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Biomedical subjects

P P Nash

Publications and source records attributed to P P Nash.

7 recordsLinked to original sources

The Kentucky medical curriculum. A response to the call for educational reform: a GPEP report card.

The resources of an important educational grant provided by the Robert Wood Johnson Foundation, as well as designated local college and medical center funds, provided support for the renewal of the undergraduate medical education program at the University of Kentucky College of Medicine. The fully revised medical curriculum, adapted to changing professional and societal needs and completely in place by the 1994-95 academic year, was influenced by the recommendations of the General Professional Education of the Physician (GPEP) Report, issued by the Association of American Medical Colleges in 1984. This paper details each of the student-centered curricular changes in the context of the GPEP recommendation that it particularly addresses.

Clinical Competence↗

The ongoing development of a problem-based surgery clerkship: year three.

The third-year clerkship at one college of medicine was modified to reflect an emphasis on adult learning principles and life-long learning habits. Problem-based learning was selected as the educational method, and the development of a cognitive knowledge base, clinical problem-solving skills, and appropriate clinical skills was stressed. At a yearly faculty education retreat, strengths and weaknesses of the clerkship were discussed. As a result of this meeting, several changes were made in the clerkship, including additional stress on students' usage of the medical library and computerized databases, a tutor development program, the addition of expert resource sessions, and more emphasis on students' development of clinical skills through a preceptor program. A comprehensive evaluation program designed to support the educational goals of the clerkship is in place. The major challenge of the program remains the proper synchronization of curricular, clinical, and student self-study activities essential for an ideal learning experience.

Clinical Clerkship↗

Problem-based learning: an effective educational method for a surgery clerkship.

Problem-based learning (PBL) has been implemented during the clinical years in a few medical schools. The purpose of this study is to determine whether PBL provides a better education than traditional methods. Students in the first and third rotations (n = 42) went through the traditional clerkship, which utilized Socratic teaching (SI), while students in the second and fourth rotations (n = 36) were taught by the PBL method. Two performance measures were used to assess clerkship effectiveness. One was a modified essay examination (MEE) administered as part of the departmental evaluation. The other was the NBME-II exam and its surgery subsection NBME-II-S. The MEE was designed to measure six dimensions of the problem-solving process. The NBME-II was utilized to measure knowledge. Unpaired t tests were used to identify statistically significant group differences. The PBL group performed significantly better on two MEE dimensions: (1) differential diagnosis formation (PBL, 92.5 +/- 0.8; SI, 89.1 +/- 0.5; P < 0.01) and (2) interpretation of clinical data (PBL, 93.3 +/- 0.6; SI, 91.6 +/- 0.4; P < 0.03). A third dimension, ordering appropriate lab and diagnostic studies, approached significance (P = 0.057), and the PBL group performed better. On the NBME-II there was not a significant difference between the two groups. However, the trend (P = 0.059) was for the PBL group to score higher on the NBME-II-S (PBL mean: 502 +/- 15; SI mean: 468 +/- 12). When overall achievement was controlled for, the PBL group performed significantly better than the SI group (P = 0.046) on the NBME-II-S.(ABSTRACT TRUNCATED AT 250 WORDS)

Education, Medical↗

Undergraduate surgical education for the twenty-first century.

This article addresses the problems associated with current undergraduate surgical education and discusses the requirements necessary for its improvement during the third and fourth years of medical school. It asserts that, coincident with the emphasis on faculty research and publication and expanded resident patient care duties, teaching, particularly medical student teaching, has assumed a very low priority. Third-year medical students are attached to surgical teams, where their education is haphazard and disorganized. Furthermore, because any teaching that occurs is teacher oriented rather than student centered, knowledge is accumulated passively and is not well retained. Traditional evaluation using shelf multiple choice examinations and ward ratings by residents and faculty may provide inaccurate assessments of the students' performance. The undergraduate surgical education program should be directed by a faculty member who has been grounded in educational techniques and research and supported by a department chairman committed to bettering the program. In the clerkship, medical students should be assigned to faculty rather than to services and should be presented problems that require solution. Students also should be provided with the resources to solve the problems and should be given sufficient time to solve them. Some operating room experience and bedside teaching should occur during the clerkship. A variety of evaluation and testing methods based on the learning objectives of the clerkship should be used. Third-year students should not be promoted until they have demonstrated their acquisition of appropriate knowledge and skills.(ABSTRACT TRUNCATED AT 250 WORDS)

Education, Medical, Undergraduate↗

Developing students' cognitive skills in a problem-based surgery clerkship.

In 1989-90, 57 students in a new program for the third-year surgery clerkship at the University of Kentucky College of Medicine participated either in a control group (22 students) receiving a traditional method of instruction (Socratic instruction, SI) or in an experimental group (35 students) taking part in problem-based learning (PBL) sessions. The two groups' performances on six evaluative instruments designed to test either their factual knowledge or their knowledge application (i.e., clinical problem-solving skills) were compared. The measures of factual knowledge were associated with higher scores for the SI group on two quizzes; scores were not significantly different on another quiz and on a cumulative final examination. The measures of knowledge application (administered at the end of the clerkship) were associated with higher scores for the PBL group: scores were significantly higher on a modified essay examination and approached significance on a standardized-patient examination. The authors conclude that their results (1) have important similarities to those of previous research suggesting that a PBL format is essentially equivalent to a traditional curricular format in improving students' factual knowledge and (2) support the hypothesis that PBL is superior in improving clinical problem-solving skills.

Clinical Clerkship↗

A student-centered, problem-based surgery clerkship.

In the academic year 1989-90, the department of surgery at one college of medicine revised its third-year clerkship to focus on students' learning decision-making skills and critical thinking (cognitive skills) and acquiring knowledge about surgery. Learning to perform procedures and tasks (psychomotor skills) would be accomplished in the required fourth-year acting internships. Problem-based learning (PBL) was chosen as the clerkship's primary instructional method. Comprehensive student and program evaluation systems were established. The response by faculty and students has been very positive. Students believe that the new clerkship has helped them increase their abilities in resource use, time management, and retention of knowledge. Faculty have noted students' increased eagerness and enthusiasm for learning.

Clinical Clerkship↗