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Teaching Methods

Teaching Methods in Clinical Presentation Curriculum

The most important feature of the Clinical Presentation Curriculum is the structuring of the content around a clinical presentation. As teachers present new content, it is vital they constantly refer to the relevant clinical presentations and demonstrate the usefulness of the new material (basic science, clinical) in solving these cases. In the pre-clerkship years, three main teaching methods are utilized:

Lectures

Lectures  are used primarily to:

1) introduce and provide an overview of topics to cover; and

2) to explain important and complex content areas. The purpose of a lecture at the beginning of a section or clinical presentation is to stimulate interest and provide a structure for the content material that will follow. In the Clinical Presentation XE "Clinical Presentation"  Curriculum, this structure is the clinical problem-solving scheme. The lecturer may present cases at the beginning and demonstrate the use of the clinical-problem solving scheme. Also, the lecture is an efficient way to present concepts to a whole group of students and ensure some uniformity in their level of understanding. Completely new domains of knowledge can be introduced with the use of a lecture to provide rapid understanding of the basic concepts and their inherent structure. In recent years, most lectures have been available as a podcast, to allow for student review, reflection, and elaboration of the important concepts.

Small Group Sessions

Student attendance at small group sessions is mandatory. Small group sessions should be used for students attempting to solve a clinical problem. The clinical problem should illustrate the use of a clinical-problem solving scheme. It is also used as an opportunity for students to learn additional content material not covered in other learning activities but considered part of the course objectives. A case should provide an opportunity for students to study independently and report to the group on their learning activities at a future session.

The major indications for small group learning include in depth analysis of content, and reinforcement of the clinical-problem solving scheme. Clinical problems studied in small group sessions provide a context for exploring new knowledge and reinforcing acquired knowledge. Once the clinical problem solving approach has been presented, small group teaching sessions smallgrpallow students to acquire finer conceptual details in a more self directed manner. 

The group, the preceptor, the material provided and the structure of the activity will guide the students in the desired direction. Learning requires repeated practice and opportunities to receive feedback. When adequately structured and lead by an effective facilitator, small groups are an ideal format for this activity. In recent years, two students, on a rotating basis, have been nominated for each session as a student facilitator. The roles of the student facilitators include a more in-depth preparation of the case and its relevant questions/material, initiating the small group process by reading the case, as well as facilitating the early small group discussion with their peers.

Clinical Correlation Sessions

Clinical correlation (bedside) sessions will continue in each course with the primary goal of reinforcing the features of a clinical presentation with real examples. Knowledge learned in the context of a lecture or a small group session needs to be transposed to the clinical situation. The clinical correlation sessions allow students to review their knowledge with a real patient. Clinical correlations preceptors should receive the relevant clinical-problem solving schemes and learning objectives so they can identify appropriate patients for the sessions. They should also be aware of which presentations have been studied at the time of theclincore session.  

In addition to these sessions, students are taught the art and science of physical examination, communication, procedural skills, global health, ethics and life as a physician by way of a longitudinal pre-clerkship course entitled “Medical Skills”. Two other longitudinal pre-clerkship courses, Healthy Populations and Applied Evidence-Based Medicine, cover such topics as evidence-based medicine, critical appraisal, biostatistics, global health and community medicine.

 

Student Evaluation

The Student Evaluation Committee is responsible for overseeing the evaluation of undergraduate medical students’ performance in the Undergraduate Medical Education (UME) curriculum. Student evaluations aim to to be consistent with the goals, objectives and philosophy of the UME program and meet or exceed Liason Committee on Medical Education accreditation standards. All policies and procedures are designed to ensure high quality examinations, including efforts to maximize reliability and validity.

Student evaluations serve several purposes, including:

  • Assessment of student performance and achievement of curricular objectives.
  • Feedback to students and faculty regarding student learning needs
  • Program evaluation including identification of strengths and weaknesses in the education program.

In order to achieve these purposes, several formats of student evaluation are used including multiple-choice examinations, Objective Structured Clinical Examinations (OSCE), student projects, and preceptor rating scales to name a few . Formal policies have been developed that outline the necessary preparation and review steps for each evaluation method.

The process of student evaluation is constantly under review. Specific criteria are in place to identify unusually difficult or easy examinations, and to identify atypical trends in student performance. Student performance on internal examinations is periodically compared to external examinations as a quality assurance strategy.

Students are included as participants on the Student Evaluation Committee. With the exception of pre-examination planning meetings where content is discussed, the students are included in the policy setting and examination review processes.

 

 

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