"Primum Non Nocere"-First, Do No Harm: A Retrospective Review of the Impact of Curricular Reform on USUHS Graduates' Performance During Their PGY-1 Year.

Autor: Melton JL; CHPE and the School of Medicine, Uniformed Services University of Health Sciences, Bethesda, MD 20814, USA., Hemmer CPA; CHPE and the School of Medicine, Uniformed Services University of Health Sciences, Bethesda, MD 20814, USA., Pock CA; CHPE and the School of Medicine, Uniformed Services University of Health Sciences, Bethesda, MD 20814, USA., Moores CLK; CHPE and the School of Medicine, Uniformed Services University of Health Sciences, Bethesda, MD 20814, USA., Pangaro CLN; CHPE and the School of Medicine, Uniformed Services University of Health Sciences, Bethesda, MD 20814, USA., Durning SJ; CHPE and the School of Medicine, Uniformed Services University of Health Sciences, Bethesda, MD 20814, USA., Witkop CCT; CHPE and the School of Medicine, Uniformed Services University of Health Sciences, Bethesda, MD 20814, USA., Zapota R; CHPE and the School of Medicine, Uniformed Services University of Health Sciences, Bethesda, MD 20814, USA., Schreiber-Gregory DN; CHPE and the School of Medicine, Uniformed Services University of Health Sciences, Bethesda, MD 20814, USA., Dong T; CHPE and the School of Medicine, Uniformed Services University of Health Sciences, Bethesda, MD 20814, USA.
Jazyk: angličtina
Zdroj: Military medicine [Mil Med] 2023 May 18; Vol. 188 (Suppl 2), pp. 63-68.
DOI: 10.1093/milmed/usad045
Abstrakt: Purpose: To determine whether medical school curricular change impacted the assessment of graduates in their first year of postgraduate training.
Methods: The authors examined for differences in the survey of postgraduate year one (PGY-1) program directors for Uniformed Services University (USU) medical school graduates from the Classes of 2011 and 2012 (pre-curriculum reform, pre-CR), Classes of 2015, 2016, and 2017 (curriculum transition), and Classes of 2017, 2018, and 2019 (post-curriculum reform, post-CR). Multivariate analysis of variance was used to explore for differences among the cohorts in the 5 previously identified factors on the PGY-1 survey (Medical Expertise; Professionalism; Military Unique Practice, Deployments and Humanitarian Missions; System-Based Practice and Practiced-Based Learning; Communication and Interpersonal Skills). Nonparametric tests were used when the error variance between cohorts was found to be unequal across samples. Kruskal-Wallis (a rank ordered analysis of variance) and Tamhan's T2 were used to characterize specific differences.
Results: There were 801 students included: 245 (pre-CR); 298 (curricular transition); and 212 (post-CR). Multivariate analysis of variance demonstrated significant differences in all survey factors among the comparison groups. From pre-CR to the curricular transition, ratings in all factors declined, but none reached the level of a statistical significance. Ratings of all 5 factors showed significant improvement from the curricular transition to post-CR, and scores from pre-CR to post-CR trended in the positive direction with Practice-Based Learning (effect size 0.77), showing significant gains.
Conclusion: Ratings by PGY-1 program directors of USU graduates over time demonstrated a very small decline soon after curriculum reform but later showed a large improvement in domains reflecting areas of emphasis in the curriculum. In the eyes of a key stakeholder, the USU curriculum reform did no harm and led to improved PGY-1 assessments.
(Published by Oxford University Press on behalf of the Association of Military Surgeons of the United States 2023. This work is written by (a) US Government employee(s) and is in the public domain in the US.)
Databáze: MEDLINE
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