CURRICULUM OVERVIEW

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CURRICULUM OVERVIEW Quality and Innovation C.
DARRELL JENNINGS, MDSenior Associate Dean for
Medical Education August 27, 2009
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• The goal of medical education according to Sir
  William Osler is, "to give a man his direction,
  point him the way, and furnish him with a chart,
  fairly incomplete for the voyage..."

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M1 Normal Structure, Function, and Development Hea
lth promotion Introduction to patient care
and The context of medicine
M2 Abnormal structure and function Basics of
therapy Patient care and the context of medicine
M4 Advanced clinical medicine Exploration of
areas of interest
M3 Clinical Medicine
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INITIATIVES

• Oversight and Accountability, more vertical
• Ownership, continue horizontal
• Evaluation of students, COMLC
• Evaluation of faculty, peers and raters
• Curricular reform, ECE, Integration BS-CS

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Curricular Innovation

• Increased use of simulation
• New course ICM, Introduction to Clinical
  Medicine
• - Longitudinal Clinical Experience as part
• of ICM 1
• Pre-matriculation course this summer-Anatomy

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Curricular Innovation

• Curriculum Task Force recommendation
• Hybrid curriculum with transition to systems
  based format.

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Years 1 and 2

• Hybrid Departmental Systems Approach
• Overriding Longitudinal Clinical Experience
• - Emphasize Professionalism, Chronic
• Care
• Department based portion of Year 1
• Systems based Year 2
• Transition compartmentalized to global

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Year 3

• Multidisciplinary integrated longitudinal
  clerkships
• Start with IM-OP, IM-IP, EM for 16 weeks
• Add Surgery, Ob-Gyn, and Family Medicine
• Add clinical skills testing, problem solving to
  CPX, and comprehensive professionalism

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Year 4

• ICU vs. non-ICU Acting Internships
• Core didactic content
• Electives
• Discipline specific clinical basic science
• Community medicine discipline specific field
  experience

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• Im all for innovation, its change that worries
  me.

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Life-Long Learning

•   The hardest conviction to get into the mind of
  a beginner is that the education upon which he is
  engaged is not a college course, not a medical
  course, but a life course, for which the work of
  a few years under teachers is but a preparation.
• Sir William Osler

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Need for Patient Centered Medicine

• An overall shift in culture and mission of the
  professions and renewed sense of professionalism
  that focuses on the needs of the patient is
  needed. To help achieve this aim, there are
  effective methods to train health professionals
  in both academic and continuing education
  programs to be more patient-centered (Lewin et
  al., 2001) that could be better emphasized as a
  core part of health professions education.
• --Institute of Medicine (IOM) of the National
  Academies
• http//www.iom.edu/Object.file/master/10/460/pati
  ent.pdf

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Need for Patient Centered Medicine

• The U.S. health care system is facing a collapse
  of primary care medicine, the ACP reported in its
  January 2006 State of the Nations Health Care
  report. The result of this collapse of primary
  care will be higher costs, lower quality,
  diminished access, and decreased patient
  satisfaction.
• --American College of Physicians
  http//www.acponline.org/pressroom/snhc1.htm

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Need for Patient Centered Medicine

• The ACP, today, proposed a bold solution to this
  looming collapse a patient-centered health care
  system. This model of health care delivery has
  been proven to result in better quality, more
  efficient use of resources, reduced utilization,
  and higher patient satisfaction.
• --American College of Physicians
  http//www.acponline.org/pressroom/snhc1.htm

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Patient Centered Medicine

• Patient Centered Medicine includes
• Understanding the patient as a whole person
• Mutual decision making
• Incorporating prevention and health promotion
• Patient-centered health care is a system that
  builds upon the relationship between patients and
  their primary and principal care physicians and
  supports the systems needed to achieve better
  results. (American College of Physicians)

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Traditional Instructional Process
Pathway to Learning
Expectations Objectives Competencies
Evaluation
Lecture
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Patient Centered Medicine
Team Approach Problem Solving
Shared Responsibility
Shared Decision Making
Student Centered Education
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What is Student Centered Learning?

• Students are active decision makers with shared
  responsibilities
• Based upon adult learning theory
• Learning is active and interactive
• Follows continuing education models
• Provides ample opportunity for student choice
• Provides a conducive learning environment in
  which students/faculty develop a teamwork
  approach to learning

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Student Centered Instructional Process
Pathways to Learning
Expectations Objectives Competencies
Formative, Summative Evaluation
Laboratory, Small groups, Self study, Shadowing,
Case based, Service learning, Experiential
Interactive, Computer-based Workshops and Human
patient simulators
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Patient Centered Medicine
Team Approach Problem Solving
Shared Responsibility
Shared Decision Making
Student Centered Education
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Most Significant Barrier to Student Centered
Learning

• Front Loading of Effort
• Building the defined expectations
• Creating the learning modules
• Building the assessment tool
• Need to continue current operations
• Use of Grant Funding
• RWJ prior experience