Alfaisal University is a new medical school in Riyadh, Kingdom of Saudi Arabia that matriculates eligible students directly from high school and requires them to participate in a hybrid problem-based learning (PBL) curriculum. PBL is a well-established student-centered approach, and the authors have sought to examine if a student-centered, integrated approach to learn human structures leads to positive perceptions of learning outcomes. Ten students were divided into four groups to rotate through wet and dry laboratory stations (integrated resource sessions, IRSs) that engaged them in imaging techniques, embryology, histology, gross anatomy (dissections and prosections), surface anatomy, and self-directed learning questions. All IRSs were primarily directed by students. During two second-semester organ system blocks, forty students responded to a structured questionnaire designed to poll students' perceptions of changes in their knowledge, skills, and attitudes as a result of IRS. The majority (60%) of students felt that the student-centered approach to learning enhanced their medical knowledge. Most students also felt that the IRS approach was advantageous for formulating clear learning objectives (55%) and in preparing for examinations (65%). Despite their positive feelings toward IRS, students did not view this learning approach as an adequate replacement for the knowledge gained from lectures and textbooks. Students' performance on objective structured practical examinations improved significantly for the two curricular blocks that included IRS compared with earlier non-IRS blocks. A student-centered approach to teach human structure in a hybrid PBL curriculum may enhance understanding of the basic sciences in first-year medical students.
BackgroundThe CanMEDS roles provide a comprehensive framework to organize competency-based curricula; however, there is a challenge in finding feasible, valid, and reliable assessment methods to measure intrinsic roles such as Communicator and Collaborator. The objective structured clinical exam (OSCE) is more commonly used in postgraduate medical education for the assessment of clinical skills beyond medical expertise.MethodWe developed the CanMEDS In-Training Exam (CITE), a six-station OSCE designed to assess two different CanMEDS roles (one primary and one secondary) and general communication skills at each station. Correlation coefficients were computed for CanMEDS roles within and between stations, and for general communication, global rating, and total scores. One-way analysis of variance (ANOVA) was used to investigate differences between year of residency, sex, and the type of residency program.ResultsIn total, 63 residents participated in the CITE; 40 residents (63%) were from internal medicine programs, whereas the remaining 23 (37%) were pursuing other specialties. There was satisfactory internal consistency for all stations, and the total scores of the stations were strongly correlated with the global scores r=0.86, p<0.05. Noninternal medicine residents scored higher in terms of the Professional competency overall, whereas internal medicine residents scored significantly higher in the Collaborator competency overall.DiscussionThe OSCE checklists developed for the assessment of intrinsic CanMEDS roles were functional, but the specific items within stations required more uniformity to be used between stations. More generic types of checklists may also improve correlations across stations.ConclusionAn OSCE measuring intrinsic competence is feasible; however, further development of our cases and checklists is needed. We provide a model of how to develop an OSCE to measure intrinsic CanMEDS roles that educators may adopt as residency programs move into competency-based medical education.
Background: In this brief report, we describe two ways in which we assessed the Scholar CanMEDS role using a method to measure residents’ ability to complete a critical appraisal. These were incorporated into a modified OSCE format where two stations consisted of 1) critically appraising an article and 2) critiquing an abstract.Method: Residents were invited to participate in the CanMEDS In-Training Exam (CITE) through the Office of Postgraduate Medical Education. Mean scores for the two Scholar stations were calculated using the number of correct responses out of 10. The global score represented the examiner’s overall impression of the resident’s knowledge and effort. Correlations between scores are also presented between the two Scholar stations and a paired sample t-test comparing the global mean scores of the two stations was also performed.Results: Sixty-three of the 64 residents registered to complete the CanMEDS In-Training Exam including the two Scholar stations. There were no significant differences between the global scores of the Scholar stations showing that the overall knowledge and effort of the residents was similar across both stations (3.8 vs. 3.5, p = 0.13). The correlation between the total mean scores of both stations (inter-station reliability) was also non-significant (r = 0.05, p = 0.67). No significant differences between senior residents and junior residents were detected or between internal medicine residents and non-internal medicine residents.Conclusion: Further testing of these stations is needed and other novel ways of assessing the Scholar role competencies should also be investigated.
The sciatic artery - a rare finding on autopsy - and continuation of the inferior gluteal artery has been reported previously. On a routine dissection, bilateral persistent sciatic arteries were found in both thighs of a female cadaver. This provided evidence that the sciatic artery follows the sciatic nerve, supplies the back of the thigh and finally joins the popliteal artery near the knee. The profunda femoris artery was completely absent bilaterally. The present report strengthens the view that the sciatic artery plays a major role in supplying blood to the lower limbs in utero and its existence after birth may have significant clinical importance.
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