Blog | Tuesday, November 6, 2012

Passing through gastroenterology and hepatology


Somehow we've already made it through two blocks of our M2 year. How can we slow time down? I'm not ready to be this close to the boards!

Course overview
GI was another five-week block and ran similarly to the last three blocks [Renal, Cardiovascular, Respiratory, and Neuroscience was an outlier.] We had one TBL, weekly quizzes, labs and lecture. Our final grade was determined from our performance on quizzes, TBL, a physiology podcast assignment [see below for details], Anatomy practical and final exam.

What I loved
Course Directors. When the course directors for the course insist on being at almost every single lecture, it really sets a positive tone. This is especially important for when we have questions about the material or the nitty-gritty about the course itself because we know we can rely on seeing our course directors in lecture.

Option for Weekly Review. In previous blocks, we had time set aside for a weekly review on Fridays. For GI, Dr. Harriott made a little lockbox for students to submit questions for the weekly review. If we had no questions that week, there was no review. I really liked this format since it meant that professors/clinicians would only have to come in if there was a need. Sometimes I felt bad that time would be taken out of their busy schedule to come to a review that might be sparsely attended; the option for submitting a question helped prevent this from happening.

Final Exam. NBME exams are wonderful. Really.

What I felt neutral about
Anatomy Practical. In Cardio and Pulmonary, the anatomy practicals weren't something I stressed myself over because they were straightforward and I knew how to study for them. But this year, we have new anatomy professors and a new style of practical exam. While I wasn't as disappointed with the GI practical as I was for the Renal one, I was still a bit perplexed by why one-third of the exam was histology. I understand that in medicine, integration is key and welcome some variety in questions, but in the past, histology was never more than a few questions or maybe ~10% of the exam. The sudden focus on histology really caught me off-guard. In the end, I can grow to appreciate the additional variety in questions, but I wish there was consistency in the exams so that once I've figured out the most appropriate way to study, I can stick to it. (This is the beauty of NBME exams, many if not most of us study from First Aid Organ Systems and consistently do well).

What could be improved
Physiology Podcast Assignment. In lieu of a normal physiology lecture, we created a Podcast lecture and a handout within our TBL groups covering a small topic. Our group's topic was the GI reflexes [e.g. gastro-colic] and their possible influence on diarrhea in irritable bowel syndrome (IBS). After creating a presentation and a handout, then recording it, each individual had to take a 10 question quiz on the material. Additionally, we were expected to provide feedback on other teams' work through an online forum.

I think that this assignment has enormous potential as a learning tool but that the way that it was executed this block, made it more of a burden than anything else. The making of the podcast took a pretty significant chunk of time, but it definitely hammered the material into our head. The quiz didn't really seem to correlate with the material presented in the podcasts, so it was frustrating to take. And it wasn't very clear as to how much feedback we were expected to provide through the online forums (i.e. did we have to comment on all 10 podcasts or just a few?).

Overall, I think that this activity/assignment could be a great learning tool but that it needed clearer expectations and the questions created directly from the material presented by each group.

Final thoughts
100% of the class passed in both the Renal and GI NBME final exams. I think this is a good sign.

Dr. Cappell and Dr. Harriott did a wonderful job with this block and I applaud them for their hard work and dedication to making it a success!

Amanda Xi, ACP Medical Student Member, is a first-year medical student at the OUWB School of Medicine, charter class of 2015, in Rochester, Mich. She has a Bachelor of Science in Engineering [Biomedical Engineering] and Master of Science in Engineering [Biomedical Engineering, again] from the University of Michigan. This post originally appeared at her blog, "And Thus, It Begins," which chronicles her journey through medical training from day 1 of medical school.