Evaluating a National Online Vascular Surgery Curriculum for Medical Students Through Design-Based Research: A Stakeholder Usability Analysis

Abstract

Background: No standard curricular recommendations exist for medical students on vascular surgery rotations. Vascular surgery educators in the United States and abroad recognize the need for a more accessible, comprehensive, uniform, and implemented undergraduate vascular surgery curriculum. To address this need, the Association of Program Directors in Vascular Surgery (APDVS) is prioritizing the creation of a standardized, distance-learning curriculum in the form of an eBook. Methods: The eBook was studied using design-based research (DBR) methodology, comprising cycles of designing, testing, evaluating, and reflecting. The evaluation phase involved a quasi-experimental, sequential explanatory mixed-methods design. Students were recruited via faculty partners, snowball sampling, and open calls on social media. Descriptive statistics and Fischer’s exact tests were conducted for discrete variables. Paired t¬-tests were performed for continuous variables. Qualitative descriptive and thematic analysis was performed. Results: Fifteen students enrolled and thirteen completed the study. Students communicated significant increases in self-reported confidence in general carotid artery stenosis (CAS) knowledge (p = 0.012), the ability to diagnose CAS (p = 0.001), the ability to create a CAS management plan (p = .001), and the ability to teach a peer about CAS (p = .001). Students demonstrated a significant increase in CAS knowledge scores (mean increase =17.9%, t(12) = 3.54, p = 0.004). Qualitative analysis revealed three themes: (1) access to a level-appropriate resource guided students in the identity evolution from pre-clinical learner to valued care team member, (2) the eBook functioned as a springboard towards an amplified, interactive, and bidirectional learning environment, (3) the eBook was welcomed in a learning environment where the return on investment of time and effort is paramount. Discussion: According to measurable outcomes and lived experiences, student eBook use during clinical rotations led to increased CAS knowledge and self-reported competence. The eBook guided professional identity formation, promoted student-teacher engagement, and increased learning efficiency. Future study is warranted to improve the eBook’s usability on mobile devices, implement and evaluate newly published chapters, and assess other learner populations and stakeholders (e.g. educators).