Curricular trends in instruction of pathology: A nationwide longitudinal study from 1993 to present

Medical schools throughout the United States continue to respond to various external and internal challenges and make modifications in their curricula . Responses obtained from 66% (n = 83) of schools on a longitudinal survey conducted during the year 2000 to stud-v trends in instruction of pathology over a 7-year period (ie, for classes entering 1993 to 1999) indicate the following. There have been steady shifts in instruction of systemic and cli nical pathology from discipline-based courses to integrated formats from 19 93 to 1999. The degree of integration with other disciplines varies among s chools, and may take one or more of die following formats: joint course (pa thology and another discipline); multidisciplinary systems course; a combin ation of pathology course and another integrated course; and completely int egrated in the form of problem-based or case-based small group discussion. Presently, at least some degree of integration occurs in 51% of schools for instruction of systemic pathology and 65% for clinical pathology, up from 31% and 48%, respectively, in 1993. Although there has been an increased tr end toward integration in instruction of general pathology as well, it is s tiff taught predominantly in a discipline-based manner in the vast majority of schools. Although often difficult to identify with certainty, the best estimates indicate that the overall scheduled length of pathology instructi on time has stabilized over the years; the mean total for the entering clas ses of 1999 was 196 hours versus 201 hours for the classes entering in 1993 . However, internal rearrangements of time for various components of delive ry of instruction continue. The lecture remains unchanged as an important m ode comprising the largest component of pathology curriculum time (53% in 1 999, 52.2% in 1993) during the 7-year period examined. The mean traditional laboratory instruction time has decreased slightly from 27% in 1993 to 24% in 1999. This decrease may be accounted for by a shift toward use of labor atory materials in various other formats and venues not included in the tra ditional laboratory instruction (eg, small group sessions, clinicopathologi c correlation conferences, study of kodachrome slides, and computer program s). The use of electronic educational resources has increased remarkably, b ut for the most part it is not measurable because of the lack of any design ated hours. Because pathology instruction occurs exclusively or primarily d uring year 2 in most schools, the classes entering in 1999 would have studi ed it during 2000 and 2001, which means the present study provides the most updated curricular trends at this time. Hum PATHOL 32:1147-1153. Copyright (C) 2001 by W.B. Saunders Company.