The Harvard Medical School Pathways curriculum: A comprehensive curricular evaluation.

Autor: Sullivan AM; Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA., Krupat E; Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA., Dienstag JL; Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA., McSparron JI; Department of Medicine, University of Michigan School of Medicine, Ann Arbor, MI, USA., Pelletier SR; Office of Educational Quality Improvement, Harvard Medical School, Boston, MA, USA., Fazio SB; Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA., Fleenor TJ; Office of Educational Quality Improvement, Harvard Medical School, Boston, MA, USA., Dalrymple JL; Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA., Hundert EM; Global Health and Social Medicine and Medical Education at Harvard Medical School, Boston, MA, USA., Schwartzstein RM; Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Jazyk: angličtina
Zdroj: Medical teacher [Med Teach] 2022 Nov; Vol. 44 (11), pp. 1268-1276. Date of Electronic Publication: 2022 Jun 28.
DOI: 10.1080/0142159X.2022.2081142
Abstrakt: Purpose: The Harvard Medical School Pathways curriculum represents a major reform effort. Our goals were to enhance reasoning and clinical skills and improve the learning environment and students' approach to learning via use of collaborative, case-based pedagogy; early clinical exposure; and enhanced approaches to teaching and evaluating clinical skills. We evaluated the impact of Pathways on key outcomes related to these goals.
Materials and Methods: In this prospective, mixed-methods study, we compared the last prior-curriculum cohort (2014 matriculation, n  = 135) and first new-curriculum cohort (2015 matriculation, n  = 135). Measures included Likert-type surveys, focus groups, and test scores to assess outcomes.
Results: Compared with prior-curriculum students, new-curriculum students reported higher mean preclerkship learning environment ratings (Educational Climate Inventory, 62.4 versus 51.9, p  < 0.0001) and greater satisfaction with the quality of their preclerkship education (88% versus 73%, p  = 0.0007). Mean USMLE Step-1 and Step-2 scores did not differ between groups. At graduation, new-curriculum students rated their medical school experience higher in 6 of 7 domains, including 'fostering a culture of curiosity and inquiry' (4.3 versus 3.9, p  = 0.006) and focus on 'student-centered learning' (3.9 versus 3.4, p  = 0.002).
Conclusions: The new curriculum outperformed or was equal to the prior one on most measures of learning environment and perceived quality of education, without a decline in medical knowledge or clinical skills. Robust longitudinal evaluation provided important feedback for ongoing curriculum improvement.
Databáze: MEDLINE
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