Evaluating the Success of a Medical School: The Beer-Sheva Experiment

Abstract

The community-oriented curriculum of Ben Gurion University (BGU) Faculty of Health Sciences, opened in 1974, was evaluated to determine whether it reached the following three major goals: to use quality educational methods, including student participation; to educate humanistic and community-oriented primary care physicians. Curricular process or outcome measures were used to evaluate each of the three major goals, e.g. debriefings evaluated how well early clinical reaching, a quality educational method, was being done; external clinical evaluation using standard criteria determined whether senior students or graduates' achieved acceptable clinical performance. Process measures at every stage of the curriculum included debriefings of all nonclinical and clinical courses, in nonclinical courses, objective examinations were used to evaluate knowledge, including problem-solving, and nontraditional methods were used in some courses to evaluate specific activities (e.g. writing scientific meeting-style poster presentations was used to evaluate achievement in immunology.(1) All major clinical activities were evaluated ruing oral, written and supervisor rating techniques. This report presents data from the following curricular outcome measures: performance an international (ECFMG) and national knowledge examinations; performance an an experimental, standardized rob playing patient examinations; subjective evaluation of BGU graduates by department chairmen from other hospitals; subjective evaluation of the curriculum by BGU graduates from cohorts 2 (1981), 6 and 10; percentage of graduates intending to work ion primary care, percentage choosing primary care residencies, and percentage staying in Beersheave. We conclude that two of BGU's major goals, using quality educational methods to produce competent and humane physicians, were achieved. However, in spite of learning successfully in a community-oriented primary care curriculum. as demonstrated by performance on various process measures, the percentage of students choosing to well in primary care is no different from that at other Israeli universities. This may be due to lack of quality in primary care teaching or role models, but the overall data fr om debriefings and primary care and community medicine examinations do not support this. A more likely explanation is that the faculty assumed unrealistically that it had sufficient control over the services to assure career choice, which was not primarily dependent on curricular content, brit rather, as has been observed repeatedly in other settings, an motivating factors in the health care services.