The process of reform of the medical curriculum in the Faculty of Medicine of the University of Lisbon (FMUL) began in the 2007-2008 academic year, involving the first, second and fifth years, and it will be completed by the academic year 2009-2010.The decision to undertake a new reform of medical teaching at the FMUL arose from the need to modernise our teaching model, bringing it closer to what is being practised in the most noteworthy European schools, and was preceded by a process of external assessment by an international committee presided over by Professor Fernando Lopes da Silva from the University of Amsterdam and made up of professors from the University of Philadelphia in the USA and Sheffield in the United Kingdom.
The aims of the reform are the following:1. Improvement on the teaching of the scientific bases of medicine alongside the development of the humanist and ethical dimensions of medicine;2. Student-centred teaching, seeking to develop their capacities for self-learning, individual responsibility, teamwork and scientific research;3. Perception of the need for the permanent updating and teaching that characterise the medical profession;
4. Integration of the subject matters and reduction in assessment periods.
The impulse provided by the implementation of the “Bologna Process” was taken as an opportunity to reduce the number of contact hours, contemplating the experiences of the practical aspects of Clinical Medicine from the fist semester, and reinforcing the horizontal and vertical integration of the teaching, reducing the barriers between the fundamental sciences and clinical medicine.
The methodology adopted for the educational aims was based on the constitution of Integrating Modules and Common Cores, in order to promote such an integration of the knowledge of the Basic Sciences and Clinical Medicine, and simultaneously extending the area of pedagogical intervention in Family and General Practice Medicine, which is an imperative and a need for the Health Services.
The system of assessment is integrated, and aims to respond to the need of greater productivity in the teaching-learning, and has a correspondence to the ECTS system (European Credit Transfer System).
Programme of the Medical Integrated Master Course.
One of the practical components of quality assurance in higher education lies in the evaluation carried out by the students who participated in the process of reform. For this, the University of Lisbon placed on-line questionnaires for the students, the answers to which are being put into databases for statistical processing. Consequently, at the present we do not possess the indicators referring to the evaluation, but we have the final classification obtained by the students, which provide information as to the educational gains and are indicators about the system of quality maintenance.
The intention was to find out the students’ adaptability to the new curricular reform in terms of educational gains. In order to respond to this aim, the classification of the students in the first, fourth and fifth years were taken. In Tables 1 to 4 the thematic contents are indicated, along with the contact hours and the respective ECTS referring to the curricular years under study. In the fourth and fifth years there are rotating blocks; that is, the contents of each semester take place in parallel and are frequented by half of the total number of students.
We considered as group “A” the first year students who had come recently from secondary school, and as group “B” the fourth and fifth year students who, as we know, had already successfully completed the basic and pre-clinical years (there is a cut-off point at the end of the pre-clinical year).
SIGES was used to gather the data on the ages and values of the classifications (data available on September 26th). SPSS was used for statistical analysis.
Most of the students (71.5%) in group “A” are between 18 and 19 years old, and most of the students in “B” (80.8%) are between 21 and 23. The percentage of female students is higher than the males and is similar in both groups (group “A” 68%, group “B” 63.5 % and 66.5% respectively for the fourth and fifth years).
Figures 1 to 18 allow one to see the distribution of the values of the grades obtained by the students in each Module and Common Core in groups A and B.
The aims of the reform are the following:1. Improvement on the teaching of the scientific bases of medicine alongside the development of the humanist and ethical dimensions of medicine;2. Student-centred teaching, seeking to develop their capacities for self-learning, individual responsibility, teamwork and scientific research;3. Perception of the need for the permanent updating and teaching that characterise the medical profession;
4. Integration of the subject matters and reduction in assessment periods.
The impulse provided by the implementation of the “Bologna Process” was taken as an opportunity to reduce the number of contact hours, contemplating the experiences of the practical aspects of Clinical Medicine from the fist semester, and reinforcing the horizontal and vertical integration of the teaching, reducing the barriers between the fundamental sciences and clinical medicine.
The methodology adopted for the educational aims was based on the constitution of Integrating Modules and Common Cores, in order to promote such an integration of the knowledge of the Basic Sciences and Clinical Medicine, and simultaneously extending the area of pedagogical intervention in Family and General Practice Medicine, which is an imperative and a need for the Health Services.
The system of assessment is integrated, and aims to respond to the need of greater productivity in the teaching-learning, and has a correspondence to the ECTS system (European Credit Transfer System).
Programme of the Medical Integrated Master Course.
One of the practical components of quality assurance in higher education lies in the evaluation carried out by the students who participated in the process of reform. For this, the University of Lisbon placed on-line questionnaires for the students, the answers to which are being put into databases for statistical processing. Consequently, at the present we do not possess the indicators referring to the evaluation, but we have the final classification obtained by the students, which provide information as to the educational gains and are indicators about the system of quality maintenance.
The intention was to find out the students’ adaptability to the new curricular reform in terms of educational gains. In order to respond to this aim, the classification of the students in the first, fourth and fifth years were taken. In Tables 1 to 4 the thematic contents are indicated, along with the contact hours and the respective ECTS referring to the curricular years under study. In the fourth and fifth years there are rotating blocks; that is, the contents of each semester take place in parallel and are frequented by half of the total number of students.
We considered as group “A” the first year students who had come recently from secondary school, and as group “B” the fourth and fifth year students who, as we know, had already successfully completed the basic and pre-clinical years (there is a cut-off point at the end of the pre-clinical year).
SIGES was used to gather the data on the ages and values of the classifications (data available on September 26th). SPSS was used for statistical analysis.
Most of the students (71.5%) in group “A” are between 18 and 19 years old, and most of the students in “B” (80.8%) are between 21 and 23. The percentage of female students is higher than the males and is similar in both groups (group “A” 68%, group “B” 63.5 % and 66.5% respectively for the fourth and fifth years).
Figures 1 to 18 allow one to see the distribution of the values of the grades obtained by the students in each Module and Common Core in groups A and B.
Group “B” had higher classifications in the Modules V.I, VIII.I e VIII.II (Figs. 8, 11 and 14), and the students from Group “A” in the Modules III.I and Common Core I. Other than these, Group “A” had lower qualifications than those of Group “B”.
The students from groups “A” and “B” completed the first year of the curricular reform with approval in the Modules and Common Cores.The two groups knew about the FMUL’s interest in the practice of student-based teaching, which might have positively increased their degree of satisfaction and their involvement in learning (8), and explain the gains in the learning verified. However, these may not be associated to indicators as to the type of approaches to self-learning used (6,9,10) due to a lack of information available at this moment.Module III.I and Common Core I have programme contents that are closer to the motivations that the first year students made explicit when they completed the questionnaire about their expectations in relation to the Course in Medicine – Integrated Master, namely to learn to improve the quality of life of another person, to be useful to society, to acquire medical/clinical skills, professional achievement/personal satisfaction (7).The process of adaptation to university teaching, within the overall concept of the cognitive, humanistic, social and logistical fields, might be a conditioning factor in the values of the classifications obtained by the first year students. These are lower than those obtained during the process of entering the FMUL, as has been the case observed in previous years.
The programme of tutors currently operating at the FMUL is a method of support for difficulties in adaptation through the providing of opportunities for dialogue and communication between students and teachers (3).
In relation to the fourth and fifth year students, they achieved higher classifications than those of the first year, which seems to indicate a greater adapting to the curriculum reform, justified by their scientific background, their performance and their attitudes, and perhaps because they had acquired greater control of their state of anxiety (4,5).In short, it seems fair to conclude that the fist, fourth and fifth year students from 2007-2008 adapted to the new curriculum reform begun at the FMUL. Its final impact will have essential to be successively assessed over different semesters, and it’s an imperative for the FMUL to allow a monitoring of this implementation of the Curricular Reform and to correct some problems that might jeopardise its pedagogical efficiency and acceptance by the community of its students and teachers.
The students from groups “A” and “B” completed the first year of the curricular reform with approval in the Modules and Common Cores.The two groups knew about the FMUL’s interest in the practice of student-based teaching, which might have positively increased their degree of satisfaction and their involvement in learning (8), and explain the gains in the learning verified. However, these may not be associated to indicators as to the type of approaches to self-learning used (6,9,10) due to a lack of information available at this moment.Module III.I and Common Core I have programme contents that are closer to the motivations that the first year students made explicit when they completed the questionnaire about their expectations in relation to the Course in Medicine – Integrated Master, namely to learn to improve the quality of life of another person, to be useful to society, to acquire medical/clinical skills, professional achievement/personal satisfaction (7).The process of adaptation to university teaching, within the overall concept of the cognitive, humanistic, social and logistical fields, might be a conditioning factor in the values of the classifications obtained by the first year students. These are lower than those obtained during the process of entering the FMUL, as has been the case observed in previous years.
The programme of tutors currently operating at the FMUL is a method of support for difficulties in adaptation through the providing of opportunities for dialogue and communication between students and teachers (3).
In relation to the fourth and fifth year students, they achieved higher classifications than those of the first year, which seems to indicate a greater adapting to the curriculum reform, justified by their scientific background, their performance and their attitudes, and perhaps because they had acquired greater control of their state of anxiety (4,5).In short, it seems fair to conclude that the fist, fourth and fifth year students from 2007-2008 adapted to the new curriculum reform begun at the FMUL. Its final impact will have essential to be successively assessed over different semesters, and it’s an imperative for the FMUL to allow a monitoring of this implementation of the Curricular Reform and to correct some problems that might jeopardise its pedagogical efficiency and acceptance by the community of its students and teachers.
Professor J. Fernandes e Fernandes,
Professor Carlota Saldanha,
Pedro MarçalDirector’s Board and Planning and Assessment Office
gpa@fm.ul.pt
(+351) 217985188
Professor Carlota Saldanha,
Pedro MarçalDirector’s Board and Planning and Assessment Office
gpa@fm.ul.pt
(+351) 217985188
Bibliography:1. Damjanov I, Fenderson BA, Hojat M, Rubin E – Curricular reform may improve students’ performance on externally administered comprehensive examinations. Pathology Education 2005; 46:443-448.
2. Fernandes e Fernandes J - Sessão solene de abertura do ano académico 2007-2008. Alocução oficial do director. Rev. FML 2007; 12:349-355.
3. Fernandes e Fernandes J - Relatório do Director e do Conselho Directivo (2005-2007). Faculdade de Medicina da Universidade de Lisboa.
4. Haryill LM, Anxiety in first year medical students. J Med Educ;1986:926-929
5. Hayes K; Feather A; Hall A; Sedgwick P; Wannan G; Wessier-Smith A; Green T; McCrorie P. Anxiety in medical students: is preparation for full-time clinical attachments more dependent upon differences in maturity or on educational programmes for undergraduate and graduate entry students? Med Educ; 2004:38:1154-1163.
6. Newble DI, Clarke RM – The approaches to learning of students in a traditional and in an innovative problem based medical school. Medical Education 1986; 20:267-273.
7. Relatório – Avaliação de expectativas e motivações. Curso de Medicina – Mestrado Integrado 2004-2008. Gabinete Planeamento e Avaliação FMUL. http://www.fm.ul.pt/#634
8. Robins LS, Gruppen LD, Alexander GL, Fontone JC, Davis WK – A predictive model of student satisfaction with the medical school learning environment. Acad. Med. 1997; 72:134-139.
9. Saldanha C – Hábitos de estudo e estilos de aprendizagem dos alunos do 1º ano da Faculdade de Medicina de Lisboa – caracterização e evolução. Rev. FML 2000; 5:313-317.
10. Shankar PR, Dubey AK, Binu VS, Subish P, Deshpande VY – Learning styles of preclinical students in a medical college in western Nepal. Kathmandu University Medical Journal 2006; 4:390-395.
2. Fernandes e Fernandes J - Sessão solene de abertura do ano académico 2007-2008. Alocução oficial do director. Rev. FML 2007; 12:349-355.
3. Fernandes e Fernandes J - Relatório do Director e do Conselho Directivo (2005-2007). Faculdade de Medicina da Universidade de Lisboa.
4. Haryill LM, Anxiety in first year medical students. J Med Educ;1986:926-929
5. Hayes K; Feather A; Hall A; Sedgwick P; Wannan G; Wessier-Smith A; Green T; McCrorie P. Anxiety in medical students: is preparation for full-time clinical attachments more dependent upon differences in maturity or on educational programmes for undergraduate and graduate entry students? Med Educ; 2004:38:1154-1163.
6. Newble DI, Clarke RM – The approaches to learning of students in a traditional and in an innovative problem based medical school. Medical Education 1986; 20:267-273.
7. Relatório – Avaliação de expectativas e motivações. Curso de Medicina – Mestrado Integrado 2004-2008. Gabinete Planeamento e Avaliação FMUL. http://www.fm.ul.pt/#634
8. Robins LS, Gruppen LD, Alexander GL, Fontone JC, Davis WK – A predictive model of student satisfaction with the medical school learning environment. Acad. Med. 1997; 72:134-139.
9. Saldanha C – Hábitos de estudo e estilos de aprendizagem dos alunos do 1º ano da Faculdade de Medicina de Lisboa – caracterização e evolução. Rev. FML 2000; 5:313-317.
10. Shankar PR, Dubey AK, Binu VS, Subish P, Deshpande VY – Learning styles of preclinical students in a medical college in western Nepal. Kathmandu University Medical Journal 2006; 4:390-395.
