LCME and Pathology Education The Mercer Experience

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LCME and Pathology Education The Mercer
Experience

• Robert S. Donner MD
• GRIPE 2007 Winter Meeting
• January 11-14, 2007
• University of South Florida College Of Medicine

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• Mercer University School of Medicine
• Background
• First Class 1982
• Presently 60 Students Each Class
• Integrated Problem-Based Curriculum
• Small Groups 6-8 Students, 1 Faculty
• Resource Sessions (Limited Lectures)
• Limited Labs (Anatomy, Autopsies)
• Computer Support (Image of the Day)

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• LCME 1
• Educational Objectives
• ED-1 The medical school faculty must define the
  objectives of its educational program.
• Educational objectives are statements of the
  items of knowledge, skills, behaviors, and
  attitudes that students are expected to exhibit
  as evidence of their achievement.
• They are not statements of mission or broad
  institutional purpose, such as education,
  research, health care, or community service.

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• LCME 2
• Educational Objectives
• Educational objectives state what students are
  expected to learn, not what is to be taught.
• Student achievement of these objectives must be
  documented by specific and measurable outcomes
  (e.g., measures of basic science grounding in the
  clinical years, USMLE results, performance of
  graduates in residency training, performance on
  licensing examinations, etc.). National norms
  should be used for comparison whenever available.

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• LCME 3
• Educational Objectives
• It is expected that the objectives of the
  educational program will be used by faculty
  members in designing their courses and clerkships
  and in developing plans for the evaluation of
  students.
• The curriculum committee, working in conjunction
  with the chief academic officer, should review
  the stated objectives of individual courses and
  clerkships, as well as methods of pedagogy and
  student evaluation, to assure congruence with
  institutional educational objectives.

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• LCME 1
• D. Curriculum Management Roles and
  Responsibilities
• ED-33 There must be integrated institutional
  responsibility for the overall design,
  management, and evaluation of a coherent and
  coordinated curriculum.
• The phrase integrated institutional
  responsibility implies that an institutional
  body (commonly a curriculum committee) will
  oversee the educational program as a whole.
• An effective central curriculum authority will
  exhibit
• Faculty, student, and administrative
  participation.
• Expertise in curricular design, pedagogy, and
  evaluation methods.
• Empowerment, through bylaws or decanal mandate,
  to work in the best interests of the institution
  without regard for parochial or political
  influences, or departmental pressures.

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• LCME Curriculum Management 2
• The phrase coherent and coordinated curriculum
  implies that the program as a whole will be
  designed to achieve the schools overall
  educational objectives.
• Evidence of coherence and coordination includes
• Logical sequencing of the various segments of
  the curriculum.
• Content that is coordinated and integrated
  within and across the academic periods of study
  (horizontal and vertical integration).
• Methods of pedagogy and student evaluation that
  are appropriate for the achievement of the
  schools educational objectives.

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• LCME Curriculum Management 3
• Curriculum management signifies leading,
  directing, coordinating, controlling,
• Evidence of effective curriculum management
  includes
• Evaluation of program effectiveness by outcomes
  analysis, using national norms of accomplishment
  as a frame of reference.
• Monitoring of content and workload in each
  discipline, including the
• identification of omissions and unwanted
  redundancies.
• Review of the stated objectives of individual
  courses and clerkships, as well as methods of
  pedagogy and student evaluation, to assure
  congruence with institutional educational
  objectives.
• Minutes of the curriculum committee meetings and
  reports to the faculty governance and deans
  should document that such activities take place
  and should show the committees findings and
  recommendations.

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• LCME Curriculum Assessment
• ED-46 A medical school must collect and use a
  variety of outcome data, including national norms
  of accomplishment, to demonstrate the extent to
  which its educational program objectives are
  being met.
• Schools should collect outcome data on student
  performance during and after medical school
  appropriate to document the achievement of the
  school's educational program objectives. The
  kinds of outcome data that could serve this
  purpose include performance on national licensure
  examinations, performance in courses/clerkships
  and other internal measures related to
  educational program objectives, academic progress
  and program completion rates, acceptance into
  residency programs, assessments of program
  directors and graduates on graduates' preparation
  in areas related to educational program
  objectives, including the professional behavior
  of their graduates.

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• MUSM Curriculum How Defined?
• Two Components of Curriculum
• Curriculum as a Whole Defined by Ten Principles
• Linked to Mission of School
• Approved by CIC 11-05-2005
• EC 8-01-2006
• Student Expectations Defined by Competencies
• Approved by Executive Committee 8-09-2005
• Are and Should Competencies Incorporated
  into Courses, Clerkships, and Phases

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• Mercer University School of Medicine
• MISSION
• To Educate Physicians and Health Professionals to
  Meet the Primary Care and Health Needs of Rural
  and Underserved Areas of Georgia.

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• Principles of the Curriculum
• Principle 1 The curriculum contains the
  educational experiences necessary to provide a
  general professional education in medicine.
• Principle 2 The curriculum is competency-based.
• Principle 3 Professionalism is emphasized
  throughout the continuum of the curriculum.
• Principle 4 The curriculum is maintained as a
  contemporary, flexible, and clinically relevant
  educational experience that is continuously
  improved by regular review and evaluation of the
  content and pedagogy.
• Principle 5 The curriculum fosters independent
  learning, the development of self-directed
  learning habits, and the mastery of
  evidence-based medicine.

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• Principle 6 The curriculum contains elements
  that foster the development of leadership skills.
• Principle 7 The curriculum promotes the practice
  of medicine in rural and medically under-served
  areas of Georgia.
• Principle 8 The curriculum promotes
  understanding of the influences of family,
  culture, community, and societal elements on
  health and health care delivery.
• Principle 9 The curriculum emphasizes disease
  prevention and health promotion practices that
  affect the health and well being of students,
  physicians, patients, and communities.
• Principle 10 The curriculum is delivered in an
  environment that encourages positive interactions
  among faculty and students, and values student
  satisfaction with their learning experiences.

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• Mercer University School of Medicine
• Domains of Medical Student Competencies of the
  Educational Program for the M.D. Degree
• Domain I PATIENT CARE
• Domain II MEDICAL KNOWLEDGE
• Domain III PRACTICE-BASED LEARNING AND
  IMPROVEMENT
• Domain IV INTERPERSONAL AND COMMUNICATION
  SKILLS
• Domain V PROFESSIONALISM
• Domain VI SYSTEMS-BASED PRACTICE

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• BMP Program Mission, Vision and Goals
• Mission To provide Mercer medical students a
  foundation in the basic medical sciences relevant
  to the practice of medicine.
• Vision Each student will leave the BMP Program
  competent in the basic science knowledge, skills,
  attitudes and behaviors that will support their
  clinical development and benefit the health of
  their patients.

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• Goals
• 1. The program will include curriculum which
  provides fundamental knowledge in the basic
  medical sciences relevant to the practice of
  medicine. (Principle 1)
• The program curriculum will incorporate analysis
  of biomedical problems to integrate information
  and concepts from individual disciplines into an
  overall understanding of medical science.
  (Principle 1, 5, 6, 10)
• 3. Curricular elements will emphasize the
  importance of articulate and thoughtful analysis
  of the scientific issues, concepts and major
  mechanisms necessary for understanding the
  underlying medical science. (Principle 1, 5)
• 4. The curriculum will provide an environment and
  resources necessary to promote the development of
  professional attitudes, skills and behaviors.
  (Principle 3)
• 5. Curricular components will include evaluation
  requirements to facilitate individual, group and
  program improvement. (Principle 4, 3,10 6).
• 6. The program components will base their
  learning objectives on the overall competencies
  of the curriculum. (Principle 2)

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• Mercer Competencies
• 71 Total Competencies
• Six Domains
• Domain I Patient Care (15)
• Domain II Medical Knowledge (13) Domain
  III Practice-Based Learning (8)
• Domain IV Interpersonal and
  Communication Skills (6)
• Domain V Professionalism (17)
• Domain VI Systems-Based Practice (12)

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• Domain I Patient Care
• Pathology Related Interpret results of common
  laboratory studies.
• Pathology Non-Related Obtain an appropriate
  medical history accurately and efficiently.

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• Domain II Medical Knowledge
• Pathology-Related Competencies
• 4. Know the various causes (e.g. genetic,
  developmental, microbiologic, autoimmune,
  neoplastic, degenerative, traumatic, behavioral)
  of illnesses and the ways in which they affect
  the body (pathogenesis).
• 5. Know the altered structure and function
  (pathology and pathophysiology) of the body and
  its major organ systems as observed in various
  diseases and conditions.

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• Domain II Medical Knowledge
• Pathology Non-Related Competencies
• 9. Know the principles of pharmacology,
  therapeutics and therapeutic decision-making.
• 10. Know the principles of bioethics.

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• Domain III
• Practice-Based Learning and Improvement
• Pathology Non-Related Utilize clinical and
  scientific information in the continuous process
  of determining priorities and care decisions for
  patients.
• Pathology Related Use information technology to
  manage information, access on-line medical
  information, and support their own educational
  endeavors.

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• Domain IV Interpersonal and
  Communication Skills
• Pathology Non-Related Create and sustain
  ethical relationships with patients based on
  mutual respect and trust.
• Pathology Related Provide information using
  effective nonverbal, oral and writing skills with
  patients, families, colleagues and other members
  of the health care team.

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• Domain V Professionalism
• Pathology Non-Related (?) Recognize ethical
  dilemmas and identify sources of appropriate
  consultation (e.g. hospital ethics committee).
• Pathology Related Demonstrate tolerance and
  consideration for the concerns and opinions of
  others.

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• Domain VI Systems-Based Practice
• Students must demonstrate an awareness of and
  responsiveness to the larger context and system
  of health care and the ability to effectively
  call on system resources to provide care that is
  of optimal value.
• No Pathology-Related Competencies.

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• Curriculum Assessment
• BMP Cardiology, Pulmonology, GI 06-22-06
• Clerkship Pediatrics 06-29-06
• Community Medicine 2 07-27-06
• BMP Phase A, Phase B, Heme 08-03-06
• Clerkships Psychiatry, Family Med 09-21-06
• Curriculum as a Whole (ED-46) 09-28-06
• Biostatistics, Grassman, Neurology 11-16-06
• Brain and Behavior, Musculo-Skeletal 11-30-06

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• LCME and Pathology Education
• Summary
• Overall Central Management of Curriculum
• Principles/Objectives Will Define Curriculum
• Pathology Curriculum Will Need to Align Its
  Goals/Objectives With Curriculum Committee
• Steps to Assess Performance Will Be Required
• It Can Be Done