An overview of Instructional approaches and decision-making strategies to curtail curricular overload

Abortion Education for Medical Students in an Era of Increased Abortion Restrictions

Following the Supreme Court's decision in Dobbs v Jackson Women's Health in June 2022, many states restricted or banned abortion. Medical educators have focused on how this change impacts abortion training for residents, but schools must also adapt undergraduate medical education. Medical schools provide the foundation for future physicians' knowledge and attitudes on abortion. Comprehensive, high-quality abortion education for all medical students is essential for the future of abortion care. Here, we present how education champions can lead curricular improvements in abortion education in the preclinical, clerkship, and postclerkship phases of undergraduate medical education.

Evaluation of Cocurricular Learning and the Influence of Student Choice

OBJECTIVE

The primary objective of this study was to evaluate the students' choice of activities and perception of a cocurricular program (CCP). Attitude and skill development and areas for program improvement were also assessed.

METHODS

Data were evaluated from 2 sources: a student survey administered to all Doctor of Pharmacy students to determine student perceptions of the CCP and barriers to success and student activity reporting data from postexperience submissions to evaluate the CCP. Data were stratified by student demographics to identify trends. A comparison of data was conducted from both sources on the students' perception of learning value.

RESULTS

Data for 405 students were available for analysis. The highest preference overall from students for hosts of activities were professional student organizations; the highest preference of location was online, asynchronous. The most meaningful benefits were learning information about a new subject (n = 258, 63.7%), ability to extend learning from the classroom to real life (n = 247, 61%), and networking opportunities (n = 218, 53.8%). The top barriers for completion of the program included scheduling challenges (n = 296, 73.1%), lack of time (n = 249, 61.5%), and lack of interest (n = 187, 46.2%). Subpopulations identified different benefits and barriers to completion.

CONCLUSION

Students have overall positive perceptions of the CCP and its value for skill development. Findings were applied to adjust the CCP at the institution, including a reduction in total hours required. The continuous evaluation of CCPs is important to optimize student learning and address curricular overload.

Exploring Tools to Manage Curricular Content and Overload Within the Professional PharmD Program

OBJECTIVE

Given recent discussions in the literature and across the Academy about curricular overload and calls for tools that aid in reducing content, it is important to determine what tools and resources programs are using to evaluate curricular content and how these resources are used to inform curricular change. Thus, the objective of this research project is to describe tools and resources pharmacy programs use for curricular content and change.

METHODS

A 17-item instrument was created, pilot-tested, and then distributed electronically to assessment leads at accredited pharmacy programs with multiple reminders to improve response rates. The instrument covered various tools for pharmacotherapy, foundational sciences, social and administrative sciences (SAS), and top 200/300 medications. Respondents provided information related to the study objectives, and data were analyzed descriptively.

RESULTS

With a 51% response rate, programs commonly used, and rated most helpful, the American College of Clinical Pharmacy (ACCP) Pharmacotherapy Didactic Curriculum Toolkit to inform curricular prioritization. Programs indicated they did not have comparable resources commonly used for determining curricular content related to foundational sciences, SAS, and top 200/300 medications.

CONCLUSIONS

Established tools, such as the ACCP Pharmacotherapy Didactic Curriculum Toolkit, are helpful in selecting curricular topics, but additional guidance is needed to optimize its usefulness in managing curricular overload. Developing toolkits for foundational sciences, SAS, and top 200/300 medications is necessary to provide similar guidance for the Academy.

A doctor of pharmacy curriculum revision process focused on curricular overload

OBJECTIVE

The objective is to describe the impact of a curricular revision process using the 8-step Kotter change model to decrease curricular overload in a Doctor of Pharmacy program at a public, research-intensive school of pharmacy.

METHODS

In alignment with the 8-step Kotter change model, the first step was to create urgency for change, which was supported by calls to action to address curricular overload. Next, a coalition of change leaders was formed, who developed 7 curriculum renewal targets to collectively address curricular overload. This vision was communicated at faculty meetings throughout the change process, with requests for feedback. Five curricular working groups were formed to empower action based on their charges. Quick wins were created by early adopters, which built momentum and led to a more streamlined course change process. Lastly, making changes stick requires ongoing evaluation.

RESULTS

In total, required didactic credits were reduced from 92.6 to 79 and didactic courses were reduced from 31 to 23 while ensuring that all required content remained. For many courses, contact hours were also reduced to align with allotted credit hours. Obstacles and challenges were encountered along the way, and a collaborative approach to finding solutions proved beneficial.

CONCLUSION

The key recommendations for implementing curricular changes to address overload include having a change model in place and identifying change leaders to support change and address faculty concerns efficiently. Effective communication through repetition of messaging is critical. Although change is complex, leaning into it with patience and perseverance can lead to success.

Evaluation of Student Academic Performance After Curricular Content Reduction

OBJECTIVE

To evaluate the effect of curricular content reduction in an integrated course sequence spanning 3 years of a Doctor of Pharmacy curriculum on student examination scores and course grades.

METHODS

This 2-year, prepost study compared student overall average and final examination scores and overall course grades after the transition from a 5-day to a 4-day week of an integrated learning experience (ILE) course sequence. In addition, an anonymous, optional 23-item survey was distributed to first to third year pharmacy students asking about the 4-day week change, how they utilized the non-ILE day, and additional demographic and social characteristics to identify factors influencing success on examination and course performance during the 4-day week.

RESULTS

There were 533 students included in the overall analysis, with no significant differences in overall course grades in the 5-day vs 4-day week. Examination scores were not significantly different after the transition, except in 2 of 12 courses where scores were higher and final examination scores were not significantly different, except for higher final examination scores in 1 course during the 5-day week. Significant positive influencers of top quartile of examination performance included prepharmacy grade point average ≥ 3.5, age 25 to 29 years, and prepharmacy coursework at the parent institution, whereas using the non-ILE day primarily to sleep negatively influenced outcomes.

CONCLUSION

Curricular density is a prevalent problem and addressing it at a program level is essential. Reducing curricular content and hours at our institution did not adversely impact student examination and course performance and slight improvement was noted in some areas.

Evaluating Curriculum Differences in US PharmD Programs: A Peer Evaluation

OBJECTIVE

To evaluate the differences in curriculum structure and content and observe commonalities across various Doctor of Pharmacy (PharmD) programs in the United States.

METHODS

This research involves the collection of course content and credit hour data from the curricula and course descriptions, course catalogs, and student handbooks of all the PharmD programs available on their websites and categorization based on the content areas outlined in the Accreditation Council of Pharmacy Education. The core courses, elective offerings, and experiential education (eg, Introductory and Advanced Pharmacy Practice Experience) were evaluated using Excel® for credit hours, integration, non-integration, program duration (3-year vs 4-year), and online offerings.

RESULTS

Of 142 accredited schools/colleges, 135 were included in the study, which met the inclusion criteria. In total, 85 of these schools have an integrated curriculum, 19 have a 3-year curriculum, and 15 offer a distance learning pathway for a PharmD degree. Fourteen of the 37 required content areas from the Accreditation Council of Pharmacy Education Appendix 1 were identified, with more than 50% of schools listing no credit hours allocated. Only 9 areas had 90% or more of pharmacy schools allocating credit hours. On average, biomedical, pharmaceutical, social/administrative/behavioral, clinical sciences, experiential education, and electives allocate 10.6, 25.3, 17.1, 40.5, 45.5, and 7.0 credit hours, respectively.

CONCLUSION

Each school's curriculum has a significant variation in credit hours, and there is an opportunity to simplify the curricular structure and content by reducing redundancy and increasing flexibility based on health care needs.

Exploring the curricular and pedagogical decision criteria for research-based learning design in undergraduate studies

Learning design has a multifaceted nature requiring a range of course- and institutional considerations. Analyzing the decision criteria's influence on research-based learning design helps understand the causes of the success/failure of the approach in achieving the teaching goals to improve the study programs. This study explores the interrelationship between the curricular and pedagogical criteria for research-based learning design decisions at the undergraduate level. For this purpose, the DEcision-MAking Trial and Evaluation Laboratory (DEMATEL) method is used to systematically analyze the decisive criteria and their causal relationships. Feedback from education professionals and university professors from Scandinavian universities is used to validate the pedagogy decision framework and provides input into the DEMATEL method. The student's role in the course is identified as the central criterion, featuring the highest level of interactions in the network of curricular and pedagogical decision criteria. Results are supportive of the identified institutional and course-specific criteria as prerequisites for the study outcomes.

A Description of Required NAPLEX Preparation Courses Among US Pharmacy Programs

OBJECTIVE

One of the final tasks for pharmacy graduates to enter practice is passing the North American Pharmacist Licensure Examination (NAPLEX). Given the recent national declines in pass rates, programs are making significant investments of time and money in NAPLEX preparation. The objective is to characterize the structure and content of required NAPLEX preparation courses.

METHODS

A survey on NAPLEX preparation practices was developed and distributed to all Accreditation Council for Pharmacy Education-accredited pharmacy schools. NAPLEX preparation course syllabi were also collected as part of this survey. Syllabus information was summarized into 4 elements: course structure, content, resources, and assessment strategies.

RESULTS

Of 144 colleges/schools of pharmacy, 100 responded to the survey, 87 reported having a NAPLEX preparation program, and 47 reported having a NAPLEX preparation course. Twenty syllabi were collected. Most courses (14) were longitudinal through the Advanced Pharmacy Practice Experiences year, 16 were credit-bearing, and 19 included a vendor NAPLEX preparatory product. Fourteen courses were hybrid delivery, and 12 focused on licensure preparation and included test-taking strategies, calculations practice, case-based discussions, etc. All 20 courses reported using unproctored timed quizzes and practice examinations, half conducted proctored timed assessments, and 11 included written reflections and/or continuous professional development activities. Most courses were pass/fail (15), and high stakes (16) were defined by delayed or withheld graduation as a consequence for failure. Only 3 of 20 NAPLEX preparation courses were mapped to NAPLEX competencies.

CONCLUSION

Although required NAPLEX preparation courses focus on assessments, the content is infrequently mapped to NAPLEX competencies. This project provides some information on how schools might create their own NAPLEX preparatory courses.

Clinical preparedness programme as perceived by first-year diagnostic radiography students in South Africa

INTRODUCTION

There is an increasing emphasis on exploring ways to improve students' transition from the classroom into the clinical environment. Diagnostic radiography (DR) students undergo rigorous theoretical and practical training before they are exposed to the clinical environment. It has been found that when DR students commence clinical learning in the workplace for the very first time, they experience difficulties in this transition. At the site of investigation, a newly integrated and dedicated clinical preparedness (CP) programme was offered; however, little is known about the DR students' perceptions of this programme.

METHODS

A qualitative approach coupled with a self-developed, cross-sectional research tool was employed. First-year DR students were purposefully sampled against the inclusion and exclusion criteria. The principle of voluntary participation was upheld throughout the data collection process. The data were analysed using Braun and Clarke's six steps of thematic analysis.

RESULTS

Forty-two responses were collected. Following a thematic analysis, two overarching themes were developed, namely: (1) reflections on the CP programme and (2) suggestions for future CP programmes.

CONCLUSION

This study demonstrated the need for effective CP programmes as an approach to ease the transition of first-year DR students from the classroom into the clinical environment. Several suggestions, for example, an extended CP programme and a clinical information pack were made for the offering of similar programmes in the future.

Assisted Reproduction for a Same-Sex Couple: Interdisciplinary Preclinical Active Learning Module Combining Case-Based Small Group Discussion and Patient Panel

OBJECTIVE

Physicians often feel they are not equipped to serve the lesbian, gay, bisexual, and queer (LGBTQ) community, but integrating education that incorporates LGBTQ content and perspective into an already-condensed medical school curriculum is challenging. We developed a preclinical active learning module on assisted reproductive technologies (ART) in LGBTQ care, integrating clinical and basic science content with patient perspective.

METHODS

We created a module that combined a case-based small group discussion with a patient panel. We developed a case for discussion in collaboration with a female cis-gender same-sex couple who conceived through ART. A patient panel with the same couple followed the discussion. All first-year medical students attended both parts of the module. Prior to participation, students learned reproductive endocrinology and genetics concepts through lectures. After the module, students voluntarily completed an anonymous survey to evaluate self-perceived changes in familiarity and confidence with LGBTQ patients and satisfaction with the module.

RESULTS

Of the 126 students who attended, 72 (57%) completed the survey. Of these, 69 (95.8%) felt the module gave them better perspectives on LGBTQ patient experiences, and 66 to 69 (92-96%) agreed the small group discussion achieved its learning objectives on LGBTQ health barriers and the application of ART. Students valued the patient panel (84.7%) and cited a better understanding of reproductive barriers for LGBTQ patients as its most valuable point.

CONCLUSION

A preclerkship module combining a case-based small group discussion and patient panel on ART delivered in the context of a real-life LGBTQ patient experience provided an opportunity for the students to integrate basic science and clinical science knowledge to reflect on the healthcare needs of this patient population. Creating the case in collaboration with the same-sex couple and having them present their own experience provided an authentic perspective to students on reproductive healthcare issues and how they impact members of the LGBTQ community.