Curricular change in a medical school: a new method for analysis of students’ academic pathways

Background Curricular changes in medical schools occur due to advances in medical sciences, but its evaluation is limited and fragmented, with scant data of students’ success as they progress through the program. Longitudinal follow-up can be “natural experiments” to explore innovative methodologies. Objective To propose a method for analyzing students’ academic pathways, and identify changes associated with a medical school curricular reform. Methods We analyzed the academic pathways of students throughout the program in two different curricula (1993 and 2010), at the National Autonomous University of Mexico (UNAM) Faculty of Medicine. Advancement of each student in the program was calculated with the “academic trajectory” using the accumulated credits in a defined time period, and the percentage of students that completed the credits for each stage of the curriculum. The theoretical framework is based on the “life course” approach, applying concepts of trajectory, transition and state. Data was analyzed with R software and TraMineR algorithm. Results Five student cohorts of the older curriculum were studied (classes of 1994, 1995, 1996, 2004 and 2005), and two cohorts of the new curriculum (2011, 2012), a population of 6829 students. Students in the newer curriculum had a faster, more timely and efficient advancement in academic pathways, than cohorts in the older one. There was a higher percentage of students with “regular” trajectory (without failed courses) in the newer curriculum. Regularity is a straightforward metric that allows identification of complex curricular changes’ associated effects. Conclusions Analysis of students’ academic pathways offers valuable information to evaluate curricular changes, which is difficult to obtain with traditional cross-sectional studies. The study does not provide proof of causality regarding the educational impact of different programs, although it can be useful to complement the array of program evaluation strategies in higher education.