Curriculum Design and Scholarship for New Educators: A Professional Development Workshop for Medical Students.

Introduction: Medical students' professional development includes their role as educators. Despite greater opportunities to join medical education curriculum development, medical students' engagement in these activities remains limited. A recent national study on student leadership in curricular change revealed a formal lack of leadership and training in medical education as significant barriers. Medical students' unawareness of how to disseminate curricula as educational scholarship and its value to their careers also restricts the fullness of their formation as educators. Methods: We designed a 3-hour, interactive, project-focused conference workshop for medical students without prior knowledge in curriculum development. Of participants, 64 worked in 10 groups creating medical curricula using Kern's six-step approach in student-facilitated breakout sessions. Completed group projects were presented, including brief action plans for transforming their work into scholarship. The workshop was evaluated using a mixed-methods approach. Results: Of survey respondents, 44 mostly medical students, faculty, and administrators from different institutions rated the workshop as a very positive experience, and the pacing of the breakout groups as effective. A notable increase in self-reported mastery, as measured by learning objectives aligned with Kern's six-step model, was recorded from student respondents as compared to faculty. A sense of readiness to participate in curricular decisions either at the home institution or in individual career paths was evident from narrative comments. Discussion: Our workshop provided medical students with a foundation in curriculum development and educational scholarship. Session design provided flexibility in the pace of breakout sessions and allowed in-depth discussion of educational topics.

A Proposal for a Shared Medical School Curricular Ecosystem.

New digital platforms are transforming learning in higher education and providing high-quality education content at little or no cost. Educators can now reach large, even global audiences. Yet, many medical schools continue to develop and maintain custom but duplicative curricular content despite having limited faculty and financial resources. In addition, medical students are faced with a multitude of potentially unaligned curricula driven by the school, national licensing exams, and the students' own perceived clinical training needs. The authors propose the creation of a common curricular component ecosystem that is developed around consensus-built foundational learning objectives aligned with core competencies that must be acquired by all students graduating medical school. Identifying and developing common curricula with standardized learning outcomes ideally should involve leading medical education, accreditation, and certification bodies in the United States. Curriculum component standards will be necessary to enable curriculum development, sharing, and adoption at scale. A shared medical curriculum ecosystem would free up faculty time to develop high-value teaching activities at individual medical schools. Students would benefit from a consistent education experience that better aligns with national licensure exams. A shared, core curriculum system could begin to bend the cost curve for medical education in the United States and scale internationally to help address the increasing global shortage of health care workers.

Practical strategies for effective lectures.

Lecturing is an essential teaching skill for scientists and health care professionals in pulmonary, critical care, and sleep medicine. However, few medical or scientific educators have received training in contemporary techniques or technology for large audience presentation. Interactive lecturing outperforms traditional, passive-style lecturing in educational outcomes, and is being increasingly incorporated into large group presentations. Evidence-based techniques range from the very simple, such as inserting pauses for audience discussion, to more technologically advanced approaches such as electronic audience response systems. Alternative software platforms such as Prezi can overcome some of the visual limits that the ubiquitous PowerPoint imposes on complex scientific narratives, and newer technology formats can help foster the interactive learning environment. Regardless of the technology, adherence to good principles of instructional design, multimedia learning, visualization of quantitative data, and informational public speaking can improve any lecture. The storyline must be clear, logical, and simplified compared with how it might be prepared for scientific publication. Succinct outline and summary slides can provide a roadmap for the audience. Changes of pace, and summaries or other cognitive breaks inserted every 15-20 minutes can renew attention. Graphics that emphasize clear, digestible data graphs or images over tables, and simple, focused tables over text slides, are more readily absorbed. Text slides should minimize words, using simple fonts in colors that contrast to a plain background. Adherence to these well-established principles and addition of some new approaches and technologies will yield an engaging lecture worth attending.

Training Pediatricians to Adhere to Asthma Guidelines.

Despite the proven efficacy of the National Heart, Lung, and Blood Institute asthma guidelines, adherence to these recommendations is suboptimal among primary care physicians. Knowledge, skills, and attitudes among pediatricians influence adherence to the asthma guidelines. Workshop-based provider education interventions demonstrate short-term improvement in knowledge, but do not lead to long-term changes in patient outcomes. Comprehensive quality improvement interventions that integrate education and process changes yield the best results in improving asthma care in children.

A randomized controlled trial to evaluate the effectiveness of a distance asthma learning program for pediatricians.

OBJECTIVES: To assess provider acceptability of a distance learning program for pediatric asthma and pilot test its effects on physician knowledge, attitudes and treatment practices. DESIGN: Randomized controlled trial. SETTING: Louisville and the surrounding central Kentucky region. PARTICIPANTS: Twenty-four pediatricians in clinical practice. Interventions. A distance learning program for pediatric asthma consisting of Web- or CD-ROM-based multimedia learning modules and two teleconference calls. OUTCOME MEASURES: Learner satisfaction and change in physician asthma knowledge, attitudes, and treatment behavior at 1 to 4 months (short term) and 6 to 8 months (long term). RESULTS: Pediatricians had graduated from medical school a mean of 11.6 years before baseline (SD +/-8.9); 56% were female. On all learner satisfaction items, the average score was a 4.0 or greater on a 5-point scale, indicating a favorable response from the participants. Participants in the education group reported increased familiarity with asthma guideline for prescribing daily-inhaled corticosteroids compared to control physicians (p = .03) at short-term follow-up. Participants also expressed increased confidence in selecting a medicine for patients requiring a low-dose inhaled steroid (p = .03). However, these differences were not seen at long-term follow-up. Compared to the control group, there was no significant increase in the proportion of patients receiving inhaled steroids for persistent asthma at short- or long-term follow-up. CONCLUSIONS: Pediatricians utilizing an asthma distance learning program expressed a high degree of learner satisfaction. The program was associated with a temporary increase in familiarity and confidence in implementing components of the asthma guidelines.

Prospective evaluation of a portable depth-sensitive optical spectroscopy device to identify oral neoplasia.

A portable, depth-sensitive clinical spectroscopy device for noninvasive early diagnosis of oral cancer is described. We carried out a pilot study to evaluate the ability of the device to identify oral neoplasia using a previously developed diagnostic algorithm. A total of 79 oral sites in 33 subjects, including 28 patients with oral lesions and 5 healthy volunteers, were measured and analyzed. Measurements of 54 nonkeratinized oral sites yielded an area under the receiver operating characteristic curve of 0.90. Measurements of 25 keratinized oral sites yielded an area under the receiver operating characteristic curve of 0.83.

Do asthma medication beliefs mediate the relationship between minority status and adherence to therapy?

Minority status has been associated with lower asthma medication adherence. We evaluated whether medication beliefs mediated this association. 86 adults with asthma on inhaled corticosteroid therapy completed surveys regarding selected beliefs about asthma medications. Medication adherence for 1 month was electronically measured. Mean daily adherence was lower in minority patients than in Caucasians (p < .001). Multiple negative asthma medication beliefs were associated with lower adherence (p's < .05). Minorities had increased adjusted odds of having a high negative medication beliefs score. Finally, a bootstrapped estimate demonstrated a mediating effect by negative asthma beliefs on the minority status-adherence association (-.073 [95% CI: -.16, -.01]).