Original reportImplementing 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
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
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