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BMC Med Educ. 2019 Jan 9;19(1):17. doi: 10.1186/s12909-018-1439-0.

Cross-sectional comparison of spiral versus block integrated curriculums in preparing medical students to diagnose and manage concussions.

Author information

1
Southern Medical Program, Reichwald Health Sciences Centre, University of British Columbia Okanagan, Kelowna, BC, Canada. sarah.fraser@alumni.ubc.ca.
2
Southern Medical Program, Reichwald Health Sciences Centre, University of British Columbia Okanagan, Kelowna, BC, Canada.
3
MD/PhD Program, University of British Columbia, Vancouver, BC, Canada.
4
Experimental Medicine Program, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
5
School of Health and Exercise Sciences, University of British Columbia Okanagan, ART 180, 3333 University Way, Kelowna, V1V 1V7, BC, Canada.

Abstract

BACKGROUND:

An integrated curriculum is designed to be repetitive yet progressive and the concept has rapidly established itself within medical education. National organizations have recommended a shift to a spiral curriculum design, which uses both vertical and horizontal integration. This study examined differences between the recently implemented integrated spiral (class of 2019) and conventional block (classes of 2016-2018) MD curricula at the University of British Columbia (UBC) with respect to knowledge of concussion.

METHODS:

Cross-sectional online survey (FluidSurveys: Fluidware, Ottawa, ON), distributed via email to UBC medical students during the 2015-2016 academic year. Questions focused on demographic data, knowledge of concussion definition, and management considerations. Differences in responses across the two groups were assessed using chi-square tests. Ordinal Likert-scale data were analyzed using Mann-Whitney U-Tests. Statistical significance was determined a priori at p < 0.05.

RESULTS:

One hundred forty eight medical students (57% female) responded with 78 students in the spiral curriculum and 70 students the block curriculum. Important differences between responses from spiral versus block curricula students included: formal exposure to concussion-related educational material (10.8 h spiral vs. 3.95 h block), understanding concussions can occur without direct head impacts (90% spiral vs. 70% block, X21,148 = 9.41, p = 0.002) and identifying long-term consequences (dementia: 90% spiral vs. 66% block, X21,148 = 12.57, p < 0.0001; second impact syndrome: 80% spiral vs. 57% block, X21,148 = 8.60, p = 0.003; Parkinsonism: 47% spiral vs. 17% block, X21,148 = 14.87, p < 0.001). Block students identified the need for a full neurological exam (X21,148 = 17.63, p < 0.001) and had greater clinical exposure to acute concussion (47% block vs. 14% spiral, X21,148 = 19.27, p < 0.001) and post-concussion syndrome (37% block vs. 19% spiral, X21,148 = 5.91, p = 0.015).

CONCLUSIONS:

The findings from this preliminary study suggest the spiral curriculum design, which emphasizes and revisits clinical competencies, promotes a strong understanding and retention of knowledge in highly prevalent clinical conditions such as concussion.

KEYWORDS:

Concussion; Curriculum design; Integrated; Medical education; Spiral curriculum

PMID:
30626361
DOI:
10.1186/s12909-018-1439-0
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