Written Examinations in Swedish Medical Schools: Minds Molded to Medicate?

Q: What are the key findings of this study?

In written examinations, pharmacology-related knowledge was valued significantly higher than lifestyle medicine knowledge, by multiples ranging from 2.4 for COPD to 31.5 for stroke.

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Medical Education (Noncommunicable Diseases) (n=124). Intervention: Questions concerning noncommunicable diseases. Primary outcome: Ratio of attainable points for pharmacology-related knowledge compared to lifestyle medicine knowledge.

Benno Krachler; Lars Jerdén; Christina Lindén

doi:10.1177/1559827617724338

August 18, 2017American Journal of Lifestyle MedicineOpen Access

Written Examinations in Swedish Medical Schools: Minds Molded to Medicate?

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Key result

Medical exams weight pharmacology knowledge up to ~32-fold higher than lifestyle medicine.

n=124

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Why the study?

Does Swedish medical school examination content value pharmacology-related knowledge more highly than lifestyle medicine knowledge for noncommunicable diseases?

Key Points

To evaluate whether lifestyle medicine knowledge is tested on equal terms with pharmacology-related knowledge for noncommunicable diseases in medical school written examinations.
Analyzed 124 written examinations from clinical courses in internal medicine across Swedish medical schools between fall 2012 and fall 2015.
Categorized exam points for 5 noncommunicable diseases (diabetes, hypertension, coronary heart disease, chronic obstructive pulmonary disease, and stroke) into lifestyle-related, pharmacology-related, and other knowledge.
Evaluated differences between attainable points using the sign test in SAS.
Lifestyle medicine knowledge yielded between 2% and 10% of total points, compared with 24% to 50% for pharmacology-related knowledge.
Pharmacology-related knowledge was weighted significantly higher than lifestyle medicine for stroke (quota 31.5, P < .0001), coronary heart disease (quota 5.2, P < .0001), hypertension (quota 4.8, P < .0001), diabetes (quota 4.3, P < .0001), and chronic obstructive pulmonary disease (quota 2.4, P < .056).

Study Design

Type

Cross-Sectional (n=124)

Multicenter

Yes

Structured PICO

Does Swedish medical school examination content value pharmacology-related knowledge more highly than lifestyle medicine knowledge for noncommunicable diseases?

P

Population

124 written internal medicine examinations from Swedish medical schools were analyzed to evaluate the emphasis on lifestyle medicine versus pharmacology for major noncommunicable diseases.

E

Exposure

Pharmacology-related examination questions

C

Comparator

Lifestyle medicine examination questions

O

Outcome

Proportion and multiplier of attainable points for pharmacology-related knowledge versus lifestyle medicine knowledge

Despite official educational goals, Swedish medical school written examinations heavily underrepresent lifestyle medicine compared to pharmacology when testing knowledge of noncommunicable diseases.

Limitations

Only covered examinations from terms that teach internal medicine, excluding other clinical terms
Did not investigate practical or oral examinations
Some universities examine primary care knowledge on different occasions, which could have inflated the bias
Only covered internal medicine examinations
Did not include practical or oral examinations

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Implication

Medical school exams may undervalue lifestyle medicine training in NCDs; leaves open whether realigning assessments would improve prevention competencies.

Abstract

Lifestyle medicine (LM) is part of official educational goals in Swedish medical schools. We studied questions concerning 5 noncommunicable diseases: diabetes, hypertension, coronary heart disease (CHD), chronic obstructive pulmonary disease (COPD), and stroke from 124 written examinations conducted between 2012 and 2015. LM knowledge yielded between 2% and 10%, whereas pharmacology-related knowledge yielded between 24% and 50%, of total points. The multiples at which pharmacology-related knowledge was valued higher than LM knowledge were 2.4 for COPD (P < .056), 4.3 for diabetes (P < .0001), 4.8 for hypertension (P < .0001), 5.2 for CHD (P < .0001), and 31.5 for stroke (P < .0001). Our results indicate that lifestyle-related knowledge, though covered by official teaching goals, is currently underrated in Swedish medical education.

Discussion

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Cite This Study

Krachler et al. (2017) conducted a cross-sectional in Medical Education (Noncommunicable Diseases) (n=124). Questions concerning noncommunicable diseases was evaluated on Ratio of attainable points for pharmacology-related knowledge compared to lifestyle medicine knowledge. In written examinations, pharmacology-related knowledge was valued significantly higher than lifestyle medicine knowledge, by multiples ranging from 2.4 for COPD to 31.5 for stroke.

synapsesocial.com/papers/6a2119c56bd086c0991e4c8f https://doi.org/10.1177/1559827617724338

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Written Examinations in Swedish Medical Schools: Minds Molded to Medicate?

Figures

Key Points

Study Design

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Written Examinations in Swedish Medical Schools: Minds Molded to Medicate?

Figures

Key Points

Study Design

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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