectives towards students; (3) Students were affected by the experience; and (4) Factors influencing patient’s responses to students, illness, and staff. The impact of patient’s behaviour has influenced students’ professional practice in two ways. The first impact is collaboration of students’ observation during clinical placement with what has been learned through the written curriculum. The second impact is through a hidden curriculum.Conclusions: The hidden curriculum has influenced our students’ learning through observation of new aspects and implementation of the learned written curriculum. Students can aspire medical educators, doctors, and medical staff to adopt approaches and attitudes that have a positive impact on students’ professional practice and to acknowledge that they are the role models for the new generation’s learning through the hidden curriculum.

Rare Diseases - Orphan Drugs

Rare diseases (RDs) are a class of diseases that do not affect most of the population. Apart from the common diseases that affect most people, some severely rare diseases often pose unique challenges to society and the healthcare systems in India. According to the National Institute of Health (NIH), the F.D.A., and the National Organization for Rare Disorders (NORD), a rare disease is any disease, disorder, illness or condition affecting fewer than 200,000 people in the United States as defined by the Orphan Drug Designation Program. However, 95% of rare diseases currently have no treatment available. Healthcare Experts estimate that around 7000 rare diseases have been identified globally, out of which 450 have been reported in India, like hemophilia, thalas-semia, sickle cell anemia, and Pompe’s disease. Rare diseases come in many forms, including cancers and auto-immune diseases. Drugs for rare diseases are among the highest-priced medications on the market than other common drugs. A medical advisory board of nationally recognized and specialized physicians can help build in-depth case management tools and clinical decision support systems to develop and advance novel therapies. Recognition of carriers harbouring clinically pathogenic genetic vari-ations is essential to provide proper genetic counselling to the patient and management. The precise delineation of distinct RDs is possible through a meticulous clinical evaluation of the patients and their genetic screening. The Electronic Health Record (E.H.R.) helps foster collaboration and better outcomes. A holistic approach should be integrated across health care providers, both at the pharmacy and medical level, that helps improve patient experience and outcomes and reduce costs. Strong health poli-cies and initiatives are required both from private and government institutions for orphan drug development. A separate course on Clinical Genetics must be included in the academic curriculum of medical students in order to provide them knowledge on the basic concepts of genetics and its applications in human health.

5 Core Care Skills Simulation Training for Undergraduate Medical Students

Throughout the coronavirus pandemic, healthcare professionals have needed to rapidly adapt to changing demands. For some, this has involved adapting a ‘task-sharing’ approach which means that professionals undertake tasks that are not usually considered part of their job role, for example, Junior doctors giving medications and many were ‘redeployed’ completely to areas of greater need. In the same vein, the role of the medical student was expanded and explored and some medical students were given the opportunity to undertake paid work as healthcare support workers (HCSWs). It can be argued that the education and training of medical students are heavily focussed on a medical model of healthcare and often lacks depth insight into the caring aspects of patient care.The aim of the study was to create an interactive practical care skills simulation training aimed at medical students.We designed a practical simulation training programme based around the ‘fundamentals of care’ as defined by the nursing and midwifery council Early versions of this course were used as part of a comprehensive induction programme that included testimony from HCSWs working within the site hospital, who were able to share real-life experiences and offer peer support. This helped influence the development of this course to shape it into an innovative multi-disciplinary training. The training course was developed reactively to meet the developing need of students to prepare for redeployment by April of 2020 and since then has grown and developed into the half-day simulation training that is outlined above. It has now been incorporated into the in-hospital clinical skills curriculum for third-year medical students passing through the trust on the understanding that, this course has helped medical students to better understand the role of other professionals and will enable closer multi-disciplinary working in future. Anecdotally, it is obvious from interacting with students that there is a need to incorporate training in basic care into the medical curriculum to prepare students for task-sharing in the future as well as to better understand the caring professions and improve multi-disciplinary working. However, there is not enough post-course data to establish a true effect from this course at present. We continue to run this training course as part of the year 3 undergraduate clinical skills programme and aim to collect more survey data to evaluate and adapt it.

72 Medical Student Attitudes Towards Point-of-Care Ultrasound in Undergraduate Medical Education

Point-of-care ultrasound (PoCUS) is a bedside imaging modality that provides the operator with instant clinical patient information. PoCUS is a low-cost, radiation-free, portable diagnostic tool that is utilized in many specialities The aim of the study was to assess undergraduate medical students’ attitudes towards PoCUS through the implementation of a rudimentary proctored PoCUS workshop.Third-year medical students at the Royal College of Surgeons in Ireland participated in a 1-hour PoCUS workshop as part of their fundamental clinical skills training. Medical students attended the in-person workshop repeated over 8 weeks. Students were exposed to three ultrasound stations. The first was a CAE Vimedix ultrasound simulator utilizing augmented reality colourization and 3D modelling. The second station was learning and performing an extended FAST scan with a focus on bright mode image acquisition and free fluid recognition. The third station was the practical placement of peripheral/central IV-line insertion helping students to identify vasculature while also manipulating the ultrasound transducer as a procedural adjunct. Students were asked to complete a post-workshop survey to investigate their attitudes towards ultrasound teaching in undergraduate medical education. The survey consisted of 10 questions to assess attendee’s prior ultrasound knowledge, to provide constructive feedback regarding the workshop and how ultrasound can be incorporated into future undergraduate medical education.A total of 121 students completed the post-workshop survey. Of those who completed the survey, 94.2% of students had never used an ultrasound machine before and 100% had never performed PoCUS previously. Collectively, participants strongly agreed 100% that PoCUS should be incorporated into the undergraduate medical student curriculum at RCSI. In particular, 89.3% and 45.5% of students indicated that POTUS should be included in the third- and fourth-year medicine curriculum, respectively. 85.1% of students indicated that PoCUS education would be most valuable to supplement clinical placement followed by anatomy (62.8%), pathology (59.9%) and physiology (23.1%). 86.8% of the students were interested in learning more about PoCUS through an online format.PoCUS appears to be an additional valuable learning resource for undergraduate medical students. Of the students surveyed, it is apparent that there is strong support in favour of early ultrasound integration into the future medical school curriculum.

Development and Implementation of a Longitudinal Global Acute Care and Systems Strengthening Program

Background:Increasing access to safe, timely, and affordable acute care in low- and middle-income countries is a worldwide priority. Longitudinal curricula on systems of acute care have not been previously described.Objectives:The authors aimed to develop a novel four-year longitudinal curriculum for medical students addressing systems development across multiple acute care specialties.Methods:The authors followed Kern’s six-step framework for curriculum design. After review of literature, a group of medical students and school of medicine faculty conducted a targeted needs assessment. Foundational goals and objectives were adapted from the 39 interprofessional global health competencies by the Consortium of Universities for Global Health. Educational strategies include didactic sessions, workshops, journal clubs, preceptorships, and community outreach. Clinical years include specialty-specific emphases, guided junior-level discussions, and a capstone project. Yearly SWOT and Kirkpatrick model analyses served as program evaluation.Findings:The Curriculum Council approved the program in July 2019. During the first cycle, the program matriculated 30 students from classes of 2023 (14) and 2022 (16). The first year produced 11 interactive sessions, 6 journal clubs, and 10 seminars led by 31 faculty and guest speakers; 29/30 students completed requirements; 87 evaluations reflected 4.57/5 content satisfaction and 4.73/5 instructor satisfaction. The 2023 cohort reported improved understanding of session objectives (3.13/5 vs. 3.82/5, p = 0.03). Free-text feedback led to implementation of pre-reading standardization and activity outlines.Conclusion:The Program was well-received and successfully implemented. It meets the needs of graduating medical students interested in leading global health work. This novel student-faculty collaborative model could be applied at other institutions seeking to provide students with a foundation in global acute care.

Hidden Curriculum and Politicization of Medical Students in the Late Ottoman Empire.

This article discusses the effect of medical education on politicization during the late Ottoman period. The article focuses on the nineteenth-century emergence of the epistemological and etiological shift in medicine on a global scale, which led to the dominance of the modernization paradigm in the environment of the Military School of Medicine in Istanbul. The ideas favoring modernization and progressivism became widespread through partnerships and differences between the two generations of physicians represented by the periods of Tanzimat (1839-1876) and Abdülhamid II (1876-1909). Based on the narratives of prominent physicians of the late Ottoman and Early Republican Turkey, the article aims to illustrate that all the activities in the school resulted in the gradual transformation of the perspective of the students in contrast to their professors, interpreting the concept of progress as an effective basis to assist the modern aspirations of the administrative elites, composing the hidden curriculum of modern medical education in the Ottoman context. The younger generation began to equate materialism with solidarity, political activism, and insurgency, which would finally enable them to lead the movement against the monarchy or sultan. This generation would also occupy leading administrative positions in the first decades of the new Turkish Republic.

A clinical reasoning curriculum for medical students: an interim analysis

Diagnostic error is a critical patient safety issue that can be addressed in part through teaching clinical reasoning. Medical schools with clinical reasoning curricula tend to emphasize general reasoning concepts (e.g., differential diagnosis generation). Few published curricula go beyond teaching the steps in the diagnostic process to address how students should structure their knowledge to optimize diagnostic performance in future clinical encounters or to discuss elements outside of individual cognition that are essential to diagnosis. In 2016, the University of California, San Francisco School of Medicine launched a clinical reasoning curriculum that simultaneously emphasizes reasoning concepts and intentional knowledge construction; the roles of patients, families, interprofessional colleagues; and communication in diagnosis. The curriculum features a longitudinal thread beginning in first year, with an immersive three week diagnostic reasoning (DR) course in the second year. Students evaluated the DR course. Additionally, we conducted an audit of the multiyear clinical reasoning curriculum using the Society to Improve Diagnosis in Medicine-Macy Foundation interprofessional diagnostic education competencies. Students rated DR highly (range 4.13-4.18/5 between 2018 and 2020) and reported high self-efficacy with applying clinical reasoning concepts and communicating reasoning to supervisors. A course audit demonstrated a disproportionate emphasis on individual (cognitive) competencies with inadequate attention to systems and team factors in diagnosis. Our clinical reasoning curriculum led to high student self-efficacy. However, we stressed cognitive aspects of reasoning with limited instruction on teams and systems. Diagnosis education should expand beyond the cognitive- and physician-centric focus of most published reasoning courses.

967. Interprofessional Education of Medical Students in a Comprehensive HIV Care Coordination Elective

BackgroundInterprofessional education (IPE) is critical in undergraduate medical student curriculum to promote teamwork, increase effective communication, and improve patient-centered care especially in medically underserved populations, including those living with HIV.MethodsMedical students participated in 2-week elective rotations at a freestanding, multidisciplinary HIV clinic providing comprehensive HIV care for more than 6,000 people in an urban, ethnically diverse, resource-limited population. The interprofessional faculty included physicians, pharmacists, case managers, social workers, service-linkage workers, substance use counselors, and medication access specialists. Students interviewed patients, rotated with at least four multidisciplinary health professionals at the clinic, and rounded with the HIV inpatient consult team and service linkage worker in the hospital. Each student completed a reflection paper on the barriers and facilitators of HIV care engagement. Student feedback was collected through course evaluations and debriefing sessions with course directors. Knowledge and ability to perform HIV-related services were assessed through student assessments at baseline and within 2 weeks of completing the rotation.IPE competencies ResultsFrom January 20, 2020 to May 21, 2021, 17 medical students completed the 2-week elective (5 second-year students, 10 third-years, and 2 fourth-years). Student reflection papers demonstrated understanding of barriers to care, social determinants of health, and potential solutions to improve health outcomes. Open-ended feedback was positive, with many commenting on the benefits of learning from diverse healthcare professionals in HIV care. At follow up, 80% of students rated their knowledge of ideal functioning of interprofessional teams as very good or excellent. Students reported increased ability to deliver team-based care, provide services to culturally diverse people, and coordinate care for non-medical needs.ConclusionInterprofessional education enhanced students’ knowledge of care coordination, interprofessional communication skills, competency in teamwork, and understanding of socioeconomic barriers to care in an underserved population with HIV. Disclosures All Authors: No reported disclosures

A High-Value Care Curriculum Using Individual and Group Structured Reflection.

One-third of all healthcare dollars are wasted, primarily in the form of clinician-ordered unnecessary diagnostic tests and treatments. Medical education has likely played a central role in the creation and perpetuation of this problem. We aimed to create a curriculum for medical students to promote their contribution to high-value care conversations in the clinical environment. At a large university medical center between March 2017 and February 2018, we implemented a 3-phase curriculum combining multimodal educational initiatives with individual and group reflection for third-year medical students during their 12-week long Internal Medicine clerkship rotation. Students were asked to identify examples of clinical decision making that lacked attention to high-value care, propose solutions to the identified situation, and pinpoint barriers to the implementation of effective solutions using a structured reflection framework and then participate in a debrief debate with fellow students. To assess the curriculum, reflective narratives were coded by frequency and codes were compared with one another and with relevant high-value care literature to identify patterns and themes. In total, 151 medical students participated in phase 1 and 119 in phase 3. For phase 2, 126 reflective narratives (94.7% participation rate) comprised 226 problems, 280 solutions, and 179 barriers. When provided appropriate resources, medical students are able to identify relevant examples of low-value care, downstream solutions, and barriers to implementation through a structured reflection curriculum comprising written narratives and in-person debate.

Evaluation of the Awareness of the Yazd Medical Students about Common Oral Diseases and its Relationship with General Health of the Body

Introduction: Considering the importance of oral health as a part of general health and the role of physicians in community health, the present study was conducted to investigate the relationship between common oral diseases and general body health from the perspective of medical students in Yazd City in 2018. Methods: In this descriptive cross-sectional study, 210 internship and pre-internship students of Shahid Sadoughi University of Medical Sciences in Yazd Cityin 2018 were selected randomly and their knowledge about common oral and dental diseases and its relationship with general body health was assessed through a valid and reliabile questionnaire consisted of 10 questions. Data were entered into SPSS version 16 statistical software and analyzed using descriptive statistics and T-test. Results: In the present study, 191 internship and pre-internship students completed the research questionnaire, of which 101 were female (52.8 %) and 90 were male (47.1%). The mean age of the students was 24.07 ±1.92. Their mean grade point average at the time of the study was 15/95±1/28. The mean score of their knowledge of oral diseases was 9.79 ± 3.27 with a range of 1 to 19. There was no statistically significant relationship between the mean score of knowledge in terms of age, sex, semester and grade point average (p˃0/05). Conclusion: The results showed that the mean score of knowledge of the internship and pre-internship students about common oral diseases and its relationship with general health is low. Therefore, it seems necessary to improve the level of knowledge of medical students in this regard by adding the mentioned topics to the educational curriculum of medical students.

Expansion of telehealth curriculum: National survey of clinical education leaders

Introduction In response to the COVID pandemic and the rapid changes in delivery of and education on telehealth services, the Research Committee of the Alliance of Clinical Education (ACE) surveyed its multidisciplinary group of medical educators to determine how telehealth was being taught pre-COVID versus during-COVID. Methods An online survey was developed by the ACE Research Committee and sent via email to the ACE delegation. The objective of the survey was to determine changes in telehealth curriculum for medical students due to the rapid transition to telehealth, and the barriers for developing and delivering a telehealth curriculum. Results Forty-nine percent of recipients (31/63) responded representing eight different disciplines in addition to institutional curriculum developers. Most programs had no formal didactics and no clinical experiences in telehealth prior to the pandemic. Most respondents added didactics and clinical telehealth encounters during COVID, although few schools required this of all students. Discussion Given the barriers of faculty training to pivot to telehealth, and the potential benefits to healthcare cost and patient satisfaction, there is a need for more formal study on best practices for teaching telehealth to prepare our future physicians.

Perceptions of medical students towards and effectiveness of online surgical curriculum: a systematic review

BackgroundOnline education has been used as an adjunct modality for teaching and it attracts attention in recent years as many medical students can not accomplish their clerkship in the hospital due to COVID-19 pandemic. This study aims to collect the articles related to online surgical education for medical students, and to analyze the effectiveness of online education and the perceptions of the medical students.MethodWe performed a systemic literature search in PubMed, MEDLINE, EMBASE, ERIC and Cochrane library. Keywords used for searching included “medical student”, “online education”, “online teaching”, “online learning”, “distance learning”, “electronic learning”, “virtual learning” and “surgical”. Medical education research study quality instrument (MERSQI) was used for the evaluation of the quality of the searched articles.ResultsFrom 1240 studies retrieved from the databases, 13 articles were included in this study after screening. The publication year was from 2007 to 2021. The mean MERSQI score of the 13 searched articles was 12.5 +/− 1.7 (range 10.0-14.5). There were totally 2023 medical students who attended online surgical curriculum. By online course, improvement of understanding and knowledge on the studied topics could be reached. The confidence in patient encounters could be improved by online curriculum with sharing experiences, discussing, and role playing. However, students felt concentration was poor during online course. Medical students studying through video platform could get better test scores than those studying with textbooks. Regarding basic surgical skills, online teaching of suturing and knot-tying could be possible and was appreciated by the students who could practice away from the hospital and get feedbacks by instructors through online environment. The scores for the clinical competence assessment for incision, suturing and knot-tying were found to be no significant difference between the online teaching group and face-to-face teaching group.ConclusionOnline surgical curriculum for medical students is not easy but inevitable in the era of COVID-19 pandemic. Although online course is not the same as physical course, there are some efforts which could be tried to increase the effectiveness. Basic surgical skills could also be taught effectively through online platform. Even if the COVID-19 pandemic is over in the future, online curriculum could still be a helpful adjunct for surgical education.

The Self-directed Medical Student Curriculum

This Viewpoint discusses the growing role of medical students in shaping their own education and outlines the measures needed to ensure that medical student–directed learning remains aligned with the educational aims of the medical discipline.

The Social Mission Committee: Establishing a Student-Based Organization to Advance Awareness of Socially Conscious Medicine.

Purpose: One of the most fundamental purposes of medical education is to train future physicians in how to best care for the sick. 1 In response to national unrest, medical schools are being increasingly called to incorporate social determinants of health into their curriculum to best provide comprehensive, informed care. 2 Traditionally, medical schools often fail to emphasize social medicine within their school processes. We propose a student-driven approach to advance awareness and adoption of socially conscious medicine. Approach/Methods: The Social Mission Committee (SMC) is a student organization that was established in 2019, to stand as 1 of 4 pillar student organizations at Vanderbilt University School of Medicine. 3 In partnership with school administration, 6 areas of focus were created into subcommittees to guide action: education, mentorship, recruitment, service, research, and evaluation. The organization functions with 2 copresidents, a director of operations, and 6 executive directors, under the guidance of 2 faculty co-advisors. Each executive director meets monthly with student organization members to work on projects that aim to improve social medicine awareness. Results: In its second full year, SMC has 129 students involved across all training levels, out of a student body of about 400 students. SMC has created 36 ongoing socially driven initiatives housed within different subcommittees. SMC has collaborated with 8 community partnerships including youth crisis groups, local prison initiatives, and refugee and immigrant support centers, and works closely with the university’s Office of Health Equity and the Meharry Vanderbilt Alliance. In addition, SMC regularly collaborates with 7 student organizations to promote diverse and social medicine-oriented events, including cultural organizations (Latino Medical Student Association, Asian Pacific American Medical Student Association, and Student National Medical Association), an organization of first-generation medical students, the school’s global health organization, and the school’s student-run free clinic. SMC’s mentorship committee has recruited 33 physician mentors, ranging from specialties including Internal Medicine, Obstetrics–Gynecology, and surgical subspecialties. Since its inception, the organization has created a comprehensive, digital Student Advocacy guide focused on specific patient populations with complex psychosocial needs. The organization has incorporated various social mission-oriented topics into the curriculum, including the addition of a case-based learning case on transgender health, 2 novel sessions on structural inequities and microaggressions in a longitudinal course, and a comprehensive proposal for longitudinal race medicine education in the curriculum. Discussion: Without changes in medical school education, the next generation of physicians will be ill-equipped to deal with equity issues as underlying racial and social biases are often reinforced throughout traditional medical training. 4 The SMC is a unique, student-based organization originally created to advance the mission statement of Vanderbilt with regards to promoting training of medical students on social determinants of health, advocacy, and health equity. The organization has created a significant impact in medical education, with over one-fourth of Vanderbilt’s student body involved. The success of this organization speaks to the impact student organizations can have on furthering social medicine within medical education. While emphasis on social determinants of health remains less prioritized within many medical school curriculums, student-based initiatives such as these are a novel, low-cost approach that can greatly enhance awareness of social medicine. Significance: Incorporation of social-centered aspects of patient care into the medical student curriculum is a critical component of medical training, as social determinant of health and health disparities often drive individual and community health. The SMC is an example of a student-based organization that aims to improve these aspects within the medical school, and its effectiveness demonstrates its utility in being a framework organization for other medical schools. Acknowledgments: The authors would like to acknowledge all members of the Vanderbilt Social Mission Committee and the Executive Board, including Samuel Massion, Aisha Suara, Victoria Lawson, Jacqueline Antoun, and Xavier Bledsoe.

Antimicrobial Stewardship: A Modified Team-Based Learning Curriculum With Timeouts for the Inpatient Medicine Clerkship.

Purpose: Medical students are typically introduced to the principle of antimicrobial stewardship in their preclinical years. However, they are often inadequately prepared to participate in the clinical application of stewardship principles when they begin clinical clerkships. 1 While stewardship is an evolving practice, students should be reintroduced and exposed to stewardship principles frequently and identify practical skills to optimize stewardship. In addition, students should be familiar with resources, such as practice guidelines and local antibiograms, as optimal therapies and resistance patterns often change. 2 A timeout is a stepwise approach to evaluating the need for antibiotics and the optimal use of antibiotics. Timeouts are a common tool implemented by hospitals to monitor and manage the use of antibiotics. We propose that teaching clinical medical students to perform timeouts can lead to increased comfort with clinical decision making as it relates to antimicrobial stewardship. Approach: We implemented a modified team-based learning (TBL) curriculum to teach medical students to perform timeouts focusing on common inpatient infections. This curriculum was integrated into the inpatient medicine clerkship orientation for third-year medical students. Students received the following presession materials: (1) a prereading assignment covering basic antimicrobial stewardship principles and a summary of guideline-directed management for common inpatient infections, and (2) a readiness test consisting of multiple-choice questions. The in-person session was 1.5 hours, led by 1 instructor and 1 facilitator, given to 25 to 30 third-year medical students during the required inpatient medicine clerkship orientation occurring 6 times per academic year. The instructor begins the session reviewing the readiness test with the group, then students divide into small groups of 4–5 to work through 2 clinical cases using the timeout framework throughout the case. The instructor and facilitator were available to assist the small groups with problem-solving and clarification. Each timeout case and learning points were discussed with the large group at the end of each case, highlighting different approaches to problem-solving and providing real-time feedback. Outcomes: Surveys completed during the pilot academic year 2017–2018 revealed that over 90% of students agreed or strongly agreed that the learning activity would help their performance on the inpatient medicine clerkship (n = 121). Over 75% of students reported an improved understanding of the purpose of a timeout, and 85% reported an improved ability to participate in completing an antibiotic timeout. Qualitative survey data indicated that students valued both the presession reading materials and interactive nature of the learning activity, which provided a useful review of common inpatient infections and helpful tools for applying the principles of antimicrobial stewardship to clinical cases. Discussion: The modified TBL session, focused on teaching antimicrobial stewardship through the structured framework of a timeout, was an effective teaching strategy in introducing and applying basic stewardship principles. Survey data from this study indicate that medical students find value in learning how to perform a timeout during this interactive session. This skill may translate to the early adoption of stewardship principles, self-guided learning, improved patient outcomes, and the lifelong practice of antimicrobial stewardship. However, further study is needed to determine the long-term effects of antimicrobial use and the most optimal modality to teach this skill set. Significance: A modified TBL curriculum shows promise as an effective teaching modality for antimicrobial stewardship. Formal instruction in how to perform timeouts should be an essential component of the curriculum for clinical medical students as they begin their medicine clerkships to promote and reinforce the practice of these skills early in their careers. Acknowledgments: The authors would like to thank Dr. Clarence Braddock for his support and mentorship in the medical education fellowship program at the University of California, Los Angeles.

Vascular Surgery Curriculum for Medical Students: A National Targeted Needs Assessment

BackgroundAt present, neither the American College of Surgeons (ACS) nor the Society for Vascular Surgery (SVS) provides curriculum recommendations for medical students rotating on a vascular surgery service. We sent a targeted needs assessment to vascular surgeons across the country in order to investigate the need for a structured curriculum for medical students participating in a vascular surgery rotation during their clinical clerkships. MethodsThe survey was developed with input from medical students, vascular surgeons, and medical educators. Respondents were identified from the Fellowship and Residency Electronic Interactive Database (FREIDA). The needs assessment was sent to program directors of vascular residencies and fellowships and to other vascular surgery educators. The survey collected data regarding the existing vascular surgery curriculum at the respondent's institution, the need for a standardized curriculum, desired experiences for medical students, and important vascular topics for medical students to cover while on rotation. ResultsResponses were obtained from 50 of the 146 surveyed individuals (response rate = 34.2%). 48 respondents (96%) worked in an academic hospital or academic affiliated hospital. With regard to the existing vascular surgery curriculum, only 28 respondents (61%) indicated that they had a curriculum approved by the surgery clerkship director. 37 respondents (77.1%) said there were at least goals and objectives for students on the vascular surgery service, and 29 respondents (60.4%) indicated that there was dedicated time for didactic sessions. Only 17 respondents (35.4%) indicated students gave a case presentation on the service. 29 respondents (63%) agreed or strongly agreed that there should be a standardized vascular curriculum for medical students. When asked to rank 9 topics from most important to least important for students to learn, respondents ranked peripheral arterial disease, aortic disease, and carotid disease highest. Simulation experience was most frequently indicated as a desired addition to the curriculum, and only 16 respondents (33.3%) reported opportunities for vascular surgery specific simulation experiences. ConclusionsThis study identified the lack of an existing structured curriculum for medical students, the desire for a standardized curriculum, and key topics and experiences that are felt to be important for students to cover. With this information in hand, vascular educators have the potential to enhance the learning experience of medical students rotating through the service by developing a standardized curriculum.

Twelve tips for developing a systematic acute care curriculum for medical students

There are inadequacies in the practice-readiness of junior doctors for providing acute care in areas of clinical deterioration. In addition, the existing undergraduate curricula are fragmented in how acute care is taught in medical schools. We propose twelve tips for developing a systematic acute care curriculum, including what to teach, how to teach it and, how to assess. Furthermore, we propose and incorporate an acute care learning dashboard as an assessment tool which collates and demonstrates the occurrence of learning, faculty feedback, and students’ reflection. We also summarise the existing online resources available for acute care training. We hope to address the existing issues and improve acute care training to prepare the graduates to become practice-ready professionals.

A comparative study of community medicine and public health curriculum at medical schools in Iran and North America

Background: Community medicine and public health are the core subjects in medical education. One of the main competencies of general physicians in the national curriculum is having knowledge and skills in health promotion and disease prevention in the health system. Any curriculum revision in community medicine departments needs to incorporate the evidence and use pioneer countries’ experiences in this issue. This study aims to compare community medicine and public health courses in medical schools between Iran and selected universities in North America. Methods: The elements of a community medicine curriculum for medical students were compared in a descriptive-comparative study using the Bereday model. These elements included objectives and competencies, educational strategies, teaching and learning methods, assessment, and educational fields in a community medicine curriculum in Iran and in selected universities in North America. A literature search was conducted in CINAHL, SCOPUS, MEDLINE, Web of Science, EBSCO, and on university websites. Results: Essential aspects of community-based strategies among community medicine and public health curriculum of general medicine in universities in Canada and the United States included a longitudinal approach, training in urban and rural primary care centers, teaching by family physicians and health center staff, a spiral curriculum, focus on social determinants of health, taking of social and cultural histories and social prescriptions, learning teamwork, and using LIC (Longitudinal Integrated Curriculum). Conclusion: The objective of community medicine and public health curriculum in selected North American universities was to prepare general practitioners who work in Level 2 and 3 hospitals and to improve their skills to provide high-quality services to the community. Some of the successful points in the selected universities that could be replicated in Iranian faculties of medicine included using integration strategy, a spiral curriculum, and an LIC approach.

Medical students’ preferences in using various learning resources for physiology

Background: The number of resources available and accessible to medical students studying a Physiology in their phase 1 of M.B.B.S. is growing in leaps and bounds. Apart from traditional learning resources such as lectures and textbooks, students are increasingly using e-learning tools to learn Physiology. The students’ preference for learning resources has not been studied in detail in any Indian settings. The deeper and better understanding of the tools used by students for learning medical Physiology could provide useful information to medical educators when designing and implementing Physiology curriculum for medical students. Methods: 200 first M.B.B.S students were invited to complete an online survey. Questions asked were pertaining to students’ frequency of using different types of resources when learning Physiology in first year of M.B.B.S. Results: 192/200 (92%) of students completed the survey, with the respondent age between 17 -19 years. The gender distribution was even, with male (n =93, 46.50%) and female (n = 99, 54.50%) students responding to the survey. The students preferred to attend practical classes (RII = 0.95), read textbooks for learning a topic (RII = 0.91), attend a lecture class (RII = 0.85) and attend a small group discussion (RII = 0.81). Conclusion: Inspite of increase in e-learning resources, traditional resources like attendance in practical classes, reading textbooks for learning a topic, attendance in lecture class and attendance small group discussion for learning Physiology are preferred ways by the students.

Designing Actionable Solutions and Curriculum for Pain Disparities Education.

The Liaison Committee on Medical Education (LCME) require medical schools to teach their students how to recognize and work toward eliminating health disparities. However, time constraints and a dearth of guidance for educators in teaching pain disparities curricula pose significant challenges. Herein we describe successes and lessons learned after designing, implementing, and evaluating an innovative pain disparities curriculum that was embedded in a longitudinal health equity curriculum for third year medical school students at an academic institution. Although the curriculum was developed for medical school students, the concepts may be broadly applicable to other training settings such as residency and fellowship programs.