|LETTER TO THE EDITOR
|Year : 2012 | Volume
| Issue : 2 | Page : 131-132
Inappropriate Time Splitting Among Endocrine Topics in Undergraduate Medical Education
M Heydari, MH Hashempur, M Shams
Endocrine and Metabolism Research Center, Namazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
|Date of Submission||21-Oct-2011|
|Date of Decision||03-Jul-2012|
|Date of Acceptance||02-Sep-2012|
|Date of Web Publication||14-Nov-2012|
Assistant Professor of Internal Medicine and Endocrinology, Endocrine and Metabolism Research Center, Namazee Hospital, Shiraz University of Medical Sciences, Shiraz
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Heydari M, Hashempur M H, Shams M. Inappropriate Time Splitting Among Endocrine Topics in Undergraduate Medical Education. Educ Health 2012;25:131-2
The increasing volume of information in the field of endocrinology and the limited amount of time typically devoted to this field within the undergraduate medical curriculum make it important for medical educators to consider how time is split among the various endocrine topics that students should learn. There have been studies of the education of medical students in endocrinology, and particularly diabetes, but they have focused on educational methods more than on the distribution of the subject content covered. , This made us evaluate our undergraduate endocrinology course at the Shiraz University of Medical Sciences in Iran, regarding the amount of curriculum time spent on the various endocrine topics. This course comprises of lecture-based classes, clinical rounds and a final examination. These three modes of education were evaluated by recording the duration of time within lectures and clinical rounds spent on various topics in three different monthly courses. In addition, the topics addressed in all final examination questions were evaluated in these three months.
Topics were divided in four groups (A to D) based on their educational importance as defined by Iran's Ministry of Health and Medical Education's guidelines on Undergraduate Medical Students' Educational Priorities in the Field of Endocrinology.  These guidelines offer four grades of importance for more than 50 endocrine diseases and in 10 separate domains for each disease (i.e. definition, epidemiology, pathophysiology, aetiology, clinical manifestations, diagnostic approach, laboratory findings, treatment, prognosis and patient education). For example according to the guidelines, non-insulin-dependent diabetes mellitus "diagnosis" and "treatment" have "A" grades for importance, which means that students "must know", both, how to diagnose and treat diabetes mellitus. In contrast, diabetes insipidus receives a "C" grade, which means it is it nice for students to know this topic, for the importance of its diagnosis and a "D" grade, which means there is no need for students to know, for the importance of its treatment. The guidelines also suggest that at least 70% of curriculum time and examinations should be devoted to topics with an "A" grade of importance.
After dividing our school's summed curriculum time and exam questions into these four disease entity classes of importance, we compared their distribution against the recommended emphasis each class should receive according to the national guidelines, specifically 70% for topics of level "A" importance and 30% for all others, less important topics combined. The concordance between the recommended time split and the split within our curriculum was evaluated with a Chi-square test.
Results are summarized in [Figure 1]. We found significant differences (P<0.01) between the proportion of our school's curricular time spent on clinical topics in "A" versus "B" through "D" fields and the desirable time split according to the guidelines for time spent in classes, on clinical rounds and on the final examination for the undergraduate endocrinology course. While desired time for topics with an "A" grade of importance was 70% of overall time, only 30-45% of curricular time was spent on these topics.
|Figure 1: Amount (%) of curriculum time specifi ed for each importance class of topics|
Click here to view
These findings show that too little time is spent on the most important topics in the various aspects of our endocrinology course. This discrepancy in actual versus desired educational time split has been found for other medical specialties.  This shows that more attention needs to be paid by curriculum developers and educators to this issue, and solutions found. Non-ideal split of curriculum time may be due to various causes, including misplaced priorities, the faculty's perceived need to cover all topics to give students a broad foundation in endocrinology, and too little attention to the importance of how curriculum time is split among topics. Changing the location of educational from hospital wards to more general clinics can alter the content of training in favour of more important subjects. Sensitizing students, educators and curriculum developers to this issue is another solution.
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