Medical Education Elective as the first elective in the Medical Education Area of Concentration

Huiju Carrie Chen, MD MSEd
Fall 2003

Background Information:

Students have traditionally contributed to the teaching endeavors at the UCSF School of Medicine. The new curriculum has seen an increase in the degree of student involvement. Students currently participate in anatomy tutoring; small group, PBL, and physical exam instruction; OSCE precepting; and curricular development among other activities. There are systems in place to help support students in some of their teaching, such as the Medical Scholars Program for anatomy tutoring and the Teaching to Teach curriculum for graduating students. However, these tend to be limited in scope and do not specifically address the increased need for student skills in the small group teaching required in the essential core curriculum.

In addition, a subset of students have an intensified interest in teaching and the medical curriculum. These students may wish to incorporate medical education as a key element of their future careers. The Medical Education Area of Concentration (Med Ed AoC) is designed both to nurture this interest and to advance student skills in teaching and curricular development. Please refer to Appendix A for additional details about the Med Ed AoC.

We propose to develop a Medical Education Elective as the first elective in the Med Ed AoC. This introductory elective will function as the "Med Ed 401" course in providing an overview of medical education for students wishing to explore an interest or declare a concentration in field. Equally important, this elective will also serve as a teaching skills course for students involved in small group and PBL teaching of the year one and year two medical school curriculum, but who may not necessarily wish to pursue the Med Ed AoC.

The Medical Education Elective will be a two-week course offered in the fall of the 4th year. The curriculum will address the general topic of teaching (lecture, small group, PBL, etc.), which has broad appeal and applicability for students in their 4th year of medical school. Specific attention will be paid to small group instruction in order to support the students who are or will be engaged in teaching small groups in the essential core blocks. As the introductory elective to the Med Ed AoC, this proposed elective mirrors the structure of the AoC in its three main components: 1) coursework to provide a foundation of knowledge and skills; 2) experiential teaching "laboratories" to provide opportunities for application and further development of knowledge and skills; and 3) a required product/legacy in the form of an education portfolio, to serve as a reflection of the student's work, progress, and plans for future growth.

Coursework will include lectures, small group activities, and independent learning exercises. Students will learn the theories behind better teaching, how and when to teach with lectures and small groups, case based teaching, tips for managing difficult group dynamics, and personal styles of teaching. All students will be asked to give lectures and participate in small groups, to self-assess their performance, as well as to evaluate the performance of others. All will also be required to teach in the small groups of the essential core blocks during the elective, and to evaluate each other's teaching performance in these sessions. A detailed description of the proposed curriculum is attached in Appendix B, and includes a list of the curricular topics and learner objectives, and a calendar of activities by teaching modality.

Goals of Project:

The goals of the Medical Education Elective are as follows:

1. To introduce 4th year students to and stimulate their interest in the field of medical education and the Med Ed AoC.

2. To provide support to and advance the teaching skills of students who participate in medical student teaching, particularly small group instruction in the first and second year essential core blocks.

3. To provide the first in a series of preparatory studies required for students who declare a concentration in the area of medical education.

It is hoped that the project will result not just in the improvement of teaching skills of senior students and of instruction received by junior students, as well as stimulation of interest in the Med Ed AoC, but also in the development and nurturing of a next generation of medical educators who will help assure quality medical student education at UCSF and elsewhere.

Plan for Measurement and Documentation of Project Efficacy and Outcome:

The course will be evaluated using a pre and post elective questionnaire, including a self reported index of interest in medical education and the Med Ed AoC, and self-assessment of personal teaching effectiveness. Differences between the pre and post elective scores will be studied. The majority of our efforts will be devoted to program development and implementation, and the program evaluation as described.

Documentation of outcomes, especially that of change in student teaching skills, will be difficult given the context. We will assess for improvement in skills over the course of the elective using serial peer evaluations of student performance in small group teaching (completed by other students in the course). This will however be over a very brief time period and may not predict sustainability of positive changes. In addition, the elective students' teaching evaluations completed by the essential core students can be compared to those of student teachers or faculty who did not take the elective. While demonstrated differences would be provocative, we will be unable to show that the differences were due to the course itself rather than the self-selection of students with skills and interests in teaching.

Plan for Continuation of Project:

These funds are being requested to help with the development, initial implementation, and evaluation of a pilot Medical Education Elective. Once developed and implemented, the elective will require fewer resources to continue to run. Lessons learned from implementation of this pilot will also help inform the streamlining of the course. The Med Ed AoC is committed to continuing the elective, and plans are in place for the development of additional electives to complement this one.

For more information, please contact:
Huiju Carrie Chen, MD MSEd