A New Approach to Learning How to Teach: medical students as instructional designers

As students at the David Geffen School of Medicine at UCLA, the student authors were given the opportunity to develop their own creative projects which would be used to teach future medical students. They chose their own topics, planned and researched their projects, and then implemented the projects in interactive digital Adobe Flash files. In the first project they created interactive case-based radiology teaching files. In the second project they integrated photographic images into the existing illustrative anatomy files. Students in subsequent years have learned from these files on computers both at home and in the school's anatomy lab. The experience of creating the files served as an opportunity for hands-on learning for the student authors, both of the material and of the practice of teaching. In this paper they describe why they undertook these projects, what exactly they did, and the impact their creation had on them. The projects demonstrate that student-driven educational materials are both possible and beneficial. Furthermore, their experience has allowed them to conclude that faculty at other medical schools should consider providing students with opportunities to develop their own creative projects that contribute to the curriculum

Biodiversity of 52 chicken populations assessed by microsatellite typing of DNA pools

In a project on the biodiversity of chickens funded by the European Commission (EC), eight laboratories collaborated to assess the genetic variation within and between 52 populations from a wide range of chicken types. Twenty-two di-nucleotide microsatellite markers were used to genotype DNA pools of 50 birds from each population. The polymorphism measures for the average, the least polymorphic population (inbred C line) and the most polymorphic population (Gallus gallus spadiceus) were, respectively, as follows: number of alleles per locus, per population: 3.5, 1.3 and 5.2; average gene diversity across markers: 0.47, 0.05 and 0.64; and proportion of polymorphic markers: 0.91, 0.25 and 1.0. These were in good agreement with the breeding history of the populations. For instance, unselected populations were found to be more polymorphic than selected breeds such as layers. Thus DNA pools are effective in the preliminary assessment of genetic variation of populations and markers. Mean genetic distance indicates the extent to which a given population shares its genetic diversity with that of the whole tested gene pool and is a useful criterion for conservation of diversity. The distribution of population-specific (private) alleles and the amount of genetic variation shared among populations supports the hypothesis that the red jungle fowl is the main progenitor of the domesticated chicken

Utility of the AAMCʼs Graduation Questionnaire to Study Behavioral and Social Sciences Domains in Undergraduate Medical Education

The Institute of Medicine (IOM) report on social and behavioral sciences (SBS) indicated that 50% of morbidity and mortality in the United States is associated with SBS factors, which the report also found were inadequately taught in medical school. A multischool collaborative explored whether the Association of American Medical Colleges Graduation Questionnaire (GQ) could be used to study changes in the six SBS domains identified in the IOM report

Developing Clinical Competence

textabstractThe development of clinical competence is the main purpose of medical education. The long road to become clinically competent starts on the first day of medical school, and every institution strives to select the best students. The responsibility of medical schools is to train those students to become clinically competent physicians who are highly qualified and specialized professionals able to function in a constantly changing society that puts continuously growing demands on the medical profession. Understanding clinical competence is therefore crucial not only for medical education, assessment, and licensing examinations, but also for society and its responsibility for the quality of health care. However, there is little consensus about what clinical competence is and how to measure it. A proper definition and a better understanding of clinical competence and its components would serve as a criterion for validating medical educational programs and would ! assure a minimum level of competency at the end of medical school and beyond during residency. Each of the previous chapters of this thesis highlights different aspects of clinical competence and its development. In the introductory chapter the lack of consistency in definitions of clinical competence is emphasized and a historical overview is given to shed light on the variety of definitions used over the last decades. The study presented in Chapter 2 explores the effect of level of pre-university performance on preclinical and clinical performance. The study in Chapter 3 addresses the impact of clinical training during clerkships on students’ learning. Specifically, the relationship among the nature and volume of patient encounters, quality of supervision, and the learning outcomes were explored. The study of Chapter 4 is directed at the interaction between knowledge and a problem-solving ability during students’ diagnostic problem solving at end-of-clerkship examinations. Chapter 5 focuses on clinical competence during clerkships and end-of-clerkship examinatio! ns. In this study we explored whether clinical teachers place different values on individual components of competence while students work on the wards or while students are examined during clerkship examinations. The study reported in Chapter 6 investigates how recall of case information changed for different expertise groups under different conditions, while research discussed in Chapter 7 was conducted to find out how the selection of case information by students and doctors during different stages of the diagnostic process is related to different expertise groups. In the present and final chapter of this thesis the main findings of all previous chapters are summarized and discussed. At the end of this chapter, conclusions and suggestions for further research are given

Effect of Repeated/Spaced Formative Assessments on Medical School Final Exam Performance

Purpose: Formative assessments, especially if spaced, encourage effective study habits such as retesting. The individual and combined effect of weekly formative assessments and cumulative assessments on final exam performance was studied. Methods: Students were placed into 6 groups by weekly formative assessment performance and practice exam utilization/performance. Students who scored below the median on weekly assessments comprised groups 1/3/5. Groups 2/4/6 scored above the median. Groups 1/2 did not use the practice exam. Groups 3/4 scored below the median on the practice exam while Groups 5/6 scored above. Multiple comparisons were made using ANCOVA. Results: Adjusted analysis showed weekly assessment and practice exam performance had a significant relationship with final exam performance (F[7,145]=18.765, p<0.0005). Groups 2/4/6 performed better on the final exam than groups 1/3/5 respectively (1v2, 80.8% vs 88.0%, p<0.0005 || 3v4, 83.4% vs 88.6%, p<0.0005 || 5v6, 84.1% vs 90.1%, p<0.0005). Group 1 performed worse than group 3 (80.8% vs 83.4%, p=0.072) and group 5 (80.8% vs 84.1%, p=0.047). Discussion: Performance on weekly formative assessments was predictive of final exam scores. Struggling medical students will benefit from extra cumulative practice exams while students who are excelling do not need extra practice

Validating OSCE Performance: The Impact of General Intelligence

Purpose: To investigate the relationship between medical students’ eductive ability as measured by the advanced version of the Raven׳s Progressive Matrices (RPM) test, reproductive ability as measured by performance on the United States Medical Licensing Examination (USMLE) Step I, and Objective Structured Clinical Examination (OSCE) performance. Method: Thirty-two third-year medical students took the Advanced Progressive Matrices (APM) online, which consists of two parts: (1) a practice set of 12 items, and (2) 36 items which become progressively more difficult as the test proceeds. Several models representing different causal structures are tested and compared. Results: Comparison of the different structural models revealed that eductive reasoning ability better predicted OSCE performance than reproductive ability. Discussion: The relationship between APM and OSCE performance indicates that more in-depth research in domain-general abilities is important

Student Perceived Value of Anatomy Pedagogy, Part II: Clinical Practice and Assessment

We describe student beliefs of how anatomy education influenced their preparation for standardized clinical assessments and clinical skills. We conducted three annual surveys of students of the David Geffen School of Medicine (DGSOM) at the University of California Los Angeles (UCLA) and students of the University of California, Riverside (UCR)/UCLA Thomas Haider Program in Biomedical Sciences from 2010 to 2012. Students were asked, “What specific knowledge or skills did you learn from your gross anatomy experience that helped you prepare for USMLE board exams, third-year clerkships, and physical examination skills?” All students who responded to the survey viewed anatomy as a highly valued part of the medical curriculum. Almost all students felt that anatomy knowledge in general was useful for their success with United States Medical Licensing Examination (USMLE) exams, how they perceived their physical exam skills, and how they perceived their preparation for third- or fourth-year clerkships. On the other hand, when asked about how the anatomy curriculum helped prepare students for fourth-year clerkships, there was a downward trend over a three-year period with each subsequent class. Although anatomy is a highly valued part of the medical school experience, students value integration of the anatomical and clinical sciences, as evidenced by a perceived diminishing value of anatomy pedagogy taught outside of clinical context with subsequent classes over the course of three years

Student Perceived Value of Anatomy Pedagogy, Part I: Prosection or Dissection?

A series of three annual surveys of David Geffen School of Medicine (DGSOM) at UCLA students and UCR/UCLA Thomas Haider Program in Biomedical Sciences students were administered from 2010 to 2012 to ascertain student perceptions of which anatomy pedagogy—prosection or dissection—was most valuable to them during the first year of preclinical medical education and for the entire medical school experience in general. Students were asked, “What value does gross anatomy education have in preclinical medical education?” We further asked the students who participated in both prosection and dissection pedagogies, “Would you have preferred an anatomy curriculum like the Summer Anatomy Dissection during your first year in medical school instead of prosection?” All students who responded to the survey viewed anatomy as a highly valued part of the medical curriculum, specifically referring to four major themes: Anatomy is (1) the basis for medical understanding, (2) part of the overall medical school experience, (3) a bridge to understanding pathology and physiology, and (4) the foundation for clinical skills. Students who participated in both prosection and dissection pedagogies surprisingly and overwhelmingly advocated for a prosection curriculum for the first year of medical school, not a dissection curriculum. Time efficiency was the dominant theme in survey responses from students who learned anatomy through prosection and then dissection. Students, regardless of whether interested in surgery/radiology or not, appreciated both pedagogies but commented that prosection was sufficient for learning basic anatomy, while dissection was a necessary experience in preparation for the anatomical medical specialties. This suggests that anatomy instruction should be integrated into the clinical years of medical education