A Novel Approach to the Medical Student Hematology Curriculum

Introduction/Background:

The American Society of Hematology and National Heart Lung and Blood Institute have long recognized the need for increased training of physicians for positions in academic and non-malignant hematology. Literature from a number of medical specialty fields supports the value of preclinical education in directing student interest and ultimately determining career choice. Many medical schools are currently changing their preclinical curricula with aims to improve student learning, increase preparedness for clinical responsibilities, and foster specialty interest. Student surveys and focus groups provide valuable feedback regarding such curricular changes. In 2015, the Yale School of Medicine (YSM) unveiled a new preclinical curriculum, which included an extensive and systemic revision of the hematology course based on several years of student feedback. We present the new YSM hematology curriculum as a model for course design and a potential tool for generating medical student interest in hematology.

Methods:

Two sources of feedback were collected annually from 2010-2015. YSM students completed anonymous surveys assessing different aspects of the previous hematology course. In addition, for each year, a randomly selected cohort of students met with course directors via a focus group discussion to provide direct, in-person feedback about the curriculum. Each year, the hematology course was modified according to specific recommendations from the surveys and the focus groups. The final hematology course, launched in 2015, was a novel curriculum combining traditional lecture formats with small-group workshops, team-based learning (TBL) sessions (which replaced traditional small-group laboratory sessions), case-based clinicopathologic correlation (CPC) sessions (jointly led by hematology and pathology faculty), large-group boards review sessions, evening faculty-student career interest dinners, and clinical shadowing experiences with designated hematology faculty. Students in the 2015-2016 class were then surveyed to assess effectiveness of the new hematology curriculum.

Results:

Prior to the new curriculum, medical students had mostly favorable impressions of the previous hematology course, with the exception of the small-group laboratory sessions, which were consistently identified as ineffective, uninteresting, and "redundant" in their material. Students evaluating the prior curriculum generally rated case-based workshops favorably for being "clinically focused" and "g[etting] everyone involved" in the learning process by "stimulat[ing] discussion." Students also specifically asked for more "interactive" sessions that "could not be done at home." With the gradual introduction of changes to the hematology curriculum each year, the percentage of students who gave the course top ratings rose considerably, from 57.1% in 2012 to 90.9% 2014. The final 2015 hematology curriculum was identified by the students as a "Gold standard" that could "serve as a model" with respect to creating a "cohesive learning experience." Students specifically highlighted the unique role of TBL and CPC sessions in the new curriculum. Using a Likert scale of up to 5 points, students found TBL to be effective (4.49) and to increase understanding of class material (4.42) by "review[ing] what we learned in lectures" and fostering "learn[ing of] the material at a deeper level." The CPC sessions were rated as "Excellent" by 88% of students, who described them as "cohesive" and "balanced" with "excellent integration" of clinical and pathologic material.

Conclusions:

A multi-modality curriculum incorporating TBL, joint hematology and pathology faculty-led CPC sessions, and out-of-classroom enrichment is an effective method for engaging students in hematology and may serve as a model for other medical schools revising preclinical curricula.