This study's goal was to determine if completing Web cases improved students' performance on clerkship assessments.
We compared scores on preceptor evaluations, National Board of Medical Examiners (NBME) Subject Exam, and a standardized patient (SP)-based exam using ANCOVA for students choosing to complete assigned cases versus students not completing the assignment. We controlled for prior academic performance and clerkship timing using US Medical Licensing Exam (USMLE) Step 1 scores and rotation order.
Students completing the case assignment scored higher on the NBME subject exam and the SP-based exam.
Web-based learning was associated with improved student performance on clerkship assessments.
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[Show abstract][Hide abstract] ABSTRACT: Web-based cases are well accepted by medical students and enable faculty to deliver equivalent educational experiences to all students. A 2009 literature search revealed no study investigating student use patterns of Web-based case libraries for self-directed learning. We investigated third-year students' use of a Web-based case program for self-directed learning in a family medicine clerkship.
We analyzed Design A Case usage patterns of 210 medical students during academic year 2008--2009. We compared board score differences between these students and those from the previous 5 years who did not use Design A Case. We analyzed data from a 13-item survey, administered to a subgroup of 85 students, about the strengths, weaknesses, and acceptability of the program.
Students completed, on average, four cases, which was beyond the requirement of three. They reported that the content was highly relevant to cases they saw in clinic. Almost 75% preferred the self-directed Web-based learning over didactics, and most (64%) felt they learned more electronically. Use of the cases was associated with equivalent Board scores versus didactic lectures.
In our setting, self-directed learning using a Web-based case program was highly acceptable to students. Web-based cases may provide an option for family medicine educators who wish to deliver equivalent educational experiences across sites.
[Show abstract][Hide abstract] ABSTRACT: E-learning technologies in education use adult learning theories that view the educator as a facilitator of learning and an assessor of outcomes. The change to this technology requires a shift in the focus of a course from the educator to the subject. The experience of one faculty member involved in an implementation of an online program is used to demonstrate the application of Fink's principles of significant learning in the virtual environment. Fink urged faculty to create learning-centered courses, as opposed to content-centered courses. The taxonomy of six course components he proposed as necessary to significant learning are foundational knowledge, application, integration, human dimension, caring, and learning how to learn. Fink's taxonomy of significant learning can be used as a framework to focus course planning and assessment of student outcomes as courses are adapted to a Web-based environment.
No preview · Article · Mar 2008 · Journal of Nursing Education
[Show abstract][Hide abstract] ABSTRACT: The synthesis of basic and clinical science knowledge during the clerkship years has failed to meet educational expectations.
We hypothesized that a small-group course emphasizing the basic science underpinnings of disease, Foundations of Clinical Medicine (FCM), could be integrated into third year clerkships and would not negatively impact the United States Medical Licensure Examination (USMLE) step 2 scores.
In 2001-2002, all third year students met weekly in groups of 8-12 clustered within clerkships to discuss the clinical and basic science aspects of prescribed, discipline-specific cases.
Students completing USMLE step 2 between 1999 and 2004 (n = 743).
Course evaluations were compared with the overall institutional average. Bivariate analyses compared the mean USMLE steps 1 and 2 scores across pre- and post-FCM student cohorts. We used multiple linear regression to assess the association between USMLE step 2 scores and FCM cohort controlling for potential confounders.
Students' average course evaluation score rose from 66 to 77 (2001-2004) compared to an institutional average of 73. The unadjusted mean USMLE step 1 score was higher for the post-FCM cohort (212.9 vs 207.5, respectively, p < .001) and associated with step 2 scores (estimated coefficient = 0.70, p < .001). Post-FCM cohort (2002-2004; n = 361) mean step 2 scores topped pre-FCM (1999-2001; n = 382) scores (215.9 vs 207.7, respectively, p < .001). FCM cohort remained a significant predictor of higher step 2 scores after adjustment for USMLE step 1 and demographic characteristics (estimated coefficient = 4.3, p = .002).
A curriculum integrating clinical and basic sciences during third year clerkships is feasible and associated with improvement in standardized testing.
Full-text · Article · Jul 2008 · Journal of General Internal Medicine