VOL 2, No 7, August 2000
Technology makes inroads in medical education
Information technology is changing the field of medical education as one school after another meshes the computer, the Internet, the lecture hall and the clinic.
First-year
students at Wake Forest University School of Medicine receive laptop computers
for use in the classroom and to complete assignments and exams.
Just up the road, students entering Wake Forest University School of Medicine (formerly Bowman Gray) receive laptops and printers to aid their studies. Two years later, they’re issued PalmPilots for use during clinical training.
Elizabeth Connor, the MUSC Library's assistant director of public services and education, explored this and other efforts to enhance medical training through information technology at the Technology Innovation in Medical Education conference held in June at Wake Forest.
“It was a great opportunity to learn new ways to transform the delivery of our medical curriculum,” she said.
Other conference hosts were the schools of medicine from Case Western University, University of California Los Angeles, and University of Pittsburgh, and Loyola University Medical Center.
Students at Wake Forest use laptops in the classroom and to complete assignments. Special ports located throughout the campus provide access to the school's network.
During their clinical rotations, at stations located in clerkship and study areas, students can place their PalmPilots in special cradles where their data is synchronized and becomes available for faculty review. Reference card information downloaded onto the PalmPilots puts medical knowledge, like normal lab values and drug references, right at students' fingertips.
A partnership with IBM and a $3,000 tuition hike cover the cost of computer equipment and its supporting infrastructure.
Based on information presented, Connor identified several key elements for successful integration of information technology into education:
- A supporting infrastructure and uniform hardware and software standards
- An emphasis on educational objectives, not technology
- Effective faculty development
- Development of web-based versions of course syllabi.
“One of our next steps is to get all syllabi online in a format that's interactive and searchable,” he continued.
During the conference, Connor had the opportunity to demonstrate some of MUSC's efforts to integrate information technology—Edweb and Human Anatomy Online. Edweb is a central point of access for all web-based education resources at MUSC; Human Anatomy online, an interactive tutorial and reference on human anatomy.
An online presence and the use of computers in day-to-day coursework can also be found in several undergraduate classes. The Department of Cell Biology and Anatomy web site provides Cell Tissue and Organ Biology students with information such as the course syllabus, practice quizzes and quiz/exam scores. Through Microbes, the web page of the education division of the Department of Microbiology and Immunology, students in Infection and Immunity can gain access to everything from course goals and objectives, to PowerPoint presentations used in class.
Students in these courses, as well as Histology, also complete exercises and portions of tests via computer.
Two on-campus resources provide assistance to faculty who wish to incorporate elements of information technology into their courses. At the Educational Technology Lab, Mary Mauldin, director, works with faculty members from all colleges to develop web-based instruction. Through the Faculty Mentoring Center, faculty can access a digital camera and other equipment that helps translate print materials to the web.
To access Edweb, visit <http://www.library.musc.edu/edweb>.
For more information on the Educational Technology Lab, call 876-5040.
For the Faculty Mentoring Center, call 792-4369.
Residency reviews restructured
GME creates standing committee to ensure quality internal reviews of residency programsIn the long list of accreditation requirements for MUSC's 45 residency programs is the internal monitoring of each's operation.
To make the most of the process, the MUSC Office of Graduate Medical Education (GME) created a standing committee to conduct all internal reviews—a significant departure from the past when different groups were assembled for each program's assessment.
Operating by the premise that practice makes perfect, a standing committee ensures consistency and quality reviews by a group educated in the evaluation process, said Franklin Medio, Ph.D., GME director.
The Internal Residency Review Committee, made up of two faculty members, one administrator, two program directors and two residents, has reviewed one to two programs each month since it came together in January 1999.
“These committee members have accumulated a tremendous amount of knowledge on how to keep a residency program healthy in terms of educational practice,” said George Arana, M.D., associate dean for Graduate Medical Education.
Site visits by the Accreditation Council for Graduate Medical Education (ACGME) can range anywhere from every one to five years. The internal review, designed to assess how well the program is meeting accreditation standards and requirements, identify areas of weakness and make recommendations for improvement, is scheduled halfway between each program's accreditation site-visit cycle.
“One of the overriding principles of medical education and practice is peer review,” Medio said. “What we're doing through the internal review process is saying to our folks that we don't want them to just meet the minimum, but to exceed it and provide the best quality education possible.”
Since they've had site visitors and presented MUSC's internal review method at national meetings of the Association of American Medical Colleges (AAMC) and Association for Hospital Education, Medio and Arana have fielded many calls and visits from other institutions interested in establishing a similar process.
“Department chairs have also requested additional assistance after completing their internal review to ensure they're well prepared for the ACGME site visit,” Arana said. “The review process has become a useful tool for residency programs instead of just another requirement to meet.”
“It's much more effective having the same group of people who are familiar with the process conduct each review,” said Amy Hutchinson, M.D., residency program director for ophthalmology. “Our internal review helped us get all the paperwork and data collection on track and prepared us well for a successful ACGME site visit.”
As the committee conducts more reviews it's also better able to identify broader institutional problems that go beyond an individual program, such as a lack of workspace or difficulties with clinical services that affect their educational program, Medio said.
Here's how the process works: The residency program directors submit information about the program The GME office interviews as many residents from the program as possible to discuss any problems or concerns. Information is reviewed by the committee who then meets with the program director, coordinator and one or two residents and conducts a formal assessment of strengths, weaknesses and areas for improvement.
After each review, a committee member is assigned to conduct a six-month follow-up to ensure the program has addressed any areas of concern or deficiency. Program directors are also asked to complete an evaluation of their own and offer comments and suggestions for improvements to the internal review process.
The initial membership of the Internal Residency Review Committee was determined based on those who expressed an interest in the internal review process. Resident representatives were elected by their peers. Each member of the group will serve for 18 months.
“It's a high intensity and high frequency role that the internal reviewers
play,” Arana said. They deserve a lot of credit for the work they’re doing
to improve the educational process.”
Revised Year 2 curriculum in place for fall
The Class of 2003 continued its progression through the new undergraduate curriculum as it began the second year of studies on Aug. 23.Last fall, these students were the first to experience the revised first-year curriculum with its consolidated course stucture and coordinated content. Those same elements are now part of the sophomore year.
Under the new curriculum, second-year students will complete three courses during the fall semester:
- Doctoring III (to include Physical Diagnosis and Medical Ethics)
- Infection and Immunity (a combination of Microbiology and Infectious Diseases and Immunology); and
- Mechanisms of Disease I (consisting of General Pathology and Neuropathology). (See next story)
The cumulative exam format introduced into the first year last fall also becomes a part of the second year.
Instead of exams at different times in each course, comprehensive exams will test the content covered in all courses during the preceding portion of the semester. Prior to each examination, students will have a weeklong period for preparation, a time during which no other academic activities will be scheduled. Two exams will be held during the semester, and one at its conclusion.
Spring 2001 brings additional course integration. Pharmacology and Therapeutics will replace Pharmacology. Doctoring IV will incorporate all segments of the former Introduction Clinical Medicine Course, and Mechanisms of Disease II will replace Systemic Pathology/Laboratory Medicine.
The Year 2 Curriculum Committee, chaired by Gabriel Virella, Ph.D., leads reorganization efforts. The committee includes course and segment directors and other faculty and staff who play critical roles in the teaching effort.
“The teamwork involved in devising the new courses and tests is probably the most significant development in the curricular revision process in the sophomore year, opening the door to very exciting opportunities for innovation in the near future,” Virella said.
New Year 2 course directors appointed
This June, new co-course directors Kim Collins, M.D., and Erin McConnell, M.D., set out to consolidate and reorganize two second-year courses—General Pathology and Neuro-patholgy.
Drs.
Erin McConnell, left, and Kim Collins are the new co-directors of Year
2's Mechanisms of Disease course.
The new course, Mechanisms of Disease I, becomes a part of the revised second-year curriculum.
In addition to consolidation of course content, Collins, associate professor of pathology and laboratory medicine, and McConnell, assistant professor of pathology and laboratory medicine, aim to increase the number of clinical presentations in the course and provide more hands on experience with the tissues studied in pathology.
“We'll be bringing back the use of microscopic slides and specimens in the Pathology Museum to enhance what students learn via lecture, textbook and computer,” Collins said. “We’ve also done a lot of work on seminar tutorials.”
“It's been a challenge to put together everything in time for classes,” McConnell said. “The support we've received from faculty and Sandy Schaller, computer/admistrative coordinator, has been extremely helpful.”
In the spring semester, Mechanisms of Disease II will replace Systemic Pathology/Lab Medicine.
Collins and McConnell hope to use student evaluations of lectures and handouts in the fall semester to better prepare spring semester revisions.
“We're open to suggestions from students,” McConnell said. “What they tell us will affect what they see in the spring semester.”
Graduate Medical Eduction
Core Curriculum Lecture SeriesDinner is provided at Thursday sessions; lunch is provided at Friday sessions.
September
7
4 - 6 p.m.
Maintaining Your Financial
Fitness
2 West Amphitheater
8
11:30 a.m. - 1 p.m.
100% Mortgage Financing
601 Clinical Sciences Building
14
4 - 6 p.m.
Effective Job-Hunting Strategies
2 West Amphitheater
15
11:30 a.m. - 2 p.m.
Effective Job-Hunting Strategies
601 Clinical Sciences Building
21
4 - 6 p.m.
Evidence-Based Medicine
2 West Amphitheater
22
11:30 a.m. - 2 p.m.
Evidence-Based Medicine
2 West Amphitheater
28
4 - 6 p.m.
Developing a Personal Financial Plan
2 West Amphitheater
29
11:30 a.m. - 1 p.m.
Determining Your Insurance Needs
601 Clinical Sciences Building
To register, call Angela Ybarra, 792-0761 or Ginger Blanchard, 792-9304.
Continuing Medical Education
The following conferences are sponsored by MUSC.September
8 - 10
Ophthalmology Clinical Update
Kiawah Island Resort
15 - 16
Issues in Medical Ethics—Thomas A. Pitts Lectureship
Gazes Auditorium
16
Endoscopic Ultrasound Course
MUSC Campus
25 - 30
Intensive Review of Emergency Medicine
Embassy Suites—Convention Center
28 - 29
6th Annual Diabetes Symposium
Sheraton—North Charleston
Call the Office of Continuing Medical Education at 876-1925 for more information.
Teaching Tips
From “Creative Medical Teaching,” Neal Whitman, 1990:Ways in which lectures commonly waver and could improve:
DON’T EXTEMPORIZE—ORGANIZE—An ad lib presentation is both superficial and desultory. Furthermore, the facts themselves are but one element in a good lecture. Repetition, selectivity, creativity, leadership and proper choice of topics all require careful preparation.
DON’T CONFESS—PROFESS— Personal experience, expert opinion, imperfect answers to unanswered questions, the anecdote that illuminates, the memorable example—in these, the lecture complements literature.
DON’T DWELL OR DEFER—More than five minutes in a one-hour talk is a long time. The speaker should always feel an urge to move on…deferring a message also can be deleterious. Mentioning a point in passing only to say “I’ll come back to that later,” leads our attention astray from the present subject.
START AND FINISH—The germane anecdotes, the story that comes
naturally, the consummate cartoon—these are appropriate. Don’t try too
hard.
Don't miss this
Oct. 27 - Nov. 1AAMC Annual Conference
Chicago
To include the Group on Educational Affairs, Research in Medical Education and Innovations in Medical Education.
For program and registration information visit <http://www.aamc.org/meetings/annual/2000/start.htm>
Oct. 28 - 29
Generalists in Medical Education 21st Annual Conference
Chicago
To be held concurrently with the AAMC Conference
For information, visit <http://www.thegeneralists.org>.
The Medical Educator is written by Kristen
D. Karig, Public Relations