Elsevier

Journal of Surgical Education

Volume 70, Issue 1, January–February 2013, Pages 109-116
Journal of Surgical Education

Original report
Implementing a Hybrid Web-Based Curriculum for an Elective Medical Student Clerkship in a Busy Surgical Intensive Care Unit (ICU): Effect on Test and Satisfaction Scores

https://doi.org/10.1016/j.jsurg.2012.06.026Get rights and content

Objective

To determine whether a hybrid traditional and web-based curriculum improves test scores and enrollment among senior medical students in an elective critical care rotation.

Design and Setting

Retrospective study in a surgical ICU at a major academic center.

Subjects

One hundred twenty-one fourth year medical students completing an elective ICU clerkship between 2007 and 2010.

Interventions

Pre-test and post-test during a 4-week rotation.

Methods

We implemented a hybrid curriculum that involved both traditional teaching methods and a new online core curriculum that incorporating audio, video, and text using screen capture technology. The curriculum was hosted on a secure online portal called ICON (Desire2Learn Inc., Ontario, Canada). The core curriculum covered topics that were considered essential to meet the didactic objectives of the rotation.

Measurements and Evaluations

A pre-test was administered online on day 1 of the rotation. A post-test was administered on the second to last day of the rotation. Both tests were composed of 20 questions randomly chosen from a question bank of 100 questions. The tests are managed (administering, grading, and reporting) exclusively online.

Results

One hundred twenty-one medical students have successfully completed the clerkship since implementing the new curriculum. Each group of students showed an improvement in the mean post-test score by at least 17%+ to 10%. The satisfaction scores of the clerkship improved consistently from 2007 and is currently rated at 4.31 ± 0.85 (on a 5-point scale). The rotation is in the top 25th percentile of all clinical clerkships offered at the University of Iowa.

Conclusion

A systematically implemented hybrid web-based critical care curriculum can improve knowledge based test scores and overall clerkship satisfaction scores in a busy surgical ICU.

Introduction

Web-based programs have been reported to improve self-directed learning (SDL) across disciplines in academic settings, especially in many nursing and medical programs.1 In a recent meta-analysis of studies of online learning, the US Department of Education concluded that student performance was enhanced with online instruction compared with face-to-face instruction.2 The use of supplementary web-based learning modules may add significant value in the training of intensive care physicians, but is largely unproven. Within critical care, high clinical demands and diversity of clinical schedules limit the traditional lecture room format. A hybrid curriculum of face-to-face instruction supplemented by a web-based core curriculum may offer a valuable option for critical care and other clinically demanding specialties. In the face of the expanding clinical load, and considering time and logistic constraints of a traditional classroom-based lecture series, we implemented an online critical care curriculum for the medical students to supplement clinical learning at the bedside beginning in 2007. Our hybrid curriculum was developed emphasizing problem identification, needs assessment, setting of goals and objectives, development of educational strategies to meet these objectives, and implementation of an online curriculum and standardized evaluation process.3 The purpose of this investigation is to evaluate the effect of implementing a learner-centered, hybrid web-based critical care curriculum on the clinical test scores and overall satisfaction scores of senior medical students.

Section snippets

Methods

We obtained consent from the institutional review board to retrospectively review the data of medical students who completed the critical care rotation between 2006 and 2010. The Surgical Intensive Care Unit (SICU) at the University of Iowa is a 38-bed multispecialty ICU with a yearly admission of approximately 3000 patients. Board certified intensivists, with primary specialties in anesthesiology, internal medicine, and surgery staff the ICU. The patient population includes trauma, general

Results

We studied consecutive groups of medical students who completed the rotation from 2007 to 2010. A total of 121 students successfully completed the clerkship after the implementation of the online curriculum. There were 49 female and 72 male students within the cohort. The mean age at the time of the rotation was 29 ± 2.74 years. Two students failed the rotation, but made up for the deficiencies and passed by the end of the academic year. Demographic data and future choice of specialties are

Discussion

This investigation evaluated the benefits of a hybrid web based curriculum and the improvement of test scores in senior medical students during a critical care training rotation. Our results support the effectiveness of the overall structure and processes of our training program.

The growth of web-based content delivery in medical education over the past decade has been exponential. Earlier studies in non-anesthesia based specialties have shown a student/resident preference for adapting and

Conclusions

This investigation showed that a systematically implemented, hybrid, web-based critical care curriculum can improve knowledge-based test scores and overall clerkship evaluation scores.

Acknowledgments

The authors acknowledge Gautham K. Suresh, MD, Associate Professor, Department of Pediatrics, Dartmouth Hitchcock Medical Center, NH, for his advice and time to discuss the project. The authors acknowledge Mindi Allbaugh for her tireless effort, enthusiasm, and efficient management of the medical student clerkship. They also acknowledge Damien Ihrig, Registrar, Carver College of Medicine, for his willingness to help with the project and for his data support.

Financial support: Departmental

References (21)

  • K. Hoffman et al.

    Problem-based learning outcomes: Ten years of experience at the university of Missouri-Columbia School of Medicine

    Acad Med

    (2006)
  • Evaluation, and Policy Development: Evaluation of Evidence-Based Practices in Online Learning: A Meta-Analysis and Review of Online Learning Studies

  • D.E. Kern et al.

    Curriculum Development for Medical Education: A Six-Step Approach

    (1998)
  • Product homepage

  • P.L. Marino et al.

    The ICU Book

    (2007)
  • Hardin Library SICU resource guide

  • Training courses

There are more references available in the full text version of this article.

Cited by (13)

  • The status of radiation oncology (RO) teaching to medical students in Europe

    2019, Clinical and Translational Radiation Oncology
    Citation Excerpt :

    Local and multi-institutional pilot initiatives were undertaken to include RO into the core curriculum for medical students [6,8,9,12,14,17,25,26]. These initiatives paralleled similar processes implemented for medical students in other medical disciplines such as internal medicine [27], surgery [28], emergency medicine [29], dermatology [30], uro-nephrology [31,32], palliative care medicine [33], radiology [20] and nuclear medicine [34]. The present survey revealed some interesting results that provide an overview of RO teaching to medical students in Europe.

  • Impact of an Interactive Vascular Surgery Web-Based Educational Curriculum on Surgical Trainee Knowledge and Interest

    2017, Journal of Surgical Education
    Citation Excerpt :

    Our observation is consistent with findings from a range of other studies that demonstrate the utility of internet-based medical education in a variety of medical specialties.1,6,19 A retrospective review of test scores of 121 senior medical students who were enrolled in an elective critical care rotation hybrid curriculum that included traditional teaching methods as well as an online interactive curriculum, had a significant increase in knowledge acquisition and clerkship satisfaction.20 Similarly, a prospective randomized study that enrolled plastic surgery residents in an adjunct interactive web-based microsurgery curriculum or traditional teaching methods, found that residents granted access to the adjunct curriculum developed both subjective and objective evidence of enhanced knowledge and improvement in microsurgical techniques.6

  • Assessment of core knowledge during ambulatory care advanced pharmacy practice experiences using online modules and pre- and post-testing

    2016, Currents in Pharmacy Teaching and Learning
    Citation Excerpt :

    Pre- and post-testing in other APPE pharmacy settings, including inpatient, focused diabetes care, and coronary heart disease risk assessment, has all shown significant improvement in scores.7–9 Similar findings utilizing online curricula have been reported in medicine and dentistry.10,11 However, most of these studies did not implement focused interventions based on identified areas of weakness following the pre-test.

  • Radiation oncology medical student clerkship: Implementation and evaluation of a Bi-institutional pilot curriculum

    2014, International Journal of Radiation Oncology Biology Physics
    Citation Excerpt :

    In a 2011 national survey, medical students who completed radiation oncology clerkships reported presenting a departmental lecture during 87% of their rotations, yet only 35% of rotations were reported to include didactic lectures specifically for medical students (1). The assessment and development of structured didactic curricula has been reported for multiple specialties, including internal medicine (2), surgery (3-5), palliative medicine (6), dermatology (7), emergency medicine (8), and urology (9-11). Within radiation oncology, curricula have been developed for all third-year medical students at 1 institution (12), and at another institution as an optional 3-week elective for third-year medical students completing the surgery rotation (13).

View all citing articles on Scopus
View full text