Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Healthy Minds Innovations, Madison, WI, USA.
Med Educ Online. 2022 Dec;27(1):2007561. doi: 10.1080/10872981.2021.2007561.
Many medical schools are moving toward integrated curricula in response to the 2010 Carnegie report. However, there is often apprehension that student performance on standard assessment metrics of medical knowledge acquisition could suffer during the transition period. Therefore, we sought to analyze the impact of curriculum redesign on the medical knowledge acquisition of the transitional cohort, as measured by NBME subject exam scores.
The University of Wisconsin School of Medicine and Public Health Legacy curriculum followed a standard 2 + 2 medical school educational model, including traditional, department-based, third-year clinical clerkships. In the new ForWard curriculum, students enter clinical rotations one semester earlier, and those core clinical experiences are organized within four integrated blocks combining traditional clerkship specialties. This retrospective program evaluation compares NBME subject exam scores between the final cohort of Legacy third-year students (2016-17) and first cohort of ForWard students (2018) for the Adult Ambulatory Medicine, Medicine, Neurology, Obstetrics and Gynecology, Pediatrics, Psychiatry, and Surgery exams.
NBME subject exam mean scores ranged from 75.5-79.4 for the Legacy cohort and 74.9-78.7 for the ForWard cohort, with no statistically significant differences in scores identified for each individual exam analyzed. Results remained constant when controlled for student demographic variables.
Faculty and students may worry about impacts to the transitional cohort during curriculum redesign, however our results suggest no substantive negative effects to acquisition of medical knowledge during transition to an integrated curriculum. Further monitoring is necessary to examine whether medical knowledge acquisition remains stable or changes after the integrated curriculum is established.
许多医学院校正在响应 2010 年卡内基报告，朝着综合课程的方向发展。然而，人们常常担心，在过渡期间，学生在医学知识获取的标准评估指标上的表现可能会受到影响。因此，我们试图分析课程重新设计对过渡 cohort的医学知识获取的影响，这是通过 NBME 科目考试成绩来衡量的。
威斯康星大学医学院和公共卫生学院的传统课程遵循标准的 2+2 医学院教育模式，包括传统的、以系为基础的、三年级临床实习。在新的前瞻性课程中，学生提前一个学期进入临床轮转，这些核心临床经验被组织在四个综合模块中，将传统的实习专业结合在一起。这项回顾性的课程评估比较了 Legacy 三年级学生（2016-17 年）的最后一个队列和前瞻性学生（2018 年）的第一队列的 NBME 科目考试成绩，涉及成人门诊医学、医学、神经病学、妇产科、儿科学、精神病学和外科学考试。
NBME 科目考试的平均分数为 Legacy 队列的 75.5-79.4，前瞻性队列的 74.9-78.7，每个单独分析的考试分数没有统计学上的显著差异。当控制学生的人口统计学变量时，结果仍然保持不变。
教师和学生可能担心课程重新设计对过渡队列的影响，但我们的结果表明，在向综合课程过渡期间，对医学知识获取没有实质性的负面影响。进一步的监测是必要的，以检查在综合课程建立后，医学知识获取是否保持稳定或发生变化。
