Faculty Development National Board of Medical Examiners Tuesday 4/20/10

Overview Board Performance declining at 0.08 Standard Deviations per year for last 4 years Rarely do our students score at the national average or above 70% of our students failed the practice Board Examination that they took this year

Some Observations Our students never reach the national average in many Disciplines/areas Genetics is the worst performing area in the 10 year average but did considerably better in 2009 than many other areas –I still want to target Genetics because I feel it is an emerging area that will have greater impact with time

Additional Observations Biochemistry appears to be a weakness of our students –I’d like to target this area for intervention Biostats is a consistent area of weakness but is sparsely represented on the Boards –Don’t feel this is worth addressing

More Observations Principles, Histology and Hematopoiesis are the next weakest areas All of the disciplines except Biochem & Anatomy perform essentially identically

More Observations Anatomy clearly is doing something correct –Maybe the rest of us can learn something from them- formative quizzes, clinical vignettes Musculoskeletal is doing something correct, although recent trend is in the wrong direction Respiratory, GI & CV performing fairly well –Lois Heller is Course director of GI & CV and students seem to be improving on their performance –This is bucking the downward trend

More The MCATs don’t seem to correlate with Board Performance –4th highest MCAT’s last year to go with 2nd lowest Board Performance –In contrast, higher MCAT scores in earlier years ( ) did go with highest Board performance

More Curricular hours do not necessarily result in higher Board Scores –Look at Anatomy in –Had large numbers of hours without good performance on Boards –Other disciplines with large numbers of hours do not perform well on boards

Potential Solutions Add cases to our 7 week blocks to emphasize major points –Recommend 1 genetics case for each block –Recommend that the case not be lecture –Preferably a case-based format where students are required to learn actively –I like PBL but do not believe we have the buy-in of faculty/leadership to do that –Could use formatting requiring students to “solve” a case in a sequential pattern getting additional information when completing an assigned task

Potential Solutions Also like to add a Biochemistry case to each block Assess whether these additions benefit student performance –Two year lag time between implementation and analysis If a benefit is realized, I would recommend that we include cases in other disciplines/areas

Potential Solutions Let’s look at expectations of the Board of Examiners They have a list of Areas and their relative weight on the Boards They also have sample questions Please look at the attachment from NBME to evaluate the questions and expectations Need to write better questions

Some Additional querries Why the better performance What are the following for the best & worst: –Objectives –Syllabus –Teaching methods –Instruction –Teaching philosophy

Some Additional querries Relationship between hours and performance Relationship between time in school year & board performance Grades in School vs Grades on Boards

Some Additional querries Has our educational delivery methods kept up with our students? Should we have board prep available on-line all the time?

Potential Solutions Additional suggestions: –One faculty member felt that Board scores would be higher if MCATs were higher –Discipline questions are too diluted in our curriculum –Faculty loss is taking a toll (especially in Pathology) –Clinical Chemistry is not adequately represented –Excitement about e-learning is misplaced –Future will be worse

Potential Solutions Additional suggestions: –One faculty member is excited about the potential for multiple regression analysis to decipher what’s going on