Tracking Active Learning in the Medical School Curriculum: A Learning-Centered Approach

Mento's change model in teaching competency-based medical education

BACKGROUND

Resistance to change is customary and is expected in any organization. However, most of the downsides of change can be avoided if the organization/individual prepares for the change by acknowledging guided strategies. In healthcare, change is the state of nature, which has also translated to medical education (ME). ME in the current era has undergone a shift from a traditional content-based curriculum to a competency-based curriculum. Recently, however, the broader social-accountability movement has accelerated this rate of transformation. One of the key challenges to educators harbingering this transformation to competency-based medical education (CBME) is to redesign the processes of teaching.

AIM

Here we define a framework designed using Mento's model of change that will totally agree with introducing positive change in teaching in an institution undergoing transformation from a traditional content-based curriculum to a competency-based curriculum.

METHODOLOGY

Using Schein's "unfreezing" as a guide term we critically reflected on the popular change-management models, to home in on Kotter's model of change to transform organizations. However, Kotter's change-model draws from Situational and Contingency Leadership Theories, which may not agree with academic organizations involved in ME. As such organizations adhere to Transactional and Transformational Leadership archetypes, where Leadership is constructively executed by "The Leader Team", we decided to adopt Mento's change-model for our study. Mento's model not only draws from the precepts of Kotter's model, but also incorporates axioms of Jick's and GE's change-models.

RESULTS

Using Mento's model a framework was blueprinted to implement active learning (AL) strategies in CBME. Here we have elaborated on the framework using the exemplar of flipped teaching. The development of this framework required the design and execution of a faculty development program, and a step by step guidance plan to chaperon, instruct and implement change in teaching to harbinger CBME. Further, we have also reflected on the change process using Gravin's framework.

CONCLUSION

To our knowledge this is the first report of the use of Mento's model of change in medical education. Also, the blueprinted framework is supported by acknowledged leadership theories and can be translated to implement any curricular change in CBME.

A challenge based learning experience in forensic medicine

Learning about forensic sciences is a crucial part of the formation of professionals working in medicine and health areas; this includes a range of coverage from legal-medical cases to forensic autopsies. However, knowledge of forensics by medical students is limited, because the teaching focus has been on the fundamentals of procedures in this field. To develop the necessary skills, specific support, and targeted learning tasks should be designed to enable the integration of interdisciplinary work in processes, infrastructure, and equipment used in a high-quality-forensic investigation. The innovative educational experience of the Crime Scene Investigation CSI Lab was a week-long activity using the pedagogical strategy of Challenge-Based Learning. It addresses the problem that students need training in an authentic setting. The intervention, in September 2017, included 33 students from different disciplines such as medicine, law, and marketing. They participated in various learning settings in multidisciplinary teams and were challenged by experts from the State Institute for Forensic Sciences to analyze specific processes. The outcomes of the CSI Lab implementations provided evidence of how the students benefited from the experience. The results showed that 80% of the teams had an excellent approach to the solution, justification of the proposal and feasibility assessment. However, only 60% achieved a solution that met the requirements. The educational process was assessed by their perceptions of the educational strategy of the CSI Lab experience. The results indicated that 88.9% of the students believed that the experience broadened their perspectives on forensic sciences. 73.1% thought that the design of the activities, visits, and plenaries added value to their academic training, and 88.9% found it to be interesting. Regarding whether or not the activities helped the participants to understand and perform a legal-medicine investigation, 92.6% believed that it did help them recognize and understand the interventional areas and processes necessary for the investigation. CONCLUSION: Students demonstrated high acceptance of the context-rich design of the practical activities and educational experiences that were grounded in active learning. The effect on curriculum design is that the interactions and interdisciplinarity of the programs must be assessed, as these experiences could motivate them to engage in solving the social challenges of the 21st century.

Key Attributes of a Medical Learning Community Mentor at One Medical School

PURPOSE

The purpose of this study was to discover the elements required for a successful learning community (LC) faculty member educator of medical students.

METHOD

The authors in this qualitative study evaluated six 90-min focus groups of faculty members. The groups included 31 experienced and 19 inexperienced LC faculty members at the University of Texas Southwestern Medical School. After achieving excellent interrater reliability, transcriptions of the discussions were subjected to thematic analysis using ATLAS.ti software.

RESULTS

Five major themes emerged: (1) LC faculty characteristics/competency, (2) suggested faculty development methods, (3) factors outside the LC environment influencing student relationships, (4) student attributes influencing teaching techniques, and (5) measuring and improving history and physical skills. Faculty characteristics/competency subthemes included role-modeling, mentoring, and teaching competence. Suggested faculty development methods subthemes included assessing and giving feedback to faculty, peer development, and learning from experts. Experienced LC faculty focused more attention on teaching competence and mentoring competence than inexperienced LC faculty.

DISCUSSION

The themes with the most extensive discussion among the experienced LC faculty groups may represent qualities to be sought in future mentor recruitment and faculty development. Future studies could build on this study by similarly investigating student perceptions.

The Integration of Active Learning Teaching Strategies Into a Radiology Rotation for Medical Students Improves Radiological Interpretation Skills and Attitudes Toward Radiology

PURPOSE

In recent years, there has been increased recognition of the benefits of teaching by active learning. However, there is a paucity of experimental studies utilizing active learning in undergraduate radiology rotations, which is traditionally a passive learning experience. We designed a new radiology rotation that integrated teaching by active learning. We prospectively examined the efficacy of this new rotation compared to our standard rotation in terms of students' radiological competency and attitudes toward radiology, as well as impact on departmental efficiency.

METHODS

This was a prospective cohort study involving fourth year medical students completing a 1-week radiology rotation at our department between January and April 2018. One cohort completed a rotational model which incorporated active learning sessions (integrated cohort) while the remainder were taught using traditional passive learning methods (standard cohort). All participants completed a radiology examination before and after the rotation and were surveyed on their attitudes toward radiology.

RESULTS

A total of 105 students enrolled in the study. The mean postrotation competency score obtained by the integrated cohort was significantly higher than that obtained by the standard cohort (82% vs 62%; P < 0.001). The integrated rotation freed up 7 hours of radiologists' time per week. While the students completing the integrated rotation had a more positive perception of radiology, they were no more likely to express a desire to pursue a career in radiology.

CONCLUSIONS

The integration of active learning sessions into an undergraduate radiology rotation results in an improvement in students' postrotation radiological competency and attitudes toward radiology.