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Review of Y2 SBM/CT and MS Course PreClinical Subcommittee November, 2013 Chris Rees (Geisel 2), Steve Benson MD, Dave Nierenberg MD. Course learning objectives Course learning opportunities Learning assessments for students Measures of overall quality for the course
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Review of Y2 SBM/CT and MS CoursePreClinical SubcommitteeNovember, 2013Chris Rees (Geisel 2), Steve Benson MD, Dave Nierenberg MD • Course learning objectives • Course learning opportunities • Learning assessments for students • Measures of overall quality for the course • Specific suggestions for improving course
1a. Learning Objectives (Dave) • In the course syllabus 2013, the course objectives are listed as follows: • To provide a thorough and detailed introduction to rheumatologic conditions and musculoskeletal medicine • To know the important historical features, physical findings, laboratory and radiographic findings that help differentiate one connective tissue disease from another • To develop a structured approach to the patient with musculoskeletal symptoms in order to construct an appropriate differential diagnosis and develop rational diagnostic and therapeutic plans. • Students are not provided with the ILIOS course objectives • Important to have one shared set of core learning objectives, presented right at the beginning of the course
Continued (Dave) • From the lecture topics, and also the categories on the final exam, we can see the core topics of the course include: • Overview of course, and the approach to the patient • Elements of the joint and MS exam • Osteoarthritis • Rheumatoid arthritis • Pediatric conditions and JRA • Lyme disease • Other types of arthritis: seronegative, crystal, infectious • Muscle conditions, myositis and myofascial pain • Vasculitis, SLE, and scleroderma • Lab testing • Soft tissue problems and injuries • Bone diseases, fractures, and tumors • DJD and other Diseases of the spine • Congenital and developmental problems • Imaging the MS and CT systems • Common genetic conditions
1. Topics in national textbook(Cecil Essentials of Medicine, 2013) • Approach to patient with rheumatic disease (Yes) • Rheumatoid arthritis (Yes) • Spondyloarthropathies (Yes) • SLE (Yes) • Antiphospholipid antibody syndrome (yes) • Systemic sclerosis (Yes) and Sjogren’s syndrome • Idiopathic inflammatory myopathies (Yes) • Sjogren syndrome (no in 2013, yes in 2014) • Systemic vasculitis (Yes) • Crystal arthropathies (Yes) • Osteoarthritis (Yes) • Non-articular soft tissue disorders (Yes) • Rheumatic manifestations of systemic disorders (Yes)
1f. Learning objectives addressing additional specific LCME topics (with Nicole) • Health of populations: • Senior epidemic of OA, and how obesity contributes to the clinical progression • Chronic pain syndromes, e.g. fibromyalgia • Basic and ethical principles of clinical and translational research: • How the intricate process of basic and translational immunology research is changing the way we approach pts with RA (William Rigby) • Gender and cultural biases in students themselves: • Not at this time • Instruction in medical ethics and human values • In 2014 will be their first Hearts and Minds session about a patient with fibromyalgia (chronic pain syndrome) and her long-term use of opioids for pain management
1g. Overlap/ILIOS word search: “Vasculitis” • Does not appear in any course objectives • Appears in one session title (SBM/MS) • Appears in 3 sessions in 3 different courses
1g. Overlap/ILIOS word search: “Rheumatoid Arthritis” • Does not appear in any course objectives • Appears in one session title (SBM/MS) • Appears in 5 sessions in 3 different courses
1g. Overlap/ILIOS word search: “uric acid”(note: there are other “hits” when “gout” is searched) • Does not appear in any course objectives • Does not appear in any session title • Appears in 4 sessions in 4 different courses
2. Course Learning Opportunities 2012-13 (Dave) • Total hours: 39 h • Traditional lectures = 29 h (74% of total hours) • Large group discussion/review = 0 h • Lab (classical) = 0 • Small groups/conferences = 6 • PBL groups = 3 • Direct patient contact or PE session = 1 (2 groups) • Panel discussion (Hearts and Minds) = 0 • Other formats = 0
3. 2012-2013 Exam items sorted by current course learning objectives (Steve)
3. Exam content (MS final exam) Question style # Factual only, test recognition/memorization Important concepts, avoid test fatigue 15 Clinical vignette with reasoning Excellent, well written, pertinent 59 Application of knowledge Interpret findings, data 7 Photos of PE findings 8 Negative stem 2 (only!) Multiple T/F format 1 (only!) Pharmacology questions 6 4 were simple recall, 2 clinical vignettes
4. Feedback about course from March 2012 AAMC GQ • How well did each of the following sciences basic to medicine prepare you for clinical clerkships and electives? • All Year 1 disciplines (n=9): mean = 3.1 • All Year 2 disciplines (n=4): mean = 3.4 (3.3) • Renal course was not broken out
Results from recent student course reviews Data from 2012-2013 evaluations: Strongest areas: • “Overall usefulness of attending laboratory sessions or simulated laboratory sessions.” 4.22 • “How well this course provided me with a useful and appropriate introduction to this field of discipline.” 4.05 • “Overall quality of the entire course” 4.00 Among the questions asked on the course review pertaining to the “usefulness” of course elements, none scored below at 3.48. All faculty were rated at a 3.16 or higher, with 16 of 20 lecturers receiving a score of 3.70 or higher.
Results from recent student course reviews Representative comments (strengths): • Many students commented on the fairness and congruence of the final exam. • “The clinic visit was fantastic. This should be standard for all courses.” • “The best part of the course was the conferences.” • The majority of faculty received overwhelmingly positive scores from the students.
Results from recent student course reviews Representative comments (weaknesses): • Several students commented that the clinical experience would be more useful later in the term. (done for 2014) • “Perhaps one or two more conference groups would be helpful.” (done for 2014) • “The organization of the course could be a little better. The arthritis lectures could be grouped together and the bone lectures could be grouped together.” (done for 2014) • Some students commented that the required paper felt like “busywork.”(replaced in 2014 by off-line quizzes)
PLANS FOR ADDRESSING CONCERNS AND ISSUES FOR NEXT CYCLE, TERM 4, 2014
DRAFT New Course Learning Objectives for 2013-14 • Each student should demonstrate an appropriate level of understanding of the pathophysiology of themusculoskeletal/connective tissues system, such that the student is prepared to recognize, diagnose, and describe effective treatment options for the most common and severe diseases and disorders of this organ/system that may be encountered during the clinical clerkships or in clinical practice.
