N. Held is currently assistant professor in pulmonary sciences and critical care medicine, University of Colorado School of Medicine, Aurora, Colorado. At the time of the study, she was a pulmonary and critical care fellow and a Department of Medicine medical education fellow, University of Colorado School of Medicine, Aurora, Colorado.
S. Jimenez is a research services senior professional and curriculum research assistant, Office of Assessment, Evaluation, and Outcomes, Office of Medical Education, University of Colorado School of Medicine, Aurora, Colorado.
Acad Med. 2023 Aug 1;98(8):922-928. doi: 10.1097/ACM.0000000000005221. Epub 2023 Mar 24.
To generate an expert-derived list of recommendations for how medical schools should approach decisions about the placement of basic science topics within shortened preclinical curricula, which allow for early clinical immersion.
A modified Delphi process was used to develop consensus on recommendations (March-November 2021). The authors performed semistructured interviews with national undergraduate medical education (UME) experts from institutions that previously underwent curricular reforms involving shortened preclinical curricula to elicit perspectives on how decisions were made at their institutions. The authors condensed the findings into a preliminary list of recommendations and distributed this list in 2 survey rounds to a larger group of national UME experts (from institutions that previously underwent curricular reforms or held positions of authority within national UME organizations) to gauge their level of agreement with each recommendation. Recommendations were revised based on participant comments, and those with at least 70% somewhat or strong agreement after the second survey were included in the final comprehensive list of recommendations.
Interviews were conducted with 9 participants and resulted in 31 preliminary recommendations that were then sent via survey to the 40 recruited participants. Seventeen/40 (42.5%) participants completed the first survey, after which 3 recommendations were removed, 5 were added, and 5 were revised based on comments-resulting in 33 recommendations. Twenty-two/38 (57.9%) participants responded to the second survey, after which all 33 recommendations met inclusion criteria. The authors removed 3 recommendations that did not directly address the curriculum reform process and consolidated the final 30 recommendations into 5 succinct, actionable takeaways.
This study generated 30 recommendations (summarized by the authors in 5 succinct takeaways) for medical schools designing a shortened preclinical basic science curriculum. These recommendations reinforce the importance of vertically integrating basic science instruction with explicit clinical relevance into all curricular phases.
生成一份专家建议清单，内容涉及医学院应如何在缩短的基础医学课程中安排基础科学主题，以便尽早进行临床实习。
采用改良 Delphi 法在 2021 年 3 月至 11 月期间达成共识，形成推荐意见。作者对在基础医学课程改革中经历过缩短基础医学课程的机构的国家本科医学教育（UME）专家进行半结构化访谈，以了解他们机构在决策过程中的观点。作者将研究结果浓缩为初步建议清单，并在两轮调查中向更多的国家 UME 专家（来自经历过课程改革或在国家 UME 组织中担任过职务的机构）分发此清单，以评估他们对每条建议的认可程度。根据参与者的意见修订建议，在第二轮调查后，至少有 70%的参与者表示有些或强烈同意的建议被纳入最终的全面建议清单中。
共进行了 9 次访谈，得出 31 条初步建议，然后通过调查分发给 40 名被招募的参与者。40 名参与者中有 17/40（42.5%）完成了第一轮调查，之后删除了 3 条建议，增加了 5 条建议，并根据意见修订了 5 条建议，共计 33 条建议。38 名参与者中有 22/38（57.9%）回应了第二轮调查，之后所有 33 条建议都符合纳入标准。作者删除了 3 条与课程改革过程没有直接关系的建议，并将最终的 30 条建议整合成 5 条简洁、可行的要点。
本研究为设计缩短基础医学课程的基础医学课程提供了 30 条建议（作者总结为 5 条简洁的要点）。这些建议强调了将基础科学教学与明确的临床相关性垂直整合到所有课程阶段的重要性。
