Western Reserve2

1
Western Reserve2 WR2
Integrating Basic and Clinical Sciences Presenta
tion by Amy L. Wilson-Delfosse, Ph.D. James
Bruzik, Ph.D. Case Western Reserve
University School of Medicine
2
Why Did Case Change?

• The Western Reserve curriculum designed in the
  1950s continued with only minor revisions despite
  enhancements in computer technology and
  unprecedented changes in the health care system
• Classrooms with 30 of students attending
• Watching lectures online double time
• Paper syllabus boundaries
• Students not preparing for class
• Teacher-centered

3
Why Did Case Change?
Course silos I dont know if youve had this yet
but Multiple choice tests nothing else
counted, binge and purge approach to
learning Difficult to get faculty to teach
clinical and research productivity Deans Vision
research and scholarship block and MD thesis
4
Principles of Western Reserve2 Building on
Western Reserve1
Integration of health and disease (normal and
abnormal) systems biology Experiential
learning, scholarship, critical thinking,
lifelong learning Active interchange of ideas
between students and faculty Graduate school
environment independent study and
self- directed learning Weave scientific
foundations and clinical medicine throughout the
4 year curriculum
5
Principles of Western Reserve2 Building on
Western Reserve1
Integration of health and disease (normal and
abnormal) systems biology Experiential
learning, scholarship, critical thinking,
lifelong learning Active interchange of ideas
between students and faculty Graduate school
environment independent study and
self- directed learning Weave scientific
foundations and clinical medicine throughout the
4 year curriculum
6
Western Reserve2 Curriculum
Year I Year II Year II Year III Year III Year III Year IV Year IV Year IV
Foundations of Medicine and Health (20 months, including vacation) Foundations of Medicine and Health (20 months, including vacation) Core Clinical Rotations IQ Program (48 weeks, flexible scheduling) Core Clinical Rotations IQ Program (48 weeks, flexible scheduling) Core Clinical Rotations IQ Program (48 weeks, flexible scheduling) Core Clinical Rotations IQ Program (48 weeks, flexible scheduling) Core Clinical Rotations IQ Program (48 weeks, flexible scheduling) Core Clinical Rotations IQ Program (48 weeks, flexible scheduling)
Foundations of Medicine and Health (20 months, including vacation) Foundations of Medicine and Health (20 months, including vacation) Research Scholarship (16 week block electives, flexible scheduling) Research Scholarship (16 week block electives, flexible scheduling) Research Scholarship (16 week block electives, flexible scheduling)
Foundations of Medicine and Health (20 months, including vacation) Foundations of Medicine and Health (20 months, including vacation) Advanced Clinical and Scientific Studies Areas of Concentration Electives (10 months, flexible scheduling) Advanced Clinical and Scientific Studies Areas of Concentration Electives (10 months, flexible scheduling) Advanced Clinical and Scientific Studies Areas of Concentration Electives (10 months, flexible scheduling) Advanced Clinical and Scientific Studies Areas of Concentration Electives (10 months, flexible scheduling)
7
WR2 Foundations of Medicine and Health
March Year 2
July Year 1
Homeostasis
Host Defense and Host Response

Cognition, Sensation, and Movement
Food to Fuel
The Human Blueprint
Becoming a Doctor (5 wk)
BOARD REVIEW BLOCK
(Medical Error, Public Health, Inequities,
Bioethics, Professionalism Epi/Biostats)
Reflection, Integration Assessment
1 Week Clinical Immersion
1 Week Clinical Immersion
1 Week Clinical Immersion
Reflection, Integration Assessment
1 Week Clinical Immersion
1 Week Clinical Immersion
Reflection, Integration Assessment
Reflection, Integration Assessment
Reflection, Integration Assessment
Reflection, Integration Assessment
(Host Defense, Microbiology, Blood,
Skin, Auto-immune)
(Endo, Repro, Development, Genetics, Mol Biol,
Cancer Biology)
(GI, Nutrition, Energy, Metabolism, Biochemistry)
(Neuro, Mind Musculoskeletal, Cellular
Neurophysiology
(CV, Pulm, Renal, Cell Regulation,
Pharmacology, Cell physiology)
Structure (Anat., Histo-Path, Radiology) Found
ations of Clinical Medicine
8
Case Inquiry Group (IQ)
Student-centered small groups with a faculty
facilitator Case-based Self-directed
learning Team work Quality improvement check
out
9
WR2 Eary Patient Experiences
August to December Year 1 January (Year 1) to December (Year 2) January Year 2
Introduction to clinical skills Advanced Clinical Skills
RAMP (Rotating Apprenticeships in Medical Practice) Clinical Preceptorships
FCM Seminars Health Policy, Leadership and Advocacy, Professionalism, Ethics
Web Resources
Integration and Assessment
10
Core and Advanced Clinical Experiences
Core Clinical Rotations
Core 1 (16 weeks) Internal Medicine and Surgery
Peri-Op and Acute Pain Core 2 (16
weeks) Pediatrics, OB-Gyn, Family Medicine
(Prevention/Wellness) Core 3 (8 weeks)
Neuroscience and Psychiatry Chronic
pain Advanced Cores (4 weeks each)
Undifferentiated and Emergent Care Aging and
Society Geriatrics, Chronic Disease, Palliative
Care, Health Systems
11
Basic Science During Clerkships IQ

• 4 hours Friday afternoon in group of 10-12
  students
• Reinforce importance of basic science and
  emerging basic science knowledge in the practice
  of clinical medicine
• Continue to use a team-based, learner-centered
  small group to enhance professional growth and
  development
• Practice advanced skills in communication,
  physical exam, clinical reasoning, evidence
  based medicine

12
IQ Typical Session
Reflection Case discussion DDX and learning
objectives Research and discussion with experts
(basic science and clinical faculty) Skills
practice Checkout
13
Example Case HLHS
Check-in Debrief, possible directed reflections
on dealing with a sick child or the parent of a
sick child. Go through the case in step by step
starting with a blue baby generate a
differential diagnosis, discuss the perinatal
changes in the circulation Come up with a list
of learning objectives and questions for the
experts.
14
HLHS continued
Expert session - paired basic scientist
neonatologist meet with larger group.
Mini-didactics QA focusing on emerging
science on the heritable nature of this problem
clinical insights.
15
(No Transcript)
16
(No Transcript)
17
HLHS continued
Skills practice Students interview the
standardized parent of this baby script calls
for integration of recently learned information
focus on delivering bad news and communicating
with families. Check out
18
Assessment
Attendance Facilitator assessment Case
development/presentation (teams) Students write
cases and run the IQ afternoon Opportunities
for scholarship Opportunities for peer
teaching
19
Acknowledgements
The faculty, staff and students of CWRU School of
Medicine
20
(No Transcript)