Development of a comprehensive e-learning resource in pain management.

OBJECTIVE: The prevalence of chronic nonmalignant pain (CNMP), the lack of confidence and reward among trainees and providers caring for patients with CNMP, and the lack of a comprehensive curriculum in pain management prompted the creation of the Virginia Commonwealth University (VCU) Chronic Nonmalignant Pain Management curriculum, an innovative e-learning resource. This article describes the development of the curriculum and presents initial evaluation data. DESIGN: The curriculum is organized into six modules that cover 20 specific Accreditation Council of Graduate Medical Education competency-based objectives. Broad content and effective instructional design elements promote its utility among a range of learner levels in a variety of medical disciplines. RESULTS: Twenty-four physician reviewers and over 430 trainees (medical students and graduate medical residents) have evaluated the curriculum. Of the respondents to course evaluation questions, 85.7% (366/427) stated that they would access the practice resources again, 86.3% (366/424) agreed that the treatment of CNMP was more important to them after completing the curriculum, 73.9% (312/422) stated that they would make changes in their behavior or practice, and 92.3% (386/418) stated that they would recommend the curriculum to their colleagues. Qualitative data are uniformly positive. Results of pretest and posttest scores and item analyses have been used to make content changes. CONCLUSIONS: The VCU Chronic Nonmalignant Pain Management curriculum is an e-learning resource that has the potential to fill a significant training void. Design and content changes have been made as a result of initial evaluation data. Data from ongoing evaluation will allow curricular refinement.

Professional development in geriatrics for community-based generalist faculty.

Generalist physicians provide most primary care for older people. Increasingly, undergraduate clinical education occurs in community sites. Hence, community-based generalist faculty members need continuing education in geriatrics to support clinical practice and teaching. The Geriatrics Scholars Program provided continuing medical education (CME) in geriatrics over a 3-year period to 88 participants. Sixty physicians completed 30 or more hours of education and were designated Geriatrics Scholars. On an anonymous exit survey, Scholars reported being better equipped to care for elderly patients and to teach geriatrics and improved patient care in specific aspects of geriatrics, including medication use, cognition, and functional assessment. In summary, community-based generalist faculty who participated in a substantial, 3-year program of geriatrics CME reported that their care of older people and their teaching of geriatrics were enhanced.

The importance of "high valence" events in a successful program for teaching geriatrics to medical students.

Virginia Commonwealth University developed an enhanced medical student geriatric curriculum that includes required home visits and nursing home visits for second year students (180 per year), an annual Forum on Aging for all first and second year students, and small group exercises. We added 30 hours of basic science material to pre-clinical courses and increased clinical exposure to geriatricians in third and fourth years. Student satisfaction with individual experiences was high. Persistent effects of "high valence" required activities, where emotion played a role, was shown by post-pre survey techniques and focus groups. Fourth year AAMC exit questionnaire items in areas addressed by this curriculum improved markedly between 2002 and 2006, while an internal control changed much less.

Using a decade of data on medical student computer literacy for strategic planning.

PURPOSE: From 1991 through 2000, incoming medical students (M-Is) at the School of Medicine at Virginia Commonwealth University have been surveyed with a written questionnaire on their computer literacy. The survey's purpose is to learn the students' levels of knowledge, skill, and experience with computer technology to guide instructional services and facilities. METHODOLOGY: The questionnaire was administered during M-I orientation or mailed to students' homes after matriculation. It evolved from sixteen questions in 1991 to twenty-three questions in 2000, with fifteen questions common to all. RESULTS: The average survey response rate was 81% from an average of 177 students. Six major changes were introduced based on information collected from the surveys and advances in technology: production of CD-ROMs distributed to students containing required computer-based instructional programs, delivery of evaluation instruments to students via the Internet, modification of the lab to a mostly PC-based environment, development of an electronic curriculum Website, development of computerized examinations for medical students to prepare them for the computerized national board examinations, and initiation of a personal digital assistant (PDA) project for students to evaluate PDAs' usefulness in clinical settings. CONCLUSION: The computer literacy survey provides a snapshot of students' past and present use of technology and guidance for the development of services and facilities.

Electrifying a medical school course: a case study.

BACKGROUND: At Virginia Commonwealth University School of Medicine, the Dean charged the curriculum office to "electrify the curriculum." An instructional development team chose a 2nd-year course to serve as a model e-course and to provide evaluation data for a 2-year study. DESCRIPTION: The instructional development process used instructional and Web design principles. An evaluation plan included a number of data collection methods: e-mail surveys, a focus group, student diaries, and comprehensive end-of-course student assessments. The e-course allowed students to take advantage of learning opportunities that traditional face-to-face instruction normally does not. EVALUATION: Students found access to multiple images; interactivity; and meaningful, efficient navigation within the site to be useful. Web-based instruction shows promise to aid students in the transition from concept acquisition to complex "doctor thinking." It does not replace the need for human teachers. CONCLUSION: The authors conclude with instructional design suggestions to exploit the power of Web-based teaching for the enhancement of complex learning.