Assessment of an integrated curriculum in radiology.

OBJECTIVE: To describe an interdisciplinary team's experience using a six-stage curriculum-development model to assess an integrated curriculum in radiology.

DESCRIPTION: In 1996 the University of Maryland School of Medicine implemented reforms of its undergraduate curriculum. A third-year required clerkship in radiology was eliminated, but an integrated curriculum was developed for first- and second-year students and for third-year students during their core clinical clerkships. A fourth-year elective was retained. In 2000 the school's Curriculum Coordinating Committee found that it lacked data regarding program performance or learner competencies in radiology since the reforms were implemented. The Committee designated an interdisciplinary team including a radiologist, an anatomist, and an internist with medical education expertise to conduct a rapid review of the adequacy of the curriculum as it is currently integrated. The team mapped the curriculum, identifying where radiology was taught, and analyzed each sub-curriculum according to a six-stage curriculum-development model. This method permitted nearly concurrent assessment of the national literature, local needs assessment, presence and adequacy of educational objectives and methods, adequacy of resources to support curriculum implementation, and the availability and adequacy of learner and program outcome measures. The team identified changes in the clinical classrooms that have been unanticipated four years earlier, including implementation of PACS systems for digital film storage and retrieval, rapid advances in clinical imaging capabilities, and diminished faculty teaching time due to increased clinical volumes. The team concluded its work in four months and issued a report recommending revisions to third-year curricula. The Curriculum Committee, the Dean's Office, and the Department of Radiology accepted the analysis and have dedicated personnel, technical, and financial resources to effect the recommended revisions, which include (1) revision of clinical clerkship objectives for competencies in radiology, (2) development of Web-based modules for self-directed learning, (3) faculty development to enhance teaching skills, and (4) competency-based assessment measures based on learning objectives.

DISCUSSION: Schools and faculty are often faced with the need to develop and implement innovative curricula rapidly. Periodic assessments by oversight groups such as curriculum committees identify where additional information is required to assess the performances of learners and curricula in rapidly-changing clinical contexts. In this study a three-member team with focused expertise in radiology, anatomy, and medicine/medical education conducted a rapid in-depth review of an integrated radiology curriculum "hosted" by several departments. A curriculum-development model provided a template for analysis of needs, objectives, methods, resources, and assessment measures for all curricula, and guided the team's recommendations for targeted revision. Each team member brought expertise in some element of the integrated curriculum or in curriculum design. The team identified what integrated curricular elements had not been designed adequately, what could no longer be supported with current resources, and how curricular revisions could be assessed for adequacy.