Curriculum Change (curriculum + change)

Distribution by Scientific Domains

Selected Abstracts

Faculty development for problem-based learning

Elizabeth A. Farmer
Changing to a problem-based learning (PBL) curriculum represents a substantial challenge because many faculty members are unfamiliar with the process. Faculty development is a crucial component of successful curriculum change to PBL. This paper describes a logical process for designing and implementing a comprehensive faculty development programme at three main stages of change: curriculum transition, curriculum implementation and curriculum advancement. The components of each stage are discussed with reference to the literature and practice. Future advances in faculty development include harnessing the potential of complex adaptive systems theory in understanding and facilitating the change process, and incorporating the results of research, which illuminates the relationships of the PBL tutorial process to student achievement. There is a continuing need for rigorous outcome-based research and programme evaluation to define the best components and strategies for faculty development. [source]

Rethinking the OSCE as a Tool for National Competency Evaluation

M. A. Boyd
The relatively recent curriculum change to Problem-Based Learning/Case-Based Education has stimulated the development of new evaluation tools for student assessment. The Objective Structured Clinical Examination (OSCE) has become a popular method for such assessment. The National Dental Examining Board of Canada (NDEB) began using an OSCE format as part of the national certification testing process for licensure of beginning dentists in Canada in 1996. The OSCE has been well received by provincial licensing authorities, dental schools and students. ,Hands on' clinical competency is trusted to the dental programs and verified through NDEB participation in the Accreditation process. The desire to refine the OCSE has resulted in the development of a new format. Previously OSCE stations consisted of case-based materials and related multiple-choice questions. The new format has case-based material with an extended match presentation. Candidates ,select one or more correct answers' from a group of up to15 options. The blueprint is referenced to the national competencies for beginning practitioners in Canada. This new format will be available to students on the NDEB website for information and study purposes. Question stems and options will remain constant. Case histories and case materials will change each year. This new OSCE will be easier to administer and be less expensive in terms of test development. Reliability and validity is enhanced by involving content experts from all faculties in test development, by having the OSCE verified by general practitioners and by making the format available to candidates. The new OSCE will be pilot tested in September 2004. Examples will be provided for information and discussion. [source]

Early Clinical Exposure to Geriatric Medicine in Second-Year Medical School Students,The McGill Experience

Gustavo Duque MD
This study examined the effect of a curriculum change on early clinical exposure to geriatrics for second-year medical students at McGill University and its effects on learning and students' appreciation of geriatrics as a subspecialty. Second-year medical students (N = 200) were exposed to a change in the curriculum involving the integration of 10 weekly sessions into one integrated week in geriatric medicine. Students participating in 10 weekly sessions were Group 1 and students participating in one integrated week were Group 2. Students rated their rotation using two different scales. The students completed 12-item questionnaires during their feedback sessions at the end of the 10-week session experience or the integrated week. The first six items assessed the students' appreciation of their improvement of knowledge in the subject of geriatrics and aging. The second and third part of the survey (questions 7 and 8) included the students' opinions about the quality of the instruction (teaching feedback) and evaluation. Students in Group 2 found their rotation more effective as a learning experience and expressed greater satisfaction with interaction with the tutors, community settings, and multidisciplinary team sessions. Grades obtained on final examinations showed a better and more-effective acquisition of knowledge by Group 2. The integrated week is a more-effective learning tool in the early clinical experience for medical students in geriatric medicine than 10 weekly sessions as the first introductory experience to the field of geriatric medicine. [source]

Preparing for the Future Through Genetics Nursing Education

Jean F. Jenkins
Purpose: To determine recommendations for curriculum change that are indicated by innovations in genetics. Methods: Both quantitative and qualitative. The sample (n = 356) consisted of nurses identified as experts in genetics (n = 228) and nurses identified as potential users of genetics education (n = 128). Nurses' opinions of core components of a genetics curriculum were elicited via a mailed survey questionnaire. Participants also provided demographic information and completed the Jones Innovativeness Scale (1997). Findings: Recommended content in genetics education for practicing nurses was identified by both groups of nurses. Innovativeness characterized 3% of the respondents. Ninety-eight percent of respondents said that adopting genetics education is important. In total, 398 items were identified as potential consequences of education that incorporates genetic information. Conclusions: Identified content provides a template for genetics education programs for nurses. Genetics nursing education was perceived to have positive outcomes for both nurses and clients. [source]

Curriculum reform: a narrated journey

Geraldine MacCarrick
Objectives, Curriculum reform poses significant challenges for medical schools across the globe. Understanding the medical educator's personal and lived experience of curriculum change is paramount. This paper illustrates the use of narrative inquiry as a means of exploring the author's own evolving professional identity as a medical educator engaged in planning and leading curriculum reform and in understanding the meanings she and other medical educators attribute to their roles as agents of change in a medical school. Context, In 2002 it was decided to radically reform a school of medicine's (SoM) traditional 6-year medical degree course (converting it to a 5-year, integrated, case-based programme). This followed a decade of adverse external reports by the national accreditation agency. The 2001 accreditation report was the most significant catalyst for change, and drew attention to the School's need for a ,collective will' to introduce a series of specific curriculum reforms. To support this reform, a new curriculum working group (NCWG) supported by a dedicated medical education unit (MEU) was established. In late 2002 the author joined the School as the director of that unit. Methods, This paper draws on a 3-year study which captured the stories of the curriculum planning project between 2002 and 2005, as well as stories of curriculum reform from past deans of the same medical school dating back to 1965. Narrative inquiry is used as a means of probing the author's own lived experience as coordinator of the new curriculum project and the experiences of key members of the NCWG, including the dean, and of former deans from the same medical school over its 40-year history. Conclusions, Through a living, telling and retelling of the story of curriculum change, narrative inquiry has a role to play in both elucidating the individual lived experience of curriculum change and shaping the evolving professional identity of the medical educator as an agent of change. [source]

Towards valid measures of self-directed clinical learning

Tim Dornan
Aim, To compare the validity of different measures of self-directed clinical learning. Methods, We used a quasi-experimental study design. The measures were: (1) a 23-item quantitative instrument measuring satisfaction with the learning process and environment; (2) free text responses to 2 open questions about the quality of students' learning experiences; (3) a quantitative, self-report measure of real patient learning, and (4) objective structured clinical examination (OSCE) and progress test results. Thirty-three students attached to a single firm during 1 curriculum year in Phase 2 of a problem-based medical curriculum formed an experimental group. Thirty-one students attached to the same firm in the previous year served as historical controls and 33 students attached to other firms within the same module served as contemporary controls. After the historical control period, experimental group students were exposed to a complex curriculum intervention that set out to maximise appropriate real patient learning through increased use of the outpatient setting, briefing and supported, reflective debriefing. Results, The quantitative satisfaction instrument was insensitive to the intervention. In contrast, the qualitative measure recorded a significantly increased number of positive statements about the appropriateness of real patient learning. Moreover, the quantitative self-report measure of real patient learning found high levels of appropriate learning activity. Regarding outpatient learning, the qualitative and quantitative real patient learning instruments were again concordant and changed in the expected direction, whereas the satisfaction measure did not. An incidental finding was that, despite all attempts to achieve horizontal integration through simultaneously providing community attachments and opening up the hospital for self-directed clinical learning, real patient learning was strongly bounded by the specialty interest of the hospital firm to which students were attached. Assessment results did not correlate with real patient learning. Conclusions, Both free text responses and students' quantitative self-reports of real patient learning were more valid than a satisfaction instrument. One explanation is that students had no benchmark against which to rate their satisfaction and curriculum change altered their tacit benchmarks. Perhaps the stronger emphasis on self-directed learning demanded more of students and dissatisfied those who were less self-directed. Results of objective, standardised assessments were not sensitive to the level of self-directed, real patient learning. Despite an integrated curriculum design that set out to override disciplinary boundaries, students' learning remained strongly influenced by the specialty of their hospital firm. [source]

The value of marginality in a medical school: general practice and curriculum change

Harriet Mowat
Objective To report the process of introduction, development and sustenance of a curriculum for a department of general practice in the context of changing curricula required by the General Medical Council. Setting and context Tayside Centre for General Practice, the Department of General Practice within Dundee University Medical School. Methods Use of action research methodology common in educational and sociological research. Action research utilizes a range of data collection techniques which allow the participants in the research full opportunities to reflect on the data as it emerges and make developments accordingly. Analysis This took place as part of the process of the 5-year project. The analysis used as its starting point the sociological theory of the social construction of power within institutions. It offers the thesis that marginality seems to be a prerequisite in confronting institutional conservatism. Conclusions Use of an action research model facilitated more effective change by providing a supportive atmosphere in which to tackle changes. The marginal status of the general practice group in relation to the medical school allowed creative negotiation of alliances within the medical school. Other groups within the medical school who are introducing new curricula can learn from this report. [source]

Assisting curriculum change through departmental initiatives

Dale Roy
This chapter describes the assumptions and principles for good practice based on case studies at a research-intensive university in which several departments introduced curriculum change through a novel departmental grants program. [source]

Graduate Medical Education Downsizing: Perceived Effects of Participating in the HCFA Demonstration Project in New York State

Linda L. Spillance MD
Abstract. Objective: Financial support for graduate medical education (GME) is shrinking nationally as Medicare cuts GME funds. Thirty-nine hospitals in New York State (NYS) voluntarily participated in a Health Care Financing Administration demonstration project (HCFADP),the goal of which was to reduce total residency training positions by 4-5%/year over a five-year period, while increasing primary care positions. The objective of this study was to determine the effect of downsizing on emergency department (ED) staffing and emergency medicine (EM) residency training. Methods: Structured interviews and surveys of NYS program directors (PDs) were conducted in October,December 1999. Simple frequencies are reported. Results: One hundred percent of 17 PDs completed the interviews and seven of 12 participants in the HCFADP returned surveys. Twelve of 17 programs participated in HCFADP and two programs downsized outside HCFADP. Seven of 12 participants lost EM positions. Six of 12 programs were forced to exclude outside residents from rotating in their ED, leading to a need for one participating program and one non-participating program to find alternative sites for trauma. Five of 12 institutions provided resident staffing data, reporting a reduction in ED resident coverage in year 1 of the project of 9-40%. Programs compensated by increasing the number of shifts worked (4/12), increasing shift length (1/12), decreasing pediatric ED shifts (1/12), decreasing elective or research time (2/12), and decreasing off-service rotations (4/12). Six departments hired physician assistants or nurse practitioners, two hired faculty, and two hired resident moonlighters. Six of 12 programs withdrew from HCFADP and returned to previous resident numbers. Eight of 12 PDs thought that they had decreased time for clinical teaching. Conclusions: A 4-5% reduction in residency positions was associated with a marked reduction in ED resident staffing and EM residency curriculum changes. [source]

Changes in perceived effect of practice guidelines among primary care doctors

Lee Cheng MD MSc
Abstract Rationale, aims and objectives, Evidence suggests that when doctors use systematically developed clinical practice guidelines they have the potential to improve the safety, quality and value of health care. The purpose of this study was to evaluate recent changes in the perceptions of practice guidelines among US primary care doctors. Methods, Data were collected from the Community Tracking Survey 1996,97 and 2000,01. All results were weighted and adjusted to reflect the complex survey design. Results, Over the 5 years, the proportion of primary care doctors who said that practice guidelines had at least a moderate effect on their practice of medicine increased from 45.8% to 60.7%. This increase was nearly equal among primary care doctors of family medicine, internal medicine and paediatrics. In the 2001 survey, a higher perceived effect of practice guidelines was described by female doctors (OR = 1.39, 95% CI 1.19,1.63) and doctors who were practising in a large model group (OR = 1.73; 95% CI 1.04,2.89). Doctors who graduated from medical school within 10 years of the survey were more likely to report that practice guidelines had a positive effect on their practice of medicine than doctors who graduated 10 or more years before the survey. Conclusion, The perceived effect of practice guidelines on primary care doctors increased over time. Improved dissemination of guidelines and curriculum changes may have led recent primary care graduates to view practice guidelines as more important. [source]