EVMS Physiology sign now

The purpose of this petition is for the medical students to address concerns regarding the M1 Medical Physiology Course. We think that both the format and the content of the Physiology exams have strayed from their originally intended functions and should be reconstructed. This issue, while significant in its own right, is compounded by the somewhat cumbersome syllabus and lecture format. While we understand that overhauling an entire class is a large thing to ask, we also feel very strongly that the tests need to be changed in fundamental ways. Please appreciate that we are not trying to make the class easier, or trying to receive higher grades. We simply desire a Physiology class that is up to par with the rest of the curriculum at EVMS and that will best prepare students for their future.

In order to understand what has happened and how it can be fixed, some history needs to be revisited first. At least ten years ago (though it could be closer to 15), members of the Physiology Department came up with a conserved bank of questions for every subject test. The final was simply a mixture of questions from each section. Every year since, a percentage of those questions have been randomly selected from the banks and used to create tests. As the tests themselves are accessible to the students, each year the questions were tweaked slightly from their original form to prevent students from simply memorizing identical exams. The question banks are still in use today. Over time, the constant reformatting and reuse of the same test questions has caused three things to happen.

First, the wording of the questions has become convoluted. Looking back at the old tests, one can easily see how once solid questions have become altered. Like a game of telephone, it has become progressively more difficult to understand their intended meaning. What was originally a simple true- false test, as it was in 1994, switched to a true-false/multiple choice hybrid (ex: which of the following choices are true), and is now in its current iteration (ex: All of the following are false except with the correct answer C: X doesnt happen). As it stands, students who know the physiology may perform poorly because they simply cannot understand whats being asked. We feel that a switch to more board style questions would make the exam scores more indicative of each students knowledge.

Second, students have begun to ask whether the content of questions still tests important topics in medical physiology and whether the class is fully preparing us for USMLE Step I. Many students feel that we were asked esoteric details instead of questions that test the knowledge of the human body in a clinically relevant way. The students believe that the content of the questions should focus on the structure and function of the human body, with an emphasis on clinically relevant material.

Third, after Physiology begins in October, students soon learn that test questions are reused, and the questions themselves are difficult to understand. This forces us to spend precious studying time poring over old tests to the detriment of learning actual physiology that will eventually be relevant in treating future patients. The result of being tested, and thus forced to learn in this way, may be passing Physiology without the knowledge and tools necessary to be competitive for USMLE Step I.

We are proposing a few solutions to improve upon the current paradigm. These are just a handful of possibilities; a meeting between the faculty, administration, and curriculum committee is bound to result in additional options.

1) One solution is to simply rewrite the test questions entirely in order for them to be more relevant and easily understood. This objective can be accomplished by forming a joint student/faculty committee to determine which topics are important with regard to USMLE Step I and develop appropriate questions.
2) We could require each student enrolled in Physiology to write a handful of practice questions for the exam and submit them a few days beforehand to the class and professors. Any questions the professors like would be added to the exam (10-20\%), and submission of the questions in itself could be worth a few percentage points. This active learning activity was employed in Medical Neuroscience this year, and worked out well. The professor wouldnt even have to handle sorting the questions directly. Medical masters who pass out of Physiology could be charged with the responsibility to help organize the tests, similar to the way that medical masters who pass out of Histology aid Dr. Scoville in the lab as TAs.
3) If the Physiology Department prefers to keep the current test questions, we can help go through them and supplement or eliminate as needed. The remaining questions would simply need to be cleaned up. There are groups of students more than willing to donate their time in support of this endeavor.

We hope that improvements are made soon, regardless of whether one of options above is used or the course is changed in another way that has not yet been suggested. Future medical school classes should complete Medical Physiology feeling prepared for Pathophysiology and USMLE Step I, and should not feel as though their medical education has been shorted.

There is one final point. While the students are frustrated by many aspects of the Physiology Course, credit should be given where credit is due. The renal, endocrine, and reproduction sections are strong. The test questions are clear and the lectures meaningful. Furthermore, the lectures are organized within the syllabus in a way that is easily understood and digestible. In addition, Dr. Meyer told us at the beginning of the year that the Physiology Department would try to generate more board style questions, and there have been improvements to the question quality from previous years. For that, we thank him. It is encouraging to know that the members of the Physiology Department understand that there are issues and are willing to work to fix them. We want to help.

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Nathan WadeBy:
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