USMLE Step 1 Standardized Scores Biostatistics & Epidemiology Section

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-0.40

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2001 2002 2003 2004 2005

Year of USMLE Exam (2nd Year Students)Arrows Indicate Change in Curriculum Format

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Sharon K. Hull, MD, MPH; Steven J. Verhulst, PhD; Tracey Smith, APRN-BCSouthern Illinois University School of Medicine, Springfield, Illinois

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This primary purpose of this project is to develop an integrated, rural-focused curriculum in Population Health and Prevention (PHP) in a midwestern, community-based medical school utilizing extensive partnerships with state and local public health agencies. The curriculum encompasses all four years of medical school instruction.

Success in our institution has been achieved for a variety of reasons that have to do with internal collaboration and strategic partnerships. Outlining these internal strategies is the primary aim of this poster.

Purpose

Methods

Key Integration Strategies

Results

Conclusions and Future Steps

PHP Curriculum Domains include:

• Quantitative Methods

• Critical Appraisal of the Medical Literature

• Public Health

• Preventive Medicine

In order to achieve a truly integrated curriculum, we designed a plan that incorporates both implementation and evaluation methods.

Successful integration of new, broadly-based content areas into an already packed medical school curriculum is possible if communication with curriculum leaders, students and institutional stakeholders is fostered. Tight integration with existing curricular content is key, and clear delineation of content domains enhances integration. Continuous, real-time response to feedback from all stakeholders is essential.

Continued future evaluation of student, faculty and Advisory Panel feedback is planned, as well as evaluation of long-term trends in USMLE performance and AAMC Graduation Questionnaire responses in these topic areas.

Program Evaluation Methods

The following three forms of information were collected to assess the level of integration of the PHP topics into the existing curriculum.

• Baseline needs assessment was done via surveys of students about their familiarity with relevant content area.

• Qualitative feedback was obtained from faculty, student quality circles, and curricular evaluations of PHP activities.

• Historical student performance on relevant portions of the USMLE examinations and appropriate responses to the Graduation Questionnaire were examined.

Implementation Methods

Using an existing curriculum governance structure, a longitudinal PHP curriculum was designed and implemented in all four years of the medical school curriculum. To achieve this three implementation methods were used:

The three primary faculty for PHP met with representatives of each unit in Y1 and Y2, and each clerkship in Y3. In these meetings, the representatives of the units and clerkships were asked by the PHP primary faculty: “What are you already doing in relationship to PHP topics?” and “How can we be a resource to you in these topic areas?”

The PHP primary faculty identified all other school faculty with an interest in PHP as well as outside interested parties. These individuals were invited to serve as an Advisory Panel for the project. Annual Advisory Panel meetings bring together these interested faculty to facilitate a discussion about content and integration for activities over all four years.

In Y4 (elective year), individual electives are being cataloged and a Career Pathway (guide for students who may be interested in careers in Population Health and Prevention) is being developed for inclusion in the Year 4 Catalog. New electives in clinical epidemiology and in service learning are being developed.

Student Experience with PHP Content

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Degree inPublic Health

Critical reviewof literature

Ever presentedat Journal Club

Ever presentedat professional

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Experience

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Matriculation End of Year 1 End of Year 2 Year 3 Year 4

• Identification of institutional stakeholders and curriculum leaders

• Avoidance of demands for “new calendar time”

• Clear delineation of curriculum domains

• Real-time response to feedback from students and curriculum leaders

• Dedication to tight integration with existing unit content

STUDENTS:

“The topic is pertinent to the unit as well as to population health.”

“Varicella-zoster vaccination was a very good topic because it pertains to the HII unit and brings up a lot of issues regarding public health outside of just statistics.”

“Excellent and relevant topic of discussion. These are topics that I know I will struggle with in the field and it is wonderful to hear about now!”

QUALITY CIRCLE::

“It is great to try and incorporate the topic into each unit but maybe focus on what is needed to know for the boards.”

“Looking back I now realize why I need to know about PHP topics but during that time I don’t think it made sense to me.”

“Possibly incorporating journal clubs to review articles relevant to the topics in the unit into Y2 would be worthwhile.”

FACULTY:

“The PHP material is working well. The key to it being so successful is the integration into the unit.”

“Making sure that the PHP activities are centered around the unit related topics has created a seamless integration of the material.”

Qualitative Feedback

Student Rating of PHP Topic Importance to Future Practice of Medicine

(1= Not Important, 4 = Extremely Important)

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PreventiveMedicine

Tools to appraiseliterature

Public Health Population Health Epidemiology Biostatics

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