Zooming into the COVID Era Together.

The pre-clinical medical school curriculum provides students with extraordinary experiences in preparation to become physicians. However, it was not originally designed to be delivered remotely. The COVID-19 pandemic promptly threw the medical education process into unforeseen circumstances. A model of student-faculty collaboration created to address new challenges and implement practical solutions rapidly is presented. This model was used effectively to respond to pre-clinical educational interruptions that were imposed by the COVID-19 pandemic and maintain high-quality training. Our experience provides valuable insights and lessons learned that can be applied to the ongoing pandemic response and to future educational challenges.

Strategies From 11 U.S. Medical Schools for Integrating Basic Science Into Core Clerkships.

Calls for curricular reform in medical schools and enhanced integration of basic and clinical science have resulted in a shift toward preclerkship curricula that enhance the clinical relevance of foundational science instruction and provide students with earlier immersion in the clinical environment. These reforms have resulted in shortened preclerkship curricula, yet the promise of integrated basic science education into clerkships has not been sufficiently realized because of barriers such as the nature of clinical practice, time constraints, and limited faculty knowledge. As personalized medicine requires that physicians have a more nuanced understanding of basic science, this is cause for alarm. To address this problem, several schools have developed instructional and assessment strategies to better integrate basic science into the clinical curriculum. In this article, faculty and deans from 11 U.S. medical schools discuss the strategies they implemented and the lessons they learned to provide guidance to other schools seeking to enhance basic science education during clerkships. The strategies include program-level interventions (e.g., longitudinal sessions dedicated to basic science during clerkships, weeks of lessons dedicated to basic science interspersed in clerkships), clerkship-level interventions (e.g., case-based learning with online modules, multidisciplinary clerkship dedicated to applied science), bedside-level interventions (e.g., basic science teaching scripts, self-directed learning), and changes to formative and summative assessments (e.g., spaced repetition/leveraging test-enhanced learning, developing customized examinations). The authors discovered that: interventions were more successful when buy-in from faculty and students was considered, central oversight by curricular committees collaborating with faculty was key, and some integration efforts may require schools to provide significant resources. All schools administered the United States Medical Licensing Examination Step 1 exam to students after clerkship, with positive outcomes. The authors have demonstrated that it is feasible to incorporate basic science into clinical clerkships, but certain challenges remain.

Competency milestones for medical students: Design, implementation, and analysis at one medical school.

Competency-based assessment seeks to align measures of performance directly with desired learning outcomes based upon the needs of patients and the healthcare system. Recognizing that assessment methods profoundly influence student motivation and effort, it is critical to measure all desired aspects of performance throughout an individual's medical training. The Accreditation Council for Graduate Medical Education (ACGME) defined domains of competency for residency; the subsequent Milestones Project seeks to describe each learner's progress toward competence within each domain. Because the various clinical disciplines defined unique competencies and milestones within each domain, it is difficult for undergraduate medical education to adopt existing GME milestones language. This paper outlines the process undertaken by one medical school to design, implement and improve competency milestones for medical students. A team of assessment experts developed milestones for a set of focus competencies; these have now been monitored in medical students over two years. A unique digital dashboard enables individual, aggregate and longitudinal views of student progress by domain. Validation and continuous quality improvement cycles are based upon expert review, user feedback, and analysis of variation between students and between assessors. Experience to date indicates that milestone-based assessment has significant potential to guide the development of medical students.

Using Small Case-Based Learning Groups as a Setting for Teaching Medical Students How to Provide and Receive Peer Feedback.

As future physicians, nearly all medical students will be required to provide face-to-face feedback. Moreover, receiving high quality feedback from multiple perspectives is particularly valuable during the pre-clerkship training period. To address these needs, we developed a straightforward, easy to implement exercise that affords students the opportunity to practice giving and receiving feedback with peers. We describe how this exercise has been tailored to fit within the case-based learning small groups of our first-year curriculum and how to enhance the activity by weaving the basic principles of quality feedback into preparation sessions. This exercise has been valued greatly by students.

From Theory to Practice: Utilizing Competency-based Milestones to Assess Professional Growth and Development in the Foundational Science Blocks of a Pre-Clerkship Medical School Curriculum.

Physicians-in-training require skills and attitudes beyond medical knowledge in order to mature into successful clinicians. However, because assessments in pre-clerkship curricula historically have focused almost exclusively on medical knowledge, faculty contributions to early student development often have been limited. To address this challenge and enhance student progress, we re-designed our pre-clerkship curriculum to include settings in which diverse facets of student performance could be observed and fostered. Concurrently, we transitioned to an assessment strategy focused on competency-based milestones. The implementation of this strategy has allowed pre-clerkship science faculty to provide early-stage students with rich holistic feedback designed to stimulate their professional growth.

From music to macromolecules: using rich media/podcast lecture recordings to enhance the preclinical educational experience.

BACKGROUND: Little is known regarding the impact of lecture recordings on medical education. AIM: This study was designed to assess the impact of lecture recordings on the educational experience of first-year medical students. METHODS: Students were provided with digital lecture recordings in Molecular Foundations of Medicine, an integrated preclinical science block. Students could access recordings as audio/visual rich media, in which lectures were linked to slide presentations, and as audio-only podcasts. Student reactions were assessed by a mandatory questionnaire on the use of recordings and by a voluntary follow-up questionnaire on the effects of recordings on learning, stress and anxiety. RESULTS: Student response to lecture recordings was universally positive. A high proportion of the class accessed recordings, with rich media being the preferred format. Students felt that the lecture recordings helped them learn course material and reduced stress and anxiety. Finally, the availability of lecture recordings had no apparent adverse effect on classroom attendance. CONCLUSIONS: The availability of lecture recordings aided medical students in their studies and reduced stress and anxiety. Student response to the recordings was universally positive, and no negative outcomes were noted by students or faculty.