Integrated selective: an innovative teaching strategy for sleep medicine instruction for medical students

Sleep disorders are common among all age groups, but repeated studies have demonstrated that physicians underdiagnose sleep disorders. Lack of curriculum time and the limited number of faculty with expertise in sleep medicine have been cited as major barriers for sleep medicine instruction. This paper describes the development, implementation, and evaluation of an integrated selective in sleep medicine for fourth-year medical students.

A one-month required fourth-year integrated selective in sleep medicine was implemented at Medical College of Wisconsin (MCW). A curriculum was developed, incorporating core competencies of sleep medicine and using a combination of instructional strategies. Three sources of data were used to evaluate the selective: an elective-specific questionnaire, learner ratings, and performance on a pre- and post-knowledge test.

Twenty medical students (13 male; 7 female) have completed the selective to date. Lack of exposure to sleep medicine during the first three years of medical school was the most common reason for taking the elective. Student evaluation of the rotation averaged 1.5 on a five-point scale (1=best), above the average for fourth-year rotations. The mean examination scores increased significantly from pre- (56%) to post- (86%) selective (p<.05). Unanticipated but associated positive outcomes included (a) an invitation to teach a 1h lecture to third-year medical students and pediatric residents, (b) a 2h workshop on sleep medicine for internal medicine residents, and (c) grant funding from the medical college's Curriculum and Evaluation Committee to support the development of on-line sleep medicine instruction.

A well-designed fourth-year integrated selective improves student knowledge in sleep medicine and may provide an opening for additional inclusion of sleep medicine instruction for various trainees.