A poll of academic leaders in laboratory medicine unveiled a number of barriers that might impede the ability of the laboratory medicine programs to thrive in U.S. medical schools. The study’s results were published in Academic Medicine, the journal of the Association of American Medical Colleges (AAMC).
Medical schools over the last 20 years have stepped up their requirements on laboratory medicine course work. Yet, “the effectiveness of these courses to train physicians to practice efficient and safe diagnostic testing and ultimately serve the public remains uncertain,” the study’s authors concluded.
They made this assessment after surveying deans, department chairs or undergraduate education directors at 131 medical schools. The study’s participants were queried about the current status of laboratory medicine curriculums, and what barriers the programs might be facing.
Of the 98 schools that provided responses, 84% said they offered courses in lab medicine, with nearly 80% requiring this type of coursework. However, fewer than half of the responding schools said they conducted ongoing formal reviews of the curriculum for lab medicine, and just eight mandated that training took place in a clinical environment. Very few of these schools did assessments on student competency, and overall, there seemed to be knowledge gaps among both residents and attending physicians on laboratory medicine practices.
“If a national assessment of knowledge (competency) could be implemented, educators could determine whether the current level of instruction is in fact accomplishing its goal. Moreover, such a tool would allow individual medical schools to adjust their curricula in a targeted fashion to ensure that students receive appropriate instruction,” the study’s authors recommended.
Less-than-adequate time devoted to laboratory medicine and a lack of student interest in the discipline were other disconcerting findings. Respondents reported that there was not enough time to teach lab medicine in either the preclinical curriculum (88%) or clinical curriculum (86%).
More than 60% of respondents cited student disinterest as a major impediment to lab medicine education. The study’s authors hypothesized that students might not be getting the message from faculty that laboratory medicine plays a significant, hands-on role in modern medicine.
“The critical role of the laboratory in therapeutic decision making has been documented for several decades, and thus it is disappointing that respondents described students as showing tepid interest in the topic,” the authors wrote.
Strengthening physician education, as well as creating faculty development plans for teaching this discipline as a way to help resolve student apathy and gaps in knowledge among residents, fellows and attending doctors, serve as potential remedies.
“Improvements in physicians’ education in laboratory medicine, in concert with the implementation of a team-based practice in which the pathologist serves as a consultant, should help effect a change in the attitudes and practice of physicians at all levels,” the authors recommended.