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multiple choice quiz was administered to assess specific learning objectives. RESULTS The Brewsters was implemented at UTHealth at all six schools during the 2011-2012 academic year and was used by 755 students. An overall average of 87% was obtained on the post-test. Substantial knowledge gain was observed at two schools at which a pre-test was administered. Student evaluations were very favorable (avg = 4.26/5). CONCLUSIONS The Brewsters has been demonstrated to be an excellent way of introducing ethics and professionalism at a health science center. Curriculum Abstract ID: 137 CAN CLINICAL CASES DRIVE ALL COMPONENTS OF A MEDICAL CURRICULUM? Stephen Charles and Dennis Valenzeno, Department of Medical Sciences, University of Kansas School of Medicine - Wichita, Wichita, KS, USA PURPOSE Can learning be driven entirely by clinical case scenarios, structured so that all curricular components are organized around cases and still provide broad scope/depth in the requisite basic medical sciences and traditional pre-clinical curricula? METHODS Representative medical school curricula primarily in the US and Canada were reviewed, during the past year. Selected model campuses were visited and representatives from others were invited to present at the KU School of Medicine - Wichita. A small faculty group used these experiences to draft a curriculum designed to drive all components from clinical cases. RESULTS Case-based/PBL/patient-centered curricula frequently engage only part of a program of study, e.g. 10-h/wk of PBL paralleled by a similar number of lecture hours that may not be directly tied to the PBL. A draft curriculum composed of weekly cases and independent study mini-cases appears capable of driving all elements needed in a full medical curriculum that uses adult learning principles to provide content through text, video, podcasts, web pages, selected lectures, small group sessions and live patient presentations. Achievement of objectives can be tracked digitally for each case and reviewed to assess remedial needs on an organ system or disciplinary basis, facilitating review for summative examinations and NBME tests. The curriculum transcends the traditional basic/clinical science divide allowing for a cohesive curriculum across 4 years. CONCLUSIONS A fully case-driven curriculum can be constructed based on adult learning principles using educational technology. With digital tracking of the mastery of learning objectives on a case-by-case basis student learning can be documented and interventions implemented when needed. Curriculum Abstract ID: 138 Oral Presentation IMPACT OF A COMPREHENSIVE CADAVER-BASED COURSE IN EMERGENT BEDSIDE PROCEDURES FOR SENIOR MEDICAL STUDENTS Samuel Clarke, MD, Harbor-UCLA Medical Center; Jonathan Wisco, PhD, David Geffen School of Medicine at UCLA; Elena Stark, MD, PhD, David Geffen School of Medicine at UCLA; Ravi Morchi, MD, Harbor-UCLA Medical Center; Wendy Coates, MD, Harbor-UCLA Medical Center, USA PURPOSE Proficiency in performing invasive procedures is essential, but learning on live patients is undesirable. Cadaver-based teaching enhances understanding of anatomy and provides an accurate substrate for procedural training. We developed an elective combining didactics and deliberate practice on unpreserved cadavers and live patients and studied its impact on students’ knowledge of anatomy, physical exam, imaging, clinical reasoning, and procedural proficiency. METHODS 4th year students were eligible for the 2-week course. Topics included airway, ENT, vascular access, extremity, laceration, ultrasound, and thoracic procedures. Students performed procedures on unembalmed cadavers, followed by live patients during supervised clinical ER shifts. In this quasi-experimental study, students completed 44-item cognitive pre/post-tests and a 12-item survey assessing comfort performing emergent procedures. A simulated encounter involving two emergencies on cadavers was the objective outcome measure. Performance was graded using criticalactions checklists. The study was approved by our IRB. Statistical analysis consisted of Wilcoxon Medical Science Educator © IAMSE 2012 Volume 22(4S) 288
signed-rank tests for pre- and post-test cognitive exam and attitudinal survey scores. RESULTS 11 of 12 enrollees (92%) consented to the study. Prevs. post-test scores showed significant positive change (p < .001) for all indices: cognitive knowledge; understanding of indications/contraindications for procedures; and procedural confidence. CONCLUSIONS The course conferred significant gains in knowledge and self-confidence regarding invasive procedures. A follow-up study has been planned which will measure knowledge retention as well as a survey of residency directors regarding these students’ procedural competency during the PGY-1 year. Curriculum Abstract ID: 139 Award Nominee STUDENTS’ INTELLECTUAL DEVELOPMENT IN THE FIRST YEAR OF MEDICAL SCHOOL Jennifer Eastwood, Minhee Seo, Victoria Lucia, Jill Stefaniak, and Holly Reed, Oakland University William Beaumont School of Medicine, Rochester, MI, USA PURPOSE Models of intellectual development, such as Perry’s (1979) scheme describe adults’ progression from viewing knowledge as unambiguous and authoritydriven (positions of dualism) to navigating complex situations based on evidence, context, and personal standards (positions of relativism and commitment). Advanced positions of intellectual development closely resemble aspects of professionalism highly valued in medical curricula (Swick, 2000). However, there is a paucity of published studies of intellectual development in medical students. As part of a four-year longitudinal study, we examined students’ intellectual development over the first semester of medical school. METHODS To identify positions along the Perry scale, the modified Learning Contexts Questionnaire (LCQ; 26 items using a 6-point Likert scale) was employed. LCQ was administered at the beginning of the first and second semesters of medical school. On the second administration, an open-ended item was added to obtain deeper insights about students’ approach to their education. Chi-square tests were performed to compare differences in Perry positions between the two semesters. Open-ended questions were qualitatively analyzed. RESULTS Thirty-nine students (78% of the class) completed both LCQ administrations. Reliability estimates were .57 and .56, respectively. The majority of students were in the intermediate position of multiplicity for both pre and post tests. More students moved to a lower position than to a higher position. Chi-square tests indicated that changes were statistically significant (X2=36.9, p
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