Requirement for Revision of Virology Education for Medical Students

Introduction

Medical education should be seen as a dynamic process and must be regularly monitored, evaluated, and changed if needed (1-3). Changes in medical training programs in various countries, based on detailed studies are being conducted continuously (4-7). These revisions usually take place with regards to specific problem of the area, for example, infectious diseases, in African medical schools are taught with higher volumes than European medical schools due to more infectious diseases in Africa.

The science of virology plays a critical role in maintaining and promoting health and preventing disease. The incidence of major viral epidemics in recent decades has high- lightened the importance of this knowledge.

Increasing and widespread impact of virology on public health indicates that  health care workers have sufficient knowledge in this field. Therefore according to the medical universities mission to preserve and promote  health, these institutions are required to provide enough knowledge of this field for their students.

In many medical curriculum programs virology is still a little part of microbiology education and many medical schools offer the program within a microbiology course. Traditionally the main part of such courses is bacteriology and in many cases virology education to medical students is neglected. Lack of educated virologists to teach medical students is another problem of many medical schools which may result in  insufficient virology education.

Here at Mashhad University of Medical Sciences we are currently training virology to medical students on the basis of general medical curriculum which has been implemented for more than two decades. In this program students should pass virology course in a single university credit point. In the program some topics of virology is put into the curriculum. The program seems to be insufficient in terms of content. For example, HIV is absent in the program while we try to teach it in a very limited time. This is true in many other viral pathogens such as viral hemorrhagic fevers which have a high mortality and therefore high clinical importance.  The paradox is that if the lecturer tries to cover such unpredicted issues, lack of planned time remains an unsolved problem.

In general, medical education should be planned based on professionalism, namely the curriculum should be established in a way in which whatever a doctor needs to know is of more importance and considered as higher priority(8-10).

Based on our current medical education, graduates will not become familiar with many human viral pathogens which are absolutely essential for physicians. Doctors are at risk of occupational exposure to potentially fatal viral infections such as viral hemorrhagic fevers, while teaching these topics is absent in their current curriculum. Considering rapid growth in the field of virology, revision of the curriculum in qualitative and quantitative aspects seems to be worthy and considerable. Meanwhile doctors also have a role in educating the community. In the lack of enough knowledge, playing this role would also be disrupted.

The current study was designed and conducted to investigate the viewpoints of medical students about the current situation of virology training in terms of content and quantity.

Methods

This cross - sectional study was designed and conducted in spring semester of 2011 to evaluate medical students' views about the current virology education in our medical school. The study sample included 80 students from basic science of Mashhad medical school who were selected purposively. We used a questionnaire created based on Likert’s scales. The validity of the questionnaire was reviewed and approved by experts and the reliability was confirmed by  calculating the Cronbach's alpha (85%). The questions were designed to assess students' views about the importance of this topic, fulfilling educational requirements, the clinical relevance, professional applications of the course and future needs to review the program. Student views about any variables were measured from very high to low according to Likert’s spectrum of rating.Thereafter student responses to each item were calculated as percentages and were demonstrated in table.

Results

The results are shown in Table 1.  As indicated in the table, the majority of respondents (82.5%) have evaluated the importance of virology as high to very high levels. The majority of respondents assessed clinical relevance and relationship of virology to their future career as high to very high (81.25 and 80%, respectively). 68.75% of students believed the course should be revised and 63.75% of the students stated the virology education should be more than the current one credit point. According to the majority of students (86.25%), the distribution of credit points in basic science education was moderate to weak.

Table  1: The perspectives of medical students  about virology course

Discussion

Lack of training may lead to lower virology diagnostic skills of physicians. This can be associated with adverse outcomes such as unnecessary use of diagnostic procedures (economic burden), unnecessary use of drugs such as antibiotics used in the treatment of viral infections (economic and physical damage), delays in treatment and prevention,  occupational risks for doctors, and finally the loss of  the role of medical education in the community.  Viral illnesses involve a broad range of medical specialties and this highlights the economic importance of such diseases.   

The majority of respondents believed that the course is related to their future career and stated reviewing and addition of new essential topics to the course is necessary. High percentage of students (86.5%) evaluated the arrangement of basic science program as moderate to weak. This requires further study and consideration of medical education experts. Although faculty members play a considerable  role in the process of education( 11), the curriculum itself also should be designed in a perfect way.The current virology program has some insufficiencies, for example in General Virology some topics such as epidemiology, pathogenesis, the body's defense against viruses, chemical and physical effects on viruses and prions are not listed in the program and these topics need to be added.  Further evaluation of the systematic virology (viral families) also makes it clear that the program needs to be completely revised. Viruses such as parvovirus B19, human papillomavirus (HPV), HIV, HTLV-1, rotavirus, Norwalk, SARS, viral hemorrhagic fevers and viral encephalitis should be added to the curriculum although some lecturers try to cover very briefly the topics but these topics should find their established and permanent position in medical education.

Virology is one of the first courses that combines basic sciences with clinical applications during medical education. It has been shown that such early clinical exposures improves the medical students' interest in the field of study(12).

Revising the program and adding new topics do not mean to increase the length of medical education period. But it is to rearrange issues according to their priority for a general medical education program. Considering the importance of the topics, program should be rearranged in a way that issues which are necessary for a general practitioner, are in priority.  Such revisions should be in line with the teaching of applied basic sciences to medical students. Considering the high volume of science which is produced, one should select the necessary parts for medical students training. This means some unessential topics in basic science education should be replaced by new important ones. Such revisions will improve the quality of education and educational standards at microbiology and virology departments (13)

Applied and practical training in basic science has been emphasized by the researchers in the field of medical education (14-17). Practical applications of the topics presented in basic science education are also important from the perspective of medical students as learners (18).

In this study, students assessed virology as a practical and applied course with high relevance to their future clinical career as practitioners, although  greater number of participants preferably from other universities and including the views of virology lecturers from different faculties might have strengthened the study.

Bed on the data presented in this study, we  suggest to consider changes in the quantity and quality of virology education for medical students in the medical sciences universities. It will be a curriculum which is responsive to the needs of the community, the approach which should be considered in any revision of medical programs (19-20).