New Curriculum Implementation

Remarks of Associate Dean for Curriculum
General Faculty Meeting - September 27, 2000
Donald J. Innes

Summary of the Goals for the Curriculum

  1. Integrate and coordinate basic science and clinical experiences.

  2. Create time in the early years for regular and frequent patient contact, integrating and coordinating patient experiences with the learning of the clinical sciences, professional attitudes, and information management skills necessary to function as a physician.

  3. Achieve a balance of lecture, problem based learning, patient experiences and blocks of open study time to improve the learning environment. Encourage a problem solving approach to learning.

  4. Create a time to encourage imaginative and creative expression of medical students in the basic sciences and clinical medicine.

  1. The new Practice of Medicine (PoM-1) course began August 2000 for first year medical students. PoM-1 is interdisciplinary and designed to learn the fundamental attitudes, skills, and knowledge required of a physician. PoM-1 brings together elements of the doctor-patient relation, physical diagnosis and ethics, and allows students to relate what they are learning in basic science courses to the care of patients.

    The course focuses on:

    (1) Basic professional skills and attitudes involved in listening to patients, including interview techniques, the formation of a respectful and attentive relationship, recognition of appropriate boundaries and possible barriers to communication, and the structure of the standard medical history;
    (2) Basic physical examination skills, including approach to the patient, proper exam techniques, use of instruments, recognition of normal physical exam findings and use of information management in medical decision making;
    (3) Knowledge of the medical profession's history, culture, and relation to society, including the profession's ethical foundations and moral obligations.

    There are 23 groups (6 students; one M.D. and one non-M.D.) meeting for approximately 3 hours each week. The format has been described as "exciting" and comfortable by students and faculty. It lends itself to a free flow of events and more of a clinical environment than a "classroom". WEB based videos of the interview and physical exam are available for use by the faculty as a model of standard practice and for the student as a review tool.

    image7Featured is the development of sound medical problem-solving and information management skills (finding, organizing, evaluating and applying information) using state of the art information technology.

    The Curriculum Committee recognizes the need for efficient use of complex information for medical problem solving.

    We recognize that the process of knowledge retrieval and decision making are as important to the future of medicine as the information on which clinical and research decisions are made.

    In order to bring medical informatics into the curriculum in a sustainable manner, we plan to integrate medical informatics into the process of creating a physician rather than develop an entirely new and separate component to the curriculum. Information mastery should be integrated into the function of a physician - into all four years, and involve all courses and all faculty.

  2. The basic schedule of classroom and laboratory hours has been altered to provide useable blocks of time for medically related student activities and self-study.

    Schedule reorganization placed lecture, laboratory and small group work into the morning hours from 8-12 with a common lunch hour for all first and second year students.

    A daily common period is provided for the development of professional attitudes and social skills through participation in collegial and humanitarian activities. Students take advantage of this period for club meetings and for speakers/presentations. The "meet the faculty" luncheons are rewarding for both students and faculty.

  3. PoM-1 parallels the major basic science courses and is integrated with Anatomy and Physiology. Basic science courses realigned for improved integration of material, e.g., Anatomy and Cell & Tissue; Cell & Tissue and Physiology. A portion of Biochemistry merged with Genetics forming a new course, Molecular & Medical Genetics.

  4. The "Clinical Connections" program for 3rd year students has begun. Reid Adams organized the session on Colorectal cancer incorporating basic science, humanities, and ethics into clinical management. Future programs include Issues in Pain Management, Neurologic Injury and Chronic Disability, and Infertility. A portion of each program is devoted to Spirituality in Medicine.

  5. A clinical associate program has been implemented to assist with the integration and coordination of basic science and clinical experiences and to ensure a balance of lecture, problem based learning and patient experiences.
Curriculum Committee Agenda - Fall 2000:
  1. Course evaluation form for use in Fall 2000 A course evaluation form has been completed and will be completed by all courses in the 2000-2001 academic year.

  2. PoM-2 - A design team will ensure a smooth and educationally sound progression from PoM-1 into and throughout PoM-2 (ICM) and on into the clerkships.

  3. Clinical medicine year 3/4 options - The Curriculum Committee will begin an assessment of the 3rd and 4th years of medical school. The Clinical Medicine Committee will work to define the knowledge, skill and attitudinal expectations for the clerkships and electives. The Curriculum and Clinical Medicine committees will then assess the degree with which we currently meet these expectations and based on this assessment, determine what action needs to be taken.

    a. Institute a program for formal assessment of "direct observation of core clinical skills" in each clerkship.

    b. Evaluate the clerkship and elective programs and if desired devise a means to allow for elective time in the 3rd year while strengthening the electives program.

    c. Teach and practice information retrieval and decision making as part of the daily clinical practice of medicine in clerkships and electives.

  4. Engage the student's creative abilities and facilitate exposure to a variety of clinical and research experiences by development of an "Exploratories" program for in-depth exploration of medical subjects in a problem solving, thought provoking, experiential setting. These elective experiences will allow students to explore areas on their own or in small groups with faculty guidance. "Exploratories" may be rooted in either basic science or clinical medicine. Some should entail community service.

  5. Develop the "Clinical Connections" program using evaluation data from the pilot program. 

To all of the faculty and staff who make the time to teach and to the students who take an active role in improving the educational process, a heartfelt thank you.