The Impact of Curriculum Design in the Acquisition of Knowledge of Oncology: Comparison Among Four Medical Schools

Abstract

Over the past 5 years, cancer has replaced coronary heart disease as the leading cause of death in the Netherlands. It is thus paramount that medical doctors acquire a knowledge of cancer, since most of them will face many patients with cancer. Studies, however, have indicated that there is a deficit in knowledge of oncology among medical students, which may be due not only to the content but also to the structure of the curriculum. In this study, we compared students’ knowledge acquisition in four different undergraduate medical programs. Further, we investigated possible factors that might influence students’ knowledge growth as related to oncology. The participants comprised 1440 medical students distributed over four universities in the Netherlands. To measure students’ knowledge of oncology, we used their progress test results from 2007 to 2013. The progress test consists of 200 multiple-choice questions; this test is taken simultaneously four times a year by all students. All questions regarding oncology were selected. We first compared the growth of knowledge of oncology using mixed models. Then, we interviewed the oncology coordinator of each university to arrive at a better insight of each curriculum. Two schools showed similar patterns of knowledge growth, with a slight decrease in the growth rate for one of them in year 6. The third school had a faster initial growth with a faster decrease over time compared to other medical schools. The fourth school showed a steep decrease in knowledge growth during years 5 and 6. The interviews showed that the two higher-scoring schools had a more focused semester on oncology, whereas in the others, oncology was scattered throughout the curriculum. Furthermore, the absence of a pre-internship training program seemed to hinder knowledge growth in one school. Our findings suggest that curricula have an influence on students’ knowledge acquisition. A focused semester on oncology and a pre-internship preparatory training program are likely to have a positive impact on students’ progress in terms of knowledge of oncology.

<p>A Thorough Analysis of the Current State of Cancer Education in Medical Schools and Application of Experimental Teaching Techniques and Their Efficacy</p>

“… 89 Additionally, use of a blocked rather than integrated curriculum significantly improves test scores at the national level. 114 A Finnish study indicated wide variation in palliative care oncology training, teamwork, and self-reflection while reportedly being strong in basic knowledge, symptom management, and communication skills practice. This study also showed that compliance with European guidelines resulted in increased test scores.…”

Progress testing as a pattern of excellence for the assessment of medical students’ knowledge: concepts, history, and perspective

“…Despite the lack of use in a different context, progress test can also be used to understand the impact of different teaching strategies in students' knowledge acquisition. Another study from Cecilio-Fernandes et al compared the teaching strategies of oncology in four different medical schools 29 . They found that teaching oncology in a block format instead of spaced throughout the bachelor and offering a refreshing course before the clinical phase has benefit knowledge retention at the end of the course.…”

Assessment programs to enhance learning

“…15,16 Progress testing has been shown to be a valid and reliable tool to measure students' knowledge, 17 knowledge growth, 18 different types of knowledge, 18 and benchmarking. 15,19,20 However, a progress test cannot replace other knowledge tests, since it is necessary to engage students in a more regularly testing in which they will focus on specific learning material.…”