A CASE-BASED EMERGENCY-MEDICINE CURRICULUM FOR SENIOR MEDICAL-STUDENTS

Objective: To determine the effects of a case-based, core content-orie nted emergency medicine (EM) curriculum on the basic EM knowledge of s enior medical students. Methods: All senior medical students rotating through the Milwaukee County EM elective during the 1992-1993 academic year were assigned specific chapter readings from a case-oriented EM textbook. A course curriculum consisting of goals and objectives for e ach chapter and two to three representative cases for the discussion t opic also was distributed to each student. Interspersed with the cases was a series of questions directed at pathophysiology, diagnosis, man agement, and disposition. The EM faculty and residents conducted case discussions three times per week. All students completing the rotation were given a pretest at the beginning and a final examination at the end of the rotation. In addition, the students rated the textbook,. co ursebook, and lecture series at the end of the rotation using a five-p oint Likert scale. Results: Seventy-five students rotated through the elective. The students showed a significant improvement in their EM kn owledge base as judged by improvement in final examination scores comp ared with pretest scores (pretest score 62.2 +/- 7.1%; final examinati on score 76.2 +/- 6.3%; p < 0.0001). The mean change in scores was 14. 8%, with a range of -1.6% to 34%. The students also rated the textbook , coursebook, and lecture series as effective, as shown by high median scores on a Likert scale. Conclusions: A case-based EM curriculum cou pled with ED clinical experience improves basic EM diagnostic and mana gement knowledge of senior medical students.