Poster1-03: THE EFFECT OF IMPLEMENTING AN INTEGRATED MEDICAL SCHOOL CURRICULUM ON STUDENT SURGERY SHELF PERFORMANCE
Jessica S Magarinos1, Erin H Chang, MD2, Inkyu Lee1, Robert DiRaimo, MD2; 1SUNY Downstate College of Medicine, 2Department of Surgery at SUNY Downstate Medical Center
Introduction: Over the past decade, curriculum reform has transformed medical education. The “traditional” medical school curriculum was widely popularized in the early 20th century and consisted of two years of basic sciences followed by two years of clinical training. At the turn of the century there was a call for integration of the basic science and clinical components of medical education. Recent trends in curriculum development have seen many medical schools shift to a systems-based curriculum. Although many studies have evaluated various facets of these curriculum changes, few have specifically looked at the effects on performance in clinical rotations. The surgical clerkship in particular may be affected by the integration of anatomy in the pre-clinical curriculum.
Methods: Data was collected from a single medical school that recently transitioned from a traditional to a systems-based curriculum. NBME Surgery shelf raw scores and percentiles from students two years prior to and after curriculum change were analyzed. T-Test analysis was used to compare raw scores and percentiles between the two curricula.
Results: There was no significant difference in the raw scores for the traditional (M=76.88, SD=7.96) and the new (M=76.07, SD=7.56) curricula; t(866)=1.53, p = 0.13. There was a significant difference in the percentiles for the old (M=57.54, SD=27.72) and the new (M=72.62, SD=20.72) curricula; t(846)=9.14, p = 4.49*10-19.
Conclusion: The implementation of a systems-based curriculum improved percentile performance on the surgery NBME. The curriculum change did not significantly impact the mean scores on the exam, suggesting both curricula are comparable in preparing students. The difference in percentiles could indicate there was a change in the difficulty of the exam over the same time period. It could also be representative of a nation-wide decline in performance on the exam compared to students who were exposed to the integrated curriculum. Students exposed to such curricula could have an advantage to their peers that are taught with a traditional curriculum. This would explain the difference in only the percentiles. This study shows the value of education reform but also calls for more work to examine the effects of these changes on medical school education.