Medical Science Educator

, Volume 21, Issue 2, pp 181–189 | Cite as

Evolution of Student Assessment Following Implementation of an Integrated Medical Curriculum: Contribution to Improved Educational Outcomes

  • Gregory K. Asimakis
  • Michael A. Ainsworth
  • Judith F. Aronson
  • Ann W. Frye
  • Steven A. Lieberman
  • Jeffrey P. Rabek


This paper describes the stimuli and rationale for and the nature of assessment changes implemented after embarking on a new student-centered, problem-based learning curriculum. In 1998, the University of Texas Medical Branch implemented the Integrated Medical Curriculum (IMC), a problem-based curriculum with sequential, interdepartmental, clinically relevant basic science courses and a concurrent Practice of Medicine course. The IMC’s aim was to improve educational quality by emphasizing knowledge application over rote memorization, student-directed learning, problem-solving skills development, basic science and clinical concepts integration, early acquisition of clinical skills, and professional teamwork. During the initial years of the IMC, students’ learning outcomes did not improve over those of the former curriculum because, in part, we did not initially modify student assessment (a driving force for student study habits) to align with the new curricular goals and philosophies. We subsequently took several steps to modify our assessment practices in order to improve student learning and understanding. These steps included (1) increasing the number and quality of higher -order exam questions, (2) sequestering examinations, (3) increasing the number of practice exam items in each course, (4) and emphasizing in-depth discussion in problem-based learning sessions by introducing small-group quiz exercises. Following the assessment modifications, our students’ USMLE Step 1 scores and our pass rate for first-time test takers rose from being consistently below the national Step 1 average to above the national average. This improvement has been sustained for the past seven years. We believe that implementing those assessment modifications within the framework of the newly devised student-centered, problem-based curriculum in an interdepartmental environment resulted in a critical mass of “local” changes. The changes, initiated and supported by students, faculty and administration, catalyzed, produced and sustained more “global” changes that improved students’ learning, thus better preparing them for the USMLE Step 1 examination.


Student assessment integrated curriculum educational outcome 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Muller, S. Physicians for the twenty-first century: report of the project panel on the general and professional education of the physician and college preparation for medicine. Journal of Medical Education. 1984; 59: 1–208.Google Scholar
  2. 2.
    Christakis, N. The similarity and frequency of proposals to reform US medical education. Journal of the American Medical Association. 1995; 274: 706–711.CrossRefGoogle Scholar
  3. 3.
    Cooke, M, Irby, D, Sullivan, W, Ludmerer, K. American medical education 100 years after the Flexner report. New England journal of Medicine. 2006; 355(13): 1339–1344.CrossRefGoogle Scholar
  4. 4.
    Donner, RS, Bickley H. Problem-based learning in American medical education: an overview. Bull Med Libr Asso. 1993; 81(3): 294–298.Google Scholar
  5. 5.
    Colliver, J. Effectiveness of problem-based learning curricula: research and theory. Academic Medicine. 2000; 75: 259–266.CrossRefGoogle Scholar
  6. 6.
    Distlehorst, LH, Dawson, E, Robbs RS, Barrows HS. Problem-based learning outcomes: the glass half-full. Acad. Med. 2005; 80: 294–299.CrossRefGoogle Scholar
  7. 7.
    Way, D, Biagi, B, Clausen, K, Hudson, A. The effects of basic science pathway on USMLE Step 1 scores. Academic Medicine. 1999;74: S7–S9.CrossRefGoogle Scholar
  8. 8.
    Muijtjens, AMM, Hoogenboom, RJI, Verwijnen, GM, van der Vleuten, CPM. Relative or absolute standards in assessing medical knowledge Using Progress Tests. Advances in Health Sciences Education. 1998; 3: 81–87.CrossRefGoogle Scholar
  9. 9.
    Swanson, D, Case, S. Assessment in basic science instruction: directions for practice and research. Advances in Health Sciences Education. 1997; 2: 71–84.CrossRefGoogle Scholar
  10. 10.
    Lieberman, S, Ainsworth, MA, Asimakis, G K, Thomas, L, Cain, LD, Mancuso, MG, et al. Effects of comprehensive educational reforms on academic success in a diverse student body. Medical Education. 2010; 44: 1232–1240.CrossRefGoogle Scholar
  11. 11.
    Kiera, K. Providing the instructor’s notes: An effective addition to student notetaking. Journal of Educational Psychology. 1985; 20: 33–39.Google Scholar
  12. 12.
    Potts, B. Improving the Quality of Student Notes. Practical Assessment, Research and Evaluation. 1993; 3(8): 1–5.Google Scholar
  13. 13.
    Cortright, RN, Collins, H L, Rodenbaugh, D W, DiCarlo, SE. Student retention of course content is improved by collaborative-group testing. Advances in Physiology Education.2003; 27(3): 102–08.CrossRefGoogle Scholar
  14. 14.
    Hodges, LC. Group Exams in Science Courses. New Directions for Teaching and Learning. 2004; 100: 89–93.CrossRefGoogle Scholar
  15. 15.
    Jensen, M S. Cooperative quizzes in the anatomy and physiology laboratory: a description and evaluation. Advances in Physiology Education. 1996; S48-S54.Google Scholar
  16. 16.
    Wallach, P, Crespo, L, Holtzman, K, Galbraith, R, Swanson, D. Use of a committee review process to improve the quality of course examinations. Advances in Health Sciences Education. 2006; 11: 61–68.CrossRefGoogle Scholar
  17. 17.
    Wenger, SL, Hobbs, GR, Williams, HJ, Hays, MA, Ducatman, BS. Medical student study habits: practice questions help exam scores. Journal of the International Association of Medical Science Educators. 2009; 19(4): 170–172.Google Scholar
  18. 18.
    Ericson, KA, Krampe, RT, Tesch-Romer, C. The role of deliberate practice in the acquisition of expert performance. Psychological Review. 1993; 100(3): 363–406.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing 2011

Authors and Affiliations

  • Gregory K. Asimakis
    • 1
  • Michael A. Ainsworth
    • 1
  • Judith F. Aronson
    • 1
  • Ann W. Frye
    • 1
  • Steven A. Lieberman
    • 1
  • Jeffrey P. Rabek
    • 1
  1. 1.Instruction Management OfficeThe University of Texas Medical BranchGalvestonUSA

Personalised recommendations