scholarly journals Applying Metacognition Through Patient Encounters and Illness Scripts to Create a Conceptual Framework for Basic Science Integration, Storage, and Retrieval

2018 ◽  
Vol 5 ◽  
pp. 238212051877777 ◽  
Author(s):  
Eileen F Hennrikus ◽  
Michael P Skolka ◽  
Nicholas Hennrikus
Keyword(s):  
Medical School ◽  
Health System ◽  
Basic Science ◽  
Problem Based Learning ◽  
School Curriculum ◽  
Lessons Learned ◽  
Mean Difference ◽  
National Board ◽  
Illness Script ◽  
Illness Scripts

Problem: Medical school curriculum continues to search for methods to develop a conceptual educational framework that promotes the storage, retrieval, transfer, and application of basic science to the human experience. To achieve this goal, we propose a metacognitive approach that integrates basic science with the humanistic and health system aspects of medical education. Intervention: During the week, via problem-based learning and lectures, first-year medical students were taught the basic science underlying a disease. Each Friday, a patient with the disease spoke to the class. Students then wrote illness scripts, which required them to metacognitively reflect not only on disease pathophysiology, complications, and treatments but also on the humanistic and health system issues revealed during the patient encounter. Evaluation of the intervention was conducted by measuring results on course exams and national board exams and analyzing free responses on the illness scripts and student course feedback. The course exams and National Board of Medical Examiners questions were divided into 3 categories: content covered in lecture, problem-based learning, or patient + illness script. Comparisons were made using Student t-test. Free responses were inductively analyzed using grounded theory methodology. Context: This curricular intervention was implemented during the first 13-week basic science course of medical school. The main objective of the course, Scientific Principles of Medicine, is to lay the scientific foundation for subsequent organ system courses. A total of 150 students were enrolled each year. We evaluated this intervention over 2 years, totaling 300 students. Outcome: Students scored significantly higher on illness script content compared to lecture content on the course exams (mean difference = 11.1, P = .006) and national board exams given in December (mean difference = 21.8, P = .0002) and June (mean difference = 12.7, P = .016). Themes extracted from students’ free responses included the following: relevance of basic science, humanistic themes of empathy, resilience, and the doctor-patient relationship, and systems themes of cost, barriers to care, and support systems. Lessons learned: A metacognitive approach to learning through the use of patient encounters and illness script reflections creates stronger conceptual frameworks for students to integrate, store, retain, and retrieve knowledge.

scholarly journals Medical Student Leadership Development through a Business School Partnership Model: A Case Study and Implementation Strategy

2021 ◽  
Vol 8 ◽  
pp. 238212052110104
Author(s):  
Timothy P Daaleman ◽  
Mindy Storrie ◽  
Gary Beck Dallaghan ◽  
Sarah Smithson ◽  
Kurt O Gilliland ◽  
...  
Keyword(s):  
Leadership Development ◽  
Medical Students ◽  
Medical School ◽  
Business School ◽  
Medical Curriculum ◽  
School Curriculum ◽  
Learning Model ◽  
Lessons Learned ◽  
Self Awareness ◽  
Program Outcomes

Background: There is an ongoing call for leadership development in academic health care and medical students desire more training in this area. Although many schools offer combined MD/MBA programs or leadership training in targeted areas, these programs do not often align with medical school leadership competencies and are limited in reaching a large number of students. Methods: The Leadership Initiative (LI) was a program created by a partnership between a School of Medicine (SOM) and Business School with a learning model that emphasized the progression from principles to practice, and the competencies of self-awareness, communication, and collaboration/teamwork. Through offerings across a medical school curriculum, the LI introduced leadership principles and provided an opportunity to apply them in an interactive activity or simulation. We utilized the existing SOM evaluation platform to collect data on program outcomes that included satisfaction, fidelity to the learning model, and impact. Results: From 2017 to 2020, over 70% of first-year medical students participated in LI course offerings while a smaller percentage of fourth-year students engaged in the curriculum. Most students had no prior awareness of LI course material and were equivocal about their ability to apply lessons learned to their medical school experience. Students reported that the LI offerings provided opportunities to practice the skills and competencies of self-awareness, communication, and collaboration/teamwork. Discussion: Adding new activities to an already crowded medical curriculum was the greatest logistical challenge. The LI was successful in introducing leadership principles but faced obstacles in having participants apply and practice these principles. Most students reported that the LI offerings were aligned with the foundational competencies.

scholarly journals From principles to practice: embedding clinical reasoning as a longitudinal curriculum theme in a medical school programme

Diagnosis ◽  
2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Mini Singh ◽  
Lisa Collins ◽  
Rebecca Farrington ◽  
Matthew Jones ◽  
Harish Thampy ◽  
...  
Keyword(s):  
Faculty Development ◽  
Medical School ◽  
Clinical Reasoning ◽  
Lessons Learned ◽  
Medical Decision ◽  
Implementation Phase ◽  
Existing Structures ◽  
Illness Script ◽  
Undergraduate Study ◽  
Competency Frameworks

Abstract There is consensus that clinical reasoning (CR) is crucial for increasing the value of diagnosis, medical decision-making and error reduction. These skills should be developed throughout medical education, starting with undergraduate study. International guidance provides principles for CR curricula but interventions to date, are short term in nature. In this report, we describe the creation of a longitudinal, spiral CR curriculum within a large UK medical school programme (2500 students). A working group drove systematic evidence-based reform of existing structures. We utilised recognised models for curriculum development and mapping, relating learning outcomes to competency frameworks. Application of multiple teaching methodologies, rooted in enquiry-based learning and reported in CR literature, encourage metacognition for information-processing and illness script development. Development of CR is emphasised with recurrent, progressive learning opportunities, each stage purposefully building upon previous experiences. Formative and summative assessment approaches to drive learning, encouraging students’ ability to apply and articulate CR, is constructed via Miller’s Prism of Clinical Competence. Implementation of pedagogy is contingent on faculty development. Whilst many clinicians practice sound CR, the ability to articulate it to students is often a novel skill. Engagement in faculty development was strengthened through cross-institutional recognition of teaching workload and flexibility of delivery. We report lessons learned from the implementation phase and plans for measuring impact.

scholarly journals The roles of library liaisons in a problem-based learning (PBL) medical school curriculum: a case study from University of New Mexico

1998 ◽  
Vol 15 (3) ◽  
pp. 185-194 ◽  
Author(s):  
JONATHAN D. ELDREDGE ◽  
JANIS B. TEAL ◽  
JUDITH C. DUCHARME ◽  
REBECCA M. HARRIS ◽  
LILLIAN CROGHAN ◽  
...  
Keyword(s):  
New Mexico ◽  
Medical School ◽  
Problem Based Learning ◽  
School Curriculum ◽  
Medical School Curriculum ◽  
University Of New Mexico

scholarly journals Lessons Learned from a Study of the Integration of a Point-of-Care Ultrasound Course into the Undergraduate Medical School Curriculum

2019 ◽  
Vol 25 ◽  
pp. 4104-4109 ◽  
Author(s):  
Mateusz Zawadka ◽  
Agata Graczyńska ◽  
Anna Janiszewska ◽  
Andrzej Ostrowski ◽  
Maciej Michałowski ◽  
...  
Keyword(s):  
Medical School ◽  
Point Of Care ◽  
School Curriculum ◽  
Medical School Curriculum ◽  
Lessons Learned ◽  
Point Of Care Ultrasound

21st Century Problem-Based Learning

2020 ◽  
pp. 110-129
Author(s):  
Susan Ely ◽  
Joanne H. Greenawald ◽  
Richard C. Vari
Keyword(s):  
Medical School ◽  
21St Century ◽  
Rational Design ◽  
Problem Based Learning ◽  
School Curriculum ◽  
Medical School Curriculum ◽  
Preclinical Medical Education ◽  
Team Based Learning ◽  
Faculty Facilitator

An account of 21st century problem-based learning (PBL) in preclinical medical education is provided through a detailed explanation of the overall process, a description of PBL case construction, and a brief consideration of related activities, including case wrap-up sessions and facilitator debriefing meetings. Composition of student PBL groups, the role of the faculty facilitator, and PBL decorum are also explored in this chapter. The implementation of PBL in a new medical school curriculum by rational design is compared to the introduction of PBL into an existing medical school curriculum by retrofit. Advantages and challenges of PBL are enumerated; a brief comparison of PBL with team-based learning (TBL) is also included.

scholarly journals Attendance, engagement and performance in a medical school curriculum: early findings from competency-based progress testing in a new medical school curriculum

PeerJ ◽  
2018 ◽  
Vol 6 ◽  
pp. e5283 ◽  
Author(s):  
Heather S. Laird-Fick ◽  
David J. Solomon ◽  
Carol J. Parker ◽  
Ling Wang
Keyword(s):  
Medical School ◽  
Basic Science ◽  
Flipped Classroom ◽  
School Curriculum ◽  
Medical School Curriculum ◽  
Science Knowledge ◽  
Large Group ◽  
Basic Science Knowledge ◽  
Group Sessions ◽  
The Relationship

IntroductionMedical students often do not value attending in-person large group sessions. It is also not clear from prior research whether attendance at large group sessions impact on performance in medical school. The goal of this study was to assess the relationship between voluntary attendance in large group sessions organized as a “flipped classroom” in a new innovative curriculum and students’ mastery of clinical applications of basic science knowledge.MethodologyOur students’ ability to apply basic science knowledge to clinical problems is assessed via progress testing using three methodologies: a locally developed multiple-choice examination, written examination developed through the National Board of Medical Examiners (NBME) Customized Assessment Services Program and post encounter questions included in a clinical skills examination. We analyzed the relationship between voluntary attendance at weekly large group “flipped classroom” sessions and the students’ performance on examinations given at four intervals over the initial 24-week module of the medical school curriculum.ResultsComplete data were available for 167 students. A total of 82 students (49.1%) attended all large group sessions, 65 students (38.9%) missed one or two sessions and 20 students (12.0%) missed three or more sessions. There were no difference between the students in the groups on their medical admission (MCAT) examination scores. The growth in performance from each time point until the next was statistically significant. There was no statistically significant difference in growth between the students who had no absences and those who had one or two absences. Students who missed three or more sessions performed significantly lower than their peers over the 24 week module and were more likely to score one or more standard deviations below the class mean on the assessments.ConclusionsWe found no relationship between attendance and MCAT scores suggesting the differences in performance on the progress tests was not due to initial differences in knowledge or reasoning skills. While the study was not experimental, it suggests large group sessions using a “flipped classroom” approach to provide reinforcement, feedback and practice may be effective for increasing learning and retention in the application of basic science knowledge among first year medical students.

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