Presentation 1 - EFFECTIVENESS OF THE HUMAN METABOLISM MAP IN MEDICAL BIOCHEMISTRY EDUCATION
Zeynep Gromley

Lincoln Memorial University - DeBusk College of Osteopathic Medicine

 

PURPOSE Understanding of the biochemical basis of disease is a crucial aspect of the medical school curriculum. One of the most commonly reported negative factors is the incorrect assumption that biochemistry requires rote memorization. In order to address this problem, biochemistry educators from Stanford developed a Human Metabolism Map and made it freely available. To evaluate the efficacy of this metabolic map in an osteopathic medical school curriculum, we incorporated its use in our biochemistry course and evaluated its effects on student learning. METHODS We compared exam performances and item analysis from 1st year medical students in the fall of 2015 and 2016, where students did not have access to the map as a study tool, to first year medical students in the fall of 2017 and 2018, where students were given the map. We evaluated selected questions by scatter plot analysis and compared between the two groups. We also collected students' perceptions using a survey. RESULTS Our study reveals that the class mean for the course was not significantly different between the two cohorts. Item analysis also shows that the performance of selected exam questions between the two groups did not change. Although we did not see a significant impact on grades or exam item performance, our survey results indicate that 85% of the students that utilized the map found it beneficial for their understanding of medical biochemistry, with the vast majority of them indicating that their ability to interpret clinical cases was enhanced. CONCLUSION These results show that providing the metabolic map to medical students as a study tool did not have an effect on the overall performance of the class.  However, those students that reported using the map said that it improved their understanding of medical biochemistry.  Future studies are needed to further analyze the discrepancy between these two results.
 

Presentation 3 - DO SOAP NOTE-STYLE EXAM QUESTION STEMS OFFER ADVANTAGES OVER VIGNETTE-STYLE STEMS?
Terrence W. Miller

Touro University Nevada College of Osteopathic Medicine

 

PURPOSE The vignette-based, multiple-choice question (MCQ) is a common format in medical school exams. While each MCQ ideally assesses a learning objective, it may also inadvertently assess reading speed. We hypothesized that question stems written in a SOAP note format, rather than a vignette, allows the examinee to process information with less emphasis on reading speed. METHODS Vignette stems were re-written with the same content presented as a SOAP note. Each of 10 exams administered to 135 osteopathic medical students possessed four experimental questions. Each student got vignette- and SOAP-questions; for a given question, half got the vignette and the other half the SOAP. We compared: 1) difficulty and discrimination indices for vignette versus SOAP questions, and 2) exam-taker behaviors derived from Examsoft testing software snapshot files - time spent per question and number of times returning to questions - when answering the two formats. RESULTS The mean difficulty indices for the 40 SOAP and 40 vignette questions were the same (0.73). The mean discrimination index was somewhat higher for the SOAP questions (0.21 vs 0.17). SOAP stems averaged 30% fewer words, and students spent significantly less time on SOAP questions (98.4s vs 103.9s, p<0.05). This difference is mainly attributable to decreased viewing time during the student's first encounter (75.6s vs 72s, p<0.05). Students revisited both question types with similar frequency (3.09 average visits for SOAP, 3.14 for vignette, p=0.266). CONCLUSIONS Students spent significantly less time on SOAP questions compared to vignette questions, mainly attributable to decreased viewing time on the student's first question encounter. Note that students averaged more total time per question than allotted for either USMLE (90s/question) or COMLEX (72s/question) licensing exams. Data supports the hypothesis that the SOAP-style question reduced the emphasis on reading speed and may offer advantages over the traditional vignette question format.

Presentation 4 - PRECLINICAL IMPLEMENTATION AND ATTAINMENT OF ENTRUSTABLE PROFESSIONAL ACTIVITIES: FIRST TIER OF A LONGITUDINAL ANALYSIS
James Keene

Pacific Northwest University of Health Sciences

 

PURPOSE This study aims to inform the preparation of our students for residency training and identify the factors that best predict preparation of our graduates to enter the postgraduate level. The research on this first tier of this analysis: evaluates implementation of the 13 EPAs in the preclinical curriculum by tracking delivery and student attainment; evaluates preclinical faculty development relative to EPA delivery; evaluates the programmatic developmental aspects and trajectory of EPA attainment. METHODS Faculty were initially provided with basic information regarding the 13 EPAs and asked to tag exam items with either an EPA. The assessment office generated a report indicating the number of questions tagged with an EPA in specific courses, along with the student performance on each EPA. Faculty development sessions were then developed with the goal of showing how EPAs can be used to better correlate learning objectives with clinically-relevant activities. The assessment office again generated a report on both course delivery and student attainment of the EPAs and developed an EPA-based preclinical curriculum map. RESULTS Results of this work include: an increase in the number and frequency of EPAs delivered and assessed in the preclinical curriculum; enhanced integration of basic and clinical science elements in the preclinical curriculum; connection of basic science content to the EPAs; generation of a robust preclinical curriculum map outlining embedded EPAs; qualitatively and quantitatively assessed EPA-oriented faculty development opportunities. CONCLUSIONS Further research will employ the application of these findings to the next tier in the longitudinal analysis of EPA implementation: how to better prepare students for clinical training, and eventually residency.