Ideas that matter

Qstream Helps Innovate Surgery Clerkship for Third Year Medical Students, Improving Final Test Scores for Participants

As we’ve discussed in the past, universities and medical schools are forever looking for new ways to innovate their curriculum, moving beyond traditional, lecture-focused teaching methods while also extending learning beyond the classroom.

Recently, I had the pleasure of speaking with the surgery clerkship director of a medical university in Arkansas who has done just that in order to keep up with a new generation of connected students entering the healthcare field. This particular university boasts over 10,000 employees, 2,834 students, 822 medical residents and 1,200 physicians who provide care to patients throughout the state. It offers 73 baccalaureate, master’s, doctoral, professional and specialist degree programs and certificates through the Colleges of Medicine, Nursing, Pharmacy, Health Professions, Public Health and graduate school.

As part of their program, third year medical students complete rotations in each department in order to gain exposure to the various disciplines. The surgery clerkship director oversees the student body in small groups of 25 students throughout the eight-week surgery rotation.

Throughout the rotation, med students are bombarded with critical information they must put to use in a clinical setting, often long after it has been presented. So, how can the teaching faculty ensure it will stick? The clerkship director explained that they rely on various methods to assess whether or not the students are learning the required skills and basic principles of surgery, which they will be tested on as part of their licensing exam.

Traditionally, this included quizzes from the text book and oral exams, but professors are always looking for ways to improve. To innovate his program, the clerkship director and his colleague set out to create a mobile app of their own, and in their research discovered Qstream. Developed at Harvard Medical School to combat the “forgetting curve”, Qstream’s approach has been validated in more than 20 randomized trials to boost retention by up to 170% and durably change practice patterns.

Happy to find a solution, they worked to implement Qstream into the surgery clerkship. It is important to recognize that the key to initiating a successful Qstream program is building quality content. Surgery faculty and residents wrote questions that simulate content the students could expect to see on their final exam written by the National Board of Medical Examiners. Using concepts commonly taught and tested on during this exam, the faculty team wrote 140 questions focusing on trauma, general surgery, thoracic surgery, etc. and rolled it out to students as an optional method of reinforcing skills and core knowledge during the clerkship.

Using Qstream, brief scenario-based challenges are delivered over spaced intervals of time to ensure that students’ skills are progressively strengthened. After a specific scenario is answered correctly twice, it is retired and points are awarded in a game-based competition. Real-time feedback lets users immediately know if their answer selection is correct, followed by rich-media explanations and social collaboration tools that make learning stick.

While Qstream was met with skepticism by some at first, the surgery clerkship director explained that the students were impressed by the convenience and non-disruptive nature of the app. Instead of having to use a desktop computer, students had the flexibility to answer questions on their smartphone. The director further described how Qstream’s mobile-first solution lends itself quite well to surgery, in fact, where you get small snipits of free time throughout your day. Imagine the minutes typically wasted in between lectures, while waiting for a patient to wake up from anesthesia in the operating room, or while a nurse gets your patient roomed. These brief periods are the perfect amount of time to pull out your smartphone and answer a few Qstream questions, reinforcing concepts learned throughout the day.

As it turns out, Qstream was a game changer for the surgery clerkship. The director noted that when compared, students who participated in Qstream scored better on their final exam vs. those who didn’t participate. More precisely, data from all comers shows that students who were enrolled in Qstream scored an average of 77.5% on their final exam vs. those not using Qstream who scored an average of 68.8%.

After conclusive results showed meaningful improvement in student test scores, Qstream became a mandatory part of the clerkship for all students.

Students also provided their seal of approval when giving feedback on the clerkship itself. The director mentioned that students are quite eager to try anything that will help them improve their test scores. When asked to evaluate the program, the student body has consistently requested to continue using Qstream as part of the clerkship. It’s also worth mentioning that surgery is the only clerkship on campus that uses Qstream at this university, which makes it stand out among the other programs.

Want to learn more about ways to innovate your medical education program? Read additional success stories here or contact Mary Hallice.