Trends in Teaching Laboratory Medicine in Microbiology to Undergraduate Medical Students: A Survey Study

Abstract

The teaching laboratory has long been a component of medical microbiology courses. Limited data suggest that many medical schools have eliminated their teaching laboratory for diagnostic microbiology despite support for active learning over didactic lectures and a concern that undergraduate medical student's education in the area of laboratory medicine is inadequate. A survey study of North American medical schools was conducted to determine if there is a trend towards decreasing or eliminating this teaching laboratory. The study also documented reasons for changes to this teaching laboratory, curricular content of existing microbiology teaching laboratories, and use of computer-assisted instruction. There was a 53 % response rate to the survey. Forty-three percent of medical schools decreased the hours or eliminated the teaching laboratory in diagnostic microbiology entirely between 2002 and 2012, and an additional 7 % of schools have plans to decrease hours or eliminate this teaching laboratory. Changes to the teaching laboratory were most often due to limited resources, reduced teaching hours, and overarching curricular changes. Because the way in which medical students are taught laboratory medicine in microbiology is undergoing a significant change, educators need to ensure that the learning experience is sufficient, and the quality is not compromised as a result.

Knowledge of Laboratory Medicine in Medical Students: Is It Sufficient?

“…There are some other studies which have identified shortcomings among medical students and/or nonpathology residents (1,3,14,(18)(19)(20) in some aspects of laboratory medicine such as inappropriate test ordering, incorrect interpretation (3,14), microscopic exam (3,15) and calculation of pre and post-test probabilities (3,16).…”

“…Information and objective data provided by clinical pathology laboratory plays an important role in nearly all aspects of clinical practice including diagnosis, treatment, management and prognosis (1)(2)(3)(4). It is believed that about 60-70% of medical decisions are based on laboratory test results (2,3,5).…”

“…In an updated report of CDC in a May 2009 (1,7), however, it was addressed that "medical education on laboratory testing is inadequate". It is believed that the amount of time devoted to this important subject in undergraduate medical education is not adequate (3,8).…”

“…In a large study of missed or delayed diagnosis, 35% and 37% were due to failure in ordering appropriate diagnostic tests and incorrect interpretation of test results, respectively (3,14). Analytical errors accounted only 8% of missed diagnosis (3,14).…”

“…Also data suggests that there are some shortcomings in medical students' ability in other aspects including provider-performed microscopy (1,3,15) and pre and posttest probability in test interpretation (1,3,16).…”