Traditional Medical Curriculum Research Articles

Simulation techniques in the anatomy curriculum: review of literature

Modern medical education faces a problem of combining the latest technology, procedures and information with classic teaching methods. Simulation is a technique, which replaces or amplifies doctor-patient experiences in controlled conditions and therefore evokes or replicates substantial aspects of the real world in a fully interactive manner. The basic course of anatomy in medical education could be recognised as the best example of implementing new educational techniques such as simulation, into the traditional medical curriculum. The PubMed database was searched using specific key words. Finally 72 articles were accepted and were divided into 3 basic categories of teaching methods: Category 1 - cadaveric dissection, Category 2 - simulator based education and Category 3 - other. A state of the art anatomical curriculum offers numerous possibilities and solutions including the oldest like cadaveric dissection and newest like simulators. Different simulation techniques are used with different intensity; however cadaveric dissection is still the most popular method. The second most frequent method is simulation-based training, in which North America is the leading country. The identification of anatomical structures during virtual surgical procedures or laparoscopic robotic procedures can be integrated into the traditional anatomy course. New technologies are supportive and beneficial in anatomy teaching however each excitement of new technologies sometimes should be tempered and evaluated for its usefulness in making the learning process constructive for students and their future practice.

‘Workshops in healing’ for senior medical students: a 5-year overview and appraisal

We report upon the design, content and feedback from an interactive, experiential series of Workshops in Healing for senior medical students. Fifty-six final year medical students enrolled in 2×3 h...

Workshops in Healing for Senior Medical Students: A 5 Year Experience

Objectives: To provide a 5-year (2008-2012) overview and appraisal of a novel course for senior undergraduate medical students (Workshops in Healing) at the University of New South Wales, Sydney, Australia within the context of a traditional 6-year curriculum. In these innovative workshops, 8-12 self-selected students per year participate over 6 hours in two sessions, several days apart. The sessions use artwork and other evocative images, poetry, music, statues and classic/contemporary literature to illustrate points of discussion relating to suffering, healing and the doctor-patient relationship. Methods: A written open-ended reflection was requested from 48 students in the final year of their 6-year medical course within a few weeks of the second workshop. The study employed an emergent qualitative design. Open coding involved repeated reading of the sections of the student’s feedback and a line-by-line analysis of this data. Selective coding was then used to link data together and develop the themes.Results: Students identified the following benefits from the workshops: 1) the opportunity to re-affirm their commitment to their chosen career path; 2) the value of listening to other students share their stories; 3) the importance of the timing of the Workshops to occur after exams; 4) the use of various mediums such as art, music and literature to present concepts of suffering and healing; and 5) the creation of a safe and confidential space.Conclusions: Students reported that the workshops gave them a renewed sense of drive and enthusiasm for their chosen career. They highlighted the importance of addressing an aspect of Medicine (healing) not covered in the traditional medical curriculum. For many students the workshops provided a broader understanding of the meaning of concepts such as suffering and healing, and helped them to rediscover a deeper meaning to Medicine, and their roles as healthcare professionals.

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Teaching secular trends of human anatomy in a novel medical school module

Human anatomical structures show a wide range of variability. Also, secular trends of human anatomy (and pathology) have been frequently reported and are of foremost interest (e.g. for surgeons). However, the variability of human morphology is often neglected in traditional medical curricula. Recently, we presented our novel full semester medical school course on Evolutionary Medicine at the University of Adelaide. This elective course addressed the degree and impact of such secular trends. Evolutionary Medicine which addressees specifically the ongoing interactions of humans and the environment such as pathogens and climate, is a field of research and teaching of growing interest. Based on our own original data of recent temporal changes in human body structures – e.g. the prevalence of additional arteries or of spina bifida occulta ‐ such topics were addressed both in a classical lecture format, as well as, part of interactive seminars run by students. Students evaluated this course highly (median response 6 out of possible 7). Thus it is planned to also teach this course at other Medical Schools. Teaching secular trends of human anatomy is not only an important part of the novel field of Evolutionary Medicine but of upmost importance for the understanding of the human body for both, medical students and clinicians.Grant Funding Source: N/A

Development of knowledge in basic sciences: a comparison of two medical curricula

Basic medical sciences education differs among medicine courses, especially as traditional and integrated problem-based learning (PBL) curricula teach basic sciences in very different ways. The literature shows no clear differences in the performance of students of these different educational philosophies. The Charité Medical University of Berlin (Charité Universitätsmedizin Berlin) teaches both a traditional medical curriculum (TMC) and a PBL reformed medical curriculum (RMC). Both curricula conduct the Progress Test in Medicine (PTM), which examines competence in the basic and clinical sciences from the first to the last semester. The aim of this study was to compare the development and retention of knowledge in the basic medical sciences between students on the traditional and reformed undergraduate medical curricula, respectively. For each student and single PTM, relative frequencies of correct answers were computed for basic sciences items only and for the whole curriculum. Frequencies were averaged and grouped by semester and curriculum. Analyses of variance (anovas) were performed at all measurement points with a Bonferroni-corrected p-value at the level of p < 0.005. Eta-squared (η(2)) was used to classify effect size. In the first three semesters, RMC students slightly outperform TMC students in the basic sciences, although TMC students receive more systematic teaching. After this, TMC students develop a peak of knowledge in basic sciences and overtake RMC students. The knowledge of TMC students then decreases over time, but despite this, they perform better in the final semester. Students on the RMC show constant progress throughout their undergraduate studies. Overall, the development of medical knowledge is consistent in both curricula. There is no significant difference in this outcome between the traditional and PBL courses. Progress testing as a longitudinal method allows us to better understand the development of knowledge during formal undergraduate education. The main difference between traditional and problem-based medical education seems to be provoked by the high-stakes national examination undertaken in the traditional course (the Physikum).

What is an objective structured practical examination in anatomy?

Assessing teaching-learning outcomes in anatomical knowledge is a complex task that requires the evaluation of multiple domains: theoretical, practical, and clinical knowledge. In general, theoretical knowledge is tested by a written examination system constituted by multiple choice questions (MCQs) and/or short answer questions (SAQ). The assessment of practical knowledge (three-dimensional anatomical concepts) involves oral, spot, or objective structured practical examinations (OSPE). Finally, the application of anatomical knowledge to patients is tested mainly through objective structured clinical examinations (OSCE). The major focus of this study is the OSPE. Although many schools challenge students using this tool in practical examinations in the early phase of the curriculum, the true meaning of OSPE is frequently forgotten and it becomes, in reality, a spot examination. This article, for the first time, describes how the concept of the OSPE has evolved and is currently being used to assess the practical domain of anatomical knowledge in a problem-based curriculum at Alfaisal University College of Medicine. In addition, it describes the main differences from the spot examination, which is normally used in traditional medical curricula. The authors believe that the OSPE remains the most efficient tool to assess the practical aspects of anatomical knowledge in a system where basic knowledge is integrated with the clinical or functional part of anatomy. However, this contention only holds true if the OSPE process revolves around structured objectives.

Active physiology learning in a diverse class: an analysis of medical student responses in terms of sex, home language, and self-reported test performance

The student body at the Nelson R. Mandela School of Medicine (NRMSM) is very diverse, representing many cultures, religions, and languages. Research has shown that weakness in English can impact student performance. Recent studies have also highlighted sex-based differences in students' learning and listening styles. These factors pose both challenges and opportunities for teachers of physiology. Student presentations were incorporated for a number of years into the traditional didactic second-year medical physiology curriculum at the NRMSM. Feedback obtained about the perceived benefits of these presentations for the learning of gastrointestinal and endocrine physiology included demographic data pertaining to students' sex, home language, and self-reported performance in tests. Analysis of the 50-item questionnaire responses, obtained over a 2-yr period, provided some interesting insights. Student responses to the items differed significantly in 27 of the 50 items in the questionnaire, based on sex alone (22%), sex and home language (7%), home language alone (37%), performance alone (26%), and performance and home language (7%). Our analyses of student perceptions support the findings of other studies and show that factors such as sex, home language, and student performance can play an important role in the way students are motivated to learn. In designing active learning strategies, academics need to take into account the potential influences that might affect student learning in diverse, multicultural, and multilingual classes.

Challenges of Teaching Physiology Following the Transition From Traditional Curriculum To An Integrated System-Based Curriculum

The transformation of a traditional discipline-based medical curriculum into a system-based integrated curriculum often poses dilemmas to faculty involved in teaching basic medical sciences. This paper examines the challenges of teaching physiology to medical students in a system-based curriculum. Some of these challenges include: defining the core curriculum, curriculum links, sequencing curriculum content, interdisciplinary integration, and student assessment. A number of relevant issues including defining the core physiology content, faculty expertise, and coping and adapting to curriculum transitions are discussed from a personal perspective. For successful implementation of a system-based curriculum and to overcome the challenges, educational issues should be debated in regional and international forums.

Yolanda Bender, Back Pain

OPEN ACCESSMarch 16, 2012Yolanda Bender, Back Pain Ralitsa Akins, MD, PhD Ralitsa Akins, MD, PhD State University of New York Upstate Medical University Google Scholar More articles by this author https://doi.org/10.15766/mep_2374-8265.9114 SectionsAbout ToolsDownload Citations ShareFacebookTwitterEmail AbstractAbstractThis is an OSCE case. Ms. Yolanda Bender, a 45-year old coordinator, comes to ambulatory clinic with complaint of low back pain that radiates to the right leg. She has had similar pain on and off for the last several years but it has never been so severe. Now she can hardly walk, trying not to use much her right leg. Last Monday, she was helping a co-worker move to a new office and felt an abrupt pain in her lower back. Since then Ms. Bender has been trying not to move much; she rested during the weekend and felt better; she went to work on Monday through Thursday, but on Friday the pain was so severe that she had to stay at home. Ms. Bender is obviously in pain, leaning slightly to the right, with her right leg slightly flexed. She tried Ibuprofen for her pain but it does not help much; her pain today is 8–9/10. Since Friday, the pain goes down the side of her right leg, down to her foot.Patients with low back pain, as the one described in this case, are often seen first in the primary care setting. It is important for the medical students to get acquainted with the approach to such patients, both in history taking and physical examination. This case was used for clinical skills exam of 100 students over two academic years with two cohorts of students (students in integrated curriculum and students in traditional medical curriculum); case statistics were calculated and found to be of good discrimination quality for future use in OSCE exams. Educational Objectives To establish a positive working relationship with patient.To use questions and physical examination maneuvers to discriminate between the major categories of processes likely to be causing low back pain. Sign up for the latest publications from MedEdPORTAL Add your email below FILES INCLUDEDReferencesRelatedDetails FILES INCLUDED Included in this publication: Yolanda Bender Back Pain Instructor's Guide.docx Yolanda Bender Back Pain Resource.docx To view all publication components, extract (i.e., unzip) them from the downloaded .zip file. Download editor’s noteThis publication may contain technology or a display format that is no longer in use. Copyright & Permissions© 2012 Akins. This is an open-access article distributed under the terms of the Creative Commons Attribution license.KeywordsHerniated DiscOSCELow Back Pain Disclosures None to report. Funding/Support None to report. Loading ...

Surgical prosection in a traditional anatomical curriculum—Tübingens’ Sectio chirurgica

Despite the rapid rise of integrated curricula, the teaching of gross anatomy by traditional dissection remains a central element in most medical programs worldwide. However, modern didactic concepts demand the integration of clinical content in preclinical settings. The implementation of interdisciplinary tools often leads to a reduction in teaching of comprehensive anatomy. ‘Tübingen's Sectio chirurgica’ (TSC) introduces a concept of a teaching activity in which surgical prosection is performed in addition to the traditional dissection course. TSC is designed to integrate clinical and preclinical content in a traditional medical curriculum without affecting the systematic presentation of anatomical content. In the past 2 years, about 10,000 medical students have participated in the use of telemedical transmissions of ‘live surgery’ in a total of 25 sessions of TSC. Here we describe the organisational plan of TSC and the results of an evaluation which was performed to monitor the influence of TSC on student motivation for surgical disciplines as well as for the learning of anatomical factual content. We demonstrate that additional surgical prosection is a valuable tool in increasing the coherence between preclinical and clinical parts of medical education programs.

Quantitative evaluation of third year medical students' perception and satisfaction from problem based learning in anatomy: A pilot study of the introduction of problem based learning into the traditional didactic medical curriculum in Nigeria

Problem-based learning (PBL) is a method of teaching that uses hypothetical clinical cases, individual investigation and group process. In recent years, in medical education, problem-based learning (PBL) has increasingly been adopted as the preferred pedagogy in many countries around the world. Controversy, however, still exists as the potential benefits and overall outcome of PBL over traditional didactic learning (TDL). The present study compared the learning effectiveness of PBL with TDL using both experimental method (students’ performance in examination) and observational method (students` responses to questionnaires). The self-administered questionnaires measured learning outcomes and acquisition of interpersonal skills on a 5-point Likert type rating scale of 1 (strongly agree) - 5 (strongly disagree). The study population comprised third year medical students of Lagos State University College of Medicine, Ikeja, Lagos, Nigeria. Half of the new innovative Human Anatomy curriculum was thought using PBL and the other half using TDL. The PBL method resulted in better examination scores than TDL for the same students. A majority of students felt that, the PBL sessions were better at fulfilling learning objectives, gave better factual knowledge of Anatomy, promoted better student participation in the learning process, provided more learning fun, ensured more students team work and interpersonal skills acquisition and enabled more students’ reflective/critical thinking and reasoning of anatomy, as compared to traditional teaching methods. Most of the students opined that more such sessions should be organized in the future. The main disadvantage perceived was that, it was time-consuming. We conclude that, based on the examination scores and the responses of the students, PBL are more successful than TDL. Key words: Problem based learning, Traditional didactic learning, medical students, perception

Encouraging Scholarship: Medical School Programs to Promote Student Inquiry Beyond the Traditional Medical Curriculum

Many medical curricula now include programs that provide students with opportunities for scholarship beyond that provided by their traditional, core curricula. These scholarly concentration (SC) programs vary greatly in focus and structure, but they share the goal of producing physicians with improved analytic, creative, and critical-thinking skills. In this article, the authors explore models of both required and elective SC programs. They gathered information through a review of medical school Web sites and direct contact with representatives of individual programs. Additionally, they discuss in-depth the SC programs of the Warren Alpert Medical School of Brown University; the University of South Florida College of Medicine; the University of California, San Francisco; and Stanford University School of Medicine. The authors describe each program's focus, participation, duration, centralization, capstone requirement, faculty involvement, and areas of concentration. Established to address a variety of challenges in the U.S. medical education system, these four programs provide an array of possible models for schools that are considering the establishment of an SC program. Although data on the impact of SC programs are lacking, the authors believe that this type of program has the potential to significantly impact the education of medical students through scholarly, in-depth inquiry and longitudinal faculty mentorship.

Leadership lessons from military education for postgraduate medical curricular improvement

quality medical education includes both teaching and learning of data-driven knowledge, and appropriate technical skills and tacit behaviours, such as effective communication and professional leadership. But these implicit behaviours are not readily adaptable to traditional medical curriculum models. This manuscript explores a medical leadership curriculum informed by military education. our paediatric anaesthesia residents expressed a strong desire for more leadership opportunity within the training programme. Upon exploration, current health care models for leadership training were limited to short didactic presentations or lengthy certificate programmes. We could not find an appropriate model for our 1-year fellowship. in collaboration with the US Naval Academy, we modified the 'Leadership Education and Development Program' curriculum to introduce daily and graduated leadership opportunities: starting with low-risk decision-making tasks and progressing to independent professional decision making and leadership. Each resident who opted into the programme had a 3-month role as team leader and spent 9 months as a team member. At the end of the first year of this curriculum both quantitative assessment and qualitative reflection from residents and faculty members noted significantly improved clinical and administrative decision making. The second-year residents' performance showed further improvement. medical education has long emphasised subject-matter knowledge as a prime focus. However, in competency-based medical education, new curriculum models are needed. Many helpful models can be found in other professional fields. Collaborations between professional educators benefit the students, who are learning these new skills, the medical educators, who work jointly with other professionals, and the original curriculum designer, who has an opportunity to reflect on the strengths and weaknesses of his or her model.

Use of Diagnostic Decision Support Systems in Medical Education

Diagnostic decision support systems are designed to assist physicians with making diagnoses. This article illustrates some of the issues that will be faced as diagnostic decision support systems become used in medical education. The objectives of this article are to examine 1) the skills that are needed to properly use these programs as part of the students' clinical experiences; 2) the changes that will be necessary in our curricula once these programs are more extensively utilized, including the implications of using these systems as an educational resource or simulation tool, and 3) the research issues that arise when these systems become an established part of our educational programs. This is a critical analysis of the literature on diagnostic decision support systems and medical education. To optimally use diagnostic decision support programs, students will need grounding in the basic knowledge and skills that have always been necessary to become a physician, such as the ability to accurately gather and interpret clinical information from the patient. In addition, students will need specific skills in 1) selecting appropriate system vocabulary and functions, and 2) applying the diagnostic system's suggestions to their particular patient. When computer-based decision support systems are incorporated in medical education, they will likely lead to changes in the traditional medical curriculum. Research will be needed on how use of these programs changes the students' knowledge, problem-solving and information-seeking skills.

Graduates from a traditional medical curriculum evaluate the effectiveness of their medical curriculum through interviews

BackgroundIn 1996 The University of Liverpool reformed its medical course from a traditional lecture-based course to an integrated PBL curriculum. A project has been underway since 2000 to evaluate this change. Part of this project has involved gathering retrospective views on the relevance of both types of undergraduate education according to graduates. This paper focuses on the views of traditional Liverpool graduates approximately 6 years after graduation.MethodsFrom February 2006 to June 2006 interviews took place with 46 graduates from the last 2 cohorts to graduate from the traditional Liverpool curriculum.ResultsThe graduates were generally happy with their undergraduate education although they did feel there were some flaws in their curriculum. They felt they had picked up good history and examination skills and were content with their exposure to different specialties on clinical attachments. They were also pleased with their basic science teaching as preparation for postgraduate exams, however many complained about the overload and irrelevance of many lectures in the early years of their course, particular in biochemistry. There were many different views about how they integrated this science teaching into understanding disease processes and many didn't feel it was made relevant to them at the time they learned it. Retrospectively, they felt that they hadn't been clinically well prepared for the role of working as junior doctor, particularly the practical aspects of the job nor had enough exposure to research skills. Although there was little communication skills training in their course they didn't feel they would have benefited from this training as they managed to pick up had the required skills on clinical attachments.ConclusionThese interviews offer a historical snapshot of the views of graduates from a traditional course before many courses were reformed. There was some conflict in the interviews about the doctors enjoying their undergraduate education but then saying that they didn't feel they received good preparation for working as a junior doctor. Although the graduates were happy with their undergraduate education these interviews do highlight some of the reasons why the traditional curriculum was reformed at Liverpool.

Aprendizagem Baseada em Problemas na formação médica e o currículo tradicional de Medicina: uma revisão bibliográfica

Este artigo analisa estudos que comparam a utilização da Aprendizagem Baseada em Problemas (ABP) na formação médica com o desenvolvimento de currículo tradicional de Medicina. O desenho metodológico, caracterizado como uma revisão da literatura sobre o assunto, realizada a partir de uma abordagem qualitativa, apoia-se na busca de artigos em bases de dados e bibliotecas virtuais, publicados de 1998 a 2008, com os termos medicina, graduação, aprendizagem baseada em problemas e ensino tradicional. O material foi estudado a partir da técnica de análise de conteúdo temática. A discussão se desenvolve a partir dos resultados acerca do uso da ABP na graduação médica em comparação aos resultados de cursos de currículo tradicional. Conclui-se que o uso da ABP na graduação médica pode ser uma alternativa na implementação das diretrizes brasileiras para a formação médica.

Anatomy education faces challenges in Pakistan

Anatomy education in Pakistan is facing many of the same challenges as in other parts of the world. Roughly, a decade ago, all medical and dental colleges in Pakistan emphasized anatomy as a core basic discipline within a traditional medical science curriculum. Now institutions are adopting problem based learning (PBL) teaching philosophies, and since medical colleges in Pakistan first introduced PBL curricula that expose the basic sciences primarily in clinical contexts, the methods and extent of anatomy teaching have been topics of much debate. Many claim that PBL curricula dilute basic science education, especially anatomy. At the same time, classically trained faculty members with PhD in anatomy have become nearly extinct in Pakistan, with only four working in country. A third challenge currently facing anatomy education in Pakistan, as in many parts of the world, is an unavailability of cadavers for dissection. As more institutions adopt PBL curricula, as PhD anatomists are harder to find, and as cadavers for dissection become scarce, Pakistan and other countries around the world will have to seriously consider how they will sustain adequate anatomy education.

MSc in Evidence-based Health Care

It was a shock to be a student again 20 years after qualifying as a doctor. Had I forgotten what it entailed, or had education fundamentally changed? There was no rote learning, no examinations, and the teachers were asking not only what I would like to learn but how I would like to learn it. It became apparent that my personal experience was considered fundamental and my contribution to the class essential. In short, I was valued, encouraged, supported, and given access to an endless supply of coffee. It felt light years away from my life in the NHS or a traditional medical curriculum. I was doing the MSc in Evidence-based Health Care in Oxford and I would strongly recommend it. The MSc is a joint programme between the department of public health and primary care and the department of continuing education at the University of Oxford. It is designed for anyone …

Medical Students’ Attitudes Toward Underserved Patients: A Longitudinal Comparison of Problem-Based and Traditional Medical Curricula

Medical education has been shown to negatively influence student attitudes toward certain types of patient populations. Past research does not inform current educational practice because today's medical school environment is different from when most of the published research was conducted. There are more female students, curricular innovations such as problem-based learning have changed the framework for educational delivery, and longitudinal studies, which could inform when interventions may be needed, are uncommon. The purposes of this longitudinal, prospective cohort study were to compare the attitudes of Problem-based learning and Traditional curriculum students toward providing care for medically indigent patients as they progressed through the four-year undergraduate medical education curriculum, and to determine if gender differences were apparent and persisted over time. Attitudes of one cohort of students enrolled in separate curricula were studied. The outcome measure was the Medical Student Attitudes Toward the Underserved questionnaire, which was administered three times. A linear mixed effects regression analysis was performed to examine changes in factor scores over time and whether these changes differed between Problem-based and Traditional students, and males and females. Longitudinal findings revealed that commitment to caring for the medically underserved was greater when students entered medical school than when they graduated. Students in both curricula, as well as male and female students, experienced increasingly negative attitudes over the four year period. Decline in attitudes toward medically underserved patients was similar to previous research results. This study showed that attitudes of students were not influenced by the preclinical curriculum they experienced.