Updating and Improving the Capstone Course Experience for Learners and Teachers

Abstract

Background:The Capstone Scholarship and Discovery Course (“Capstone course”) is a required four-year course which aims to support students in the design, execution, writing, and presentation of a longitudinal scholarly project. Currently, the Capstone course meets criteria for “underperforming” designation (<75% approval) designationin two areas: Overall, how would you rate this course? | 2.52/4 | 52.77% Feedback on reports supported progress/learning | 2.95/4 | 74.07% The overall medical school curriculum is transitioning to a new curriculum (“Vista”) in which Capstone will fit into the context of student-selected Pathways. As the Capstone student representative responsible for communicating student feedback to Capstone leadership, I became interested in taking advantage of this opportunity to improve the course. I believe that every medical student should feel supported in their Capstone research and finish medical school with a foundational understanding of how to conduct longitudinal scholarly work. Objectives: 1) Identify student and faculty concerns about the Capstone course 2) Propose potential changes to the Capstone course to address the most significant concerns 3) Measure student approval towards these proposed changes 4) Summarize and present the most highly student-approved proposed changes to Capstone Course Leadership Team. Methods: I reviewed all Capstone oasis evaluations from the 2020 – 2021 Academic Year, which included 109 faculty evaluations of students, 133 student evaluations of Capstone faculty (~80% response rate), and 136 student evaluations of the Capstone course (~81% response rate). I also created a pre-survey to assess the most unclear aspects of the Capstone course as well as top barriers to meeting deadlines. I received 44 survey responses from third-year students (~22% response rate) and 47 responses from fourth-year students (~30% response rate). From the oasis evaluations and survey responses, I identified the most significant concerns. I generated twenty-two proposed changes to address these concerns, and created a slideshow that summarizes these proposed changes to the Capstone course. This was distributed to current third- and fourth-year medical students, along with a post-survey where students could vote on the proposed changes and indicate whether these changes addressed the unclear aspects of the Capstone course and top barriers to meeting deadlines. (Terminology note: learning community assigned affiliate = “affiliate”, faculty advisor specific to project = “advisor”). Results: I received 29 post-survey responses from third-year students (~15% response rate) and 37 responses from fourth-year students (~23% response rate). Between the pre- and post-surveys, the average % of students finding certain aspects of Capstone “unclear” decreased by 26.1%, and the average % of students rating certain barriers as significant for meeting Capstone deadlines decreased by 15.5%. Notably, the post-survey found that some students believe the proposed changes would not address their lack of interest in doing a longitudinal project (53.1%), and that certain projects students are interested in would still not meet Capstone requirements (31.3%). An abbreviated summary of the most popular proposed changes (>50% of students agree, and/or >10% of students indicated it as one of their top three changes, highlighted in bold) is below. Proposed Solution | % top 3 | % disagree | % neutral | % agree 1a) Create research project database | 30.4 | 3.1 | 12.3 | 84.6 1b) Create roster of past highly-rated advisors (based on oasis evals) | 7.1 | 4.6 | 24.6 | 70.8 1d) MS1 Capstone curriculum focused on developing research skills | 23.2 | 9.2 | 18.5 | 72.3 1e) Affiliate must give feedback on project feasibility as a Capstone project within a month of project proposal. | 5.4 | 6.2 | 32.3 | 61.5 2a) Add additional, optional Capstone poster presentation session before ERAS deadline so presentation can be on ERAS app | 10.7 | 6.2 | 24.6 | 69.2 2b) Optional workshops (or asynchronous videos) on common issues | 5.4 | 15.4 | 32.3 | 52.3 3a) In place of report submissions, create a live document that can be accessed by affiliate and mentor | 16.1 | 10.8 | 26.2 | 63.1 3b) Flexible format (such as Senior Scholars format: background, objectives, methods, results, conclusion) with no length requirement | 21.4 | 1.5 | 12.3 | 86.2 3c) Rework deadlines to avoid exam dates, Step 1 period, holidays, and flexible range of deadlines provided during clinical rotations | 33.9 | 0 | 3.1 | 96.9 3d) Timeline of deadlines given to affiliates and mentors, with exam dates and Step 1 period marked on timeline | 5.4 | 1.6 | 15.6 | 82.8 3e) No punishment for those who get their work done early | 23.2 | 0 | 4.7 | 95.3 3f) Meeting with affiliate can substitute for an update with affiliate approval | 1.8 | 4.7 | 25 | 70.3 4a) Projects that take place over >1 month should be accepted as “longitudinal” and all affiliates should be on the same page. | 42.9 | 1.5 | 16.9 | 81.5 5a) Students may submit outside project to their affiliate to be approved for Capstone credit as long as they worked on this project during med school | 44.6 | 1.5 | 10.8 | 87.7 5c) Website should be simplified. | 7.1 | 0 | 21.9 | 78.1 Conclusion: Students enter medical school with widely differing levels of experience in conducting scholarly research, and the current Capstone course does not have flexibility for different types of projects, or the resources needed to accommodate student needs. Capstone affiliates and advisors also face difficulties providing optimal assistance to students. Through this work, I have identified solutions that are popular amongst students, which address unclear aspects of the Capstone course and top barriers to meeting deadlines. Bringing these solutions to the Capstone Course Leadership Team is the next step to addressing these concerns. Future goals include asking Capstone affiliates for their input, as this group was not included either in the oasis evaluations or the surveys. Another limitation of this study was the low survey response rates, ranging from 15-30%. I hope that ultimately some of these proposed changes to the Capstone course will be adopted and integrated into the new Vista curriculum.