Prepared by the COLLEGE OF MEDICINE CURRICULUM COMMITTEE, SY 2010-2011 (The workshop ran from March 31 to April 2, 2011 at Hotel Kimberly, Tagaytay City, Cavite)

Background

A curriculum is a work in progress. It needs to be constantly evaluated to assess its effectiveness in achieving its objectives, and improved to maintain relevance to the needs of all stakeholders. Hence, there is a need for continuing, periodic evaluation and development workshops such as this.

Objectives

At the end of the workshop, the participants were expected to:

  1. Review implementation of the curriculum for SY 10-11 per year level, as assessed by faculty and students
  2. Prepare an action plan per year level
  3. Agree on resolutions for curricular implementation
  4. Learn additional concepts on curriculum change and evaluating clinical skills
  5. Review the following programs implemented this school year:
    1. Mentoring Program
    2. Neurology Transition Program
    3. Concept Map Development
    4. Clinical Clerkship Program Development

Methods

Prior to the workshop, the faculty was asked to evaluate the various courses handled by the different departments following the tool developed by the Program Evaluation Committee of the Medical Education unit (MEU). These reports were collected, clarified and summarized by the Year Level Coordinators. Students in all year levels were likewise requested to evaluate all relevant aspects of the curriculum pertaining to their year level, using the same evaluation form. These were summarized by selected student representatives for each year level. The Chief of Clinics and JI (a.k.a. Clinical Clerk) Coordinators of the different clinical departments, guided by MEU faculty, developed a Clinical Clerkship Program.

During the two-and-a-half-day workshop, these were presented, along with the feedback on programs/activities conducted during the school year: [1] student & faculty satisfaction survey, [2] the Mentoring Program, [3] concept maps, [4] Neurology Transition Program, and [5] Clinical Clerkship Objective Structured Clinical Evaluation (OSCE).

Based on the problems in curriculum implementation that were identified, action plans and resolutions were developed per year level by the participants, who were divided into four workgroups.

Faculty members who attended the pre-conference workshop on the use of simulation in medical education and the main Asia-Pacific Medical Education Conference(APMEC) in Singapore gave an echo.

(Research coordinators of the different academic departments concurrently held a separate workshop to develop the College's research agenda and research plan. These were likewise subsequently presented.)

Results

Based on the evaluation of students and faculty members, the following problems were identified with the corresponding resolutions recommended to address these:

PROBLEMS and RESOLUTIONS
Students OSCE
1] Problem: Expected increase in number of freshmen 1] Problem: inadequate utilization and conduct Resolutions:
• Initially divide 1st Year students into 3 sections 'til large lecture rooms are ready
• Review faculty plantilla and make necessary recommendations to increase no. of faculty
• Upgrade/increase number of lab and av equipment
• Create a focus group to improve conduct
• Use standardized or simulated patients
• Re-orient clinical faculty re. mechanics
• Review checklist of skills
• Exam Feedback
2] Problem: Teacher-student ratio in all levels not conducive to learning 1] Problem: inadequate implementation
Resolution: Increase number of faculty members
or hire contractual preceptors where feasible
3] Problem: Inefficient manual checking of
attendance
Resolution: Use biometrics (may also be used to
check faculty attendance and punctuality)
• Years 1-3: schedule during the course,
not during exam week
• Year 4: schedule exam at least 3 days before end
of rotation & remind coordinators
to give feedback after
• Answers should be explained
• Critically Appraised Topic (CAT)
FACULTY
1] Problem: Poor attendance and punctuality of
clinical faculty in teaching-learning activities
Resolutions:
• Re-orient faculty on roles and responsibilities
• Properly orient new faculty members
• Biometrically check attendance
• Document infractions
• Remind and give sanctions
1] Problem: Has to be accomplished by Year 4
students to improve their research skills
Resolutions:
• Schedule lectures for students & faculty research
coordinators on how to do/assess a critical appraisal
• Remind Research Coordinators in different clinical
departments to review the Clinical Clerks' CATs
TEACHING-LEARNING ACTIVITIES
• Clinico-Pathological Conferences (CPC)

LEARNING RESOURCES
1] Problem: inadequate clinical material for Yrs. 2 & 3
Resolutions:
• Utilize normal individuals in initial phases of
teaching physical examination skills
• Use OPD patients or pay patients
• Increase number of charity patients by increasing
IndigencyFund or similar resources
1] Problem: Too many student CPCs in Year 3
Resolution: Decrease from 8 to 6 per year
2] Problem: Too few faculty CPCs
Resolution: restore monthly faculty CPCS
(10 per year)
3] Problem: Weight of CPC and OSCE grades in
Year 3 not uniform across departments
Resolution: Standardize to 2% per station for
OSCE & 2% of Final Grade for CPC
2] Problem: Poor lab facilities/equipment in basic
sciences
Resolution: Provide appropriate e-learning
methods/equipment/infrastructure
3] Problem: classrooms not conducive to learning
Resolution:Install/improve sound-proofing, AV systems,
air-conditioning, chairs in major lecture rooms
• Pre-Clinical Ward Observation
1] Problem: Year 3 students not immediately
attended to by clinical faculty
Resolution: Postgraduate interns to assist clinical
faculty in supervising students during their
rotation.
CURRICULUM GAPS
1] Problem: Patient Safety & Professionalism
Resolutions:
• Incorporate in all courses concerned
• Schedule lectures on Professionalism for Year 4
• Develop a standardized form for patient and peer
evaluation

The following are the results of the feedback/reports on:

  1. Student/faculty Satisfaction Survey
    • Students and faculty members were satisfied with the College's academic quality, course syllabi,
      pace and difficulty, required textbooks, and technological and multimedia instructional resources.
    • Both were dissatisfied with the class size.
    • Students were dissatisfied with the quality of instruction, faculty availability, safety and security
      on campus, health services and over-all experience in UERM while the faculty were
      generally satisfied with these.
    • Faculty were dissatisfied with classroom facilities and laboratories, the physical condition of the
      campus and library acquisitions and space, while the students were generally satisfied with these.
  2. Mentoring Program
    • The program provided an opportunity for students and faculty to interact on a closer,
      more personal level.
    • Since the objectives of the program and the roles of the mentors and mentees were unclear,
      both groups should be given an orientation on these.
    • It should be voluntary on the part of both students and faculty.
    • Since there were too many mentees per group among 2nd-year students, perhaps 1st-year
      faculty members should mentor 1st-year students, 2nd-year faculty for 2nd-year students,
      and so on for all year levels.
  3. Concept Maps
    • Concept maps for the 12 organ systems have been developed (copies were provided to each
      department head during the workshop).
    • These should serve as guides on what should be taught in each discipline, in the contexts of
      both the entering competencies of the students and the subsequent topics to be covered.
      They may also guide evaluation of the implementation of teaching-learning processes in a discipline.
  4. Neurology Transition Program
    • This was developed for implementation as a temporary measure in SY 2010-2011, to bridge the
      gap between 1st-year Neuroanatomy and 3rd-year Neurology. It is to be replaced by incorporation
      of a Neurology I course in 2nd year for SY 2011-2012: one hour per week in the 1st semester
      for lectures, while preceptorships will continue to be incorporated in Medicine I.
    • Syllabus has to be changed, as well as changes in annual percentage load. Both of these
      have to be approved by the Commission on Higher Education (CHED).
      With regard to the knowledge gained from the APMEC pre-conference workshop and
      main conference, it was resolved:
    • the use of simulation-based medical education be assessed regarding its cost-effectiveness and
      utility, and
    • a gap analysis be submitted to determine which lessons learned from the APMEC are
      useful and may or must be implemented.

Recommendations

While some resolutions have been accomplished in the past school year, there are new issues that need to be addressed and there are old persistent problems that need greater will and effort to resolve.

New problems include the expected increase in the number of freshmen in June 2011 while no new rooms, facilities or faculty have been added. The proposed renovations have to be fast-tracked; otherwise the current complaints of students regarding faculty unavailability and poor learning environment will be magnified many times over. Department heads should evaluate the need for new faculty members and make the necessary recommendations.

Other new issues like improving the conduct and utilization of OSCE, implementing cats in year 4, adjusting the number of CPCs and incorporating Professionalism and Patient Safety into the IDs of concerned courses should be doable as they entail the cooperation of a more limited number of people and resources.

Old problems which persist, despite resolutions in several past workshops to address these, include poor clinical faculty punctuality and attendance in teaching-learning activities like lectures and preceptorships. It is recommended that department heads should police their own ranks and follow SOPs on faculty members who are remiss in performing their duties. The use of biometrics to document faculty and student attendance and punctuality was suggested to address this problem.

Another recurring problem is the lack of teaching-learning resources, e.g., lab equipment, clinical material, other innovative teaching strategies (e-learning, models for Skills Lab). Needs should be specifically identified by each department and recommendations made, to include the necessary brochures, costing, etc.

The concept maps should be utilized to improve the IDs of the different courses in all year levels and guide the faculty in preparing their lectures and other teaching-learning activities.

Conclusions

The workshop was successful in achieving its objectives, with the following output: resolutions and action plans for SY11-12 for each year level

Attendance to the workshop was good, with 56 participants, including four students.

The accomplishment of some of the previousschool year 's resolutions is encouraging. however, certain major problems persist. It is hoped that-with the current set of resolutions and the promise of the administration to deliver as far as construction of the much needed, adequately equipped, large lecture rooms and additional smaller preceptorship rooms, and upgrading of the Skills Lab and other facilities-these grievances will not recur.

 

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