First, do no harm: impact of the transition to an integrated curriculum on medical knowledge acquisition of the transitional cohort

• Published in: Medical education online Vol. 27; no. 1; p. 2007561
• Main Authors: Nackers, Kirstin, Tatar, Raquel, Cowan, Eileen, Zakowski, Laura, Stewart, Katharina, Ahrens, Sarah, Jacques, Laura, Chheda, Shobhina
• Format: Journal Article
• Language: English
• Published: United States Taylor & Francis 01.12.2022; Taylor & Francis Ltd; Taylor & Francis Group
• Subjects: Acquisition; Adult; Anxiety; Child; Clinical Clerkship; Clinical experience; Curricula; Curriculum; curriculum redesign; Education, Medical, Undergraduate; Educational Measurement; Gynecology; Humans; integrated clerkships; Integrated curriculum; Knowledge acquisition; Medical education; medical knowledge acquisition; Medical schools; Medical students; national board of medical examiners; Neurology; Obstetrics; Pediatrics; Program evaluation; Psychiatry; Public health; Retrospective Studies; Schools, Medical; Students; Students, Medical; subject exam; Surgery; Tests; Worry; medical education; program evaluation; curriculum redesign; subject exam; integrated clerkships; medical knowledge acquisition; clinical clerkship; Medical schools; national board of medical examiners
• DOI: 10.1080/10872981.2021.2007561
• ISSN: 1087-2981

Many medical schools are moving toward integrated curricula in response to the 2010 Carnegie report. However, there is often apprehension that student performance on standard assessment metrics of medical knowledge acquisition could suffer during the transition period. Therefore, we sought to analyze the impact of curriculum redesign on the medical knowledge acquisition of the transitional cohort, as measured by NBME subject exam scores. The University of Wisconsin School of Medicine and Public Health Legacy curriculum followed a standard 2 + 2 medical school educational model, including traditional, department-based, third-year clinical clerkships. In the new ForWard curriculum, students enter clinical rotations one semester earlier, and those core clinical experiences are organized within four integrated blocks combining traditional clerkship specialties. This retrospective program evaluation compares NBME subject exam scores between the final cohort of Legacy third-year students (2016-17) and first cohort of ForWard students (2018) for the Adult Ambulatory Medicine, Medicine, Neurology, Obstetrics and Gynecology, Pediatrics, Psychiatry, and Surgery exams. NBME subject exam mean scores ranged from 75.5-79.4 for the Legacy cohort and 74.9-78.7 for the ForWard cohort, with no statistically significant differences in scores identified for each individual exam analyzed. Results remained constant when controlled for student demographic variables. Faculty and students may worry about impacts to the transitional cohort during curriculum redesign, however our results suggest no substantive negative effects to acquisition of medical knowledge during transition to an integrated curriculum. Further monitoring is necessary to examine whether medical knowledge acquisition remains stable or changes after the integrated curriculum is established.