Assessment of toxicology knowledge in the fourth-year medical students: Three years of data

doi:10.5847/wjem.j.1920-8642.2018.03.005

Abstract

Abstract:

BACKGROUND: Pharmacology and toxicology are core content knowledge for physicians. Medical students should demonstrate understanding of general pharmacology and basic treatment of poisoning. The objective of this study was to measure the knowledge of the 4th-year medical students (MS4) on these topics over 3 years.
METHODS: A multiple-choice exam (15 questions) was administered to MS4 students in spring of 2010, 2011, and 2012. Questions were developed by medical toxicologists to evaluate basic knowledge in three areas: pharmacologic effects (PE), treatment of poisoning (TOP), and pharmacokinetics (PK). The students were grouped by intended specialties into pharmacologic intense (anesthesia, emergency medicine, internal medicine, pediatrics, and psychiatry), less pharmacologic intense specialties (dermatology, OB/GYN, ophthalmology, pathology, physical medicine and rehabilitation, radiology, and surgery) and by completion of a pharmacology or toxicology elective. Mean group scores were compared using ANOVA.
RESULTS: Totally 332 of 401 (83%) students completed the survey. Mean scores were stable over the three years, higher for students completing a toxicology rotation and for students entering a pharmacologically intense specialty.
CONCLUSION: The external validity is limited to a single medical school with incomplete participation and content was limited by the survey length. Consistent results over the three-year period and correlation of performance with completing a toxicology rotation and intent to enter a pharmacology intensive specialty suggest this survey may correlate with toxicology knowledge. Implementation of required core courses focused on toxicology may improve core content knowledge in fourth year medical students.

Key words: Medical student, Education, Toxicology, Knowledge

Jennie Buchanan, Daniel Windels, Jeffrey Druck, Kennon Heard. Assessment of toxicology knowledge in the fourth-year medical students: Three years of data[J]. World Journal of Emergency Medicine, 2018, 9(3): 191-194.

Figures/Tables 2

References 7

[1]	Golberg L. Broader aspects of clinical toxicology. Clin Toxicol. 1980; 16(3):365-70. doi: 10.3109/15563658008989960 pmid: 7398224
[2]	http://lcme.org/wp-content/uploads/filebase/standards/2016-17_Functions-and-Structure_2015-6-16.docx Accessed 05/17/2016
[3]	Counselman FL, Borenstein MA, Chisholm CD, Epter ML, Khandelwal S, Kraus CK, et al. EM Model Review Task Force, Keehbauch JN; American Board of Emergency Medicine. The 2013 Model of the Clinical Practice of Emergency Medicine. Acad Emerg Med. 2014; 21(5):574-98. doi: 10.1111/acem.12373 pmid: 24842511
[4]	Kim H, Heverling H, Cordeiro M, Vasquez V, Stolbach A. Internet training resulted in improved trainee performance in a simulated opioid-poisoned patient as measured by checklist. J Med Toxicol. 2016; 12(3):289-94. doi: 10.1007/s13181-016-0544-x pmid: 27037564
[5]	Thompson TM. Medical toxicology education in a world of limited resources. J Med Toxicol. 2015; 11(3):281-2. doi: 10.1007/s13181-015-0487-7 pmid: 26013747
[6]	Wong A, Vohra R, Ruha AM, Koutsogiannis Z, Graeme K, Dargan PI, et al. The Global Educational Toxicology Uniting Project (GETUP): an Analysis of the First Year of a Novel Toxicology Education Project. J Med Toxicol. 2015; 11(3):295-300. doi: 10.1007/s13181-015-0479-7 pmid: 25952764
[7]	World Health Organization. http://www.who.int/ipcs/poisons/en/ accessed 05/17/2016

Group	Number	Mean (SD) overall score	Mean (SD) PE score	Mean (SD) TOP score	Mean (SD) PK score
All students	332	10.0 (2.4)	3.1 (1.2)	3.5 (1.0)	3.4 (1.1)
Year 1: 2010	108	10.2 (2.2)	2.9 (1.1)	3.6 (1.0)	3.7 (1.0)
Year 2: 2011	116	9.9 (2.3)	3.1 (1.2)	3.4 (0.9)	3.3 (1.2)
Year 3: 2012	108	9.8 (2.7)	3.1 (1.2)	3.3 (1.1)	3.3 (1.1)
Pharmacology intense	216	10.3 (2.2)	3.2 (1.1)	3.5 (0.9)	3.5 (1.1)
Less pharmacology intense	95	9.4 (2.7)	2.8 (1.3)	3.3 (1.0)	3.3 (1.2)
Both	10	11.2 (1.8)	3.3 (1.3)	4.1 (0.7)	3.8 (1.0)
Toxicology	35	11.6 (2.0)	3.7 (1.2)	4.0 (0.9)	3.9 (0.9)
Clinical pharmacology	86	10.1 (1.9)	3.0 (1.2)	3.5 (0.9)	3.5 (0.9)
Neither	201	9.6 (2.5)	3.0 (1.1)	3.3 (1.0)	3.3 (1.2)

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