Student performance and grading changes in a systems-based curriculum

Abstract

IntroductionChanging from a conventional discipline-based, basic science medical school curriculum to an integrated systems-based curriculum, which was graded on overall performance not by discipline, was associated with a highly significant improvement in an externally administered comprehensive exam at the end of the 2-year basic science program. The reason for the improvement was unclear, but we hypothesized that it was partly due to a change in student study strategy. Anecdotal evidence suggested that students had changed their study habits to spend less time on previously harder-to-pass courses and more time on courses with previously lower failure rates. If this were so, performance in previously harder disciplines might have deteriorated, while performance in previously easier disciplines could have improved.MethodsWe examined relative performance in the four discipline-based courses of Systemic Pathology, Microbiology, Pharmacology, and Introductory Clinical Medicine (ICM) in the fourth (and last) semester of the curriculum. We compared failure rates in these four courses for the three cohorts before the change with the three cohorts after.ResultsPharmacology and Microbiology which had failure rates over twice as high as Systemic Pathology and ICM in the conventional program before the curriculum change showed a deterioration in performance after the change with an approximately threefold rise in internal failure rate. In contrast, Systemic Pathology showed a dramatic improvement with a more than threefold drop in the failure rate, while the ICM clinical skills course, which was largely assessed by a practical exam in all 6 cohorts, showed no change.ConclusionThe improvement in student performance in an external assessment may be due, at least partly, to a change in the school's internal grading policy which led to a more appropriate balancing of student study strategies. Future studies on the effect of curriculum change should include an assessment of the impact on student study strategies.

A Qualitative Exploratory Study to Elucidate The Impact of Integration on Pre-Clinical Disciplines Compared to Disciplines-Based Curriculum

“…(Azzalis et al, 2012) Another study supported the claims made in our research that students time in an integrated curriculum is a finite resource and as multiple subjects are vying for the student's attention, integrated assessments inculcate the tendency in the students to favor some disciplines over the others and thus affecting their performance in those disciplines. (Cooles et al, 2014) Sami Hussein in his article reported that integrated curriculum does lead to a deterioration in students' performance as is reported in our research as well. (Hussein, 2017) Number and depth of assessments: The study participants reported that the number of assessments in an integrated system are adequate, but the depth of the assessments has been compromised since the introduction of integrated exams, as the total number of MCQs in an integrated exam are divided amongst the various disciplines according to the table of specifications which reflects the number of hours taught by each subject.…”

Student Performance Outcomes and Perceptions in Two Content Areas in Conventional Versus Integrated Pharmacy Curricula

“…These findings align with previous studies of integrated curricula in medical education, which demonstrated similar or improved board examination scores and residency match rates. 2,8,11,12 Students in the conventional curriculum may have rated their confidence in integrating knowledge, communicating with patients, and making therapeutic recommendations higher at the beginning of a course due to their exposure to the basic sciences, such as pharmacology, prior to taking therapeutics courses on that content. Conversely, students in the integrated curriculum received little instruction in the basic sciences of a content domain prior to entering their integrated block.…”

Implementation and modification of an anatomy‐based integrated curriculum

“…One way to confirm that curricular change is successful is student performance on examinations. While some programs have experienced increased subject examination performance after revising the curriculum (Vasan et al, ), others saw improvements on in‐course examinations (Marinović et al, ) and comprehensive examinations (Damjanov et al, ; Cooles et al, ). Clear elevations in the Gross Anatomy and Embryology and Histology and Cell Biology NBME Subject Examination scores were seen in the first 3 years (Phase II) since implementing the integrated curriculum.…”