Abstract ID 23564

Poster Board 595

Aim: Pharmacology instruction has traditionally been presented during the second year of medical school training. Our innovative curriculum integrates pharmacology instruction from the beginning of preclinical year 1. We report our findings on student performance on customized, standardized testing with such an early adoption.

Methods: In our medical school’s integrated, organ systems-based and active learning curriculum, Phase 1 covers basic science content tightly integrated within clinical contexts. As such, pharmacology is integrated beginning week one, within weekly problem-based learning cases, team-based learning sessions, as well as during their Phase 1 longitudinally integrated clerkships. We analyzed performance on pharmacology content covered during the first three months of preclinical training. The pharmacology topics covered during this period were pharmacokinetics, pharmacodynamics, principles of chemotherapy (anticancer, antimicrobials), anti-inflammatory agents, and immunotherapy.

Students are assessed by summative exams using the customized National Board of Medical Examiners (NBME) exams. Item analysis report is obtained using the NBME Customized Assessment Software. On the item analysis summary report, the NBME describes the performance of students outside of the school administering the test as "source." The source majorly includes students who have taken pharmacology in the second year of the curriculum as opposed to our students who are in year one.

Results: Twenty-six exam items represented pharmacology content covered over three months in the faculty-generated customized NBME exams. Our students’ (n=57) performance level on these exam items was similar to the source average. Average difficulty level (p-value) of the pharmacology items on the administered customized NBME exams was 0.78 compared to the source’s mean difficulty level of 0.81. Anecdotally, student feedback was positive. Students appreciated learning principles of pharmacology from week one of their medical training.

Conclusion: Item analysis of pharmacology questions on the summative exams shows that our students’ performance is comparable to the “source.” Level of performance on pharmacology items on tests that are normally taken by medical students upon completion of basic science curriculum has provided evidence that it is worthy to expose medical students to pharmacology content from day one of preclinical training. Early integration of pharmacology instruction appears to promote understanding of pharmacotherapeutic principles that students continue to build on as they progress through remaining curriculum content. Our pharmacology curriculum design and lessons learned from its successful implementation can be useful in informing other medical schools and educators attempting to integrate pharmacology throughout an innovative medical curriculum.