Prematriculation Program Research Articles

A Survey of the Design of Pre-matriculation Courses at US Medical Schools

In medical education literature, it is unclear whether standard practices exist among pre-matriculation courses at US medical schools. The purpose of this project was to investigate how pre-matriculation courses are designed and utilized in US medical schools. Lists of the current medical schools that belong to the AAMC and AACOM were obtained. Medical schools in Canada and Puerto Rico were excluded. A total of 171 schools met the inclusion criteria. A phone survey consisting of 19 questions was conducted obtaining information about pre-matriculation courses and their design from 2012 to 2014. Data was manually entered into IBM SPSS 19, which was used to generate summary statistics. Of the 171 schools that met inclusion criteria, 133 schools were reached. Thirty-one schools responded “yes” to having a pre-matriculation course. Since 2010, there was a 52.2% increase in the prevalence of pre-matriculation programs in the USA. Only 21.7% of courses are exclusively geared toward “high-risk” students. The mean course length is 3.96 weeks, 75% of the courses are delivered by faculty, and 75.65% of course content covers basic science material. An improvement in student academic performance was listed by 95.7% of the schools as a primary goal. Pre-matriculation courses at US medical schools are not compulsory, and the trend toward utilizing these courses appears recent. There are many intended outcomes. Our literature review and survey research do not conclusively support the efficacy of pre-matriculation courses in improving student performance but, rather, provide a basic framework for current course design.

Development of an interdisciplinary pre-matriculation program designed to promote medical students’ self efficacy

ABSTRACTBackground and objectives: A four-week interdisciplinary pre-matriculation program for Native American and rural medical students was created and its impact on students’ transition to medical school was assessed. The program extends the goals of many pre-matriculation programs by aiming to increase not only students’ understanding of basic science knowledge, but also to build student self-efficacy through practice with medical school curricular elements while developing their academic support networks.Design: A mixed method evaluation was used to determine whether the goals of the program were achieved (n = 22). Student knowledge gains and retention of the microbiology content were assessed using a microbiology concept inventory. Students participated in focus groups to identify the benefits of participating in the program as well as the key components of the program that benefitted the students.Results: Program participants showed retention of microbiology content and increased confidence about the overall medical school experience after participating in the summer program.Conclusions: By nurturing self-efficacy, participation in a pre-matriculation program supported medical students from Native American and rural backgrounds during their transition to medical school.Abbreviations: CAIMH: Center of American Indian and Minority Health; MCAT: Medical College Admission Test; PBL: Problem based learning; UM MSD: University of Minnesota Medical School Duluth

Medical Student Bridge Program Case: Mary Beth Chrispy.

Many colleges and medical schools are incorporating boot camps and transition programs for students prior to their first year of medical school. In these prematriculation programs, students are given early introductions to teaching modalities and study strategies. This resource provides a realistic case scenario that introduces students to the basic case format while guiding them through the thought process needed to work through a case. Additionally, it provides students with small-group skills that will be beneficial when working through cases in the first and second years of medical school. The case features Mary Beth Chrispy, a 25-year-old second-year medical student who visits her primary care physician with complaints of fatigue and difficulty with focusing on her studies. Presenting questions throughout the case help guide students in making necessary connections and allow the facilitator to lead the students through each section of the case. There is no prereading to be done before the first meeting of the case. Students need to be willing to participate in the motions of the case so that they are prepared for their actual casework in the first year of medical school. Six questions pertaining to the case were placed on a self-assessment, and the students' ability to answer the questions, based on their work throughout the week, was measured. On five out of six questions, 94.4% of students (N = 19) answered correctly. On the remaining question, 100% of the students were able to answer correctly. We concluded that the activity met our learning objectives. Institutions that would like to include this case in their own prematriculation programs may want to utilize a standardized patient during its introductory clinical encounter.

A Summer Prematriculation Program: Bridging the Gap for Disadvantaged Underrepresented Minority Students Interested in a Nursing Career.

The nursing and health care workforce needs diverse clinicians who can provide culturally competent and high-quality care to an increasingly diverse U.S. Achieving this goal requires creating learning environments that foster the success of disadvantaged underrepresented minority (URM) students seeking nursing careers. This 4-week summer prematriculation program introduced 33 URM individuals from disadvantaged backgrounds to nursing as a career through financial support, academic enrichment, and social support to enhance nursing program admission success. Federal guidelines were used to establish URM and economically disadvantaged status. To date, one third of program participants have been admitted to nursing programs. Fundamental reforms in pre-college education systems, such as the evidence-based strategies implemented in our summer prematriculation program, may be needed to achieve a diverse, culturally competent workforce that can help eliminate persistent health and health care disparities. [J Nurs Educ. 2016;55(8):471-475.].

Impact of Pre-Matriculation Instruction on Student Acculturation and First-Year Academic Performance in Medical School

The Texas A&M University Health Science Center College of Medicine recently implemented a pre-matriculation program (MedCamp) for a targeted group of first-year students. This pilot study was conducted to correlate the MedCamp experience with academic performance in the first-year biomedical science disciplines in gross anatomy, histology, physiology, biochemistry, and genetics. The academic performance of students who participated in MedCamp was compared with that of students who did not participate in MedCamp. The components of this 4-week MedCamp included activities geared toward preparing students for the rigor of the medical curriculum, social and professional expectations as medical students, and insight into areas for improvement. Twenty-four students participated in MedCamp. Students ranged in age from 21 to 51, with 10 females and 14 males that represented many ethnic groups, and had an average MCAT score of 29.17 and overall BCPM (biology, chemistry, physics, and math) GPA of 3.61. Quantitative analyses of overall performance in the first three basic science foundation blocks indicated that the MedCamp participants did not show a significant difference in performance when compared with their peers (two tailed t tests, α = 0.05). Qualitative results were positive from the participants, highlighting expectations, acculturation, mentorship, and professionalism.

Preparation for Medical School via an Intensive Summer Program for Future Doctors: A Pilot Study of Student Confidence and Reasoning Skills

A medical school conducted a summer pre-matriculation program. The program provided basic sciences content comparable to first year medical student instruction along with clinical and other learning experiences. The study purpose was to examine self-confidence levels and reasoning skills of a single cohort of students. We examined the association between students’ confidence, reasoning skills and performance measures. We also examined performance differences based on student gender, ethnicity and socioeconomic backgrounds. 32 students were given two confidential surveys in a pre/post-test format. Student confidence was measured using a modified version of the Motivated Strategies for Learning Questionnaire (MSLQ). Student reasoning skills were measured using the Health Sciences Reasoning Test (HSRT). Student performance was measured via written exams. Survey item mean differences and inter-item correlations were examined using the T-test and Spearman procedures. Data were analyzed using SPSS software, with significance levels for all tests set at p=.05. Completed pre- and post-test surveys were returned from 29 students (91%) for the MSLQ and 18 students (56%) for the HSRT. A single item on the MMSLQ was significantly different on the post-test. Student race, gender and socioeconomic background were poor predictors of overall performance but were associated with selected measures of student confidence and reasoning skills. Students enrolled in medical school preparatory classes may be overly confident prior to experiencing medical school. Demographic variables deserve attention by medical school staff, particularly when the school’s mission focuses on successful performance by students from under-represented groups.

A Medical School Prematriculation Program for Rural Students: Staying Connected With Place, Cultivating a Special Connection With People

Problem:Rural medical students who attend urban medical schools experience urban disruption that may make it less likely that they will return to rural practice. Most prematriculation programs focus on academic preparation and are in urban areas, potentially adding to urban disruption. Most initial learning experiences concerning communication with patients are also in urban areas. Intervention: Fifty-nine rural preclinical students completed a 3-week summer rural prematriculation program from 2009 to 2014. The focus was on learning a holistic approach to interviewing patients and experiential learning based in a rural practice. Group reflection sessions focused on understanding health beliefs, psychosocial details of the patient's life, and the importance of the sense of place. Measures included student reports, program evaluations, and a pre- and post- 10-item opinion survey focused on the students' perceived importance of traditional biomedical and psychosocial knowledge. Context: The program was based at the Trover Campus, a regional clinical campus of the University of Louisville School of Medicine, in a town of 20,000 in the western Kentucky coalfields that is 150 miles from the main urban campus. Practice site assignments were in surrounding medically underserved towns in family medicine practices. Outcome: After the 3-week experience, students became comfortable with interviews concerning health habits using the Prochaska model of lifestyle modification and expressed an increased importance of some psychosocial factors and a corresponding decrease in importance of traditional biomedical factors in choosing treatment for an individual patient (significant results by Mann–Whitney, two-tailed, ranged U = 1136.0, p = .001 to U = 1377.5, p ≤ .05). Student reports showed that the students gained a new detailed understanding of rural practice. Students also expressed an appreciation for having developed a support network of fellow rural students with whom they would begin medical school on the urban campus. Lessons Learned: These results support the value of a summer prematriculation program for rural students based in a rural area. New appreciation for psychosocial patient factors, new skills in communication with patients, new understanding of the details of rural practice, and new relationships with other rural classmates were perceived as positive aspects of the program. Longer term measures of whether the program decreased urban disruption significantly will require continued tracking of the students until they make a practice choice 7 to 9 years later. Wider collaboration with other medical school rural programs is necessary to determine which aspects of rural-focused training are most effective.

Are Clinical Vignette Questions Harder Than Traditional Questions in Gross Anatomy Course?

The introduction of clinically relevant materials into Gross Anatomy education has created the need for these changes to be reflected in assessment of anatomy knowledge in the form of clinical vignette questions (CVQs). Although there is widespread support for more integration of clinical scenarios throughout the new basic science curricula, little is known about how first year medical students handle the seemingly more complicated CVQ format. Thus, it is incumbent upon us as anatomists and educators to evaluate the pros and cons about CVQs using other than anecdotal evidences. The purpose of this study is to compare the scores between CVQs and well‐matched traditional questions in a summer pre‐matriculation program. 24 students who had already been accepted into either medical or dental school participated in a six‐week‐long summer gross anatomy program that consisted of two blocks covering the back & upper limb and head & neck accompanied by cadaveric dissection. Both lab and written tests were given for each section. The latter consisted of 50 multiple‐choice questions with 25 CVQs and 25 traditional questions. Our data indicated that students didn't adapt well to the CVQ format in the first exam (P<0.05, n=24). However, results from the second test demonstrated an opposite but statistically insignificant trend between the CVQs and traditional questions (n=22). The current study suggests that students can quickly learn how to answer questions with clinical scenarios after practice. Although a survey indicated that students perceived CVQs as more difficult than traditional questions (n=22), results of the second test indicated that CVQs were not harder than similar traditional questions.

Implementation of a study skills program for entering at-risk medical students.

While the first year of medical school is challenging for all students, there may be specific issues for students from rural areas, economically disadvantaged backgrounds, ethnic minorities, or nontraditional age groups. A Summer Prematriculation Program (SPP) was created to prepare entering at-risk students for the demands of medical school. For the past 2 yr, an emphasis was placed on the development of appropriate study plans and skills. On presurveys, students predicted an increase in their number of study hours per lecture hour, from 7.6 h in undergraduate coursework to 9.1 h in medical school coursework (n = 35). These study plans were infeasible given the rigorous didactic lecture schedule in medical school. Interventions were made through lectures on study plans and modeling of appropriate study habits using engaging lectures in the SPP physiology course. At the end of the program, a postsurvey was given, and students reported a reduction in the planned hours of study to a more realistic 3.9 h of study time per hour of lecture. Furthermore, students planned to decrease their use of textbooks while increasing their use of concept mapping, videos, and peer teaching. The majority of students completing the SPP program with a study skills emphasis performed well in the Medical Physiology course, with 4 students honoring in the course, 27 students passing, and 2 students remediating the course after an initial failure. These results indicate that at-risk medical students may have inappropriate study plans that can be improved through participation in a program that emphasizes study skills development.

The use of a Prematriculation Medical Physiology course to help at‐risk students develop appropriate study plans

Medical schools frequently have trouble recruiting students from rural areas and ethnic minorities, and often these students are at high risk for academic challenges. A Prematriculation Program was created to assist at‐risk students in preparing for demanding medical school didactic schedules. Students were exposed to core content, as well as strategies for time management, study skills, etc. On pre‐surveys, students predicted an increase in their number of study hrs/ lecture hr, from 6.2 hrs in undergraduate coursework to 8.4 hrs in medical school coursework (n=17). Students reported to revise their study methods by increasing the use of instructors’ notes, multimedia resources, flow charts and diagrams, and group study strategies. A discussion illustrated the infeasibility of 8.4 hrs of study time with the content load, so students were exposed to active learning strategies and study skills to improve their ability to master Physiology efficiently. At the end of the course, a post‐survey was given, and students reported similar plans for their study methods. However, there was a reduction in the planned hours of study to a more realistic 3.9 hrs of study time/hr of lecture.

University of Nebraska College of Medicine

University of Nebraska College of Medicine

Developing an Online Prematriculation Orientation Program and Its Relation to Student Performance in the First Class Taken in Medical School

Background: In 2004 the University of Nebraska College of Medicine developed an online prematriculation program, Fast Start, to introduce students to the environment and expectations in medical school. Purpose: This quantitative study was conducted to determine whether using Fast Start correlated with performance in the gross anatomy course. Methods: A hierarchical regression analysis was used to correlate grades in gross anatomy with a set of common prediction variables and a variable for use of Fast Start. Results: The results showed that the predictive power of the full model, including the Fast Start variable, was slightly stronger than for the reduced model. A separate model verified the absence of an interaction between Fast Start use and prior academic ability. Conclusions: The online Fast Start program provided an efficient and effective method of delivering a prematriculation student orientation experience; its use was associated with marginally improved performance in a medical school course.

Performance in a prematriculation gross anatomy course as a predictor of performance in medical school

The University of California at Davis School of Medicine offers a prematriculation program to nontraditional students. As part of the program, students take a 7-day course on the gross anatomy of the upper limb that concludes with a written examination and a practical examination based on prosections. Here, the performance of students who took the course from 2002 to 2004 (n = 48) is compared with their performance in the medical gross anatomy course as well as their performance on Step 1 of the United States Medical Licensing Examination (USMLE). Both rank in the prematriculation program's anatomy course and the score on the examination were correlated (significant at the 0.01 level) with performance on the medical gross anatomy midterm and final examinations, the overall final grade, and class rank. Performance in the prematriculation anatomy course was also correlated with the score on Step 1 of the USMLE (rank significant at the 0.02 level; examination score, significant at the 0.05 level). Students who took the prematriculation course who eventually withdrew, were dismissed for academic reasons, or who failed the first attempt at the Step 1 of the licensing exam (n = 5) had a significantly lower score (77.6 +/- 11.1; P < 0.05) on the prematriculation examination than did successful prematriculation students (86.2 +/- 7.9). Thus, a gross anatomy examination following a short prematriculation course can be a predictor not only of medical student performance in anatomy, but also of performance on a standardized licensing examination.

Pre-matriculation program at the University of South Florida College of Medicine.

Underrepresented-minority (URM) students at the University of South Florida College of Medicine increased from 4.9% to 10.5% of the total student body from 1991 to 1997. During that period it became clear that some majority and minority students had serious academic difficulties with the first-year curriculum and that a higher proportion of the minority matriculants had difficulties. In response, the college in 1997 created the Summer Pre-matriculation Program to reduce the number of first-year students who had academic difficulty. In the summer before they matriculate in the college, the students complete a six-week program of lectures, small-group discussions, compute-aided instruction, and laboratory instruction in biochemistry, human embryology, and gross anatomy. URM students, non-science majors, and students who have been away from the academic environment (e.g., pursuing medicine as a second career) are given priority for the 20 positions available each year. At the end of the first cohort's first medical school year, the academic performances of program participants and other students were compared, and it was clear that the program participants had performed as well as or slightly better than their counterparts in gross anatomy, biochemistry, and human embryology. Further, the program participants performed at or above the class average in medical school courses for which they had not had targeted instruction during the program. The College of Medicine is committed to diversifying its student body and realizes that diverse students bring varying levels of academic preparation as well as diversity in cultural and academic backgrounds. Concerted efforts such as the pre-matriculation program may be required to normalize the "playing field" at the very outset of medical school and to ensure that every matriculant has an equal opportunity to succeed.

The Urban Health Program to encourage minority enrollment at the University of Illinois at Chicago College of Medicine.

Since 1969, the University of Illinois at Chicago College of Medicine has worked to recruit, admit, and graduate a more diverse population of physicians. The state of Illinois ranks third in the nation in the number of African American residents, and fifth in the number of Latinos, and these groups together account for approximately 60% of Chicago's population. To attract applicants from these groups, the medical school created the Medical Opportunities Program and its successor, the Urban Health Program, to maximize this pool of applicants. Outreach activities at undergraduate colleges, in association with premedical organizations, identify underrepresented-minority (URM) students who should receive support in their applications. The organizations assist in monitoring the applications of URM candidates. Also, the medical college created academic and social support programs for its URM students: a prematriculation program, small-group review sessions for every major course in the first two years of the curriculum, help for second-year students preparing for the United States Medical Licensing Examination Step 1 and fourth-year students preparing for Step 2, and support for organizations for minority students. Over its 30 years, the program has had a substantial impact on the number of URM students entering the medical college, other medical schools, and other health professions. Over these years, the proportion of URM students in the medical college's overall enrollment rose from 10% to 23%. Also, a higher proportion of the college's URM graduates than its non-URM graduates practice in the Chicago area.

Minority enrichment programs at the New Jersey Medical School: 26 years in review.

In 1971 the New Jersey Medical School formed a task force to address the training of physicians from minority and disadvantaged backgrounds, and in 1972 the Students for Medicine Program (SMP) was launched. The program, one of the first of its kind, provided previews of college science courses to help minority students develop their noncognitive skills and make the transition to medical school. The school has also established other minority programs. The programs have been designed to form a health careers pipeline for college-bound students, beginning in the eighth grade. Grade-specific summer experiences, as well as year-round monthly workshops, are offered to all participants. The workshops for pre-college and college students and their parents are designed to strengthen students' academic skills, address issues such as self-esteem, provide exposure to health professions, and increase parents' knowledge and involvement. From 1972 to 1998, there had been 1,722 participants in the pre-college, 1,875 in the college, and 683 in the prematriculation programs, respectively. They were from the inner city, most of them African American, but with a growing number of Hispanics. From 1987 to 1994, 36% of the SMP participants entered health professions schools. In 1996, the medical school created the New Jersey Partnership for Health Professions Education, a collaboration of high schools, universities, community-based organizations, the federal government, and the health professions schools. It works to strengthen the medical school's "pipeline" for underrepresented minority students while eliminating competition among programs for the same students and simultaneously developing a larger pool.

Prematriculation program grades as predictors of black and other nontraditional students' first-year academic performances.

This study explored the relative strengths of select background variables, including grades in a summer prematriculation program (SPP), as predictors of students' first-year academic performances. During the years 1980-1989, 115 black and other nontraditional prematriculants at the Medical College of Georgia School of Medicine attended a four-week SPP featuring courses in biochemistry, anatomy, and immunology. Canonical correlation analysis revealed that the combination of undergraduate grade-point average (GPA) and SPP grades in biochemistry and anatomy was the best predictor of the students' academic performances based upon their first-year grades in biochemistry, anatomy, and microbiology, and upon their GPAs for all first-year basic science courses. The authors conclude that SPP grades can be used to identify the specific academic weaknesses of nontraditional students at highest risk of falling into academic jeopardy.

Evaluation of a summer prematriculation program for black and other nontraditional students.

This study evaluated the effectiveness of the Medical College of Georgia School of Medicine's Summer Prematriculation Program in facilitating participants' first-year achievement and retention from 1980 to 1989. The four-week curriculum included biochemistry, anatomy, immunology, learning skills, medical or anatomy terminology, and clinical forums. Of 101 black and 96 other nontraditional, at-risk students who had been invited to attend the program, the 115 attendees were compared with the 82 nonattendees on a variety of demographic and academic measures. For all measures examined, no statistically significant difference was found between the two groups. Several factors may have obscured the results. However, there were indications that the program had a favorable effect, including the evaluation by over 90% of the attendees that the program had contributed positively to their adjustment to medical school.