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Successful implementation of a longitudinal, integrated pathology curriculum during the third year of medical school.

For clinicians in virtually every specialty, the care of patients depends upon the accurate interpretation of laboratory tests as well as biopsy and surgical specimens. As such, medical school curricula must ensure that students become well-rounded physicians with knowledge of and appreciation for the role of the pathologist in patient care. Unfortunately, there are few examples of the successful integration of pathology teaching, both anatomic pathology and laboratory medicine, in the clinical years of medical school. In the United States, a recent report from the Centers for Disease Control and Prevention concluded that current medical student training in laboratory medicine is "inadequate" and "despite the integral role of laboratory testing in the practice of medicine, formal teaching of laboratory medicine is a relatively neglected component of the medical school curriculum." (1)

During the preclinical years of US medical training, almost all medical schools have some form of a pathology curriculum. The teaching, however, varies significantly from a stand-alone course to fully integrated organ system-focused curricula that include problem-based materials. (2) Yet, there is limited outcomes research in pathology undergraduate education, with a recent review suggesting that the focus has been directed toward teaching methods and time spent in pathology courses rather than actual learning. (3) In addition, there is evidence that medical students incorrectly believe the television-promoted stereotypic view of the pathologist as primarily involved in forensics, and not as an active participant in patient care through interpretation of surgical and biopsy specimens, integrated roles on clinical services including blood banking or apheresis, and clinical laboratory oversight and result interpretation. In one study, even after a preclinical pathology course, students believed that a pathologist only spends approximately 60% of his/her time with specimens from living patients. (4)

The third and fourth years of medical school should be ideal for linking the pathology learned in the preclinical courses to patient care as well as for promoting better understanding of pathology as a profession. While students may attend conferences, such as mortality and morbidity sessions or tumor boards in which pathologists present results, these are geared toward the resident or attending level and focus primarily on anatomic pathology. While fourth-year electives in pathology exist at most medical schools, at our institution only a small percentage of medical students typically participate in these rotations. In addition, specimens observed during these electives are not typically integrated into the other aspects of patient care (eg, seeing the patient in the ward or clinic). Despite a published medical school clinical pathology curriculum, there is limited evidence for programmatic attempts to incorporate pathology teaching into the third- and fourth-year clinical clerkships and even less evidence for determining the educational success of these programs. (1,5)

Longitudinal clerkships and curricula provide continuity across third-year medical school rotations through courses, conferences, and mentoring. In comparison with a traditional structure, a year-long longitudinal curriculum at our institution led to similar clinical aptitude with a greater appreciation of patient-centered care. (6) Curricula such as ours also offer the opportunity to incorporate areas not typically included in third-year medical student training or that span more than one clinical or departmental area, such as nutrition, geriatrics, ethics, and pathology. In this article, we report our initial experience with incorporating pathology teaching into a third-year longitudinal clerkship.


Study Population

Students at Harvard Medical School (Boston, Massachusetts) are assigned to complete all their third-year rotations at a single main institution (Beth Israel Deaconess Medical Center, Brigham and Women's Hospital, Massachusetts General Hospital [all in Boston, Massachusetts] or Cambridge Hospital [Cambridge, Massachusetts]) through a course entitled "Principal Clinical Experience" (PCE). Student preference combined with a lottery system is used to determine student assignment. At our institution, students rotate through radiology (4 weeks), obstetrics-gynecology (6 weeks), medicine (12 weeks), surgery (12 weeks), neurology (4 weeks), and psychiatry (4 weeks). A 6-week rotation at pediatrics is completed at Children's Hospital Boston (Boston, Massachusetts). This study included students doing their PCE year at our hospital for the 2009-2010 academic year and was approved for exempt status by the Harvard Medical School Office of Research Subject Protection.

Planning the Curriculum

The PCE course at our hospital incorporates all the third-year medical student core clerkships (mentioned above) as well as a longitudinal curriculum to complement these clerkships. (6) This longitudinal curriculum includes a transition course of practical hands-on training in a simulation center and introductory lectures focused on the management of common medical emergencies, clinical radiology, and available educational resources; an 8-month ambulatory continuity clinic experience; bimonthly case conferences; a longitudinal course focusing on humanism in medicine; and longitudinal mentoring relationships with assigned faculty. There are also opportunities for year-long electives that meet once every 4 to 6 weeks. Current offerings include a writing workshop, longitudinal patient experiences in a variety of specialties, bedside diagnosis, advanced simulation training, basic science-clinical medicine correlation conferences, and a pathology elective (described below). (7,8)

Although the initial PCE curriculum guide included "understanding principles of laboratory diagnosis and clinical pathology" as a teaching objective, no specific curricular components had been designed to achieve this goal. To remedy this problem, course leadership and faculty designed a pathology curriculum that was integrated into the other PCE course elements.

Pathology Curriculum Components

Transition Course.--At the end of this component of the curriculum, students are expected to be able to:

1. Describe the role of both anatomic and clinical pathologists in patient care.

2. List the testing performed by the different pathology laboratories.

3. List the available hospital resources for understanding pathology testing.

4. Identify the locations of the various pathology laboratories.

5. Describe pathology residency training pathways.

The transition course now includes a 60-minute session designed to familiarize the students with pathology and laboratory medicine at our hospital. Twenty minutes are allocated to describe the roles of anatomic and clinical pathologists in patient care (including testing performed by the different laboratories); familiarize students with mechanisms to contact hospital pathologists; detail the pathology resources available to students, such as the online laboratory manual; and describe pathology residency training pathways. This part of the session is led by one of the authors and the pathology chief residents. The chief residents then lead the students on a guided tour of the anatomic and clinical pathology areas of the hospital.

Case Conferences

This portion of the curriculum is designed to enable students to:

1. Describe case-specific roles of pathologists in patient care.

2. Interpret case-specific pathology results.

Approximately 2 student-led case conferences are held each month (beginning in month 2 of the year of this study), each lasting 90 minutes and focusing on 2 cases from the full spectrum of clerkships. For each session, with a case chosen by the student, pathology faculty work with case conference faculty and the student to identify a relevant pathology topic. As such, a predetermined list of topics for the year is not created; however, attention is given to achieving a balance in both clinical and anatomic pathology. The goal is to integrate pathology concepts into 1 case per session with a pathologist leading a discussion.

Pathology Elective

This portion of the curriculum is designed to enable students to:

1. Describe how pathologic diagnoses and laboratory testing affect patient management.

2. Describe the role of the pathologist in patient care.

3. Describe research opportunities in pathology.

4. Interpret and evaluate both basic and difficult anatomic and clinical pathology cases.

5. Interpret clinical information in the context of relevant pathology.

6. Interpret a pathology report and understand its clinical significance.

A year-long elective was created to help integrate pathology into third-year training for interested students. The elective consists of monthly presentations by faculty on topics of interest to the students; pairing of students with an advisor to facilitate understanding of the pathology of cases seen by students as part of their clinical clerkships; clerkship-specific activities; and a 15-minute student case presentation to faculty and the other students participating in the elective at the end of the year. Clerkship-specific activities include review of placental pathology, gynecologic cytology, grossing of surgical specimens, serum protein electrophoresis, anti-nuclear antibody testing, and transfusion practice. To ensure adequate integration with the core clerkships, the pathology elective was first discussed with and approved by core clerkship directors.



In 2009, surveys were given to all students 3 months into and at the end of the PCE. The initial time point was chosen for logistical reasons as it was the first opportunity to administer a survey to all the PCE students that included questions regarding their experience with the transition course. Several questions were based on a previous survey designed to gauge medical student perceptions of pathology. (4) At the first pathology elective session, students were asked to anonymously record their reasons for choosing the elective. An end-of-elective survey was also administered.


For quantitative data, means and ranges are reported and the [chi square] test and unpaired t test were used to compare categorical and ordinal variables, respectively, between presurvey and postsurvey responses.


Baseline Characteristics

A total of 55 students participated in our hospital's 2009-2010 PCE course and surveys were given to all students 3 months into and at the end of the PCE year. Forty-eight students completed the initial survey (87%). Although only 1 student listed pathology as a possible first choice for residency, the mean rating for interest in learning more about pathology on a scale of 1 to 5 (with 5 being "very interested") was 3.6, with 56% of students selecting a 4 or 5. Despite this self-described interest, students had poor knowledge of training pathways in pathology. When asked about anatomic pathology-only and clinical pathology-only residency programs, 19% and 31%, respectively, responded that, before the third year of medical school, they did not know about these programs. Even though it is the most common pathology residency training pathway, 60% responded that before beginning their third year of training, they were unaware that combined anatomic pathology/clinical pathology programs existed and, interestingly, approximately 29% of students indicated that they first learned of these programs from the PCE transition course (the numbers were 13% for anatomic pathology-only and 27% for clinical pathology-only programs). With respect to the types of specimens an anatomic pathologist examines, only 19% answered correctly that most are from living patients (Figure).

Case Conferences

In a prior iteration of these conferences (2008-2009), all cases to be presented were reviewed by one of the authors who worked with case conference faculty and the medical students to identify relevant pathology topics. The author then selected a pathologist (typically the physician who formally reviewed or was directly involved with the case) to lead a 5-minute discussion. Initial feedback from the PCE faculty responsible for leading the case conferences noted inconsistency in the quality of presentations (eg, taking up too much time, varying presentation skills). Consequently, in 2009-2010, a group of 8 pathologists with an interest in teaching were selected to serve as the "core pathology" teaching faculty for the conferences and these issues were resolved. Students are currently assigned to 1 of 4 conference groups and work with a designated anatomic pathologist and clinical pathologist for each group.

There were 75 case conferences during the 2009-2010 academic year. Sixty-three pathology topics were covered during the conferences (Table 1). Thirty-three topics were related to anatomic pathology and 30 were related to clinical pathology. In the end-of-year survey, the average rating for pathology integration into the case conferences (5-point scale: poor, fair, good, very good, excellent) was "good," with 43% rating "very good" or "excellent." Two of the 3 individuals selected by the third-year class for teaching awards as outstanding case conference consultants were pathologists.

A thank you e-mail from a student to a pathology consultant describes how the conferences help fill gaps in medical student education:

"I have to admit, I had no idea that c-ANCA [anti-neutrophil cytoplasmic antibody] and p-ANCA were subsets of immunofluorescence patterns when testing for ANA [anti-nuclear antibody]. I had no idea that they were done differently than the ELISA [enzyme-linked immunosorbent assay] antibody tests against specific protein antigens within a cell. Prior to this I had only memorized the various autoantibody names associated with various diseases, and never quite understood what they meant--your two minute presentation helped me clarify something I've struggled to understand over the last two years."

Pathology Elective

Eight students participated in the pathology elective (15% of total third-year students at our institution). During the introductory session, students were asked to anonymously describe their reasons for taking the elective. Only one specifically indicated an interest in becoming a pathologist. Several major themes emerged: 3 students wrote they were interested owing to a perceived inadequate exposure to pathology in the first 2 years of medical school; 2 students wrote they would like a better understanding of the clinical relevance of pathology; and 2 students incorporated both of the above themes in their comments. Examples of representative comments are noted below:

"I felt I was approaching the time when I could start folding pathology into my understanding of disease. In the first two years I wasn't ready to put pathology into my foundation and it largely went right over me."

"I felt that after two years of medical school I still did not have a good foundation of knowledge in pathology and I felt that understanding pathology is crucial to being a good physician."

"I think the main reason I chose the elective is because I think it will help me develop a deeper appreciation of pathophysiology. I would like to continue my pathophysiologic education both out of general interest but I'm also confident that it will be clinically relevant."

"I would like to see how pathology fits into medicine and hope it will help reinforce pathophysiology."

In addition to the introductory session, there were 6 additional 90-minute sessions. The first 2 sessions provided an introduction to anatomic pathology and an introduction to clinical pathology. At these sessions, faculty reviewed their duties as pathologists and gave in-depth tours of the department. Based on student interest, there was then a session on dermatopathology and a session devoted to reviewing blood smears. The final 2 sessions centered on the student presentations.

A variety of cases were reviewed with a pathologist and discussed at the end-of-year presentations (Table 2). On several occasions, residents or faculty supervising the student on the clinical clerkship also came to the case review with the pathologist. Participation in the elective's activities was excellent; only 2 activities, a transfusion audit and review of anti-nuclear antibody testing, were completed by less than 50% of the group. No activity was rated as "not helpful" and most activities were rated either as "helpful" or "very helpful" (Table 3). Overall assessment of the curriculum was also positive with ratings of a 4 or a 5, with 5 being the highest rating, and all students indicated they would recommend the elective to others (Table 4). The comments regarding the elective are listed below:

What Students Learned Regarding the Practice of Pathology.--"It's a very academic profession far from a lone pathologist working in the lab. It's very social and deliberative."

"I learned the different career options available for pathologists. I also learned the role of pathology in the diagnosis of disease, especially through my clinical cases with my patients."

"What pathologists do and see on a day-to-day basis."

"The relationship between pathologists and clinicians."

"That the practice of pathology is relevant and useful to all fields of medicine (from medicine to surgery)."

"Diversity of applications."

"It is essential to a wide variety of diagnoses."

What Students Liked About the Elective.--"I really liked knowing people in the department that I could call and review cases with. It was extremely enriching and helped demonstrate your interest to the course directors on the various rotations."

"Eagerness of facility to teach us and go over cases."

"I really enjoyed the end-of-year presentations" (3 comments).

Suggestions for Improvement.--"More meeting and more sessions with hands-on stuff, it was a little heavy on path as a profession."

"Would be nice to even do midcourse presentations if enough time were available."

In addition to the comments noted above, a summary of an end-of-year focus group (conducted by education staff separate from the pathology department) for all third-year medical students stated: "Students had praise for the pathology elective; they learned a lot, and it added whenever pathology was relevant to a case they were dealing with." In regard to career choice, 1 elective participant (the individual who originally indicated an interest) subsequently chose a career in pathology. She was the only student from her graduating class who entered a pathology residency program. Other elective students chose careers in anesthesia, medicine, surgery, and obstetrics/gynecology.

Of particular note, a student case led to quality improvement within the pathology department. In the process of reviewing a case of Streptococcus bovis bacteremia with a student, the director of the microbiology laboratory and student discussed the importance of different S bovis subtypes. The pathologist discovered that the laboratory had the capability to determine subtypes but was not currently reporting the results. The interaction with the medical student led to an improvement in test reporting at our institution.

Overall Curriculum Assessment

Fifty-three PCE students (96%) completed the end-of-year survey. When asked to rate the overall integration of pathology into the third year of medical school, the mean rating was between fair and good (2.4 on a scale of 1 to 5). A number of questions were asked on both the presurvey and postsurvey to gauge medical student knowledge of the role of pathologists in patient care. In regard to the "importance of pathology to the nonpathologist," there was no significant difference at the 2 time points (3.7, pre, and 3.4, post, on a scale of 1 to 5 with 5 being "very important"; P = .52, t test). Furthermore, there were no significant differences in answers regarding the frequency of pathologist contact with other clinicians (mean response between "once a day" and "more than once a day," P = .72, [chi square] test). There was, however, a trend toward better understanding of the percentage of autopsy specimens examined by anatomic pathologists (Figure; P = .13, [chi square] test).


We describe a novel, integrated pathology curriculum for third-year students within a longitudinal clerkship framework. The core components included an introduction to pathology during a transition course, pathologist-led focused teaching in case conferences, and a year-long pathology elective. Our data suggest that students, after the preclinical years, have motivation to learn about pathology and its links to clinical medicine but have limited knowledge regarding pathology as a career. Most students believed that 40% or more of a typical pathologist's caseload consists of autopsy specimens, and many students were unaware of the training pathways in pathology. Our data confirm the utility of the transition course lecture; this session was the source of information regarding residency programs for a significant percentage of students.

The addition of pathology teaching into the case conferences was well received and resulted in discussions that covered a wide variety of topics in both anatomic and clinical pathology. Of course, medical students attend other hospital conferences that involve pathologists, but the discussions at these sessions are directed more to attending physicians and residents. The fact that our original strategy to include all pathologists in our department in the student case conferences did not work demonstrates that teaching medical students requires a unique skill set. We needed to recruit a dedicated group of pathologists with an interest in medical student teaching to make the case conferences successful. As a result, for the first time at our institution, pathologists received teaching awards from third-year medical students.

The pathology elective was also rated highly and all participants would recommend the elective to their colleagues. The students in the elective engaged in activities that addressed a wide range of topics relevant to patients for whom they were providing care during their core clerkships. As opposed to fourth-year pathology electives, the third-year elective allowed a holistic approach in which pathology was integrated into the context of other rotation-specific patient care. That is, the student did not just review multiple biopsies or surgical specimens during a day of sign-out. They reviewed the pathology findings of a patient who they actually also saw in clinic or on an inpatient service. As such, based on student comments, it appears we achieved one of our major objectives, namely, to ensure that students understand the role of pathologists in patient care. On several occasions, the elective also led to opportunities to educate residents and faculty in other departments regarding pathology topics. In addition, the case regarding S bovis testing, which led to a change in microbiology result reporting, demonstrates the potential for a third-year pathology curriculum to improve patient care.

Despite all the curricular innovations in the PCE course, and in contrast to the higher scores for pathology integration with the PCE case conferences, students still believed pathology was integrated poorly into the third year of medical school (degree of integration rated only 2.4 out of 5). We hypothesize that this likely reflects continued lack of integration of pathology teaching during the individual core clerkships. This gap analysis suggests that a huge need and opportunity exist to expand current pathology teaching with links to department-specific clerkship activities. Further research can help elucidate these issues and provide additional opportunities for clinically linked pathology teaching.

Our study is limited by having only subjective measurements of efficacy. Although it is complicated to design validated assessment tools, we intend in future studies to include more objective measures such as tests of pathology knowledge, as well as student performance in their clinical electives. Metrics could include appropriate test ordering and team contact with pathology during the course of a clerkship. As more students participate, it will also be informative to determine if the curriculum generates increased interest in a career in pathology. In addition, we only analyzed a single year of the curriculum at a single institution and, for the pathology elective, our study group included only a small number of students. Regardless, a review of the medical education literature shows that our curriculum remains one of the only efforts to fully integrate pathology into the third year of medical school. Our results can serve as a starting point for other institutions to consider exposing a larger number of students to pathology during the clinical years of training (ie, aside from the few who take electives in the fourth year) through integrated teaching activities that are linked both to individual clerkships and departments or are centered within pathology. Although we used the framework of a longitudinal curriculum, pathology can still be integrated into rotation-specific case conferences even if clerkships occur at different sites. For example, pathologists could collaborate at the different sites to allow medical student review of cases. In fact, we have made arrangements with pathologists at Children's Hospital Boston to assist during the pediatrics clerkship. The elective sessions, if appropriately scheduled to allow travel time, could be effectively centralized to a single hospital.

The third year of medical school is the optimal time for students to expand and practically apply the knowledge they obtained in the preclinical years of training. We believe this time should also include training in pathology.

The authors wish to thank Lori Newman, MEd, for her critical review of the manuscript.


(1.) Smith BR, Aguero-Rosenfeld M, Anastasi J, et al. Educating medical students in laboratory medicine: a proposed curriculum. Am J Clin Pathol. 2010;133(4): 533-542.

(2.) Kumar K, Indurkhya A, Nguyen H. Curricular trends in instruction in pathology: a nationwide longitudinal study from 1993 to present. Hum Pathol. 2001;32(11):1147-1153.

(3.) Marshall R, Cartwright N, Mattick K. Teaching and learning pathology: a critical review of the English literature. Med Educ. 2004;38(3):302-313.

(4.) Holland L, Bosch B. Medical students' perceptions of pathology and the effect of a second-year pathology course. Hum Pathol. 2006;37(1):1-8.

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(6.) Bell SK, Krupat E, Fazio SB, Roberts DH, Schwartzstein RM. Longitudinal pedagogy: successful response to the fragmentation of third-year medical student clerkship experience. Acad Med. 2008;83(5):467-475.

(7.) Roberts DH, Kane EM, Jones DB, et al. Teaching medical students about obesity: a pilot program to address an unmet need through longitudinal relationships with bariatric surgery patients. Surg Innov. 2011;18(2):176-183.

(8.) Bell SK, Krupat E, Fazio SB, Pelletier SR, Schwartzstein RM, Roberts DH. Writing community: a humanism curriculum with an academic lens. Med Educ Dev. 2011;1(1). doi:10.4081/med.2011.e4.

Richard L. Haspel, MD, PhD; Parul Bhargava, MD; Hannah Gilmore, MD; Sarah Kane, MD; Amy Powers, MD; Alireza Sepehr, MD; Amy R. Weinstein, MD; Richard M. Schwartzstein, MD; David H. Roberts, MD

Accepted for publication January 10, 2012.

From the Departments of Pathology (Drs Haspel, Bhargava, and Sepehr) and Medicine (Drs Weinstein, Schwartzstein, and Roberts) Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts; the Department of Pathology, University Hospitals Case Medical Center, Cleveland, Ohio (Dr Gilmore); Commonwealth Pathology Partners, Salem, Massachusetts (Dr Kane); and the Department of Pathology, The Queens Medical Center, Honolulu, Hawaii (Dr Powers).

The authors have no relevant financial interest in the products or companies described in this article.

Reprints: Richard L. Haspel, MD, PhD, Department of Pathology, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Yamins 309, Boston, MA 02215 (e-mail:
Table 1. Pathology Topics for Case Conferences


Anatomic Pathology

Ovarian tumors (2) (a)
Placenta (2)
Endometrial cancer
Spinal tumor
Sweet syndrome
Crohn disease
Pneumocystis jiroveci
Gallbladder pathology
Thyroid cancer
Pancreatic cancer
Lung cancer
Spine tumor
Melanoma (2)
Germ cell tumor
Meconium peritonitis
Henoch-Schonlein purpura (2)
Breast cancer (5)
Cervix pathology


Diabetes testing (2)
Thyroid testing
Excessive testing (endocrine)
Anti-neutrophil cytoplasmic
Protein electrophoresis
Hepatitis serology
Brain natriuretic peptide
Arterial blood gases
Adrenal testing
Multiple sclerosis testing
Diabetic ketoacidosis
Hemoglobin A1c


Lymphoma (2)
Red cell indices
Thrombophilia (test ordering)
Hemophagocytic lymphohistiocytosis (2)
Joint fluid
Atypical lymphocytes (viral)


Clostridium difficile colitis
Blood cultures (2)
Stool cultures
Lyme disease


Intravenous immune globulin
Apheresis for myasthenia gravis

(a) The data in parentheses indicate the number
  of times the topic was covered.

Table 2. Topics Covered During the Pathology Elective


Anatomic Pathology               Clinical Pathology

Pleural biopsy                   Streptococcus milleri empyema
Breast cancer                    Cerebrospinal fluid review
Endometrial cancer (2) (a)       Type and screen
Colon biopsy                     Streptococcus bovis endocarditis
Liver biopsy                     Complete blood count
Melanoma                         Heparin-induced thrombocytopenia
Thyroid                            testing
Mediastinal mass
Meconium peritonitis             Final Presentations
Gastrointestinal stromal tumor
Autoimmune hepatitis (2)         Pneumocystis jiroveci pneumonia
Pancreatic tumor                 Autoimmune pancreatitis
Skin hypersensitivity reaction   Mycobacterium avium-intracellulare
Carcinoid                        Heparin-induced thrombocytopenia
Fibroid                          Sarcoid
                                 Prostate cancer
                                 Thyroid cancer

(a) The data in parentheses indicate the number of times the topic was

Table 3. Pathology End-of-Year Elective Survey Activity Assessment

Activity                              No. Participating   Mean Rating
                                                          (Range) (a)

Session 1: Introduction to faculty            8              3 (2-4)
Session 2: Introduction to anatomic           8            3.5 (3-4)
Session 3: Introduction to clinical           8            3.4 (3-4)
Session 4: Dermatopathology                   7            3.7 (3-4)
Session 5: Blood smear review                 8            3.7 (3-4)
Having pathology advisor/mentor               8            3.5 (2-4)
Reviewing rotation cases with                 8            3.9 (3-4)
Leaving OR to view frozen sections            7            3.9 (3-4)
with pathologist
Spending time in the grossing room            7            3.3 (2-4)
Reviewing placental gross anatomy             4            3.3 (3-4)
Reviewing gynecologic cytology with           4            3.8 (3-4)
a pathologist
Performing a transfusion audit                2            3.5 (3-4)
Reviewing anti-nuclear antibody               3              3 (3-4)
testing with a pathologist
Reviewing serum protein                       5            3.4 (3-4)
electrophoresis with a pathologist
Preparing for your pathology                  8            3.5 (2-4)
Attending the elective student                8            3.4 (2-4)
pathology presentations

Abbreviation: OR, operating room.

(a) Responses on a scale of 1 to 4 (1 = not helpful, 2 = somewhat
helpful, 3 = helpful, 4 = very helpful). Students were also able to
select "did not participate in" (N = 8).

Table 4. Pathology End-of-Year Elective Survey
Curriculum Assessment

Pathology Elective Attributes            Mean Rating
                                         (Range) (a)

Clear and realistic objectives            4.1 (4-5)
Material that is relevant and valuable    4.3 (4-5)
Adequate time allotted                    4.5 (4-5)
Adequate instructional/presentation
  techniques                              4.5 (4-5)
Taught principles you can apply during
  rotations                                 4 (4-5)
Stimulated my interest "subject"          4.3 (4-5)
Recommend to others                       4.4 (4-5)

(a) Responses on a scale of 1 to 5 (1 = strongly disagree,
3 = neutral, 5 = strongly agree) (N = 8).
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Author:Haspel, Richard L.; Bhargava, Parul; Gilmore, Hannah; Kane, Sarah; Powers, Amy; Sepehr, Alireza; Wei
Publication:Archives of Pathology & Laboratory Medicine
Date:Nov 1, 2012
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