Two Perspectives on the Effects of a Curriculum Change: Student Experience and the United States Medical Licensing Examination, Step 1

Abstract

To understand the outcomes of a large-scale curricular intervention, interactions of curriculum and aptitude should be examined.

Effects of comprehensive educational reforms on academic success in a diverse student body

“…Those previous curriculum reform reports showed a puzzling range of negative, neutral and positive results 4–8 . We hypothesise that even theoretically sound and well‐implemented instructional method changes may not realise their full potential without coordinated changes in assessment methods and academic support.…”

“… 4 reported increased Step 1 scores (effect sizes of 0.3–0.4 for 5 years and 0.5–0.6 for 1 year of the 10 years reported) after implementing a hybrid curriculum with a strong PBL emphasis and a multi‐modal assessment approach. Other studies of PBL curricula, however, reported effect sizes of − 0.32 5 and 0.01, 6 and additional reports without effect sizes showed a positive change only for students in the lowest Medical College Admissions Test (MCAT) quartile 7 or a negative change 8 . Most of these reports and the attendant debate focus on instructional methods and make surprisingly little mention of assessment, despite the axiomatic concept that ‘assessment drives learning’ 9 …”

No content without context: Integrating basic, clinical, and social sciences in a pre-clerkship curriculum

“…However, in year-end surveys, students who completed UCLA's HB&D curriculum reported marked improvement in their own ability to integrate clinical and basic sciences as compared to prior classes who completed a departmental curriculum, while exhibiting the same level of performance on the United States Licensing Examination, Step 1, with higher than predicted scores for at-risk students (Wilkerson et al 2007).…”

A New Approach to Learning How to Teach: medical students as instructional designers

“…The first two years of education at the David Geffen School of Medicine at UCLA are generally made up of faculty-driven lectures, labs, and problem-based learning (1). However, students are free to choose how to spend eight weeks in the summer between first and second years.…”