Alignment of learning objectives, assessments, and active learning to promote critical thinking in a first-year medical physiology course: lessons learned

Medical students must be adept at critical thinking to successfully meet the learning objectives of their preclinical coursework. To encourage student success on assessments, the course director of a first-year medical physiology course emphasized the use of learning objectives that were explicitly aligned with formative assessments in class. The course director introduced the physiology discipline, learning objectives, and evidence-based methods of studying to students on the first day of class. Thereafter, class sessions started with a review of the learning objectives for that session and included active learning opportunities such as retrieval practice. The instructor provided short answer formative assessments aligned with the learning objectives, intended to help the students apply and integrate the concepts. Midsemester, students received a link to an online survey with questions on studying habits, class attendance, and student engagement. After finals, students were invited to participate in focus groups about their class experience. A qualitative researcher moderated focus groups, recorded responses, and analyzed the narrative data. Of 175 students, 95 submitted anonymous online surveys. Student engagement was significantly correlated with in-person class attendance (r = 0.26, T = 2.5, P = 0.01) and the completion of open-ended formative assessments (r = 0.33, T = 3.3, P = 0.001). Focus groups were held via videoconference. From the class, 14 students participated in 4 focus groups; focus group participants were mostly women (11 of 14) and mostly in-class attendees (13 of 14). The students in this sample valued critical thinking but misunderstood expectations on exams and few students used learning objectives to study.NEW & NOTEWORTHY We introduced formative assessments and study techniques to first-year medical students in a physiology course. Mastery of learning objectives was emphasized as the key to success. We asked how they studied physiology through an anonymous online survey and focus group interviews. The students enjoyed physiology but had difficulty with exam expectations. Helping students use learning objectives to guide their study may lead to improved exam scores. It may also help administrators meet their curriculum goals.

Visualizing Study Profiles Using the GMDS Competency Catalog for Medical Informatics Programs

BACKGROUND

Medical informatics programs cover a variety of topics.

OBJECTIVES

To test the utility of the GMDS medical informatics competency catalog in comparing programs by developing study profiles.

METHODS

Coverage of 234 competencies is recorded and visualized in a spider diagram.

RESULTS

Spider diagrams allow visualizing various study profiles.

CONCLUSION

The GMDS catalog seems useful for comparing medical informatics study programs, e.g., for interested students, employers, or accreditation reviewers.

Instructional Insights: Building Well Aligned Courses Using Performance-Based Backward Design

This paper describes an example of collaborative course development, in which occupational therapy faculty members designed a two-course sequence for teaching content related to occupational therapy with children and youth. They used a backward course design approach and performance-based learning objectives to create alignment between Accreditation Council for Occupational Therapy Education (ACOTE) standards, course assignments and instructional content. The authors present examples from their course design, along with evidence-based resources to guide educators working on developing new courses or revising existing courses. Outcomes achieved from four years of teaching and refining the developed courses are also described.

Creating the HAPS Physiology Learning Outcomes: terminology, eponyms, inclusive language, core concepts, and skills

Learning outcomes are an essential element in curriculum development because they describe what students should be able to do by the end of a course or program and they provide a roadmap for designing assessments. This article describes the development of competency-based learning outcomes for a one-semester undergraduate introductory human physiology course. Key elements in the development process included decisions about terminology, eponyms, use of the word "normal," and similar considerations for inclusivity. The outcomes are keyed to related physiology core concepts and to process skills that can be taught along with the content. The learning outcomes have been published under a Creative Commons license by the Human Anatomy and Physiology Society (HAPS) and are available free of charge on the HAPS website.NEW & NOTEWORTHY This article describes the development of competency-based learning outcomes for introductory undergraduate human physiology courses that were published and made available free of charge by the Human Anatomy and Physiology Society (HAPS). These learning outcomes can be edited and are keyed to physiology core concepts and to process skills that can be taught along with the content.

ESMO/ASCO Recommendations for a Global Curriculum in Medical Oncology Edition 2023

The European Society for Medical Oncology (ESMO) and ASCO are publishing a new edition of the ESMO/ASCO Global Curriculum (GC) with contributions from more than 150 authors. The purpose of the GC is to provide recommendations for the training of physicians in medical oncology and to establish a set of educational standards for trainees to qualify as medical oncologists. This edition builds on prior ones in 2004, 2010, and 2016 and incorporates scientific advances and input from an ESMO/ASCO survey on GC adoption conducted in 2019, which revealed that GC has been adopted or adapted in as many as two thirds of the countries surveyed. To make GC even more useful and applicable, certain subchapters were rearranged into stand-alone chapters, that is, cancer epidemiology, diagnostics, and research. In line with recent progress in the field of multidisciplinary cancer care new (sub)chapters, such as image-guided therapy, cell-based therapy, and nutritional support, were added. Moreover, this edition includes an entirely new chapter dedicated to cancer control principles, aiming to ensure that medical oncologists are able to identify and implement sustainable and equitable cancer care, tailored to local needs and resources. Besides content renewal, modern didactic principles were introduced. GC content is presented using two chapter templates (cancer-specific and non-cancer-specific), with three didactic points (objectives, key concepts, and skills). The next step is promoting GC as a contemporary and comprehensive document applicable all over the world, particularly due to its capacity to harmonize education in medical oncology and, in so doing, help to reduce global disparities in cancer care.

Learning by doing and creation of the shared discovery curriculum

BACKGROUND

The Michigan State College of Human Medicine began as an experiment to teach medical students in community-based settings and to create a primary care workforce for the state. Decades later, CHM faced internal and external challenges that spurred creation of a new curriculum - the Share Discovery Curriculum - founded on learning by doing and other learning theories.

METHODS

A curricular design group (CDG) developed guiding principles for reform. Based on this, pedagogies and structures were selected to achieve this vision and developed into a curricular structure. Components of the first-year curriculum were piloted with a group of students and faculty members.

RESULTS

Six guiding principles were endorsed, grounded in learning theories such as Dewey's Learning by Doing. Based upon these, several key features of the new curriculum emerged: learning communities; one-on-one coaches for students; symptom-based presentations for content; simulation, authentic clinical tasks, flipped classrooms, and modified practice-based learning as primary teaching modalities; early, integrated clinical and scientific learning; milestones as course learning objectives; and a multidimensional, competency-based assessment system.

DISCUSSION

The process and outcomes described here are intended as an exemplar for schools undertaking curricular change. Early stakeholder engagement, faculty development, sustainable administrative systems, and managing complexity are core to the success of such endeavors.

On the Effective Dissemination and Use of Learning Objectives Catalogs for Health Information Curricula Development

Catalogs of competency-based learning objectives (CLO) were introduced and promoted as a prerequisite for high-quality, systematic curriculum development. While this is common in medicine, the consistent use of CLO is not yet well established in epidemiology, biometry, medical informatics, biomedical informatics, and nursing informatics especially in Germany. This paper aims to identify underlying obstacles and give recommendations in order to promote the dissemination of CLO for curricular development in health data and information sciences. To determine these obstacles and recommendations a public online expert workshop was organized. This paper summarizes the findings.

An epilepsy curriculum for primary health care providers: a report from the Education Council of the International League Against Epilepsy

Objective

Primary health care providers are directly responsible for the care of people with epilepsy. However, their education about epilepsy might be inadequate or lacking. Our objective was to develop an evidence-based and consensus-driven educational curriculum for the management of epilepsy within the primary healthcare setting.

Methods

The International League Against Epilepsy (ILAE) Education Council commissioned a task force of international experts, who met virtually at monthly intervals in 2020/2021 to develop the curriculum. The task force adopted and added to five domains from the ILAE Epileptology Curriculum after discussions on context, structure and wording of associated competencies and learning objectives. The consensus-approved curriculum was disseminated to the ILAE leadership and constituency in six different languages. An online survey was used to collate structured feedback which further refined the curriculum.

Results

Feedback was obtained from 785 voluntary respondents who were inclusive of epilepsy specialists and primary healthcare providers. Nearly two thirds of the respondents approved the use of the curriculum to advance the competency of primary health care providers in epilepsy. The final educational curriculum comprised six domains, 26 competencies and 85 learning objectives. The six domains were: (1) ability to diagnose epilepsy and its broad subtypes; (2) ability to provide counselling to people with epilepsy over a range of issues; (3) ability to introduce treatment and follow-up to people with epilepsy; (4) competency to appropriately refer people to higher centres of care; (5) ability to manage epilepsy emergencies including status epilepticus; and (6) ability to recognize and provide basic care for psychiatric and somatic comorbidities.

Conclusions

The curriculum represents an advance in providing inclusive care for epilepsy within the primary health care setting and ideally should be used to facilitate future primary health care epilepsy education packages.

Veterinary Students' Use of Learning Objectives

Learning objectives (LO) are the foundation of a competency-based curriculum, but no studies assess how students use LO for exam preparation and/or their general attitudes toward LO. Therefore, the objectives were to evaluate how much veterinary students use LO to study, assess student attitudes toward simple and expanded LO, and determine if LO type impacts grade performance. An alternative-treatment design with pre-test and nonrandom groups was used. Veterinary students in the Endocrine Systems course in the 2019 spring (n = 89) and fall (n = 86) semesters were invited to participate and provided with simple and expanded LO, respectively. After an examination, participants completed an online survey before and after receiving their grade. Overall, 114 students (65%) responded. The percentage of students using simple versus expanded LO was not statistically different (χ² = 1.874, df = 1, p = .171). Fifty-five students did not use LO; the majority (76.4%) preferred other study methods. Independent samples t-tests found no significant differences in student perceptions of helpfulness (t(30) = -1.118, p = .272), format (t(29) = 0.813, p = .423), or relevance (t(30) = 0.326, p = .747) between simple and expanded LO. Students agreed that LO were helpful (M = 3.33) and well formatted (M = 3.42) and that the provided information was relevant and detailed (M = 3.36). An ANOVA tested whether exam grade differed between students using simple versus expanded LO and for students who did not use LO; no significant differences were found (F(2,78) = .087, p = .917). In conclusion, students did not prefer more detailed LO and LO use did not impact grade performance.

10-year anniversary of the European Somnologist examination - A historic overview and critical appraisal

The European Somnologist certification programme was developed by the European Sleep Research Society to improve patient care in sleep medicine by providing an independent evaluation of theoretical and practical knowledge. The examination of eligible experts plays a key role in this procedure. A process was started more than 15 years ago to create the European sleep medicine curriculum, eligibility criteria for certification, and sleep centre accreditation criteria. The process was characterised by interdisciplinary collaboration, consensus, and achieving new solutions. During the past 10 years, experience has been gained by the examination and certification of more than 1000 sleep medicine experts from more than 50 countries. The process has continuously been improved. However, as the programme was designed and administered mainly by medical experts in the field, systematic influence from teaching and pedagogic experts was partially underrepresented. The current critical appraisal pinpoints several missing links in the process – mainly as a missing constructive alignment between learning objectives, learning and teaching activities, and the final assessment. A series of suggestions has been made to further improve the ESRS certification programme.

Online Neuroscience Instruction: Insights, Lessons Learned, and Moving Forward

Prior to the COVID-19 pandemic, most of us had little to no experience with online teaching. With the realization that we would need to teach our students remotely during the pandemic, we needed to develop our online teaching skills and apply this knowledge to create effective online classes for our students. Tulane University's Center for Engaged Learning and Teaching (CELT, http://celt.tulane.edu) and its Innovative Learning Center (ILC, http://it.tulane.edu/innovative-learning-center) partnered to teach an Online Teaching Training (OTT) course for all instructors. This five-week session covered many of the topics needed to teach an engaging and interactive online course. The training included not only the theory but also practical applications of many resources available to online course instructors. This training prepared me to teach a fully online course for the first time in Summer, 2020 and again the following summer. Student evaluations compared between the Emergency Remote Learning done in quick response to the COVID-19 pandemic (Spring 2020) and the online course after completion of the OTT (Summer 2020) indicated that student experiences were much more positive when taught by a trained instructor. Many of the resources/techniques for online courses can be incorporated into in-person or hybrid classes, and vice versa. Further, sharing ideas among colleagues, especially as new resources become available, is critical for the success of all instructors. In this article I share my lessons learned, insights, and thoughts for moving forward as we approach a new era of neuroscience instruction.

Eight Recommendations to Promote Effective Study Habits for Biology Students Enrolled in Online Courses

To achieve meaningful learning experiences in online classrooms, students must become self-regulated learners through the development of effective study habits. Currently, there is no set of recommendations to promote study habits in online biology learning environments. To fill gaps in our understanding, a working group associated with a research coordination network (Equity and Diversity in Undergraduate STEM, EDU-STEM) convened virtually in June 2021. We identify student barriers to self-regulated learning in online environments and present eight practical recommendations to help biology educators and biology education researchers apply and advance evidence-based study habits in online courses. As higher education institutions continue to offer online learning opportunities, we hope this essay equips instructors with the knowledge and tools to promote student success in online biology coursework.

Interprofessional geriatric assessment in nursing home (IgAP): a curricular development in geriatrics

The hallmark of medical action in geriatrics is the interprofessional treatment of the patient by a multi-professional team consisting of doctors, nurses and therapists with the aim of treating the patients primarily in a way that preserves their function and thereby enabling them to live as independently as possible. Therefore, at the beginning of every geriatric treatment, there is a multiprofessional geriatric assessment of functional abilities. With regard to successful medical action, this necessarily requires all health professions involved to understand geriatric patients and their limitations. Under ideal circumstances, their competencies overlap. From the point of view of the related disciplines, this means to teach working together with the other professions - interprofessionally - and learning from one another in order to effectively collaborate. After comparing the existing education in geriatrics within the Medical Curriculum Munich (MeCuM) with the European catalog of learning objectives for geriatricians (UEMS-GMS), a deficit with regard to geriatric assessment was recognized in the field of multi-professional training. Therefore, the existing geriatric curriculum of the Ludwig Maximilians University (LMU) in Munich should be expanded to include an interprofessional course on geriatric assessment. This project report aims to show the development and implementation of this course. For this purpose, the model for curriculum development according to Kern was used by the planners to establish an interprofessional briefing. Due to its innovative character, the course received public recognition and is the basis for the expansion of interprofessionalism in the sense of professional cooperation in geriatrics. Establishing interprofessionalism in other disciplines and locations is welcome.

Helping medical students to learn pathology more effectively

Context

Teaching methods in pathology for undergraduate medical students are not effective.

Aims

To document measures that can be adopted by individual teachers that can excite the interest, participation of the students and help them learn pathology in a clinical reasoning context.

Settings and Design

Medical students in a large international medical school with class sizes of 700-900 were taught the pathology course in a period of sixteen weeks for two cohorts of students each year over a period of twenty years.

Subjects and Methods

Specific learning objectives were devised to achieve higher levels of cognitive domain including interpretation, analysis and problem solving of clinical data of patients related to the objectives. The teaching sessions were modified to provide for maximum active participation by students with effective feedback at multiple points. Additional learning tools like concept maps, clickers, modified essay questions, flipped classrooms, clinicopathological conferences, directed self-learning activities were included. Learning objectives and assessment tools for professional behavior and communication skills were included.

Results

The students actively participated in all the learning activities with enthusiasm and achieved the objectives as reflected in the performance in the in-house examinations and the USMLE step one examination which tests clinical vignette-based problem-solving principles of which around 70% are related to pathology.

Conclusions

The teaching sessions in pathology were useful and effective with adaptation to interactive, clinical reasoning platforms for teaching and assessment.

Public Health Education Should Include Point-of-Care Testing: Lessons Learned from the Covid-19 Pandemic

GOAL

The goal is to present key principles of point-of-care testing (POCT) in educational curricula that meet critical needs for rapid decision-making in disasters, outbreaks of highly infectious diseases, emergency management, and complex crises.

OBSERVATIONS

The coronavirus disease 19 (COVID-19) pandemic unequivocally proved the value of POC strategies. Striking needs identified by COVID-19 challenges have yet to be entirely fulfilled. A comprehensive national survey showed absence of POCT training in public health colleges, schools, and programs. Fundamental improvements in national structuring of POC knowledge, skills, experience, training, dissemination, accreditation, and licensing are necessary, so that multidisciplinary public health teams can respond effectively and efficiently by geospatially optimizing the control and mitigation of highly infectious diseases and other critical challenges.

CONCLUSIONS

Four sets of POCT learning objectives were developed for public health and other educational institutions. Global implementation of POC diagnostics in the hands of trained personnel will help avoid untimely worldwide crises, huge economic losses, uncounted excess mortality, and sudden disruptive surges of dangerous infectious threats to personal security and cultural stability.

Inconsistent seduction: Addressing confounds and methodological issues in the study of the seductive detail effect

INTRODUCTION

The inclusion of interesting but irrelevant details in instructional materials may interfere with recall and application of the core content. Although this seductive detail effect is well researched, recent research highlights factors that may influence the effect size.

OBJECTIVES

The current study discusses confounds and methodological issues in the study of seductive details and outlines strategies for overcoming them. These practices were then applied in a study that examined the role of learning objectives on the seductive detail effect.

METHODS

Seductive details were selected on the basis of interest and importance level and matched for word count and reading level. The 3 × 2 between-subjects design presented 132 undergraduate students with a lesson on plate tectonics; participants completed tests on both recall and transfer.

RESULTS

Results did not reveal a consistent detrimental effect of high-interest details on core content recall and transfer. On the recall test, contrary to expectation, the seductive detail effect obtained only when objectives were provided. A similar pattern emerged on the transfer task.

CONCLUSION

These findings highlight the difficulty of consistently eliciting the seductive detail effect. We discuss outstanding issues that must be addressed in order to develop practical guidelines on the inclusion of seductive details in educational materials.

The digital use of simulated patients in times of the corona pandemic - considerations and proposals

The corona pandemic has posed major challenges for teaching with simulated persons (SPs), which usually requires the physical presence of the participants. Within a short period of time, a large number of individual solutions were developed. The committee "Simulated Persons" of the Society for Medical Education has developed considerations and proposals in five areas to meet the qualitative challenges of the method. First and foremost, the safety of the SPs is at stake, both in terms of infection prevention and role-related stress to which the SPs are now exposed at home alone instead of the usual setting, where they are in a teaching building with the connection to the staff on site. Furthermore, it should be noted that the changed framework conditions also require a reflection on behalf of the learning objectives, since not all teaching scenarios with SPs can be transferred from a real setting to a digital environment. Furthermore, even under corona conditions, the constructive alignment must not be disregarded, i.e. the question of testability must be considered from the very beginning. Aspects of the technical infrastructure for all participants and compliance with data protection requirements must also be considered. Last but not least, the forced changes are also an opportunity to take a proactive approach to the topic of telemedicine in teaching.

Characteristics and quality of rotation-specific resident learning goals: a prospective study

Background: Residents are expected to develop the skills to set learning goals. Setting learning goals is part of self-regulated learning, setting the foundation for creating a learning plan, deploying learning strategies, and assessing their progress to those goals. While effective goal setting is essential to resident self-regulated learning, residents struggle with setting learning goals and desire faculty assistance with goal setting.Objective: We aimed to characterize the topics and quality of residents' rotation-specific learning goals.Design: We conducted a prospective study of 153 internal medicine residents, assessing 455 learning goals for general medicine inpatient rotations. We coded learning goal themes, competencies, and learning domains, and assessed quality using the validated Learning Goal Scoring Rubric. We compared topic categories, competencies, learning domains, and quality between the first and second months of postgraduate (PGY)-1 residents and between PGY-1 and PGY-3 residents. We assessed factors associated with learning goal completion.Results: The overall response rate was 80%. The top three learning goal categories were patient management, specific diseases related to general medicine, and teaching skills. There were no changes in learning goal characteristics between PGY-1 months (p ≥ 0.04). There were differences between PGY-1 and PGY-3 residents' learning goals in patient management (28% vs 6%; p < .001), specific disease conditions (19% vs 3%; p < .001), and teaching skills (2% vs 56%; p < .001). There was no difference in learning goal quality between PGY-1 months (1.63 vs. 1.67; p = 0.82). The PGY-3 learning goals were of higher quality than PGY-1 learning goals for the 'specific goal' item (1.38 vs. 0.98, p = 0.005), but not for other items or overall (all p ≥ 0.02). Residents reported 85% (297/347) learning goal completion.Conclusions: Resident rotation-specific learning goals reflect a broad array of topics. Residents' learning goal quality was low and residents may benefit from guidance to support residents' learning goals.

[Reflections on Trends in the Undergraduate Curricula of Human Medicine at the Universities in Switzerland]

Reflections on Trends in the Undergraduate Curricula of Human Medicine at the Universities in Switzerland Abstract. Reflections on current trends and progressions in the undergraduate curricula of Human Medicine of the universities in Switzerland. Both updated modern learning objectives and the politically intended higher number of graduated swiss physicians will make an impact on clinical skills training and offers opportunities in focusing as well as in coordinating the curricula.

Assessing clinical investigators' perceptions of relevance and competency of clinical trials skills: An international AIDS Malignancy Consortium (AMC) study

INTRODUCTION

The AIDS Malignancy Consortium (AMC) conducts clinical trials of therapeutic and prevention strategies for cancer in people living with HIV. With its recent expansion to Sub-Saharan Africa and Latin America, there was a need to increase the competence of clinical investigators (CIs) to implement clinical trials in these regions.

METHODS

AMC CIs were invited to complete a survey to assess role-relevance and self-perceived competence based on the Joint Task Force for Clinical Trials Competency domains.

RESULTS

A total of 40 AMC CIs were invited to complete the questionnaire and 35 responded to the survey. The data management and informatics and engaging with communities' domains were lowest in the average proportion of CIs rating themselves high (scores of 3-4) for self-perceived competency (46.6% and 44.2%) and role-relevance (61.6% and 67.5%), whereas, the ethical and participant safety considerations domain resulted in the highest score for competency (86.6%) and role-relevance (93.3%). In the scientific concepts and research design domain, a high proportion rated for competency in evaluating study designs and scientific literature (71.4% and 74.3%) but a low proportion for competency for designing trials and specimen collection protocols (51.4% and 54.3%).

CONCLUSIONS

Given the complexity of AMC clinical research, these results provide evidence of the need to develop training for clinical research professionals across domains where self-perceived competence is low. This assessment will be used to tailor and prioritize the AMC Training Program in clinical trial development and management for AMC CIs.

Society of Toxicology Develops Learning Framework for Undergraduate Toxicology Courses Following the Vision and Change Core Concepts Model

The Society of Toxicology announces the development of a Learning Framework (https://www.toxicology.org/education/docs/SOT-Toxicology-Learning-Objectives.pdf) for undergraduate toxicology that will facilitate the development and sharing of evidence-based teaching materials for undergraduate toxicology educators throughout the world. This Learning Framework was modeled on the "Vision and Change Report" (www.visionandchange.org), an effort of the National Science Foundation and American Association for the Advancement of Science defining Core Concepts and Core Competencies to inform undergraduate biology course design. Vision and Change (V&C) has gained national acceptance, becoming a foundation for 14 upper-level courses designed by professional life science scientific societies. The undergraduate toxicology Learning Framework includes 5 Core Concepts aligned with V&C that encompass the discipline of toxicology: Evolution; Biological Information, Risk and Risk Management; Systems Toxicology; and Pathways and Transformations for Energy and Matter. Underpinning the Core Concepts are Level 2 Toxicology Concepts, which are broad disciplinary categories, Level 3 Learning Objectives, which address specific learning goals, and Level 4 Example Learning Objectives and Case Studies, which provide examples of how content might be taught. Syllabi from more than 20 undergraduate toxicology courses and several undergraduate toxicology textbooks were surveyed to determine toxicology-related Learning Objectives. From these, undergraduate educators can design courses tailored to their institutional needs by selecting a subset of Learning Objectives. Publication of a Learning Framework for toxicology will enable integration into other disciplines and facilitate the development and sharing of evidenced-based teaching materials for toxicology to educators in allied disciplines. Ultimately this will expand toxicology's impact to a broader audience.

Identifying the learning objectives of clinical clerkship in community health in Japan: Focus group

Background

The value of medical education in the community has been increasingly and globally recognized. In 2015, the World Federation for Medical Education emphasized the importance of medical education in various settings in their standard. Similarly, in Japan, the Model Core Curriculum for Medical Education in Japan (MCCMEJ) is revised in 2016. However, both the learning objectives of such clerkships and their concrete strategies in Japan are not clearly established. In this study, the authors identified the learning objectives of clinical clerkship in community health reflecting the perspectives of medical professionals and community inhabitants.

Methods

They held six focus groups that included physicians, other medical professionals, and inhabitants (n = 35) who were involved in a clinical clerkship in community health at three prefectures in Japan from 2017 to 2018. Further, they recorded, transcribed, and thematically analyzed the discussion using MCCMEJ as conceptual frameworks.

Results

The learning objectives comprised of 13 domains. The following four domains were not found in "Basic Qualities and Capacities for Physicians" in MCCMEJ: "future-oriented systematic view," "organic integration of knowledge/skill," "understanding of the community," and "awareness as an individual physician."

Conclusion

With the community inhabitants' participation, the study results reflect the community needs in Japan. The authors hope that the outcome of this study will be useful to further improve clinical clerkship in community health.

Curricula and learning objectives in nurse practitioner programmes: a scoping review protocol

INTRODUCTION

Globally, nurse practitioner (NP) has become an important nursing role in the pursuit of a more efficient healthcare, possessing the necessary expert skills to work as autonomous practitioners. Nevertheless, there are barriers in the implementation of this role. One barrier concerns the different levels of education required for NPs. Previous studies demonstrate the importance of acting for a uniform international education. The aim of the scoping review was to compile research about education to become an NP, focusing on the content of curricula and learning objectives.

METHODS AND ANALYSIS

The six-stage methodological framework by Arksey and O'Malley will guide the scoping review through the following stages: identifying the research questions; identifying relevant studies; study selection; charting the data; collating, summarising and reporting the results; and consultation. The research questions are as follows: What is the content of curricula in NP programmes? What are the learning objectives in NP programmes? The literature searches will be conducted between March and June 2019 in the following databases: PubMed, CINAHL and ERIC, followed by hand searching reference lists of key studies. Grey literature will be searched in Google Scholar, Libsearch, existing networks and relevant organisations. Two researchers will screen titles and abstracts. Included full-text articles will be screened by three researchers and assessed for their methodological quality by the use of the Critical Appraisal Skills Programme. The PreferredReporting Items for Systematic Reviews and Meta-Analyses flow diagram will be used to demonstrate included and excluded articles. The findings will be presented through a numerical summary of the included articles, followed by a thematic analysis.

ETHICS AND DISSEMINATION

Research ethics approval is not required for a scoping review. The scoping review will be submitted to a peer-reviewed journal. Additionally, the findings will be disseminated to stakeholders representing political, educational, professional and union organisations through a Delphi study as part of the consultation stage of the Arksey and O'Malleys framework.

Hygiene in medical education - Increasing patient safety through the implementation of practical training in infection prevention

Objective: Insufficient hygiene knowledge increases the risk of hospital-acquired infections through insufficient compliance and therefore poses a potential risk to patient safety. Therefore in 2015 the teaching project "OT Training" was introduced at the Faculty of Medicine (MF) Leipzig and a restructuring of the series of lectures and practical training on the topic of "Hygiene" was developed and integrated in the medical study curriculum. Methodology: The "OT Training" in the pre-clinical component and the didactic restructuring of the hygiene workshops in the hospital semester were comprehensively developed by means of the currently applicable learning objective catalogues and have already been tested in existing teaching (per year N=320 students; 2015-17: N= 960). The "OT Training" and the series of lectures and practical training are evaluated externally by the Faculty of Medicine. In addition a self-developed questionnaire (for "OT Training") and an internal evaluation (for practical stations as part of the practical training series) were used. Results: Overall the "OT Training" was evaluated as "very good" (N=492; RR=51%). Alongside the high importance of hygiene in the hospital and operating area (Overall_hospital=97% and Overall_{Operative area}=98%) the salient feature of hygiene for self-protection and in particular for patient safety was also recognised at an early stage. Through the series of lectures and practical training which were also evaluated positively, the self-reported level of knowledge and the importance of hygiene for the students improved significantly (level of knowledge M_before=2.8 vs. M_after=3.9; p>0.000; importance M_before=3.3 vs. M_after=4.2; p>0.000; 5 point Likert scale; t-Test). Conclusion: Hygiene errors constitute a potential risk to patients. Consequently the early and continuous focus on hygiene in student education makes a contribution to increasing patient safety in the healthcare sector.

Assessing the Alignment of Objectives, Instructional Activities, and Assessments in a Biomedical Informatics Curriculum

The objective of this research was to assess the alignment of course learning objectives, instructional activities, and course assessments in a Biomedical Informatics curriculum. Each syllabi in the curriculum was reviewed and scored according to a validated rubric. Disagreements among reviewers adjudicated by consensus. Only low and moderate levels of alignment were identified. The results indicated the needs and goals of courses could be more effectively met with faculty investment in syllabi redesign and clarification to achieve course objectives. Root causes included word choice in learning objective statement as well as lack of consideration of instructional scaffolding by the course developer.

Matching medical student achievement to learning objectives and outcomes: a paradigm shift for an implemented teaching module

INTRODUCTION

Low student achievement in a basic imaging module was the impetus for an assessment of the module.

METHODS

A valid, reliable, and structured Likert scale was designed to measure the degree of student satisfaction with the domains of the module, including learning objectives (LO), teaching strategy and tools (TT), assessment tools (AT), and allotted credit hours (CH). Further analysis was conducted of student dissatisfaction to determine the subdomain in which module improvement was to be implemented. Statistical analysis of data among Likert scale domains was conducted.

RESULTS

Likert scale data showed the TT domain to be the major reason for low student achievement. Statistical studies revealed 57/117 students (48.6%) were dissatisfied with TT, compared with LO 16/117 (13.6%), AT 54/117 (46.1%), and CH 12/117 (10.2%). Significant P-values were obtained for LO vs TT (P<0.0001), LO vs AT (P<0.0001), LO vs CH (P<0.03), TT vs CH (P<0.0001), and AT vs CH (P<0.0001). No significant difference was observed between TT and AT (P<0.29). Regarding TT, 41/117 (34.9%) students were dissatisfied with lectures (L) compared to hospital-based teaching (HPT) 24/117 (20%), problem-based learning (PBL) 8/117 (6.8%), self-directed learning (SDL) 3/117 (2.5%), and seminars (S) 4/117 (3.4%). Significant P-values were obtained for L vs HPT (P<0.0001), L vs PBL (P<0.0001), L vs SDL (P<0.0001), L vs S (P<0.0001), HPT vs PBL (P<0.002), HPT vs SDL (P<0.0001), and HPT vs S (P<0.0001). Regarding lecture modifications, student satisfaction was 78.3% compared to 52% before modification. A significant P-value (P<0.0001) was obtained between Likert scale domains before and after modification. Lecture modification resulted in a good student response and satisfaction.

CONCLUSION

The major reason for low student achievement was the teaching tools, particularly the lectures. Major modifications to lectures improved student achievement. The students and most of the teaching staff were highly satisfied with the modifications, which provided for reciprocal discussion and interaction. These results should encourage and guide other medical schools to investigate the points of weakness in their curriculum.

Evaluation of a National Pediatric Subinternship Curriculum Implemented Through Individual Learning Plans

OBJECTIVE

The Council on Medical Student Education in Pediatrics and Association of Pediatric Program Directors developed a Pediatric Subinternship (CAPS) curriculum for use with an individualized learning plan (ILP). The authors determined which learning objectives (LOs) pediatric subinterns selected when provided the CAPS curriculum, summarized students' self-reported progress, and determined feasibility of ILPs in subinternship.

METHODS

Students from 10 medical schools completed a standardized ILP during pediatric subinternship. Students listed ≥3 LOs using CAPS curriculum as a guide and self-assessed their progress. Students reviewed ILPs with faculty preceptors; preceptors completed questionnaires on time and effort spent. Authors mapped student LOs to CAPS curriculum objectives and grouped in Accreditation Council for Graduate Medical Education competency domains.

RESULTS

Two hundred four students documented 850 LOs. Authors mapped student LOs to 61 of the 69 CAPS objectives (88%). Students most commonly chose Patient Care LOs, with the top 3 related to oral presentations, time management, and management plans. Student LOs not in CAPS addressed nutrition, child development, test interpretation, and cost. No students chose LOs related to health disparities, shared decision making, informed consent, or patient safety. Students self-reported significant progress on most LOs (73%). Faculty met with students ≥1 time and 93% met for a total of ≤1 hour. According to faculty, students required little or no help completing ILPs.

CONCLUSIONS

Students chose a wide range of LOs when provided the CAPS curriculum. Revision to include additional student-identified LOs would enhance CAPS curriculum's comprehensiveness. Using this curriculum with an ILP during subinternship is feasible, but gaps between educator-identified and student-identified objectives require further exploration.

How could the topic patient safety be embedded in the curriculum? A recommendation by the Committee for Patient Safety and Error Management of the GMA

The topic of patient safety is of fundamental interest for the health care sector. In view of the realisation of the National Competence-Based Learning Objectives Catalogue for Undergraduate Medical Education (NKLM) this topic now has to be prepared for medical education. For a disciplinary and content-related orientation the GMA Committee developed the Learning Objectives Catalogue Patient Safety for Undergraduate Medical Education (GMA-LZK). To ensure an optimal implementation of the GMA-LZK we recommend a longitudinal embedding into the existing curriculum. This position paper supports the implementation of the GMA-LZK and is aimed at everyone who wants to establish teaching courses on the topic patient safety and embed them in the curriculum. In light of this, we will initially describe the key features for a structured analysis of the current situation. Based on three best-practice-examples, as seen in the faculties of Freiburg, Bonn and Munich, different approaches to the implementation of the GMA-LZK will be illustrated. Lastly, we will outline the methodical requirements regarding the curriculum development as well as the disciplinary and methodical competences that the lecturers will have to hold or develop to fulfil the requirements.

How to Write Well-Defined Learning Objectives

Writing effective learning objectives is a necessary skill in academic medicine. Learning objectives are clearly written, specific statements of observable learner behavior or action that can be measured upon completion of an educational activity. They are the foundation for instructional alignment whereby the learning objectives, assessment tools, and instructional methods mutually support the desired learning outcome. This review article describes the essential components of a learning objective and provides practical tips on writing well-defined learning objectives.

How to Write Well-Defined Learning Objectives

Writing effective learning objectives is a necessary skill in academic medicine. Learning objectives are clearly written, specific statements of observable learner behavior or action that can be measured upon completion of an educational activity. They are the foundation for instructional alignment whereby the learning objectives, assessment tools, and instructional methods mutually support the desired learning outcome. This review article describes the essential components of a learning objective and provides practical tips on writing well-defined learning objectives.

The Relationship Between Levels of Fidelity in Simulation, Traditional Clinical Experiences and Objectives

The purpose of this study was to explore the relationship of baccalaureate nursing students' (BSN) perceived learning effectiveness using the Clinical Learning Environments Comparison Survey of different levels of fidelity simulation and traditional clinical experiences. A convenience sample of 103 first semester BSN enrolled in a fundamental/assessment clinical course and 155 fifth semester BSN enrolled in a leadership clinical course participated in this study. A descriptive correlational design was used for this cross-sectional study to evaluate students' perceptions after a simulation experience and the completion of the traditional clinical experiences. The subscales measured were communication, nursing leadership, and teaching-learning dyad. No statistical differences were noted based on the learning objectives. The communication subscale showed a tendency toward preference for traditional clinical experiences in meeting students perceived learning for communication. For student perceived learning effectiveness, faculty should determine the appropriate level of fidelity in simulation based on the learning objectives.

ESMO / ASCO Recommendations for a Global Curriculum in Medical Oncology Edition 2016

The European Society for Medical Oncology (ESMO) and the American Society of Clinical Oncology (ASCO) are publishing a new edition of the ESMO/ASCO Global Curriculum (GC) thanks to contribution of 64 ESMO-appointed and 32 ASCO-appointed authors. First published in 2004 and updated in 2010, the GC edition 2016 answers to the need for updated recommendations for the training of physicians in medical oncology by defining the standard to be fulfilled to qualify as medical oncologists. At times of internationalisation of healthcare and increased mobility of patients and physicians, the GC aims to provide state-of-the-art cancer care to all patients wherever they live. Recent progress in the field of cancer research has indeed resulted in diagnostic and therapeutic innovations such as targeted therapies as a standard therapeutic approach or personalised cancer medicine apart from the revival of immunotherapy, requiring specialised training for medical oncology trainees. Thus, several new chapters on technical contents such as molecular pathology, translational research or molecular imaging and on conceptual attitudes towards human principles like genetic counselling or survivorship have been integrated in the GC. The GC edition 2016 consists of 12 sections with 17 subsections, 44 chapters and 35 subchapters, respectively. Besides renewal in its contents, the GC underwent a principal formal change taking into consideration modern didactic principles. It is presented in a template-based format that subcategorises the detailed outcome requirements into learning objectives, awareness, knowledge and skills. Consecutive steps will be those of harmonising and implementing teaching and assessment strategies.

Approaches to Teaching Biometry and Epidemiology at Two Veterinary Schools in Germany

In a thematically broad and highly condensed curriculum like veterinary medicine, it is essential to pay close attention to the didactic and methodical approaches used to deliver that content. The course topics ideally should be selected for their relevance but also for the target audience and their previous knowledge. The overall objective is to improve the long-term availability of what has been learned. For this reason, an evaluation among lecturers of German-speaking veterinary schools was carried out in 2012 to consider which topics in biometry and epidemiology they found relevant to other subject areas. Based on this survey, two veterinary schools (Berlin and Hannover) developed a structured approach for the introductory course in biometry and epidemiology. By means of an appropriate choice of topics and the use of adequate teaching methods, the quality of the lecture course could be significantly increased. Appropriately communicated learning objectives as well as a high rate of student activity resulted in increased student satisfaction. A certain degree of standardization of teaching approaches and material resulted in a comparison between the study sites and reduced variability in the content delivered at different schools. Part of this was confirmed by the high consistency in the multiple-choice examination results between the study sites. The results highlight the extent to which didactic and methodical restructuring of teaching affects the learning success and satisfaction of students. It can be of interest for other courses in veterinary medicine, human medicine, and biology.

Learning Doctor-Patient Communication - Evaluating the effectiveness of the communication training course at Leipzig University from the students' point of view

OBJECTIVE

At the University of Leipzig, the requirements of the Licensing Regulations for Doctors (Approbationsordnung für Ärzte) for the practical training of communication skills are actively implemented by a two-semester communication course. During this course, student tutors impart the basics of interpersonal as well as selected aspects of doctor-patient communication using interactive training methods. This article reports on the effect the training has on the self-assessed communication skills of the medicine students.

METHODS

The students' self-perceived communication skills were assessed, both at the beginning and after the completion of the first and second course semesters using questionnaires related to the course's learning goals. Pre-post comparisons were then carried out. 142 students (of 163 students in total) participated in the survey at the start of the course, of which 117 completed the T2-questionnaire at the end of the first course semester. Only the 84 students who also completed the questionnaires in the second course semester were included in the statistical analysis. These responses were analysed using both descriptive and inferential statistics.

RESULTS

The comparison of the self-assessments between the four measurement points showed that statistically significant learning progress for all assessed communication skills had taken place from the point of view of the students. The largest changes between measurements, and therefore the greatest learning progress, could be seen in knowledge related skills.

CONCLUSION

From the students' point of view the communication training contributes significantly to the acquisition of communication skills. The results suggest that this "hands-on" course concept is suited to successfully enhance the students' communication skills. The course concept should therefore be retained for both the course in its current form as well as for any extension of the course into the clinical part of medical school. However, further assessments on the exam results and long-term effects should take place.

Current Practices in Global/International Advanced Pharmacy Practice Experiences: Preceptor and Student Considerations

The objective of this article is to describe the key areas of consideration for global/international advanced pharmacy practice experience (G/I APPE) preceptors, students and learning objectives. At the 2013 Annual Meeting of the American Association of Colleges of Pharmacy (AACP), the GPE SIG prepared and presented an initial report on the G/IAPPE initiatives. Round table discussions were conducted at the 2014 AACP Annual Meeting to document GPE SIG member input on key areas in the report. Literature search of PubMed, Google Scholar and EMBASE with keywords was conducted to expand this report. In this paper, considerations related to preceptors and students and learning outcomes are described. Preceptors for G/I APPEs may vary based on the learning outcomes of the experience. Student learning outcomes for G/I APPEs may vary based on the type of experiential site. Recommendations and future directions for development of G/IAPPEs are presented. Development of a successful G/I APPE requires significant planning and consideration of appropriate qualifications for preceptors and students.

The Blooming Anatomy Tool (BAT): A discipline-specific rubric for utilizing Bloom's taxonomy in the design and evaluation of assessments in the anatomical sciences

Bloom's taxonomy is a resource commonly used to assess the cognitive level associated with course assignments and examination questions. Although widely utilized in educational research, Bloom's taxonomy has received limited attention as an analytical tool in the anatomical sciences. Building on previous research, the Blooming Anatomy Tool (BAT) was developed. This rubric provides discipline-specific guidelines to Blooming anatomy multiple-choice questions (MCQs). To test the efficacy of the BAT, a group of volunteers were randomly split up and asked to Bloom a series of anatomy MCQs using either the BAT or a traditional Bloom's reference called Bloom's Learning Objectives (BLO). Both groups utilized each rubric for a different series of MCQs. Examination question categorizations made using each rubric were tested for accuracy and interrater reliability. In addition, previous experience in anatomy and Bloom's taxonomy were considered. Results demonstrated that volunteers using the BAT had consistently higher levels of interrater reliability, but accuracy varied and was similar between rubrics. Neither measure was substantially impacted by experience in Bloom's taxonomy or anatomy. A poststudy survey indicated that volunteers strongly preferred the BAT and felt it was more helpful in categorizing anatomy MCQs than the BLO. These results suggest that the BAT can be useful in educational research in the anatomical sciences to aid in aligning observer judgment on Bloom taxonomic levels and improve consistency, especially when used in conjunction with a norming session prior to data collection.

The surgical experience of current non-surgeons gained at medical school: a survey analysis with implications for teaching today's students

BACKGROUND

It is unknown what aspects of undergraduate surgical curricula are useful for future non-surgeons. We aimed to define relevant, enduring learning achievements for this subgroup to enable student-centered teaching.

METHODS

An online questionnaire using open ended questions was distributed to physicians of non-surgical specialties at the University Hospital of Tuebingen, Germany and its associated teaching hospitals. Participants were asked to describe knowledge and skills that endured from their surgical clerkship and which of these are used in daily practice. Textual responses were initially coded using content analysis and the frequency of recurrent categories was calculated.

RESULTS

Sixty-seven of 153 questionnaires were returned; participants belonged to six different non-surgical specialties and had received their training at 22 different medical schools. Sustaining learning achievements included basic skills (suturing and working under sterile conditions), learning about professionalism and appreciating working conditions in surgery. Two learning techniques were valued: witnessing of rare cases or complications and working autonomously.

CONCLUSION

Integration of our findings in undergraduate surgical teaching may focus teaching on students' interests and improve surgical teaching.

Topics of internal medicine for undergraduate dental education: a qualitative study

INTRODUCTION

Due to the ageing population, internal medicine has become increasingly important for dental education. Although several studies have reported dentists' dissatisfaction with their internal medicine training, no guidelines exist for internal medicine learning objectives in dental education. The aim of this study was to identify topics of internal medicine considered to be relevant for dental education by dentists and internists.

METHODS

Eight dentists from private dental practices in Hamburg and eight experienced internal medicine consultants from Hamburg University Hospital were recruited for semi-structured interviews about internal medicine topics relevant for dentists. Internal diseases were clustered into representative subspecialties. Dentists and internists were also asked to rate medical diseases or emergencies compiled from the literature by their relevance to dental education.

RESULTS

Coagulopathy and endocarditis were rated highest by dentists, whilst anaphylaxis was rated highest by internists. Dentists rated hepatitis, HIV, organ transplantation and head/neck neoplasm significantly higher than internists. The largest number of different internal diseases mentioned by dentists or internists could be clustered under cardiovascular diseases. The number of specific diseases dentists considered to be relevant for dental education was higher in the subspecialties cardiovascular diseases, haematology/oncology and infectiology.

CONCLUSION

We identified the internal medicine topics most relevant for dental education by surveying practising dentists and internists. The relevance of these topics should be confirmed by larger quantitative studies to develop guidelines how to design specific learning objectives for internal medicine in the dental curriculum.

Development of learning objectives for neurology in a veterinary curriculum: part I: undergraduates

BACKGROUND

With an increasing caseload of veterinary neurology patients in first opinion practice, there is a requirement to establish relevant learning objectives for veterinary neurology encompassing knowledge, skills and attitudes for veterinary undergraduate students in Europe. With help of experts in veterinary neurology from the European College of Veterinary Neurology (ECVN) and the European Society of Veterinary Neurology (ESVN) a survey of veterinary neurologic learning objectives using a modified Delphi method was conducted. The first phase comprised the development of a draft job description and learning objectives by a working group established by the ECVN. In the second phase, a quantitative questionnaire (multiple choice, Likert scale and free text) covering 140 learning objectives and subdivided into 8 categories was sent to 341 ESVN and ECVN members and a return rate of 62% (n = 213/341) was achieved.

RESULTS

Of these 140 learning objectives ECVN Diplomates and ESVN members considered 42 (30%) objectives as not necessary for standard clinical veterinary neurology training, 94 (67%) were graded to be learned at a beginner level and 4 (3%) at an advanced level. The following objectives were interpreted as the most important day one skills: interpret laboratory tests, perform a neurological examination and establish a neuroanatomical localization. In this survey the three most important diseases of the central nervous system included epilepsy, intervertebral disc disease and inflammatory diseases. The three most important diseases of the peripheral nervous system included polyradiculoneuritis, myasthenia gravis and toxic neuropathies.

CONCLUSIONS

The results of this study should help to reform the veterinary curriculum regarding neurology and may reduce the phenomenon of "Neurophobia".

Assisting students to prepare for a clinical practice placement

All students undertaking a nursing programme are required to complete clinical practice placements. These placement hours are an essential component of the training necessary to join the Nursing and Midwifery Council register and to practise as a nurse. Clinical practice placements can be stressful for students, and this can compromise their learning. Thorough preparation by the student and an understanding of the change in learning environment that accompanies a placement can reduce anxiety and improve the learning experience. This article describes the preparations a student can make to ensure a successful and educational clinical practice placement.

Using curriculum mapping to engage faculty members in the analysis of a pharmacy program

OBJECTIVE

To develop a curriculum mapping process that supports continuous analysis and evidence-based decisions in a pharmacy program.

DESIGN

A curriculum map based on the national educational outcomes for pharmacy programs was created using conceptual frameworks grounded in cognitive learning and skill acquisition.

ASSESSMENT

The curriculum map was used to align the intended curriculum with the national educational outcomes and licensing examination blueprint. The leveling and sequencing of content showed longitudinal progression of student learning and performance. There was good concordance between the intended and learned curricula as validated by survey responses from employers and graduating students.

CONCLUSION

The curriculum mapping process was efficient and effective in providing an evidence-based approach to the continuous quality improvement of a pharmacy program.

Examining why ethics is taught to veterinary students: a qualitative study of veterinary educators' perspectives

Although it is widely agreed that veterinary students need to be introduced to ethics, there is limited empirical research investigating the reasons why veterinary ethics is being taught. This study presents the first extensive investigation into the reasons for teaching veterinary ethics and reports data collected in semi-structured interviews with educators involved in teaching undergraduate veterinary ethics at three European schools: the University of Copenhagen, the University of Nottingham, and the Technical University of Lisbon (curricular year 2010-2011). The content of the interview transcripts were analyzed using Toulmin's argumentative model. Ten objectives in teaching veterinary ethics were identified, which can be grouped into four overarching themes: ethical awareness, ethical knowledge, ethical skills, and individual and professional qualities. These objectives include recognizing values and ethical viewpoints, identifying norms and regulations, developing skills of communication and decision making, and contributing to a professional identity. Whereas many of the objectives complement each other, there is tension between the view that ethics teaching should promote knowledge of professional rules and the view that ethics teaching should emphasize critical reasoning skills. The wide range of objectives and the possible tensions between them highlight the challenges faced by educators as they attempt to prioritize among these goals of ethics teaching within a crowded veterinary curriculum.

Inclusion of rehabilitation medicine concepts in school of medicine resources

PURPOSE

To perform a gap analysis of rehabilitation medicine learning objectives (RMLOs) coverage within school of medicine (SOM) curriculum and educational resources as a basis for development of educational resources to fill any identified gaps.

METHOD

Following ethics approval, interviews were carried out with SOM academics and clinicians to assess the relevance of a set of RMLOs and the extent to which RMLOs were addressed in SOM resources. Interviewee opinion was quantified via Likert scales and additional free comments were subjected to thematic analysis.

RESULTS

Most RMLOs were perceived as relevant by more than half of the 18 participants. There was evidence of relevant material relating to each RMLO in SOM resources. Thematic analysis suggested that rehabilitation medicine was addressed at the SOM in less detail than outlined in the RMLOs, and that additional rehabilitation content could be included in SOM resources across a number of courses and year levels.

CONCLUSIONS

Rehabilitation medicine is considered relevant by clinicians and academics at the SOM. The most effective way of filling identified gaps in coverage of rehabilitation medicine at the SOM will be via engagement across a number of medical and surgical disciplines. Implications for Rehabilitation Rehabilitation-related knowledge and skills are relevant to medical education. Many of these issues are already partially addressed in existing educational resources. The design and delivery of medical school curricula should include a trans-disciplinary and inter-year approach to the inclusion of rehabilitation concepts and aptitudes. This could be done by introducing relevant concepts early, making resources available online, and embedding rehabilitation items across different disciplines, courses and assessments.

Impact of a service-learning course on first-year pharmacy students' learning outcomes

OBJECTIVES

To assess the differences in learning outcomes of first-year (P1) pharmacy students enrolled in a course based on service learning with those of a comparable group of students not enrolled in a course involving service learning.

DESIGN

Students on 2 campuses of a school of pharmacy completed a required P1 course involving service learning. A control group of students at a different school completed typical P1 courses, none of which involved service learning.

ASSESSMENT

A questionnaire was administered to P1 students in the study group at the conclusion of the service-learning course, and a similar questionnaire was administered to P1 students in the control group in the spring of their P1 year. Survey questions inquired about what the students had learned generally and in the areas identified as common to the 2 groups of respondents. Differences in the learning outcomes of the students were identified, most notably in the areas of professional communication, cultural competence, the elderly, and awareness of service-providing agencies in the community.

CONCLUSION

This study demonstrated that service-learning positively impacts pharmacy students' learning outcomes.

The practial use of the consensus statement on practical skills in medical school--a validation study

Objective: The importance of the acquisition of practical medical skills during medical school is increasing. With the consensus statement “Practical Skills,” developed by the GMA as part of the National Competency-Based Learning Objective Catalogue for Medicine (NKLM), a reference frame was created for the procurement of such skills. This frame consists of 290 learning objectives divided by “organ system,” type (core or elective learning objective), current stage of medical education and level of instruction.

By comparing a large and well evaluated range of student tutorials with the consensus statement, one can analyze the practical benefit of the statement, as well as evaluate the tutorial program for completeness.

Methods: In the first stage, four evaluators in two groups independently classified all consensus statement’s learning objectives by each of the 48 tutorials currently offered. The inter-rater reliability among the evaluators of each group was calculated both collectively, and according to each organ system. In the second stage, disagreements in the classification were resolved through discussion and consensus decision-making. The coverage of the learning objectives by the tutorials, in the required level of instruction, was then analyzed separately by learning objective type and organ system. Reasons for any initial dissent were recorded and grouped thematically.

Results: The correlation between the classifications of the two evaluators was moderately significant. The strength of this correlation, and thus the precision of individual learning goals wording, varied according to organ system. After a consensus was reached, the results show that the offered tutorials covered 66% of all learning objectives, as well as 74% of the core objectives. The degree of coverage differed according to organ system and stage of medical education.

Conclusion: The consensus statement is suitable to systematically analyze and develop teaching units. The comparison with established curricula also offers possibilities for further development of the consensus statement, and therefore also of the NKLM.

Evaluation of pharmacist continuing professional development portfolios

OBJECTIVE

The purpose of this study was to conduct a random continuing professional development (CPD) portfolio audit to assess the portfolios of pharmacists who completed CPD training in the state of North Carolina and reported adopting it in place of the annual 15-hour continuing education (CE) requirement when applying for re-licensure.

METHODS

The NC Board of Pharmacy (NCBOP) staff randomly selected 30 pharmacists to provide CPD portfolio documentation to the Board electronically or in paper format. This documentation included their completed learning plan, a learning activity worksheet for each completed activity, and the Accreditation Council on Pharmacy Education (ACPE) universal activity number for the CPD training program attended. The Task Force used a multicomponent audit tool to assess each portfolio.

RESULTS

Eighty percent of portfolios had at least 15 hours of learning reported. Portfolio assessments indicated an average of 5 learning objectives per individual. Based on the scale of 1 to 5, the Measurable and Specific sections of the objectives scored the lowest with an average score of 3 on both sections. An overall assessment of "adequate" or "comprehensive" was noted for 60% of the portfolios.

CONCLUSION

Pharmacists completing CPD training are capable of following the CPD process with some potential challenges in documentation. Information submitted to the board of pharmacy is considered sufficient for license renewal purposes.

Use of SMART learning objectives to introduce continuing professional development into the pharmacy curriculum

OBJECTIVE

To determine whether a 2-year continuing professional development (CPD) training program improved first-year (P1) and second-year (P2) pharmacy students' ability to write SMART (specific, measurable, achievable, relevant, and timed) learning objectives.

DESIGN

First-year students completed live or online CPD training, including creating portfolios and writing SMART objectives prior to their summer introductory pharmacy practice experience (IPPE). In year 2, P1 and P2 students were included. SMART learning objectives were graded and analyzed.

ASSESSMENT

On several objectives, the 2011 P1 students (n = 130) scored higher than did the P2 cohort (n = 105). In 2011, P2 students outscored their own performance in 2010. In 2011, P1 students who had been trained in online modules performed the same as did live-session trainees with respect to SMART objectives.

CONCLUSION

With focused online or live training, students are capable of incorporating principles of CPD by writing SMART learning objectives.

Musculoskeletal education in US medical schools: lessons from the past and suggestions for the future

Despite the prevalence of musculoskeletal disorders in the United States, physicians have received inadequate training during medical school on how to examine, diagnose, and manage these conditions. This article provides an overview of the existing literature on undergraduate medical musculoskeletal education, including learning objectives, researched methodology, and currently utilized assessment tools. A discussion of challenges to and suggested approaches for the implementation of medical school musculoskeletal curricula is presented.

Novel approach to parental permission and child assent for research: improving comprehension

OBJECTIVE

The aim of this research was to test a multimedia permission/assent (P/A) process. The overall hypothesis was that children and their parents exposed to a multimedia P/A process would have better comprehension compared with those exposed to a text-based process.

METHODS

Traditional and multimedia P/A processes were created by using an innovative learning-objective approach. A total of 194 parent-child dyads (children aged 11-14 years) were enrolled: 24 dyads in a prestudy testing P/A components for preference and effect on comprehension and 170 dyads in a randomized trial of a multimedia or paper P/A process for a hypothetical study. Participants were predominantly white and were from a metropolitan area served by a tertiary care pediatric hospital and outpatient facility. Comprehension of 8 essential elements of the P/A process was assessed.

RESULTS

The majority of prestudy subjects preferred the video version of the dual-energy radiograph absorptiometry description over the animated and paper versions combined (41 of 48 [85%]; P < .0001), and there were similar results for the abdominal ultrasound description (38 of 47 [81%]; P < .0001). Children exposed to the novel process showed significantly better overall comprehension compared with the paper P/A process (P = .0009), and there were highly significant differences in understanding of study procedures (P = .0002) and risks (P < .0001). The parental multimedia group had significantly better overall comprehension (P = .03).

CONCLUSIONS

Multimedia approaches to the research P/A process may improve overall understanding of research participation for children and parents. Improved understanding of study-specific research components (rather than research rights) may improve overall comprehension.