Medical Science Curriculum Research Articles

Teaching framework of basic sciences in medical curriculum: A literature review

Objectives: The quantity, quantity, and timing of basic sciences teaching in the context of clinical learning have been a debatable issue for a long time. Therefore, this study was planned to evaluate the teaching framework of basic sciences in undergraduate medical education. Materials and Methods: The publications were collected through online searches according to predefined inclusion and exclusion criteria. Three reviewers analysed the data and arrived at a conclusion to select 90 publications. These publications were analysed thoroughly to classify them into ten categories of basic sciences teaching frameworks. Content analysis of these publications was done for comparison across publications. Results: The reviewer’s rate of agreement for their conclusions varied between 89 and 94% for different phases of analysis. The most common category was ‘Integration’ (29%), followed by ‘Problem-based/Case base learning’ (18%) and ‘Mixed-methods approach’ (14%). The strategies being used in basic sciences teaching were mostly learner centred (68.9%). Conclusion: The review of basic sciences teaching frameworks in our study indicates that various frameworks of basic sciences teaching are being used in various medical schools throughout the world. The pattern of these frameworks can contribute to effective policy-making for improving basic sciences teaching.

Impact of team‐based virtual microscopy on student learning in histology

IntroductionHistology is a chief discipline in the basic medical science curriculum, and the practice of teaching it is based on theoretical didactic stratagem followed by practical training. Conventionally, students use to accomplish practical competence in this subject by learning optical microscopy. Nowadays, students can utilize latest information and communication technologies in the study of digital microscopic images. A virtual microscopy program was initiated at All India Institute of Medical Sciences, Jodhpur, India. In view of the fact that little pragmatic substantiation is there regarding the impact of virtual microscopy against optical microscopy on the acquisition of histology comprehension, this study was set up.ObjectiveThe purpose of this study was to: Provide students with a core content resource that transcends the classroom. To assess the students feedback and the impact of a set of measures deliberated to improve an experimental group's understanding of histology. This study evaluate and compare overall laboratory averages and individual test scores along with a student appraisal to determine the effects of using virtual microscopy in place of optical microscopes in a large undergraduate human anatomy course.Material and MethodA pretest‐post test and cross‐over design was adopted. The students' reactions to the instructional measures were assessed by course evaluation data. In the first segment, the experiment yielded two groups in an entire census of 100 students, Group 1 performing the practical sessions with Optical Microscopy versus Group 2 performing the same sessions with Virtual Microscopy. In the second phase, the research subjects switched conditions. The prior knowledge level of all research subjects was assessed with a pretest. Knowledge acquisition was measured with a post test after each phase. Analysis of covariance was done to study the differential gain in knowledge at T1 and T2, considering the possible differences in prior knowledge at the start of the study. Quantitative assessment of students was based on laboratory quizzes.ResultBoth short and long term outcome of implementing such module will be discussed at time of conference. Along with that, discussion would emphasize on its role in the medical education system.ConclusionAlthough allowing students access to high‐quality digitized materials and boosting prerequisite skills are clearly not entirely sufficient to boost final competence. Instead, the solution may lie in making students externally accountable for their learning throughout their training. More importantly, data from assessment scores and evaluation surveys indicated that use of the virtual microscope may significantly improve student performance and learning efficiency. Procedures for successfully implementing this change shall be discussed.

The Necessity of Art Integration in Medical Education from the Viewpoints of Education Experts

Introduction: Medicine is not only a biological science, but also includes the art of dealing with human and spiritual dimensions. Therefore, this study was conducted to investigate the views of medical education professionals and students regarding the integration of art in the medical science curriculum. Method: In this multi-method research, 22 prominent experts in the field of education and 35 medical education students participated. The research tool was a researcher-made questionnaire with seven questions about the need to combine art in medical education, which was done simultaneously with quantitative study, qualitative study and data analysis. Quantitative study method was used descriptively-analytically and content analysis was used in the qualitative part .The face validity and content of the instrument were confirmed by professors and its reliability was confirmed by Cronbach's alpha coefficient (α = 0.832). Result: Basically, 100% of the experts and 80% of the medical students agreed with the integration of art in medical education. They also acknowledged that it does not officially exist in the country's universities and it is necessary to include in the medical curriculum. Also, art has many applications in medical education, including improving teaching and learning, promoting creativity and emotions, keeping content in mind, applied learning, and fostering critical and creative thinking. Conclusion: The results emphasized the integration of art in the medical curriculum as well as the use of art-based teaching-learning in medical sciences. But it is better to be in such a way that does not impose more educational burden on students.

Knowledge and attitude on biostatistics in medical curriculum among medical students

Background: Medical biostatistics has got an important role in the modern medical science curriculum. The present study was planned to assess the knowledge and attitude among medical graduates regarding the role and utility of biostatistics in medical science.Methods: A cross-sectional study among 120 medical students of MBBS final professional of Saraswati Medical College, Lucknow was conducted by using a pre-designed, pre-tested and semi-structured questionnaire. A Chi-square test was applied to find a statistical association. A p value of <0.05 is considered to be significant.Results: Most of the students considered biostatistics is important and helps them in their UG/PG curriculum and thesis/dissertation. Fifty-seven per cent of the study participants are aware of any software used in the analysis of data. Males used at least anyone statistical software more than females (p=0.017). The majority of males (70.3%) and females (67.4%) expressed that it is difficult to understand the concepts of biostatistics. Almost all males (97.30%) and majority females (84.80%) reported that biostatistics textbooks need to be written in simple language (p value=0.026).Conclusions: The role of biostatistics among medical students is of utmost importance as research purpose and importance is increasing in all domains of medical sciences, moreover, the basics of biostatistics should play a pivotal role in the current medical curriculum.

ASSESSMENT OF KNOWLEDGE AND PERCEPTION OF RECONSTRUCTIVE SURGERY AMONG MEDICAL INTERNS.

Plastic surgery is an essential surgical sub speciality which is commonly represented as being a purely aesthetic improvement science. However in reality it holds a vital link in management of oncological or trauma cases. The medical science curriculum does not put weightage on this sub speciality. The present study was formulated to ascertain if the medical interns are adequately oriented to this speciality and the perceptions that they hold for the science. The study included 102 interns who submitted a questionnaire for assessment of their knowledge and perception. The results led to the conclusion that inadequate knowledge exists in terms of plastic surgery and must be attended to. Keywords: Interns, Reconstructive surgery, perceptions

English

BACKGROUND Medical students in India come from diverse cultural, linguistic, economic and social backgrounds. Further, students from similar backgrounds are often found to have obtained their school education from different educational boards. Thus, to ensure a smooth initiation of these diverse population of high school graduates to the challenging medical science curriculum, a foundation course at the beginning of Bachelor of Medicine and Bachelor of Surgery (MBBS) programme was considered to be of utmost importance. General guidelines for this ‘Foundation Course’ were laid down and all institutions were expected to abide by them but provisions were allowed to institutions to make local changes depending on the context and requirements. We wanted to analyse the feedback from the students regarding the foundation course. METHODS A pre-validated questionnaire-based, cross-sectional study was carried out among MBBS students in our institution. The study was conducted in the month of November 2019 after obtaining the institutional ethics committee clearance. RESULTS Most of the students agreed (a total of 86 out of 96 students) with the comment that the course fulfilled the objectives set out in the foundation course brochure. 52.08 % students agreed and 29.16 % students strongly agreed that the course satisfied their need and expectations. 88 out of 96 students agreed that there was opportunity for feedback and evaluation which in turn gives the scope to introduce formative assessment in the course. This constituted the best part in our learning experience. CONCLUSIONS In general, majority of the students’ feedback on the foundation course was in an affirmative note. Most of them felt that the course was well structured and informative enough for them to apply the newly learnt lessons to cope with some of their real-life problems. Their positive feedback as well as the relevant suggestions they submitted will obviously contribute towards encouraging the involved faculties as well as the institute to execute the foundation course in a more user-friendly and structured manner in the future years to come. KEYWORDS Foundation Course, Feedback, MBBS

A Comparison of Oral Health Related Knowledge between Undergraduate Medical and Dental Students

Aim: Studies have reported that the knowledge of medical doctors about dental conditions is not satisfactory. Medical and dental students need to have and reflect good oral health knowledge as they will be major providers of health services in future. This study was conducted to assess and compare the level of oral health knowledge of medical and dental students. Materials and Methods: Using a self-administered structured questionnaire, cross-sectional study was conducted at King Faisal University University, Saudi Arabia. The survey tool consisting of 25 items assessed knowledge about oral health problems, etiology and importance in relation to general health. Descriptive statistics were performed using SPSS version 20. Results: Medical students exhibited a good level of oral health knowledge on 16 (64%) items, whereas dental students demonstrated on 18 items (72%) (p=0.02). In both streams, male students displayed a good level of knowledge on 17 items, while female displayed on 11 items. Mean score of male students to all the questions was 80.68% and that of females was 66.96% (p=0.001). Dental students scored marginally better than medical students for 14 out of 25 items, and mean scores was insignificant between medical and dental students (p=0.21). Students of years 2, 3 and 4 displayed better knowledge compared to those from years 1 and 5 (p=0.001). Students from any particular year did not seem to be having consistently better knowledge than the other years across all the items. Conclusion: This study showed a moderate to good level of knowledge about oral health. Dental students and men displayed somewhat better knowledge levels compared to medical students and women, respectively. Clinical Significance: This study highlights the importance of scientific oral health knowledge for the future health care professionals. Objective is to draw attention towards incorporation of preventive oral health sciences in medical curriculum at undergraduate level.

The effect of Peer instructor teaching and clinical supervision on the status and stressors of clinical nursing education

Introduction: Peer instructor teaching is an educational model in which senior students teach to their classmates or junior students. Clinical supervision is a formal, systematic, and continuous that the inexperienced person reviews and improves their performance by receiving advice from a supervisor or expert. Clinical education is a vital component of the medical science curriculum and the quality and control of its stressors are important. The purpose of this study was to combine peer instructor training model with clinical supervision on the status and stressors of clinical nursing education. Methods: This is a quasi-experimental study in which a combined Peer instructor teaching and clinical supervision program was implemented. The research samples were 60 nursing students of Yazd nursing and Midwifery College who were studying in third and sixth semesters. They were selected by purposive sampling method. Data gathering tools included a four-part questionnaire including demographic characteristics, a questionnaire for assessing instructor performance in clinical education, a standard questionnaire for clinical stressors, a course satisfaction questionnaire and a clinical supervisor completed by self-report. Data analysis was done using SPSS 16 software. Result: on the finding the mean score of peer instructor evaluation was 56.42 ± 9.38 and mean score of clinical stressors was 38.72 ± 5.6. Peer instructor in most cases agreed with the peer instructor program and clinical supervision program. Conclusion: From the learners' point of view, peer instructor performance is at a good level, as well as clinical stressors at the boundary level between moderate and weak, although both results are satisfactory but there is a need for more careful planning and more training by peer educators and more accurate clinical supervision.

Improving genomics and bioinformatics literacy in the undergraduate medical science curriculum

Improving genomics and bioinformatics literacy in the undergraduate medical science curriculum

Identification of dimensions and indicators of spiritual health: A qualitative study.

INTRODUCTION:Spiritual health is considered one of the important dimensions of health and has been given serious attention by the scientific community, World Health Organization, health discourse, and medical education. However, despite these considerations, there is a controversy in defining the nature of this category and its dimensions and indicators. The purpose of this study is to identify the indicators and dimensions of spiritual health for medical students.MATERIALS AND METHODS:This qualitative study with exploratory approach utilized conventional content analysis and individual in-depth interviews with experts in the area of spiritual health and spirituality in medical sciences selected through purposeful sampling. The study was conducted at Aja University of Medical Sciences in Tehran in 2018. The semi-structured interview was a tool used to achieve data saturation, that interviewed with 19 experts. Member check, credibility, and reliability were measured to increase the validity and reliability of the results. Inductive content analysis was used for the analysis of data in three main phases: preparation, organization, and categories and creating categories.RESULTS:Based on the findings of the interviews, 52 indicators were identified.Then, the indicators of spiritual health were identified in the following four categories) relationship with God, relationship with himself, relationship with others, relation with the environment (and these categories were divided inthree dimentions (cognitive, attitudes and emotions, behavioral)CONCLUSION:The findings of the present study showed that in order to have spiritual health, it is important to pay attention to one's relationship with God and one's relationship with oneself, one's relationship with others, and one's relationship with the environment, and it is necessary to pay attention to it in medical science curricula.

Discussion on teaching design of medical experimental zoology

Medical experimental zoology is a very important course in medical colleges. The course construction of medical experimental zoology is of great significance for students in their understanding of the subject and scientific research as a whole. This article reviews the current situation of experimental zoology courses in medical colleges at home and abroad, describes the teaching design, teaching content and assessment methods in our school (North Sichuan Medical College), and then collects feedback and advices from students after they finish the course. This study aims to provide certain reference and thought for medical science curriculum reform innovation. Key words: Medical experimental zoology; Teaching design; Discussion

Integration of a Massive Open Online Course on Clinical Kidney, Pancreas and Islet Transplantation into a Regular Medical Science Curriculum

Integration of a Massive Open Online Course on Clinical Kidney, Pancreas and Islet Transplantation into a Regular Medical Science Curriculum

Study of impact of vertical integration in medical education in a medical college of India

Background: It is postulated that memory of basic sciences in medical curriculum and its correlation with clinical work among undergraduate students is less than expected, which drives into the dire necessity to vertically integrate the subjects. The aims and objectives of the study were to assess the impact of vertical integration of teaching among medical undergraduate students of a medical college and to assess the perceptions of the medical undergraduate students about the vertical integration of teaching during lecture classes in a medical college.Methods: Ninety six out of 119 second MBBS students had undergone vertically integrated sessions by six departments of a medical institute on assessment and management of diarrhoea using four interactive methods and two traditional teaching methods during April 2015 to September 2015 among the M.B.B.S. students of Rohilkhand Medical College and Hospital, Bareilly. Inclusion criteria were all the M.B.B.S. 2nd year students of 2013 batch were included in the study. Exclusion criteria were the M.B.B.S. students who were absent on the day of study were excluded. Competency of students was assessed using competency based assessment methods i.e. OSCE, OSPE, DOPS, SAQ and MCQs and their perceptions recorded using Likert’s Scale. Comparative analysis of pre and post-tests was done using paired t-test and ANOVA.Results: The difference between the mean value of the marks obtained by the medical students using the five assessment tools was found to be statistically significant (p value being <0.05) using paired t-test, showing improvement in competency. Vertical integration was strongly agreed upon as the best method by 45.8% on Likert scale. Comparative analysis of variance (ANOVA) of the assessment tools was also found to be highly significant (p value being <0.05).Conclusions: The indexed study derives us to a conclusion to incorporate vertical integration in our medical education in order to accomplish higher learning domains.

Does study skill matter? A descriptive study on undergraduate health profession students in the University of West Indies

Introduction: Academic success requires students to evolve good study skills, time management and reducing distractions. As students in medical education are adult learners, it is expected that students need to be effective learners and should use self-directed strategy to find out the necessary information. Therefore, the teaching learning process in medical schools should encourage and motivate students to improve their self-directed capabilities. This body of research was conducted to identify the different study habits among students from five undergraduate health disciplines. Method: The Approaches and Study Skills Inventory for Students (ASSIST) questionnaire was administered to 367 students from five undergraduate health disciplines selected through convenient sampling. Results: The most popular definition of learning picked up by the respondents (73.3%) was ‘able to use the information’. Majority of the students were found to be strategic/deep learners. Male (vs. female students) and nursing students (vs. others) opted deep approach of learning. Students who are staying at home mainly used strategic/deep approach. Deep style was adopted least by the dentistry students, whereas the strategic style was used least by the veterinary students. One way ANOVA reveals that types of school in which the students are enrolled has significant effect on all the subscales of approach to studying either at 0.05 or 0.01 levels except ‘interest in ideas’ and ‘organised studying’. Conclusion: Students from different schools used varied approaches to their study and understanding of learning and as a whole student mainly adopted strategic and deep approaches, Students with a deep approach usually achieve a higher academic performance and motivating students towards a deep approach should be main aim of the medical science curricula. Further studies of learning styles in other medical schools in the Caribbean are required to examine whether there are specific benefits to particular styles for certain disciplines.

Avoiding Racial Essentialism in Medical Science Curricula

A wave of medical student activism is shining a spotlight on medical educators' sometimes maladroit handling of racial categories in teaching about health disparities. Coinciding with recent critiques, primarily by social scientists, regarding the imprecise and inappropriate use of race as a biological or epidemiological risk factor in genetics research, medical student activism has triggered new collaborations among students, faculty, and administrators to rethink how race is addressed in the medical curriculum. Intensifying critiques of racial essentialism are a crucial concern for educators since bioscientific knowledge grounds the authority of health professionals. Central ethical issues-racial bias and social justice-cannot be properly addressed without confronting the epistemological problem of racial essentialism in bioscience teaching. Thus, educators now face an ethical imperative to improve academic capacities for robust interdisciplinary teaching about the conceptual apparatus of race and the recalibration of its use in teaching both genetics and the more pervasive and urgent social causes of health inequalities.

Problem-Based Learning Facilitates Vertical Integration of Basic and Clinical Sciences in Medical Curriculum

Problem based learning facilitates vertical integration of basic and clinical sciences in medical curriculum

A Sustainable Medical Anatomy Program Supported With Small 3‐D Printed Human Parts

PurposeCadaver dissection is a rite of passage for medical students in the U.S. Learning gross human anatomy though the identification, characterization and functions of tissue, bone and organ, etc. is a unique visual, tactile and visceral experience. Numerous ethical issues surround the proper acquisition of cadavers using informed, implied consent, willed body program and collection of bodies that are abandoned in hospitals and morgue that make cadaver harvesting a continuing challenge.Sustaining a human cadaver anatomy lab requires look at two distinct lenses: as curriculum and financial opportunities. The Human anatomy lab is a unique learning that students have to perform their exploration and examination within this controlled environment. The opportunity to learn about specific diseases that have physical manifestations in the human body such as cavitation and black tar deposit in smokers, cataracts in the eyes and other organ‐based tumors are possible as manufactured specimens in a 3‐D printer which have become affordable to acquire and maintain.Human anatomy labs that can house numerous bodies require a climate controlled space, trained personnel, safety and septic protocols, a robust cadaver donation and body cremation program that can is costly to operate. Other methods such as plastination which preserves the human cadaver for longer periods of time, prosections for close‐up study of specific sections of the human body typically cost less than a full‐body cadaver, simcadavers which are full body synthetic cadavers and computer based cadavers are available as human cadaver lab replacements or supplements.MethodsThe first phase of this program is to create a pilot program that will create a talent base of instructors, staff and students who can be proficient in the use of a 3‐D human anatomy modeling program and in the use of 3‐D printers. Instructional activities will incorporate “Learning through Design” that will use Higher Order Benjamin Bloom's taxonomy of learning objectives in the “Create” level which is one of the highest level of cognitive dimensions. Students will start off with basic virtual organ models that can be modified and specific morbidities designed with them. Students will be assigned in teams to work on their models and print them for peer and instructor critique and study.ResultsStudents in the Gross Anatomy basic medical science curriculum will be able to experience learning not just by dissecting, probing and analyzing human anatomy but also through the building of models and printing them in a three dimensional format. There will be some learning curves for the faculty, staff and students to implement this innovative “Learning through Design” program which will challenge and eventually innovate the teaching of anatomy to medical students.ConclusionThis proposed enhancement of the teaching of gross anatomy in a basic medical science curriculum looks at not replacing the traditional cadavers but supplementing the program through specific human anatomical parts such as the prostate gland, testicles and breast tissue, etc. and reproducing gross anatomical diseases such as organ specific tumors and lung damaged tissue of smokers, etc. Faculty and students will learn how to use a three dimensional software to model the gross organs and a three dimensional printer. Students can create the specific organ with the associated morbidity without the fear of contracting contagious diseases.Support or Funding InformationNone

Knowledge and perception regarding clinical trials among doctors of government medical colleges: A questionnaire-based study.

Aims:By virtue of being a specialized field by itself, the science of clinical trials (CTs) may not be well understood by doctors who are not specifically trained in it. A lack of knowledge may translate to a negative perception toward CT. With the idea of getting a situational snapshot, we estimated the knowledge and perception of CTs among doctors from government medical colleges of West Bengal who are not trained on CT in their postgraduate curriculum. Several determinants of knowledge and perception regarding CT were also evaluated.Methods:We have quantified the knowledge and perception of CTs by a structured validated questionnaire. Development and validation of the questionnaire was performed prior to the study.Results:Among 133 participants, 7.5% received focused training on CT and 16.5% participated in CTs as investigators. Majority of the doctors were unfamiliar with the basic terminologies such as, “adverse event” and “good clinical practice.” Encouragingly, 93.3% doctors advised that a detailed discussion of CT methodology should be incorporated in the under graduate medical science curriculum. They had an overall positive attitude toward CTs conducted in India, with a mean score that is 72.6% of the maximum positive score. However, a large number of the doctors were skeptical about the primary motivation and operations of pharmaceutical industry sponsored CTs, with 45% of them believing that patients are exploited in these sponsored CTs.Conclusion:Participant doctors had a basic knowledge of CT methodology. The study has revealed specific areas of deficient knowledge, which might be emphasized while designing focused training on CT methodology.

Comparison between standards of medical school accreditation of World Federation for Medical Education and Korean Institute of Medical Education and Evaluation

7Division of Rheumatology, Department of Internal Medicine, KyungHee University Medical Center, KyungHee University, Seoul, Korea.Medical school is the core of medical education to teach students. Medical school has a educational programmes under adifferent environment. Evaluation of medical school undertakes to promote the highest scientific and ethical standards in medicaleducation, initiating new learning methods, new instructional tools, and innovative management of medical education. We findout the differences compared the standards of WFME and KIMEE.World Federation for Medical Education(WFME) is an accrediting agency charged with quality improvement in the medicaleducation in the world. The WFME recommends global standards, which are structured to 9 areas with a total of 36sub-area inthe medical education. 9 Areas are mission and objectives, educational programme, assessment of students, students, academicstaff/faculty, educational resources, programme evaluation, governance and administration, continuous renewal. Sub-areas aredefined as specific aspects of an area, corresponding to performance indicators including basic standard and standard forquality development. Korean Institute of Medical Education and Evaluation (KIMEE) evaluates the 'Basic Medical ScienceCurriculum' in medical schools in Korea. The KIMEE recommends standards, which are structured to 6 domain with a total of 97sub-domain in the medical education. 6 domains are operating system, basic medical curriculum, student, faculty, facilities&equipments, and post-graduation. KIMEE has developed 97 global standards for appraisal of basic medical education. Bothinstitutions have the common standards to improve basic medical education and undertakes to promote the high scientific andethic standards in medical education. Modification of the WFME standards according to our country reality will be validity andobjective..

"Where Does the Circle End?": Representation as a Critical Aspect of Reflection in Teaching Social and Behavioral Sciences in Medicine.

This paper describes a reflective learning program within a larger curriculum on behavioral and social science that makes use of close reading, written representation of experience, discussion, and textual response. This response may in turn lead to further reflection, representation, and response in a circular pattern. A unique feature of this program is that it pays attention to the representation itself as the pivotal activity within reflective learning. Using the narrative methods that are the hallmark of this program, faculty writings were analyzed to characterize the essential benefits that derive from these practices. In the context of a faculty development seminar on the teaching of behavioral and social sciences in medical curricula, a group of 15 faculty members wrote brief narratives of reflective learning experiences in which they had made use of the methods described above. Their responses were submitted to iterative close reading and discussion, and potential themes were identified. Four themes emerged: writing as attention to self, writing as attention to other, writing as reader/writer contract, and writing as discovery. In each instance, writing provides a new or deepened perspective, and in each case, the dividends for the writer are amplified by the narrative skills of those who read, listen, and respond. The narrative pedagogy described and modeled herein provides a potentially promising approach to teaching the social, cultural, behavioral, and interpersonal aspects of medical education and practice. Future research will deepen our understanding of the benefits and limitations of this pedagogy and expand our appreciation of its applications.